Cancer and Gerontology Flashcards
What are the 3 main stages of cancer?
- Initiation
- Promotion
- Progression
What occurs in the Initiation stage of cancer?
cancer cells arise from normal cells, these cells develop mutations
What occurs in the promotion stage of cancer?
characterized by reversible proliferation of alt cells
What are some promoting factors in the promotion stage?
- dietary fat
- obesity
- cigarette smoking
- Ethol consumption
What is the key prevention in the 2nd stage?
activity of promoters are reversible
How is the 3rd stage of cancer characterized?
- increased growth rate of tumor
- invasiveness
- Metastasis
Where are the common locations cancer can metastasizes?
- brain and CSF
- lungs
- liver
- adrenals
- bone
What is cancer?
a group of > 200 diseases that are characterized by uncontrolled and unregulated growth of cells
List the 4 clinical staging classifications
Cancer in situ
SI: Tumor limited to tissue of origin; localized tumor growth
SII: Limited local spread
SIII: Extensive local and regional spread
SIV: Metastasis
Describe what is the TNM System
anatomic extent of disease is based on 3 parameters:
Tumor size and invasiveness
Spread to lymph nodes
Metastasis
At what and frequency should women get mammograms?
annually for women older than 40
At what age and frequency should adults screen for fecal occult blood?
annually for adults of all ages
At what age and frequency should men receive a digital rectal exam?
men older than 50 yrs
Who and at what age should they screen for colon cancer by getting a colonoscopy?
at age 50 and they q10yrs
At what age and freq should women receive a clinical breast exam?
annually for women older than 40 and q3yrs for women 20-39 yrs old
List the risk factors for developing cancer (11)
- Age
- immune fxn
- chronic irritation and tissue trauma
- race
- genetics
6, exposure to chemicals, tobacco, and Ethol - Exposure to some viruses and bacteria
- diet
- sun, UV light or radiation exposure
- sexual lifestyle
- poverty, obesity, and chronic GERD
- chronic disease
- air pollution
What can a pt do to have a better prognosis?
early dx of cancer
Which population tends to have a worse prognosis for cancer?
minority
What is the purpose of the acronym CAUTION?
stands for 7 warning signs pts should watch for
What does the acronym stand for?
Change in bowel or bladder habits A sore that doesn't heal Unusual bleeding or discharge Thickening or lump in the breast or elsewhere Indigestion or difficulty swallowing Obvious change in warts or moles Nagging cough or hoarseness
What is chemotherapy?
administration of systemic or local cytotoxic meds that damage a cell’s DNA or destroy rapidly diving cells
If a pt. is undergoing chemo, what can you expect to see as an adverse effect regarding their immune system?
immunosuppression and neutropenia
What is the cause of immunosuppression and neutropenia as a result of chemo?
this occurs bc of the bone marrow suppression by cytotoxic meds
What are some nursing considerations for immunosuppression and neutropenia?
- monitor temp, WBC, and ANC
- a fever >100 should be reported immediately
- Monitor skin and mucous membranes for infxn
- Place pt in a private room, so ANC will not become <1000/mm^3
What are some pt teaching regarding immunosuppression and neutropenia?
- pt should avoid lg crowds
- take temp daily
- avoid food sources that could contain bacteria
- , avoid yard work
- avoid fluids that have been sitting at room temp longer than an 1 hr
- Wash all dishes in hot soapy H2O
- Wash toothbrush daily in dishwasher
- Do not share toiletries
- Report fever >100
Alopecia occurs due to the meds interfering w/ life cycle of cells throughout the body. What are some nursing considerations for alopecia?
- discuss the effect of alopecia on self-image
- discuss options such hats or wigs to deal with hair loss
- Provide resources like the American Cancer Society
- Inform pts that hair loss occurs 7-10 days after tx begins
- Reinforce that is only temp. and should return 1 mo after chemo
What are some pt teachings for alopecia?
- avoid the use of damaging hair such as electric rollers or curling irons
- suggest cut hair prior to tx
- Suggest wig be worn before tx
- Protect the scalp from sun exposure and use a diaper rash for itching
- Edu. pt regarding the use of head coverings to reduce body heat and protect skin
What are 2 oral effects of chemo?
- mucositis
2. stomatitis
This term refers to inflammation of tissues in the oral cavity, such as gums, tongue, roof and floor of the mouth, and inside the lips and cheeks.
stomatitis
This term refers to inflammation in the mucous lining of the upper GI tract from the mouth to the stomach.
mucositis
What are some nursing considerations for the oral effects of chemo?
- examine the pt’s mouth several times a day and inquire about the presence of oral lesions
- document the location and size of lesions
- Avoid using glycerin-based mouthwashes, but use nonetholic and anesthetic mouthwashes
- administer a topical anesthetic prior to meals
- discourage consumption of salty, acidic, or spicy foods
- offer oral hygiene before and after meals
What are some pt teachings for oral effects caused by chemo?
- encourage pt to wash mouth with NS or room temp tap H2O
- encourage pt to floss and brush using a soft-bristled toothbrush
- Rinse the mouth before and after meals
- avoid Ethol
- eat foods that are soft, bland and high in calories (mashed potatoes, scrambled eggs, oatmeal, milk shakes, ice cream and bananas)
What are some nursing considerations for anemia due to chemo?
- monitor for fatigue, pallor dizziness, and SOB
- help pt to schedule activities w/ rest periods in between and using energy saving measures during ADLs
- Administer enthropoietic meds
- Monitor Hgb values
What are some considerations for thrombocytopenia due to chemo?
- monitor for petchiae, ecchymosis, bleeding of the gums, nosebleeds, fecal occult blood in stool, hematuria or blood in vomitus
- Avoids IVs and injxns
- Apply P for approx. 10 mins after blood is obtained
- administer thrombopoietic meds and monitor platelets
What is the loss of snesory or motor fxn of peripheral nerves?
chemotherapy-induced peripheral neuropathy
What is the cause of chemo-induced peripheral neuropathy?
exposure to certain anticancer meds
What are some nursing considerations for chemo-induced peripheral neuropathy?
- monitor for loss of sensation in hands and feet, orthostatic hypotension, loss of taste, and constipation
- Monitor for early Si/Sx including numbness, tingling and redness
