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Medsurg Exam 1 > Cancer > Flashcards

Cancer Flashcards

1
Q

top new cases of cancer in US

A

female breast cancer

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2
Q

top cancer deaths in the US

A

lung and bronchus

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3
Q

what prevents cancer in normal cells

A

tumor suppressor genes

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4
Q

cells have abnormal regulation of growth
cells continue to grow, even at the expense of their host

A

malignant (cancerous) cells

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5
Q

process in which healthy cells become malignant, is a multi-step process involving both environmental exposure to cancer-causing agents and random errors in replication of DNA that result in genetic mutations over time

A

carcinogenesis

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6
Q

The following cellular changes are essential to carcino-genesis:

A

loss of sensitivity to growth inhibitory signals
evasion of apoptosis (programmed cell death)
limitless replicative potential
angiogenesis (growth of new blood vessels)
potential for metastatic/tissue invasion

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7
Q

Tumors also have the capacity to invade and spread from their original site to other organs in the body

A

metastasis

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8
Q

possible etiologies for cancer

A

-viruses and bacteria
-physical agents
-chemical agents
-genetics or familial factors
-dietary and lifestyle factors
-hormonal agents

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8
Q

immune systems job with cancer

A

-An intact immune system has the ability to combat cancer cells in several ways
-Usually, the immune system recognizes as foreign certain antigens on the cell membranes of many cancer cells.

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9
Q

cell mutation begins in a solid organ, cells grow into a tumor and invade, destroy and overtake surrounding tissues

A

solid tumors

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10
Q

cell mutation begins in the bone marrow, lymph tissue or spleen. Can impact any one (or all) of the blood forming components

A

hematological malignancies

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11
Q

examples of solid tumors

A

lung
breast
bone
prostate
liver

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12
Q

examples of hematological malignancies

A

leukemia
lymphoma
multiple myeloma

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13
Q

prevention strategies are aimed at preventing or delaying the development of cancer

A

primary prevention

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14
Q

examples of primary prevention strategies

A

-cancer prevention programs
-minimize exposure to known carcinogens
-adopt healthy lifestyles (tobacco)
-maintaining a healthy weight
-performing regular exercise (150 min/wk)
-eating a diet rich in fruits and vegetables (at least five servings per day) -limiting red meat, high fat, and processed foods
-limiting alcohol
-using sun protection
-getting regular checkups
-being familiar with their own family history and personal cancer risks
-immunizations (hep and HPV)

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15
Q

examples of secondary prevention

A

-early detection
-cancer-screening events that focus on cancers with the highest incidence rates or those that have improved survival rates if diagnosed early, such as breast cancer

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16
Q

management of progression of a disease to later stages

A

tertiary prevention

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17
Q

CAUTION UP acronym for diagnosing cancer

A

Changes in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious changes in warts or moles
Nagging cough or persistent hoarseness
Unexplained weight loss
Pernicious anemia

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18
Q

Patients with suspected cancer undergo extensive testing to:

A

(1) determine the presence of a tumor and its extent
(2) identify possible spread (metastasis) of disease or invasion of other body tissues
(3) evaluate the function of involved and uninvolved body systems and organs
(4) obtain tissue and cells for analysis to assist in the evaluation of tumor type, stage, grade, and molecular and genetic changes.

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19
Q

lab tests for diagnosing cancer

A

Complete blood count (CBC).
Tumor markers.
Blood protein testing.
Circulating tumor cell tests.

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20
Q

imaging for diagnosing cancer

A

X-ray
ultrasound
CT scan
MRI
PET scan

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21
Q

what should the nurse do to prepare the pt for diagnostic cancer testing

A

nurse can help relieve the patient’s fear and anxiety by explaining the tests to be performed, the sensations likely to be experienced, and the patient’s role in the test procedures
encourages the patient and family to voice their fears about the test results, supports the patient and family throughout the test period, and reinforces and clarifies information conveyed by the primary care provider.

