Cancer

Question 1

radiation therapy purpose

Answer 1

destroy cancer cells with minimal damaging effects of surrounding normal cells

Question 2

types of radiation therapy

Answer 2

• teletherapy - external radiation to a specific part

- brachytherapy - radiation seeds

Question 3

side effects of radiation (5)

Answer 3

• local skin changes and hair loss
• altered taste sensations
• xerostomia
• fatigue - increased energy demands
• inflammatory responses, fibrosis, scarring

Question 4

nursing care for radiation (6)

Answer 4

• teach accurate objective facts to help pt cope
• don’t remove markings for teletherapy
• skin care - lotion only if approved by provider
• avoid direct skin exposure to sunlight
• care for xerostomia
• prevent fractures - bone exposed to radiation more vulnerable

Question 5

chemotherapy nursing care (4)

Answer 5

• PPE when administering
• infection risk - neutropenic precautions
• chemotherapy-induced nausea/vomiting - antiemetics (ondansetron/Zofran)
• care for mucositis, alopecia, changes in cognitive function, peripheral neuropathy

Question 6

hormone manipulation

Answer 6

decreasing hormone amounts to hormone-sensitive tumors to slow cancer growth rate

Question 7

oncologic emergencies (6)

Answer 7

• sepsis
• syndrome of inappropriate antidiuretic hormone (SIADH)
• spinal cord compression
• hypercalcemia
• superior vena cava syndrome
• tumor lysis syndrome

Question 8

sepsis symptoms (4)

Answer 8

• tachycardia - first warning sign
• fever
• increased WBC
• can be accompanied by disseminated intravascular coagulation (DIC)

Question 9

sepsis management

Answer 9

• prevention = best measure
• IV antibiotics (culture before administering)
• anticoagulants, cryoprecipitated clotting factors - for DIC

Question 10

SIADH

Answer 10

• most common in carcinoma of the lung
• water is reabsorbed excessively by kidneys → dilutional hyponatremia, hypervolemia
• care: fluid restriction, diuretics

Question 11

spinal cord compression management (5)

Answer 11

• early recognition and treatment - may be palliative
• high-dose corticosteroids
• high-dose radiation
• surgery
• external back/neck braces to reduce pressure in spinal cord

Question 12

hypercalcemia symptoms (7)

Answer 12

• fatigue
• loss of appetite
• nausea/vomiting
• constipation, paralytic ileus
• polyuria, dehydration
• muscle weakness, loss of tendon reflexes
• ECG changes

Question 13

hypercalcemia management (4)

Answer 13

• oral hydration
• IV NS
• drug therapy - diuretics
• dialysis

Question 14

superior vena cava syndrome patho

Answer 14

• superior vena cava is compressed or obstructed by tumor growth
• usually occurs with breast or lung cancer
• can lead to painful, life-threatening emergency

Question 15

superior vena cava syndrome symptoms (5)

Answer 15

• edema of face, hands, arms
• Stoke’s signs - edema around neck/collar bones
• dyspnea
• erythema
• epistaxis - nose bleeds

Question 16

superior vena cava syndrome management (3)

Answer 16

• diuretics - for airway and edema
• emergency high-dose radiation therapy
• metal stent placement in vena cava

Question 17

tumor lysis syndrome patho

Answer 17

large numbers of tumor cells destroyed rapidly → intracellular contents (potassium, uric acid) released into bloodstream faster than body can eliminate them

Question 18

tumor lysis syndrome management (4)

Answer 18

• Kayexalate - gets rid of potassium
• calcium glutamate - protects heart from effects of hyperkalemia
• insulin - lowers serum potassium
• allopurinol - for uric acid