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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
Q

screening tools for prostate cancer

A

prostate-specific antigen
digital rectal exam

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25
Q

lung screening tools

A

baseline low-dose CT scan

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26
Q

colorectal cancer screening tools

A

guaiac-based fecal occult blood test
fecal immunochemical test
stool DNA test
CT colonography
double-contrast barium enema
sigmoidoscopy
colonoscopy

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27
Q

TNM staging designation for solid tumors

A

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

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28
Q

Tx meaning (primary tumor)

A

tumor cannot be assessed

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29
Q

T0 meaning (primary tumor)

A

no evidence of primary tumor

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30
Q

Tis meaning (primary tumor)

A

carcinoma in situ

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31
Q

T1-4 meaning (primary tumor)

A

increasing size and/or local extent of primary tumor

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32
Q

Nx meaning (regional lymph nodes)

A

regional lymph nodes cannot be assessed

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33
Q

N0 meaning (regional lymph nodes)

A

No regional lymph nodes metastasis

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34
Q

N1-3 meaning (regional lymph nodes)

A

increasing involvement of regional lymph nodes

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35
Q

Mx meaning (distant metastasis)

A

distant metastasis cannot be assessed

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36
Q

M0 meaning

A

no distant metastasis

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37
Q

M meaning

A

distant metastasis

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38
Q

types of surgery for cancer treatment

A

-diagnostic
-surgery as primary treatment
-phophylactic surgery
-palliative surgery

39
Q

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

A

radiation therapy

40
Q

palliative radiation therapy is used to relieve symptoms of:

A

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
Q

what is the purpose of chemotherapy

A

primarily to treat systemic disease rather than localized lesions that are amenable to surgery or radiation

42
Q

what is the goal when chemotherapy is combined with surgery and radiation

A

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
Q

most common side effects of chemotherapy

A

myelosuppression (decreased bone marrow activity)
alopecia
N/V
anorexia
fatigue

44
Q

pt education before chemotherapy

A

side effects
exposure risk
toxicity

45
Q

chemotherapeutic agents that are specific to certain phases of the cell cycle are termed:

A

cell cycle-specific agents

46
Q

Chemotherapeutic agents that act independently of the cell cycle phases are termed:

A

cell cycle-nonspecific agents

47
Q

Delivery of ionizing radiation to the cancer cells to induce death

A

radiation

48
Q

types of electromagnetic rays (radiation therapy)

A

x-rays
gamma rays

49
Q

types of particles (radiation therapy)

A

electrons
protons
neutrons
alpha particles

50
Q

safety precautions for radiation therapy

A

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
Q

side effects of radiation therapy

A

radiation dermatitis
bone marrow suppression
gonadal toxicity
skin changes
salivary changes
nausea
pituitary and thyroid glands
lungs
bones
breasts
cartilage
pancreas

52
Q

goal of bone and stem cell transplant

A

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
Q

side effects of transplants

A

rejection
graft vs host disease
immunosuppressants

54
Q

normal RBC range

A

4.2-5.9 x 10^6

55
Q

normal WBC range

A

4-10,000

56
Q

normal platelet range

A

150-300,000

56
Q

normal platelet range

A

150-300,000

57
Q

nursing management of cell transplants

A

vital signs
assess adverse effects (fever, chills, SOB, chest pain, hives, N/V, hypotension or hypertension, tachycardia, anxiety, taste changes

58
Q

neutrophil normal range

A

> 75%

59
Q

Diagnosis for w patient cancer

A

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
Q

planning for pt with cancer

A

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
Q

expected pt outcomes may include:

A

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
Q

oncological emergencies

A

superior vena cava syndrome
spinal cord compression
hypercalcemia
pericardial effusion and cardiac tamponade
DIC
SIADH
tumor lysis syndrome

63
Q

why does a SVCS occur in oncology:

A

bronchiogenic cancer
lymphoma
internal occlusion from central vein catheter occlusion

64
Q

why does SCC occur in oncology:

A

malignant disease or a pathologically collapsed vertebrae compresses or displaces the thecal sac that contains the spinal cord, leading to neurologic impairment.

65
Q

why does hypercalcemia occur in oncology:

A

-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
Q

why does Pericardial Effusion and Cardiac Tamponade occur in oncology

A

late-stage disease and carries a high mortality rate

67
Q

why does DIC occur in oncology:

A

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
Q

why does SIADH occur in oncology:

A

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
Q

why does TLS occur in oncology:

A

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
Q

nursing priorities for end of life cancer care

A

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
Q

common cancer nursing diagnosis

A

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
Q

shape of benign cancer cells

A

rounded edges and easier to remove

73
Q

shape of malignant cancer cells

A

frayed edges and harder to remove

74
Q

problem where the body cannot absorb vitamin B12

A

pernicious anemia

75
Q

Lab tests for diagnosing cancer

A

CBC
SBC
PLT
blood protein
tumor markers
PSA (males)
urine test
fecal-occult

76
Q

what to look for in endoscopy

A

stomach cancer
polyps and lesions

77
Q

nursing role in biopsy

A

education, pain management, witness consent, emotional support, witness consent

78
Q

hematological cancer are always considered:

A

stage IV

79
Q

characteristics of stage I tumors

A

loacalized and contained

80
Q

characteristics of stage II tumors

A

involvement of lymph nodes
invasion of deeper tissue

81
Q

characteristics of stage III tumors

A

large, invasive

82
Q

characteristics of stage IV tumors

A

spread to different sites
advanced

83
Q

goal for curing cancer

A

cancer free for at least 5 years

84
Q

goal of remission of cancer

A

disease free but cancer could return at any point

85
Q

who and how are chemotherapy drugs administered

A

certified nurse
port-a-cath

86
Q

symptoms of toxicity of chemotherapy

A

N/V
Myelosuppression
Thrombocytopenia
Leukemia
Neutropenia
Anemia

87
Q

side effects and timing for external radiation

A

beam to skin – dermatitis – requires sensitive touch and handling – fatigue – 2-3 wks

88
Q

side effects of internal radiation

A

radioactive emission – spreads – pt on bedrest so radiation does not spread through the body

89
Q

side effects of systemic radiation

A

specific spots
sores inside the mouth

90
Q

stimulate body’s own immune response - flu like side effects

A

immunotherapy

91
Q

cannot return blood to the heart

A

superior vena cava syndrome

92
Q

causes neurological impairment

A

spinal cord compression

93
Q

causes bone destruction

A

hypercalcemia

94
Q

causes electrolytes to be leaked into system

A

Tumor lysis syndrome

Medsurg Exam 1 (4 decks)

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