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HA oral > Cancer > Flashcards

Cancer Flashcards

1
Q

Pre Op for CA

A 
dx, surg for CA?
location
mets
n/v
pain-how control, with what 
airway
meds
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2
Q

lung CA concern

A

oxygenation

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3
Q

Breast CA concern

A

anxiety, IV/BP placement

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4
Q

GI/Liver CA concern

A

metabolic, elyte, fluid changes
dec Albumin=edema
BP issues and free drug

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5
Q

Brains CA concern

A

HA, sz

don’t use drugs that lower sz threshold

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6
Q

Throat/Thyroid CA concerns

A

swallowing and airway

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7
Q

surgery invasive: minimally, moderately, highly

A

min: little tissue trauma, min BL
mod: some disruption of physiology, some BL, may need invasive monitoring, ICU
HIgh: signif disruption of physiology, can require transfusion, ICU admit

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8
Q

Lung CA/procedure

A

1associated with CAD
2pulm insufficiency after resection- check RA O2sat
3high BL: H&H, T&S, T&C

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9
Q

Bronchial/neck CA

A

1AIRway mgmt- imagining
2dysphagia, difficulty breathing
3signif BL
4lack of access to airway during case

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10
Q

CA ROS: Heme

A

anemic-BM suppression for chemo
neutropenia, thrombocytopenia
Thrombosis: pancreatic CA
**labs: CBC

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11
Q

CA ROA: Pulm

A

pulm edema, CHF, pleural effusion, pneumonitis
Squamous cell: hyperca
Adenocarcinoma: hypercoagulable, osteoarthistis
Large cell: gynecomastic
Small cell: inappropriate ADH, eptopic corticotropic, Eaton-Lambers syndrome (muscle weakness)

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12
Q

CA ROS: Neuromuscular

A

peripheral neuropathy
SC compression
Eaton-Lambers syndrome- muscle weakness like myasthenia gravis

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13
Q

CA ROS: Anorexia/wt loss

A

DONT turn off hyperalimentation, if do of hypoglycemic

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14
Q

CA ROS: Elyte

A

hyperca due to bone mets

Na and K changes due to N/V

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15
Q

CA ROS: adrenal insufficiency

A

tumor or from corticosteroids

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16
Q

CA ROS: cardiac
pericardium
mediastinum

A

1malignant of paricardium(rare): electric alternans, paroxysmal A fibs, pericardial tampande(most common with Lung CA, dont dec BP)
2SVC compression: if mets spread to mediastinum= get venous engorgement above waist, dyspnea, airway obstruction
3drug induced cardiomyopathy

17
Q

Drug induced Cardiomyopathy

A

impairment of LV function even 3 yrs after dc
**Doxorubicin and Daunorubicin: dose related
CHF, acute cardiomyopathy-ranging in severity
*Enhances myocardial depression of anesthetics
*use drug least cardio-depressive

18
Q

CA Pulm tox

A

1Methotrexate: pulm edema, infiltrates, effusions

  1. Bleomycin: endothelial damage looks like pna, pulm fibrosis, Inc A-a gradient,
    * *induced hypERoxic pulm injury give ONLY
19
Q

5-fluorouacil

A

immunosuppression, leukopenia

20
Q

Cyclophosphamide

A

with high doses: ENCEPHALOPATHY, acute delirium

21
Q

Methrotrexate

A

with high doses: ENCEPHALOPATHY

reversible but prolonged use–dementia

22
Q

Cisplatin

A

RENAL toxic, dose limiting effect
*avoid other drugs that could cause renal damage
it will: Dec GFR in 3-5days, cause ARF- may need dialysis
*give hydration and mannitol to protect agains advancement of renal tox
ALSO: dose dependent dorsal root gangli-large fiber neuropathy

23
Q

Vinca Alkaloids (Vincristine)

A

peripheral neuropathy, sensory/motor

Autonomic neuropathy-usually reversible, dizziness, BP problems

24
Q

Alkylating agents: Cytoxan

A

plasma cholinesterase inhibition…which is what reverse succ
*not endogenous reversal of such–prolonged duration

25
Q

CA Pulm complications MEDs

A 
Bleomycin, Busulfan, BCNU
pneumonitis, fibrosis
s/s cough, dyspnea, basilar rales
tx: corticosteroids 
***AVOID high FiO2 and use Colloids
26
Q

Cardiac complications

A

Doxorubicin (Adriamycin), Danuorubicin
ECG disturbances: SVT
initial symptoms suggest URI–leads to CHF

27
Q

CA Tx N/V

A

metoclopromide, droperidol, Aofran
*have high anxiety related to N/V concerns
Control N/V

28
Q

CA Pain mgmt

A

Visual analogue scale (VAS)
what works for them
have tolerance high dose–until pain control
nerve block- neurolysis

29
Q

Radiation

A

in neck—airway concern
can cause fibrosis: limited ROM, cardiomyopathy
Cystitis

30
Q

CA Labs/test: use judgment

A 
Hct
Plt
WBC
LFT
PT
Chem7-elytes,
BUN/Cr
BGL
ABG
CXR, ECG
31
Q

CA CXR

A 
tracheal deviation
mass
aortic aneurysm
fx
pulm edema
PNA
atelectasis
32
Q

CA ECG

A

afib, aflutter, heart blocks, ST changes,

recent PE, LVH

33
Q

CA Airway

A

dyphagia, difficulty breathing
tracheal obstruction
colon obstruction—considered full stomach
one-lung vent–need to use double lumen tube

HA oral (9 decks)

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