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Week 1 (exam 1) Flashcards

1
Q

Disease process of cancer

A

Some type of carcinogen causes a cell to become abnormal. the initial genetically altered cell forms a clone and begins to proliferate abnormally, evading normal intracellular and extracellular growth-regulating processes

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2
Q

Viruses that can cause cancer (and what type they cause)

A

Hepatitis B (liver cancer)

HPV (cervical cancer)

Epstein Bar (Burkett lymphoma and nasopharyngeal cancer)

Mono

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3
Q

Bacteria that can cause cancer (and what kind they cause)

A

Helicobacter pylori (stomach cancer)

Salmonella (colon cancer)

Chlamydia trachomatis (ovarian and cervical cancer)

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4
Q

3 step of carcinogenesis

A

Initiation: carcinogens cause mutations in cellular DNA

Promotion: repeated exposure of carcinogen causes proliferation and expansion of initiated cells

Progression: the altered cells exhibit increasingly malignant behavior, they acquire the ability to stimulate angiogenesis

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5
Q

Malignant cell characteristics

A

cells bear very little resemblance to the surrounding tissue, they infiltrate surrounding tissue, rate of growth depends on the differentiation, the more anaplastic the tumor the faster it grows. These cells also cause generalized weakness and tissue damage.

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6
Q

Different ways that cancer cells spread

A

Lymphatic spread

Hematogenous spread

Angiogenesis

Invasion

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7
Q

Primary prevention

A

concerned with reducing cancer risk in healthy people

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8
Q

Secondary prevention

A

detection, screening to achieve early diagnosis, intervention

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9
Q

Tertiary prevention of cancer

A

monitoring for and preventing recurrence of the primary cancer as well as screening for the development of second malignancies in cancer survivors

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10
Q

How is cancer diagnosed

A
  • blood work
  • Imaging (ultrasound, CT, MRI)
  • Biopsies
  • tissue scraping
  • surgical excision
  • body fluids such as urine
  • PET scan
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11
Q

steps to diagnosing cancer

A

(1) determine the presence and extent of cancer

(2) identify possible disease metastasis

(3) evaluate the function of involved and uninvolved body systems and organs

(4) obtain tissue and cells for analysis, including evaluation of tumor stage and grade.

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12
Q

Tumor staging and grading

A

this is done prior to treatment to provide a baseline for evaluating the outcomes of therapy

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13
Q

Staging and Grading definition

A

Staging describes the size of the tumor and Grading is the classification (how abnormal the cancer cells look compared to the normal tissue cells) of tumor cells

Grading is on a scale of 1-4 , the higher the grade the worse it is

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14
Q

TNM classification system

A

T- The extent of the primary tumor

N- The absence or presence and extent of regional lymph nodes metastasis

M- The absence or presence of distance metastasis

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15
Q

Disease process of cancer

A

Some type of carcinogen causes a cell to become abnormal. the initial genetically altered cell forms a clone and begins to proliferate abnormally, evading normal intracellular and extracellular growth-regulating processes

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16
Q

Viruses that can cause cancer (and what type they cause)

A

Hepatitis B (liver cancer)

HPV (cervical cancer)

Epstein Bar (Burkett lymphoma and nasopharyngeal cancer)

Mono

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17
Q

Bacteria that can cause cancer (and what kind they cause)

A

Helicobacter pylori (stomach cancer)

Salmonella (colon cancer)

Chlamydia trachomatis (ovarian and cervical cancer)

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18
Q

3 step of carcinogenesis

A

Initiation: carcinogens cause mutations in cellular DNA

Promotion: repeated exposure of carcinogen causes proliferation and expansion of initiated cells

Progression: the altered cells exhibit increasingly malignant behavior, they acquire the ability to stimulate angiogenesis

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19
Q

Malignant cell characteristics

A

cells bear very little resemblance to the surrounding tissue, they infiltrate surrounding tissue, rate of growth depends on the differentiation, the more anaplastic the tumor the faster it grows. These cells also cause generalized weakness and tissue damage.

