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NURS 470 > Cancer > Flashcards

Cancer Flashcards

1
Q

3 stages of carcinogenesis and what happens in each stage

A
  1. initiation: mutation of cellular DNA
  2. promotion: growth of altered cells
  3. progression: tumor growth rate increases, metastasis occurs
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2
Q

What happens in cancer cells?

A

stem cells differentiate and lose functionality
lack of contact inhibition (keep growing)
continuous proliferation (doubling time and pyramid effect)
no apoptosis
oncogenes
altered cellular appearance

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3
Q

pyramid effect

A

doubling time of cancer tumor
exponential growth

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4
Q

Cancer warning signs (CAUTION)

A

Change in bowel/bladder habits
A sore that does not heal
Unusual bleeding/discharge from body orifices
Thickening or a lump in the breast/anywhere else
Indigestion or trouble swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

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5
Q

primary prevention

A

decrease/eliminate exposure to carcinogens
healthy diet
exercise
alcohol in moderation
limit uv exposure (sun/tanning beds)

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6
Q

secondary prevention

A

inspection
palpation
screening

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7
Q

treatment modalities

A

surgery, chemotherapy, radiation, immunotherapy

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8
Q

goals of treatment

A

cure, control, palliation

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9
Q

how do we determine extent of cancer

A

histologic grading
staging

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10
Q

histologic grading

A

how similar cancer cells looks to cell of origin

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11
Q

staging

A

how advanced cancer is

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12
Q

lung cancer risk factors

A

smoking
pollution
radiation exposure
asbestos exposure
exposure to industrial agents
genetics: EGFR gene

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13
Q

early lung cancer manifestations

A

persistent cough, blood tinged sputum, dyspnea, wheezing, chest pain

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14
Q

late lung cancer manifestations

A

anorexia, fatigue, weight loss, SVC syndrome, pericardial effusion, dysphagia,

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15
Q

lung cancer diagnostic tests

A

CXR
CT scan
biopsy (sputum cytology, pleural fluid)
MRI, PET, bone scan, CBC, CMP

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16
Q

lung cancer treatment

A

surgical resection
radiation
chemotherapy
targeted therapy

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17
Q

colorectal cancer risk factors

A

diet: processed foods and meats
lifestyle: alcohol, smoking, inactivity
history of IBD: damaged cells
heredity

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18
Q

colorectal cancer manifestations

A

anemia r/t bleeding
rectal bleeding
abdominal pain
change in bowel habits
tenesmus: feeling like you have to poop but nothing comes out

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19
Q

colorectal cancer diagnostic studies

A

flexible sigmoidoscopy
colonoscopy
CEA
FOBT: fecal occult blood test

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20
Q

colorectal cancer treatment

A

surgery: resection, excision, colectomy
chemotherapy
targeted therapy
radiation

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21
Q

breast cancer risk factors

A

increasing age
ethnicity: african-american
long hormonal cycle exposure: early menarche & late menopause
pregnancy history: nulliparity & first child after 30
HRT >10yrs
benign breast disease combined w/ family history
family history 15-20% genetic + environmental
genetics: BRCA1, BRCA2, p53 tumor suppressor gene
hx of mantle radiation for HL
alcohol consumption, an increased dietary fat

