week 4: cancer

Question 1

what are hemopoietic growth factors and how do they help with cancer treatment

Answer 1

they stimulate the bone marrow to make good cells

Question 2

what is nadir

Answer 2

lowest point of white blood count and shows us how immunocompromised the patient is

Question 3

what is ANC

Answer 3

absolute neutrophil count (basically the nadir)

Question 4

what is thrombocytopenia

Answer 4

impaired clotting with no platelets

Question 5

how does cancer affect GI tract

Answer 5

increases metabolic rate, decreases appetite and affects taste

Question 6

how does cancer affect the nerves

Answer 6

it is rare but they can affect peripheral sensory nerve perception.
this may be due to a tumour in the spine or neurotoxic chemo.

Question 7

how can cancer affect central motor and sensory function

Answer 7

cancer invades bone or brain, which causes hypercalcemia

Question 8

what is pleural effusion

Answer 8

collection of fluid between lining and wall of lungs

Question 9

what is the dosing of pain medication you should be giving to a cancer patient

Answer 9

regular dosing is key. every 4-6 hours should be good

Question 10

how can we prevent extravasation from chemo

Answer 10

use a central line

Question 11

whats a port-a-cath

Answer 11

its a line that’s under the skin, with a pouch that is relatively shallow. you can puncture it very easily to draw blood or give medications

Question 12

what drug go we give to help with diarrhoea in cancer patients

Answer 12

Imodium

Question 13

whats the #1 antiemetic for cancer treatment

Answer 13

ondansetron

Question 14

what is brachytherapy

Answer 14

internal radiation (using seeds, ribbons, capsules)

Question 15

what is radiation dermatitis

Answer 15

radiation can lead to an open wound

Question 16

what is xerostoma

Answer 16

severe tooth decay and dry mouth

Question 17

what lab values determine bone marrow suppression

Answer 17

decreased platelets, Hgb, wbc

Question 18

what are some things we can do to help with skin care for patients going through radiation

Answer 18

avoid skin irritation by using light clothes, no tight belts/bands/cuffs, moisturise with a water based moisturiser, avoid alcohol based anything and retinol. avoid sun expusoreu and heat.

Question 19

describe internal radiation

Answer 19

• its safer because it reduces exposure to ionising radiation. they put seeds (radioactive isotopes) into the body, patients needs their own bathroom and cant interact with anyone pregnant.

Question 20

which temperature of a cancer patient should we flag

Answer 20

anything above 37.5

Question 21

what are the 2 types of breast cancer

Answer 21

non-invasive: remains in mammary duct
invasive: most common: spreads around to surrounding lymph nodes

Question 22

what is a lumpectomy

Answer 22

breast conserving, cuts out only the part with cancer.

Question 23

what is a partial mastectomy

Answer 23

a little more of breast is removed

Question 24

what is a simple mastectomy

Answer 24

remove breast

Question 25

what is a modified radical mastectomy

Answer 25

remove breast and glands

Question 26

what is a breast cancer surgery with "clear margins"

Answer 26

basically they took out the cancer, and there's no cancer in surrounding tissues

Question 27

what is an ALND (auxiliary lymph node dissection)

Answer 27

remove pretty much all the lymph nodes really old school we don't do this much anymore

Question 28

what is a SNLD (sentinal lymph node dissection)

Answer 28

lymph node closest to the tumour is removed and sent to pathology to see of cancer cells have spread

Question 29

why wouldn't we want to remove too many lymph nodes

Answer 29

because the less you remove, the less of a risk for lymphedema (like long, extreme swelling)

Question 30

what is an autologous DIEP flap

Answer 30

basically a BBL but takes fat from the stomach and uses it to create new breasts

Question 31

what is som post op considerations for a mastectomy

Answer 31

- they will have a drain attached to them so make teach family how t empty the drain - increase hight of bed and raise affected arm - sleep on non-dependent side - teach about signs of lymphedema

Question 32

what are signs of lymphedema

Answer 32

limb may feel heavy, achy, num, tingly, swelling.

Question 33

what is the main goal post mastectomy in relation to mobility

Answer 33

to prevent frozen shoulder

Question 34

what are some ways to prevent frozen shoulder

Answer 34

- pain meds before exercise, - warmth to relax muscles - elevate arm post-op avoid sun and trauma no BP on that arm

Question 35

what is ALL

Answer 35

acute lymphoma leukemia - most common - starts in bone marrow and spreads to other parts of the body

Question 36

what is AML

Answer 36

acute myeloid leukaemia - starts in myeloid and spreads

Question 37

what is CLL

Answer 37

chronic lymphotic leukemia - slow growing starts in WBC

Question 38

what is CML

Answer 38

chronic myeloid leukemia - starts in myeloid - slow progression

Question 39

what are some potential side effects of leukemia

Answer 39

splenomegaly, hepatomegaly, lymphadenopathy, bone pain, meningeal irritation.

Question 40

what us a vibe narrow aspirate

Answer 40

determines sybtype of leukemia and treatment protocol

Question 41

what are the three phases of leukemia treatment protocol

Answer 41

induction phase: literally kill all leukaemia cells. consolidation: continue to kill cells maintenance: treat with lower doses every 3-4 weeks for prolonged time.

Question 42

what should nurses focus o n in the induction phase of leukemia protocol

Answer 42

managing v low WBC (including neutropenia, thrombocytopenia and anemia) preventing infection and support systems such as O2, IV fluid, protecting kidney function, etc.

Question 43

how does septic shock present in cancer patients

Answer 43

Low grade fever of 38 may be the only sign.

Question 44

what are the nursing interventions for septic shock

Answer 44

follow protocol: culture, CXR, swabs, start antibiotics ASAP

Question 45

what is DIC

Answer 45

decimated intravascular coagulation - often caused by sepsis - basically body starts to form mini clots all over - v bad sign - patient usually dies within the next few hours

Question 46

how does cancer cause SIADH

Answer 46

cancer cells make, release, and store ADH.

Question 47

what are symptoms of SIADH

Answer 47

nausea, vomiting, seizure, obtundation, brain swelling.