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sav nur 334 final exam week 7 > Cancer > Flashcards

Cancer Flashcards

1
Q

Prevention & early detection of cancer

A
  • avoid carcinogens
  • diet/exercise/rest
  • regular health exam
  • regular cancer screenings
  • learn/practice self-exams
  • know the seven warning signs of cancer
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2
Q

7 warning signs of cancer

A

C hange in bowel or bladder habits
A sore that does not heal
U nusual beeding of discharge for any body orifice
T hickening or a lump in the breast or elsewhere
I ndigestion or difficulty swallowing
O bvious change in a wart or mole
N agging cough or hoarseness

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3
Q

Diagnostic tests for cancer

A
  • cytology studies
  • tissue biopsy
  • serum lab values
  • CXR
  • radiologic studies
  • scans
  • presence of tumor markers
  • bone marrow exam
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4
Q

Diagnosis of cancer

A
  • health history
  • diagnostic tests

waiting for results produces enormous anxiety!

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5
Q

Surgery purposes and outcomes

50% of cancer patients

A
  • prophylaxis
  • diagnosis (biopsy)
  • cure
  • control
  • palliation
  • “second look”
  • reconstruction/rehabilitative
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6
Q

debulking procedure purpose

A

reduce size of tumor, making radiation/chemo more effective

this surgical procedure is not curative, just control

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7
Q

chemotherapy

A

mainstay of cancer treatment to treat solid tumors and hepatologic malignancies

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8
Q

general nursing implications for chemo administration

A
  • certification required to administer
  • toxic agents: protect patient, self, & environment
  • double check dose/order with another RN
  • avoid extravasation; CVCs preferred
  • pre-medication common (anti-emetics, anti-infammatory, anti-allergy)
  • monitor lab values (WBCs & platelets)
  • provide patient/family support
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9
Q

avoid extravasation

A
  • monitor often
  • ensure constant free-flowing IV with good blood return
  • cardinal symptom is pain, but not always
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10
Q

extravasation treatment

A
  • stop infusion immediately
  • attach disposable syringe at IV exit site
  • aspirate slowly & gently (goal: obtain as much solution as possible)
  • remove original cannula
  • elevate arm
  • infuse antidote intradermal per protocol
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11
Q

radiation therapy purpose and % of patients that receive

A
  • to achieve local control
  • carefully defined area of the body
  • used independently or in conjunction with surgery/chemo

60%

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12
Q

types of radiation

A

external (teletherapy) - most common

internal (brachytherapy)

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13
Q

types of brachytherapy

A

temporary implants (sealed)

radiopharmaceutical therapy (unsealed)

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14
Q

When is patient radioactive?

A

Internal radiation

  • sealed sources (solid implants)-radioactive while implant is active; secretions are not
  • unsealed sources (suspended in fluid)- eliminated in waste, which is radioactive
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15
Q

How close can i get to a radioactive patient?

A

remember the principle of time, distance, & shielding

inverse square law of radiation exposure

dosimeter

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16
Q

care of patient with sealed implants

A
  • private room/bath
  • place “caution: radioactive material” sign on door
  • wear dosimeter AAT
  • no pregnant women or <16 years old in room
  • limit each visitor to 30 minutes/day, keep 6 feet from source
  • never touch radioactive source with hands, use forceps
  • keep lead container in room and place source in there
  • save all dressings/linens until after source is removed, then discard in usual manner
17
Q

patient education with radiation

A
  • wash irradiated area each day with water only, or mild soap
  • use hand, not wash cloth
  • rinse soap thoroughly
  • do NOT wash off markings r/t radiation focus
  • dry area with patting, no rubbing
  • use no powders, lotions, or creams at site unless prescribed by radiologist
  • wear soft clothing over site
  • avoid anything that binds/rubs site
  • avoid sun exposure to irradiated area
  • avoid temperature extremes
18
Q

side effects of chemotherapy

A

bone marrow suppression
gi effects
skin reactions

19
Q

Bone marrow suppression

A

neutropenia-risk for infection

thrombocytopenia–risk for bleeding

anemia–risk for fatigue

20
Q

GI effects

A

anorexia
N/V
stomatitis
altered bowel patterns

21
Q

nursing implications with neutropenia

A
  • monitor WBCs (WBC w/diff and absolute neutophil count (ABC))
  • alterations in labs may delay treatment or decrease dose
  • teach pt/family about risk for infection
  • admin. WBC growth factors - filgastrim (Neupogen)
22
Q

Absolute Neutrophil Count (ANC)

A

-actual number of netrophils (segs and bands)

>2,500 = normal
>1,000 = safe 
<1,000 = neutropenia
<500 = Precautions & Protective Isolation
23
Q

Nadir

A

time after chemo when the WBC or platelet count is at its lowest point

patient implications- when they will feel the worst

24
Q

neutropenic diet

A
  • raw fruits and veggies which can’t be peeled are avoided
  • food and flatware is wrapped for delivery
  • no raw peanuts & seeds
25
Q

thrombocytopenia

A

risk of serious bleeding not apparent until platelet count < 50,000

platelet transfusion if < 20,000

26
Q

nursing implications for anemia

A
  • monitor H&H
  • teach energy conservation, but encourage activity
  • encourage adequate nutrition
  • if Hgb < 11, often give RBC growth factor - epoetin
  • if extremely anemic, give PRBCs
27
Q

nursing implications for anorexia & N/V

A
  • anorexia - taste changes are common, focus on foods they like
  • N/V (also anticipatory N/V) - anti-emetics
  • monitory weight twice weekly
  • monitor relevant lab values
  • encourage small, frequent, high protein, high calorie meals
  • nutritional supplements
28
Q

nursing implications for stomatitis

A
  • thorough oral assessment
  • meticulous mouth care
  • toothbrushing, flossing, unless contraindicated
  • saline gargles and other rinses, NO alcohol mouthwash
  • artificial saliva
  • soft, non-irritating foods
29
Q

Other side effects of radiation & chemo

A
  • fatigue - r/t anemia & cancer
  • alopecia
  • pulmonary effects - lung damage r/t radiation, adverse drug effects
  • CV effects - secondary to radiation/drug adverse effects
  • reproductive effects - potential for infertility
30
Q

Psychosocial concerns

A
  • disfigurement
  • secondary cancers
  • recurrence after ‘cure’
  • disability & death
31
Q

body vigilant

A

once a person has had cancer, anytime something happens to them, they think the cancer is back

32
Q

how nurses can enable hope in patients with cancer

A
  • helping the pt develop an awareness of life
  • id a reason for living
  • help pt establish support system
  • incorporate religion, as appropriate
  • incorporate humor, as appropriate
33
Q

spirituality and cancer

A

may have a positive or negative impact

may question or be angry with god, may fear relationship with their god

may develop a renewal of faith (r/t facing mortality)

34
Q

social support and cancer

A

one of the most important parts of cancer treatment

35
Q

nursing implications r/t social support and cancer

A
  • assist when needed
  • an ear to listen
  • shoulder to cry on
  • educate about support groups

sav nur 334 final exam week 7 (8 decks)

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