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22
Q

breast cancer

A

skin changes, lumps, nipple discharge

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23
Q

metastatic disease

A

dyspnea, pain in back, confusion/altered LOC

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24
Q

breast cancer diagnostic tests

A

mammography
ultrasound
biopsy
HER2/hormone receptor status

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25
breast cancer treatment
surgery: lumpectomy, mastectomy radiation: external beam, brachytherapy, palliative chemotherapy hormonal therapy triple negative breast cancer
26
Endometrial cancer risk factors
unopposed estrogen age nulliparity obesity smoking diabetes
27
endometrial cancer clinical manifestations
abnormal uterine bleeding pain
28
endometrial cancer diagnostic tests
biopsy hormone receptor status
29
ovarian cancer risk factors
BRCA gene nulliparity early menarche, late menopause obesity family history age
30
ovarian cancer clinical manifestations
vague symptoms abdominal pain or bloating changes to bowel or bladder early satiety weight loss or weight gain menstrual changes
31
ovarian cancer diagnostic tests
no specific screening test ultrasound pelvic exam
32
cervical cancer risk factors
exposure to HPV (types 16 and 18( multiple sexual partners or partner with multiple sex partners early age of first intercourse smoking tobacco low SES status untreated chronic cervical infections STDs
33
cervical cancer clinical manifestations
dysplastic changes are asymptomatic leukorrhea and bleeding pain bowel or bladder changes weight loss anemia
34
cervical cancer diagnostic tests
pap smear colposcopy biopsy
35
treatment of gynecologic cancers
radiation: external beam, brachytherapy surgery: vaginal vs abdominal hysterectomy chemotherapy hormone therapy
36
prostate cancer risk factors
age (increased) ethnicity family history diet high in red meat and high fat, dairy, low vegetable intake occupational exposure: fertilizer, textile, rubber industries
37
prostate cancer clinical manifestations
asymptomatic in early stages urinary changes pain in lumbosacral area (metastasis)
38
prostate cancer diagnostic tests
PSA testing DRE transrectal resection of prostate (biopsy) MRI/CT
39
prostate cancer treatment
active surveillance radiation: external beam, brachytherapy hormone therapy chemotherapy (palliative) surgery: radical prostatectomy (retropubic, perineal, laparoscopic, robot assisted), nerve sparing procedure post surgical care: catheter 3 way foley, perineal care complications: hemorrhage, DVT, PE, infection, ED, urinary incontinence
40
oncologic side effects
bone marrow suppression(pancytopenia) fatigue GI: nausea, vomiting, diarrhea, mucositis, anorexia integumentary: radiation, chemotherapy, alopecia, post surgical reproductive pain respiratory, hepatic, renal toxicities
41
oncologic emergencies
acute condition that is caused by cancer or its treatment, requiring rapid intervention to avoid death or severe permanent damage structural, metabolic, infiltrative, or infectious
42
in what cancers is superior vena cava syndrome seen?
non-hodgkins lymphoma, breast, lung, mediastinal mass
43
superior vena cava syndrome symptoms
headache facial/periorbital edema vein distension in head/neck/chest
44
superior vena cava syndrome treatment
radiation to reduce tumor size thrombolytic steroids
45
superior vena cava syndrome nursing management
elevate HOB O2 weights ADLs
46
what cancers is spinal cord compression seen?
breast, lung, prostate, GI, renal, melanoma
47
spinal cord compression symptoms
change in bowel/bladder intense pain in the back motor dysfunction/weakness change in sensation
48
spinal cord compression treatments
MRI/CT steroids radiation chemotherapy
49
spinal cord compression nursing management
spinal precautions pain management
50
in what cancers is hypercalcemia seen?
multiple myeloma, advanced metastatic cancers (lung, breast, kidney, colon, ovarian, thyroid)
51
hypercalcemia symptoms
apathy confusion depression fatigue ECG changes muscle weakness anorexia nausea and vomiting
52
hypercalcemia treatments
Ca greater than 12 mg/dL so IV fluids (hemodilution), biphosphonate therapy, diuretics
53
hypercalcemia nursing management
safety precautions, monitor labs, increase mobility
54
what cancers is SIADH seen in?
small cell lung cancer (SCLC), GI cancers, brain, esophagus, ovarian
55
SIADH symptoms
weight gain weakness alteration in reflexes confusion oliguria coma
56
SIADH treatments
treat underlying cause correct electrolytes 3% NaCl fluid restriction
57
SIADH nursing management
seizure precautions safety management education
58
in what cancers is tumor lysis syndrome seen?
leukemia, lymphoma, bulky tumors
59
tumor lysis syndrome symptoms
hyperuricemia hyperkalemia hyperphosphatemia hypocalcemia muscle cramps nausea, vomiting diarrhea weakness
60
tumor lysis syndrome treatments
allopurinol treat electrolyte abnormalities IV fluids
61
tumor lysis syndrome nursing management
serial labs education for patient
62
in what cancers is DIC seen in?
leukemia, pancreatic, ovarian, lung, breast, prostate, sepsis/infection
63
DIC symptoms
bleeding petechiae tachycardia low SaO2 prolonged bleeding times (PT, PTT/INR) decreased fibrinogen and platelets increased d-dimer
64
DIC treatments
treat underlying cause FFP possible heparin infusion
65
DIC nursing management
bleeding precautions supplemental O2
66
When is sepsis seen?
indwelling lines, nadir, hematologic malignancies
67
sepsis symptoms
hypotension alteration in temperature hi/low WBCs chills confusion
68
sepsis treatments
IV abx IV fluid manage BP
69
sepsis nursing management
frequent vital signs protective precautions patient education CXR ABG labs
70
how to provide support
provide resources assess coping maintain hope RN relationship
71
survivorship
starts from time of diagnosis living with, through, and beyond cancer 3 stages: acute, extended, permanent
72
Acute stage of survivorship
time of diagnosis through end of treatment
73
Extended stage of survivorship
begins when patient starts to respond to treatment fewer appointments with medical professionals physical, emotional, psychologic side effects of treatment
74
permanent stage of survivorship
late effects of disease/treatment celebrate recovery
75

NURS 470 (28 decks)

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