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20
Q

Primary prevention

A

concerned with reducing cancer risk in healthy people

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21
Q

Secondary prevention

A

detection, screening to achieve early diagnosis, intervention

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22
Q

Tertiary prevention of cancer

A

monitoring for and preventing recurrence of the primary cancer as well as screening for the development of second malignancies in cancer survivors

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23
Q

How is cancer diagnosed

A
  • blood work
  • Imaging (ultrasound, CT, MRI)
  • Biopsies
  • tissue scraping
  • surgical excision
  • body fluids such as urine
  • PET scan
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24
Q

steps to diagnosing cancer

A

(1) determine the presence and extent of cancer

(2) identify possible disease metastasis

(3) evaluate the function of involved and uninvolved body systems and organs

(4) obtain tissue and cells for analysis, including evaluation of tumor stage and grade

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25
Tumor staging and grading
this is done prior to treatment to provide a baseline for evaluating the outcomes of therapy
26
Staging and Grading definition
Staging describes the size of the tumor and Grading is the classification of tumor cells Grading is on a scale of 1-4 , the higher the grade the worse it is
27
TNM classification system
T- The extent of the primary tumor N- The absence or presence and extent of regional lymph nodes metastasis M- The absence or presence of distance metastasis
28
Primary tumor (T)
Tx - Primary tumor can not be assessed T0 - No evidence of primary tumor T- Carcinoma in situ (in the place where it originally formed) T1, T2, T3, T4 increasing size or local extent of the primary tumor
29
Regional Lymph Nodes (N)
Nx - Regional lymph nodes cannot be assessed N0- No regional lymph node metastasis N1, N2, N3 increasing involvement of regional lymph nodes
30
Distant Metastasis (M)
Mx - Distant metastasis cannot be assessed M0- No distant metastasis M1- Distant metastasis
31
Incisional biopsy is performed...
if the tumor mass is too large to be removed. in this case a wedge of tissue from the tumor is removed for analysis. negative biopsies do not guarantee the absence of cancer
32
Needle biopsy is performed to...
sample suspicious masses that are easily and safely accessible, such as some masses in the breasts, thyroid, lung, liver, and kidney these are most often performed on an out pt basis
33
Chemo effects on psychosocial/emotions
- brain fog - depression - anxiety/fear (anticipatory nausea) - guilt - shock/overwhelmed - fear of the unknown -hopelessness - new found dependency
34
Chemo effects on the hematologic system
- myelosupression - neutropenia (increased risk of infection - they will need to go on neutropenic precautions) - thrombocytopenia - increased risk of bleeding (eliminate fall risk, use soft bristle tooth brush, electric razor) - anemia - fatigue, impaired O2 exchange
35
Chemo effects on the respiratory system
- dyspnea - impaired perfusion - inflammation - decreased SpO2 - dry cough - lung wheezes or crackles (pulmonary edema) - chest pain - pneumonia - fatigue - coughing up blood
36
Chemo effects on the Integumentary system
- sunlight sensitivity - skin peeling or rash - alopecia - blisters - skin thickens
37
radiation effects on the integumentary system
skin can be... dry, peeling, red, itchy sores may develop may look sunburnt swollen or puffy skin
38
Chemo effects on the GI system
- N/V - diarrhea - taste changes - nutritional deficiencies - fluid and electrolyte imbalances (due to vomiting and diarrhea) - stomatitis
39
How to treat/improve the chemo effects on the GI system
- encourage small frequent meals - give antiemetics - oral care - probiotics - give fluids and electrolytes
40
Superior Vena Cava Syndrome
the obstruction of the SVC thus preventing blood flow
41
Signs and Symptoms of superior vena cava syndrome
- SOB - nagging cough - upper edema - JVD
42
Causes of Superior Vena Cava Syndrome
- Lung cancer - Bronchogenic carcinoma - Lymphoma
43
Treatment of Superior Vena Cava syndrome
- stent placement - anticoagulants - chemo therapy - endovascular therapy - radiation therapy basically get rid of tumor
44
What is tumor lysis syndrome?
Occurs when tumor cells break apart and release contents into the blood stream causing and imbalance of electrolytes
45
Symptoms of tumor lysis syndrome
- decreased urine output - increased HR - confusion - numbness - tingling
46
Spinal Cord Compression
When pressure is applied to the spinal cord preventing nerves from working properly
47
Treatment of tumor Lysis syndrome
