Cancer Flashcards
List the CAUTION UP warning side effects of cancer
Changes in bowl/bladder habits
A sore that doesn’t heal
Unusual bleeding/discharge
Thickening/lump in breast
Indigestion/difficulty swallowing
Obvious wart/mole changes
Nagging cough/persistently hoarse
Unexplained weight loss
Pernicious anemia
Identify 8 risk factors for cancer
Tobacco smoking
Alcohol
Obesity
Genetics
Sun exposure
Radiation exposure
Unhealthy food
Age
Explain the histologic grading scale and the staging scale
I: well-differentiated, closely resembles tissue cells
IV: poorly differentiated, difficult to determine tissue of origin
X: unable to assess
Stages:
0: in situ
1: limited to tissue of origin
2: limited local spread
3: extensive local and regional spread
4: metastasis
Many chemo drugs are derived from ____
Plants
What are two dose-limiting side effects of chemo?
How are they improved?
GI effects: stomatitis, obstruction, decreased appetite, cachexia, N/V/D
-antiemetics, bland foods, protein drinks
Immune Effects: immunosuppression (#1 AE). Myelosuppression peaks 7-10 days after treatment
Explain chemo effects on RBCs and how they can be treated
Anemia: pale, SOB, weak, fatigue
-oxygen if sats are low, transfusion if hgb <7, epoetin alpha
Explain chemo effects on WBCs and how they can be treated
Infection risk= nadir= lowest neutrophil count
-ANC <500 = severe neutropenia
-Hold chemo, neutropenic precautions, filgrastim, report fever
Explain chemo effects on platelets and how they can be treated
Bleeding risk
-teach bleeding precautions (soft toothbrush, electric razor)
-platelet transfusion
Explain low-energy and high-energy radiation beams.
Which kind is less harmful on the skin?
Explain radiosensitivity
Low energy: expend energy quickly on impact, penetrate short distance- superficial skin lesions
High energy: don’t reach full intensity until they reach a certain depth- penetrate further. Can spare skin while reaching a target in the body
Radiation is not appropriate for _____ cancers
systemic
-because radiation affects tissues within a treatment field
What happens during radiation simulation?
Treatment fields are defined, filmed, and marked out on the skin. Target areas are determined by CT scans, x-rays, PET scans, etc.
Explain external beam radiotherapy
Radiation hits the body from the outside. Most common form of radiation treatment delivery
Explain internal beam radiotherapy (brachytherapy)
Implantation/insertion of radioactive material directly into the tumor or near the tumor. Patient will be radioactive.
What are used to treat systemic cancers?
Radioactive drugs
-oral med or drink
Explain ALARA
As Low As Reasonable Achievable
-your contact w/ the patient receiving internal radiation should be as low as possible
Explain caregiver safety w/ internal radiation
Should always be aware when pt is emitting radioactivity
Use ALARA principles
-cluster care
Radiation Safety Officer determines isolation time
Use shielding
Wear a film badge (dosimeter) showing radiation exposure
Dispose of patient waste cautiously/according to facility instructions
Why does chemo cause hyperuricemia?
What are 2 ways that nurses manage this?
Uric acid, released from lysed cancer cells, crystallizes and gets stuck in places, causing gout.
Give allopurinol
Increase fluid intake
How do you treat peripheral neuropathy caused by chemo?
Monitor for pain/altered sensations
Give gabapentin
Describe Dry and Wet Desquamation
Skin reactions to radiation
DRY: due to loss of keratinization due to decrease in number of basal layer dermal cells.
-erythema, use aloe vera/unscented lotion
WET:cell sloughing is faster than ability to replace dead cells. Painful.
-Dermis exposed, weeping of serous fluid
-NS compresses, vaseline gauze
-Protect skin and prevent infection
Hot / cold therapy should _____ be used on areas that have been radiated
NOT
Explain the following bone marrow transplant methods:
Allogenic
Syngenetic
Autologous
Allogenic: human donor after HLA tissue typing (most common)
Syngenetic: from identical twin
Autologous: Patient’s own treated stem cells
Spinal Cord Compression
ONCOLOGIC EMERGENCY
-intense back pain, motor weakness, parethesia, bowel/bladder dysfunction
Management:
-Radiation, corticosteroids, surgical decompression, activity limits, pain magement
Superior Vena Cava Syndrome
ONCOLOGIC EMERGENCY
-Facial/periorbital edema, neck vein distention, head, chest, headache, mediastinal mass on cxr
Management:
-radiation to obstruction
-chemo for sensitive tumors
Third Space Syndrome
ONCOLOGIC EMERGENCY
-hypovolemia- low BP, high HR, low UOP
-fluid shifts to interstitial space
Management:
-fluid, electrolyte, plasma protein replacement
