Cancer Flashcards
normal cells vs cancer cells
uniform shape vs abnormal cell cohesive vs not controlled growth vs rapid and disorderly well differentiated vs poorly mortal vs. immortal
Who is at risk for cancer?
People with immune-compromised d/t inability to get rid of tumor-assoc. antigens.
What labs to monitor?
Oncofetal
Dx/Classification?
H/P Diagnostic studies radiology studies lab studies bone marrow exam biopsy classification anatomic site classification histology classification extent of disease classification (higher the grade, higher the risk) TMN classification (0-4)
Nurse intervention fators
Screenings, don’t smoke, sunscreen, reduce stress, diet, limit red meat and salt cured meat, limit smoked meat, exercise, normal body weight
Warning Signs of Cancer
C - change in bowel or bladder habits.
A - sore that does not heal
U - Unusual bleeding or discharge from any body orifice
T-thickening of lump in breast or elsewhere
I- Indigestion or diff. swallowing
O- Obvious change in a wart or mole
N - nagging cough or hoarseness
Goal of cancer treatment
Cure
Control (can’t cure, but maintain)
Palliation (relief of sx)
Treatment includes…
Chemo/radiation Surgical Immunotherapy Targeted (specific per type of cancer) Hormone therapy
Surgery
Surgical: prevents/cures/controls. Supportive and Palliative.
Chemotherapy
Oral/Intravenous
Regional chemo admin (intraarterial, intraperitoneal, intrathecal, intraventricular, intravesicular)
Effects of chemotherapy on normal tissues…extravasation!!
Radiation
External Beam or Internal Beam (Bracytherapy)
External Beam vs. Internal Beam
- Patient NEVER radioactive vs. IS radioactive.
- local treatment and site marked vs. implantation or insertion of radioactive material.
- Internal: HDR/LDR
ALERA!!! As Low As Reasonable Achievable (exposure for nurse). This is determined by radiation safety officer.
Nursing Management for radiation and chemotherapy
Bone Marrow Suppression = Nadir…neutropenia (neupogen and neulasta) /thrombocyt (neumega) / anemia (Procrit)
Nadir is lowest 10-14 days post treatment.
Fatigue (anemia??)
- lack of sleep
- anxiety
- dehydration
- activity helps…nurse intervention!
GI Effects
- nausea/vomit
- diarrhea
- mucositis
What to monitor?
dehydration, fatigue, electrolytes! Nausea/vomiting/diarrhea (Antiemetic) ...low fiber! Hydration may be necessary...even just coming in for IV. Skin breakdown in Perineum! Mucositis- effected by dry mouth. Loss of taste, painful swallowing, esophagitis... Monitor for oral thrush!! Anorexia...
monitor labs!
-albumin, weight loss, electrolytes.
Management
Reproductive - chemo leads to fertility issues.
Pulmonary - SOB/dyspnea/side affect of tx?
Cardio - cardiac toxicity! HF!
Cognitive - Chemo brain is real.
