Cancer Flashcards
What are the grades of cancer cells
Grade I – Cells differ slightly from normal cells and are well differentiated
Grade II – Cells are more abnormal and moderately differentiated
Grade III – Cells are very abnormal and poorly differentiated
Grade IV – Cells are immature, primitive and undifferentiated, cell of origin is difficult to determine
Grade X – Grade cannot be assessed
What are the stages of cancer
Stage 0 – Cancer in situ
Stage I – localized tumor growth in origin area
Stage II – Limited local spread
Stage III – Extensive local and regional spread
Stage IV – Metastasis
What are some neutropenic precautions
no flowers or fresh fruit
gown up
monitor for fever so take temp more often
separate room
What might you need to do regarding platelets
platelet transfusion below 20k
What is NADIR
your lowest immune cell count that you dont want to go below
When does NADIR usu appear
7-10 days
How does chemotherapy effect the GI sys
cells slough off causing dia, nausea/vom, pain from eating
What is a complication of dia/N/V from chemo
dehydration
anorexia
nutritional deficit
What meds are given for N/V from chemo and when do you give them
before they have symps
metoclopramide
ondansetron
cons for dia and chemo
low fiber diets analgesic for anal area from rawness monitor the amount with a catch device like a hat supplemental nutrition may need extra IV fluids if gets too bad
What are cons with mucositis
teach them stuff to coat their gums and tongue
soft brissel brush
them might lose taste
What are cons with nutrition and why
more smaller meals instead of less larger ones bec of discomfort
may need TPN
What are skin change cons with chemo
may have an allergic rx look
tx these like a normal burn
What are some alopecia cons
emotional distress
sometimes perminent, sometime returns different color and tecture
when will hair typically return
3-4 weeks after discon of meds
What are lung and heart cons with chemo
pneumonitis 1-3mo after tx spontaneous Pulm edema causing cough and dyspnea pericardial effusion pericarditis damage to valves and coronary vessels
What meds cause cardiotoxicity more oftn
Anthracyclines like. Adriamycin, daunorubicin
What are cognitive and reproductive cons with chemo
damage to repro organs so preserve eggs and sperm
chemo brain may dev
What test is important to monitor with pats taking chemo or rad
blood count
What is the target blood count that providers want to get a pat to
NADIR
because chemo and rad lowers blood counts, what precautions/problems do these pats need to be in
neutropenic
bleeding from thromcytopenia
anemia
What vital sign would indicate an emergency for chemo/rad pats
high temp (fever)
When would bleeding risk become high priority
platelet count below 50K
What are some care cons for anemia and chemo rad pats
space out activities bec of fatigue
smaller more freq meal
What should you do if the pats N/V didnt subside after the first use of a antiemetic
get new drug, dont continue using it bec its not going to work the second time
What is some dia teaching for discharge pats
log poops, I/O and diet to monitor nutrition
Do chemo rad pats have more freq dysphagia/odynophagia
yes
What might be given if N/V isnt resolved with N/V meds,
IV drip called BAD
Benydryl
Ativan
Prednisone
What is BAD’s regimen
slowly over 48 hours, decreasing the dose every 6 hours
What is a skin reaction sydrome that can develop from chemo
erythrodysesthesia syndrome – also called palmar-plantar erythrodysesthesia
What is erythrodysesthesia syndrome – also called palmar-plantar erythrodysesthesia
mild symps of redness and tingling in soel of feet and palms
What are some is a care con for pats taking (Adriamycin), daunorubicin)
they will have routine echo’s done on their heart during and after tx