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22
Q

screening tools for breast cancer

A

breast self-exam
clinical breast exam
mammogram
ultrasonography
MRI

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23
Q

screening tools for cervical cancer’

A

pap test
HPV test

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24
screening tools for prostate cancer
prostate-specific antigen digital rectal exam
25
lung screening tools
baseline low-dose CT scan
26
colorectal cancer screening tools
guaiac-based fecal occult blood test fecal immunochemical test stool DNA test CT colonography double-contrast barium enema sigmoidoscopy colonoscopy
27
TNM staging designation for solid tumors
T = the extent of primary tumor N = The absence or presence and extent of regional lymph node metastasis M = The absence or presence of distant metastasis
28
Tx meaning (primary tumor)
tumor cannot be assessed
29
T0 meaning (primary tumor)
no evidence of primary tumor
30
Tis meaning (primary tumor)
carcinoma in situ
31
T1-4 meaning (primary tumor)
increasing size and/or local extent of primary tumor
32
Nx meaning (regional lymph nodes)
regional lymph nodes cannot be assessed
33
N0 meaning (regional lymph nodes)
No regional lymph nodes metastasis
34
N1-3 meaning (regional lymph nodes)
increasing involvement of regional lymph nodes
35
Mx meaning (distant metastasis)
distant metastasis cannot be assessed
36
M0 meaning
no distant metastasis
37
M meaning
distant metastasis
38
types of surgery for cancer treatment
-diagnostic -surgery as primary treatment -phophylactic surgery -palliative surgery
39
used to control malignant disease when a tumor cannot be removed surgically or when local nodal metastasis is present, or it can be used prophylactically to prevent leukemic infiltration to the brain
radiation therapy
40
palliative radiation therapy is used to relieve symptoms of:
metastatic disease, especially when the cancer has spread to brain, bone, or soft tissue, or to treat oncologic emergencies, such as superior vena cava syndrome (SVCS) or spinal cord compression.
41
what is the purpose of chemotherapy
primarily to treat systemic disease rather than localized lesions that are amenable to surgery or radiation
42
what is the goal when chemotherapy is combined with surgery and radiation
cure control palliation -reduce tumor size preoperatively -to destroy any remaining tumor cells postop -conditioning therapy prior to stem cell transplant -treat hematologic malignancies (lymphoma and leukemia)
43
most common side effects of chemotherapy
myelosuppression (decreased bone marrow activity) alopecia N/V anorexia fatigue
44
pt education before chemotherapy
side effects exposure risk toxicity
45
chemotherapeutic agents that are specific to certain phases of the cell cycle are termed:
cell cycle-specific agents
46
Chemotherapeutic agents that act independently of the cell cycle phases are termed:
cell cycle-nonspecific agents
47
Delivery of ionizing radiation to the cancer cells to induce death
radiation
48
types of electromagnetic rays (radiation therapy)
x-rays gamma rays
49
types of particles (radiation therapy)
electrons protons neutrons alpha particles
50
safety precautions for radiation therapy
TIME - with pt increases exposure rates DISTANCE - closer you are to pt, greater the radiation Shielding - use of lead shied to buffer exposure of radiation
51
side effects of radiation therapy
radiation dermatitis bone marrow suppression gonadal toxicity skin changes salivary changes nausea pituitary and thyroid glands lungs bones breasts cartilage pancreas
52
goal of bone and stem cell transplant
allows the bone marrow to be “rescued” from the toxic effects of the chemotherapy, therefore allowing higher doses of chemotherapy to be delivered safely
53
side effects of transplants
rejection graft vs host disease immunosuppressants
54
normal RBC range
4.2-5.9 x 10^6
55
normal WBC range
4-10,000
56
normal platelet range
150-300,000
56
normal platelet range
150-300,000
57
nursing management of cell transplants
vital signs assess adverse effects (fever, chills, SOB, chest pain, hives, N/V, hypotension or hypertension, tachycardia, anxiety, taste changes
58
neutrophil normal range
>75%
59
Diagnosis for w patient cancer
Appropriate nursing diagnoses of the patient with cancer may include: Impaired oral mucous membranes Impaired skin integrity Nausea Pain, acute Pain, chronic Imbalanced nutrition: Less than body requirements Fatigue Activity intolerance Risk for infection Risk for bleeding Disturbed body image Based on the assessment data, potential complications include the following: Infection and sepsis Hemorrhage SVCS Spinal cord compression Hypercalcemia Pericardial effusion Disseminated intravascular coagulation (DIC) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) Tumor lysis syndrome
60
planning for pt with cancer
