409 Final 6 (cancer) Flashcards
anytime cells grow and its not needed for normal development or healing, its called
neoplasia
Neoplasms can be benign or cancer, but they come from
normal cells originally
In normal cells, the nucleus
doesn’t take up much room
Normal cells have specific functions and they
tightly adhere to each other
benign cells overall description
Normal cells that are just growing in the wrong place and wrong time
Benign cells still look like
the cells they came from (which is normal)
Benign cells’ nucleus is
small
Benign cells function
normal
Benign cells growth
even though the grow at the wrong time, the RATE is normal
Initiation
the 1st step of CA development
Normal cells that promote reproduction are turned on too high
Initiation is irreversible
Promotion
this is when the initiated cell is encouraged to grow
latency period
the time between initiation and overt tumor
Promoters
are things that shorten the latency period
Progression
this is an increase in malignancy
During this time, the tumor develops its own blood supply
The cells might differentiate making the tumor more malignant and strong
The cells might differentiate making the tumor more malignant and strong
Progression
During this time, the tumor develops its own blood supply
Progression
Progression: During this time, the tumor develops
its own blood supply
If the primary tumor is in soft tissue, like the breast
it doesn’t life threatening until it spreads
The last stage in CA development is
Mets
3 classification systems
Grading
Ploidy
Staging
classification systems: Grading
Some CA has more malignant qualities than others. The stronger the qualities, the higher the grade
classification systems: Ploidy
Tells you how malignant it is based on how far off the chromosomes are
classification systems: Staging
based on Mets and location
Mitotic index
% of actively dividing cells in the tumor
less than 10% = slow growing
greater than 85% = fast growing
There are 3 factors that really contribute to CA development
Genetics
Carcinogens
Immune Functions
The single most important factor in CA development
old age
Under the primary prevention, umbrella, there is limiting
associated factors for example women having multiple sex partners isn’t a proven cause, but IS associated with CA
Under the primary prevention, umbrella, there is ___ to prevent viruses causing CA
vaccine
With radiation therapy, you don’t lose scalp hair because
its not systemic, its local
What are the terms for radiation given and radiation absorbed
exposure
and
dose
radiation therapy: Teletherapy: the patient is not
radioactive and not hazardous to others
radiation therapy: Teletherapy: you need to make sure the patient can maintain
a specific position while shooting the beam at them
radiation therapy: Brachytherapy
the one with the implant
Care of radiation pt: the door
to their room should be closed
Care of radiation pt: pregnant nurses
shouldn’t go in there
Care of radiation pt: visitors (time and space)
no more than 30 min
6 feet back
Care of radiation pt: Don’t take any dressings or sheets
out of the room
Care of radiation pt: Skin care
wash with water and mild soap
powders/creams only if prescribed
Care of radiation pt: only the local site is affected, but the affects
could be permanent
the exception to the “local rule” is taste and fatigue, which can be affected
Nadir
the period of chemo where the WBCs are at their lowest
The dose is based on
patient size and type of CA
The major concern when giving chemo IV is
extravassation aka infiltration
The major concern when giving chemo IV is extravassation; you should be OK if the amount that leaked is
less than .5 ml
Some chemo can be taken orally. Note these meds are
just as toxic as the IV forms
CA can become resistant by
skipping doses
Sometimes cytoprotectants can be given with chemo to
reduce SE
The most common reason for needing to change the chemo dose is the
hematologic SE
After chemo is finished, bone marrow suppression
should improve
BRM
biologic response modifiers, which can help counter act the bone marrow suppression
Teach the CNA that even if the patient is very tired,
some hygiene can’t be delayed , like mouth care
Any temperature over 100
is a potential emergency in a neutropenic patient
The one thing you do NOT have to worry about re: infection
don’t worry about the CA pt infecting OTHER ppl
Platelets less than ___ can cause bleeding from minor trauma; less than ___ can cause spontaneous bleeding
50k
20k
anemic/trombocytopenic patient: if trauma occurs, apply
ice
anemic/trombocytopenic patient: tell them not to
blow their nose
Alopecia prevention
you can’t
Alopecia: teach them not to wear
headsets/things that rub on the scalp
Chemo induced peripheral neuropathy
sometimes permanent
no prevention
Chemo induced peripheral neuropathy: your goal is to
prevent injury
What does hormone therapy do
slows growth, but doesn’t cure it
Targeted therapy: how does it work
blocks communication that’s needed for the cells to replicate
Sepsis is a CA emergency, and also increases the risk for another CA emergency:
DIC
SIADH: increased fluid causes what electrolyte problem
hyponatremia
CA emergency: Can be caused by the tumor directly invading bone, or can be from bone degradation
Spinal cord compression
CA emergency: Spinal cord compression: tx could include ____ to decrease the swelling
steroids
CA emergency: Spinal cord compression: ___ can be used to shrink the tumor
radiation
CA emergency: Spinal cord compression: ___ can be used to remove the tumor
surgery
CA emergency: SVC syndrome
the SVC is squished by a tumor
CA emergency: SVC syndrome: the patient wakes up in the morning, they may have facial edema because
the fluid is being pushed back up to the head
CA emergency: SVC syndrome: as it progresses they’ll have
erythemia in the upper body
CA emergency: TLS:
When a bunch of cells are killed and contents spill everywhere
CA emergency: TLS: can lead to what kind of injury
AKI
CA emergency: TLS: a good way to prevent it is
hydration
CA emergency: TLS: severe hyperkalemia may need
diuretics and IV glucose + insulin