- Agressive IV hydration - Uric acid management (allopurinol, rasburicase) - Electrolyte management - Dialysis (in severe cases)
48
Causes of spinal cord compression
- bone fragments - tumors - abscesses cancers that can cause it - breast - lung - prostate - lymphoma
49
Symptoms of spinal cord compression
- back and neck pain, that worsens when laying down - bladder/bowl dysfunction - local inflammation - edema - venous stasis - impaired blood supply to nerve tissues
50
Treatment of Spinal cord compression
51
Doxorubicin
the most harmful chemo to the heart
52
Cardiotoxicity symptoms
- increased BP - signs and symptoms of HF - abnormal heart rhythms - chest pain/pressure - edema - SOB - dizziness - QT prolongation this will increase your risk of blood clots, MI, and CVAs
53
Treatment of Cardiotoxicity
- diuretics - cardiac meds
54
Hypercalcemia is most often seen in
bone cancer and possibly in tumor lysis syndrome it is important to know if this pt has heart failure
55
Hypercalcemia symptoms
- N/V - bone pain - weakness - fatigue
56
Treatment of hypercalcemia
- give fluids to dilute Ca levels careful not to overload pt with fluids especially if they have a hx of heart failure - Biophosphanates - Calcitonin
57
External Bean Radiation Therapy
radiation delivered in small doses over several weeks, aims radiation, right at targeted area rather than the whole body
58
Brachytherapy
Internal radiation both low dose and high dose
59
Low dose
Typically with gynelogil cancers - in patient - providers need to be wearing protective equipment - no pregnant visitors - bed rest - log roll pts - remains in place for 72 hours - low fiber diet - we do not want them straining to have a BM
60
High Dose
Seen most often with prostate cancer - hooked up to a bunch of rods - takes 15 min - Pt is not admitting any radiation after the 15 min - side effects of radiation often are determined by where the radiation is delivered anyone around radiation should wear dosimeter
61
Chemotherapy
agents used to destroy tumor cells by interfering with cellular function replication either kills cell or kills the cell at a certain point in the cell cycle
62
Effects of chemo on the renal system
chemotherapy agents can cause renal dysfunction by damaging the blood vessels or filtering structures of the kidneys. Damage to the kindneys can also lead to SIADH.
63
nursing management in chemotherapy
assess... - fluid and electrolyte status (serum levels, HR, I's and O's - cognitive status - for signs of bleeding - IV site if chemo is being given through IV modify risks for infection, such as - neutropenic precautions
64
when starting chemo...
2 nurses check bag, dose, and hang chemo bag together
65
Hypersensitivity reactions with chemo
may occur within 5min to 6 hrs of infusion or may not occur until infusion is complete. Most hypersensitivity reaction come with repeated exposure to chemo - life threatening give medications before chemo administration such as steroids, antihistamines, Tylenol, or IV benadryl
66
types of stem cell transplantation
Allogeneic HSCT (AlloHSCT): From a donor other than the patient Autologous: From the patient Syngeneic: From an identical twin
67
Allogeneic HSCT (AlloHSCT) is primarily used for...
Diseases of the bone marrow and is dependent on if they are able to find a donor that is a match
68
Autologous HSCT (AuHSCT) is considered for...
Patients with disease of the bone marrow who do not have a suitable donor for AlloHSCT
69
Syngeneic transplants result in...
less incidence of GVHD and graft rejection; however, there is also less graft-versus-tumor effect to fight the malignancy. For this reason, even when an identical twin is available for marrow donation, another matched sibling or even an unrelated donor may be the most suitable donor to combat an aggressive malignancy
70
Graft-Versus-Host disease
Occurs when the donor lymphocytes initiate an immune response against the recipient’s tissues, such as skin, GI system, or liver
71
Cancer management (Infection)
Common sites of infection, such as the pharynx, skin, perianal area, urinary, and respiratory tracts, are assessed on a regular basis. The nurse also monitors laboratory studies to detect early changes in WBC counts and inititates neutropenic precautions as needed.
72
Cancer management (Septic Shock)
73
Cancer management (Bleeding hemorrhage)
fall precautions
74
Radiation
Used with or without chemo is used to decrease the size of the tumor so it can be surgically removed.
75
Hypersensitivity reactions symptoms
rash, urticaria, fever, hypotension, cardiac instability, dyspnea, wheezing, throat tightness, and syncope
76
Thrombocytopenia is defined as a platelet count of
less than 100,000/mm3

Med Surge 3 (11 decks)

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