major goals for the patient may include relief of fatigue, absence of complications, management of stomatitis, maintenance of nutrition, body image, relief of pain, effective progression through the grieving process.
61
expected pt outcomes may include:
Maintains integrity of oral mucous membranes Maintains adequate tissue integrity Maintains adequate nutritional status Achieves relief of pain and discomfort Demonstrates increased activity tolerance and decreased fatigue Exhibits improved body image and self-esteem Progresses through the grieving process Experiences no complications, such as infection, or sepsis, and no episodes of bleeding or hemorrhage
62
oncological emergencies
superior vena cava syndrome spinal cord compression hypercalcemia pericardial effusion and cardiac tamponade DIC SIADH tumor lysis syndrome
63
why does a SVCS occur in oncology:
bronchiogenic cancer lymphoma internal occlusion from central vein catheter occlusion
64
why does SCC occur in oncology:
malignant disease or a pathologically collapsed vertebrae compresses or displaces the thecal sac that contains the spinal cord, leading to neurologic impairment.
65
why does hypercalcemia occur in oncology:
-Bone destruction by tumor cells and subsequent release of calcium -Production of prostaglandins and osteoclast-activating factors, which stimulate bone breakdown and calcium release -Tumors that produce parathyroid-like substances that promote calcium release -Overproduction of vitamin D analogues (calcitriol), seen most commonly in hematologic malignancies -Most commonly seen in breast cancer, lung cancer, and myeloma
66
why does Pericardial Effusion and Cardiac Tamponade occur in oncology
late-stage disease and carries a high mortality rate
67
why does DIC occur in oncology:
hematologic cancers (leukemia) cancer of prostate, GI tract, and lungs chemotherapy (methotrexate, prednisone, L-asparaginase, vincristine, and 6-mercaptopurine) disease processes such as sepsis, hepatic failure, and anaphylaxis
68
why does SIADH occur in oncology:
failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone (ADH). Some malignancies, such as small-cell lung cancer, inappropriately release antidiuretic hormone (ADH). The excessive release of ADH produced by tumor cells or by the abnormal stimulation of the hypothalamic–pituitary network leads to uncontrolled water reabsorption. The most common cause of SIADH is cancer, especially small cell cancer of the lung.
69
why does TLS occur in oncology:
rapid release of intracellular contents as a result of radiation- or chemotherapy-induced cell destruction of large or rapidly growing cancers, such as leukemia, lymphoma, and small cell lung cancer.
70
nursing priorities for end of life cancer care
PAIN CONTROL!!! What are the patient/family goals? Patient/family preference. Have these discussions prior to end of life Advanced directives Hospice vs. palliative care
71
common cancer nursing diagnosis
Activity Intolerance (Risk for) Anxiety Disturbed body image Impaired Comfort Impaired skin integrity Impaired tissue integrity Chronic pain Ineffective coping Constipation (Risk for) Fatigue Fluid volume, deficient Risk for infection Nausea Acute pain
72
shape of benign cancer cells
rounded edges and easier to remove
73
shape of malignant cancer cells
frayed edges and harder to remove
74
problem where the body cannot absorb vitamin B12
pernicious anemia
75
Lab tests for diagnosing cancer
CBC SBC PLT blood protein tumor markers PSA (males) urine test fecal-occult
76
what to look for in endoscopy
stomach cancer polyps and lesions
77
nursing role in biopsy
education, pain management, witness consent, emotional support, witness consent
78
hematological cancer are always considered:
stage IV
79
characteristics of stage I tumors
loacalized and contained
80
characteristics of stage II tumors
involvement of lymph nodes invasion of deeper tissue
81
characteristics of stage III tumors
large, invasive
82
characteristics of stage IV tumors
spread to different sites advanced
83
goal for curing cancer
cancer free for at least 5 years
84
goal of remission of cancer
disease free but cancer could return at any point
85
who and how are chemotherapy drugs administered
certified nurse port-a-cath
86
symptoms of toxicity of chemotherapy
N/V Myelosuppression Thrombocytopenia Leukemia Neutropenia Anemia
87
side effects and timing for external radiation
beam to skin – dermatitis – requires sensitive touch and handling – fatigue – 2-3 wks
88
side effects of internal radiation
radioactive emission – spreads – pt on bedrest so radiation does not spread through the body
89
side effects of systemic radiation
specific spots sores inside the mouth
90
stimulate body's own immune response - flu like side effects
immunotherapy
91
cannot return blood to the heart
superior vena cava syndrome
92
causes neurological impairment
spinal cord compression
93
causes bone destruction
hypercalcemia
94
causes electrolytes to be leaked into system
Tumor lysis syndrome

Medsurg Exam 1 (4 decks)

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