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NSG 478 > Cancer and Mgmt in the adult population (Not finished because its too info dense) > Flashcards

Cancer and Mgmt in the adult population (Not finished because its too info dense) Flashcards

1
Q

Malignancy

A
  • Group of 100+ disorders
  • characterized by abnormal cell proliferation, uncontrolled growth resulting in a mass (Solid Tumor) or invading hematologic system (Liquid Tumor).
    • Acquired or inherited genetic mutation
    • Tumors cause destruction of tissue around them
    • Able to evade natural cell death (apoptosis)
    • Can occur in any body tissue

Early detection prevention are best treatment

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2
Q

Solid Tumor

A

Uncontrolled growth of cancer leading to a mass formation

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3
Q

Liquid tumor

A

Uncontrolled growth of cancer, leading to inflitration into the hematologic system

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4
Q

Metastasis:

A

Abnormal cells from the primary tumor spread through the blood and lymph system to other areas of the body

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5
Q

Benign Tumors

A

do not spread but can increase in size and press on local structures. These cells are NOT cancerous/malignant.

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6
Q

Carcinogenesis

A
  • Malignant transformation of normal cells into cancer cells
  • Carcinogens-chemicals, physical factors and other agents that cause cancer
  • Three step process
    • Initiation
    • Promotion
    • Progression
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7
Q

Carcinogenesis: Initiation

A
  • carcinogens cause mutations in cellular DNA
    • can be reversed by DNA repair mechanisms or by apoptosis (programmed cellular death) or cell senescence(a state of irreversible growth arrest)
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8
Q

Carcinogenesis: Promotion

A
  • repeated exposure to agents cause proliferation and expansion of initiated cells with increased manifestations of abnormal genetic information
    • preneoplastic/benign lesions
    • Can be reversible if promoting agent removed (tobacco smoke)
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9
Q

Carcinogenesis: Progression

A
  • the altered cells exhibit increasingly malignant behavior
  • Able to stimulate angiogenesis-new blood vessel growth, needed to “feed” cancer cells for growth, invasion
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10
Q

Locations of cancer

A
  • Brain and Spinal Cord
  • Eyes
  • Head and Neck (sinuses, nasopharynx, larynx, oropharynx)
  • Skin
  • Connective Tissue, Bone, Fat, Muscle (Sarcoma)
  • Lung
  • Breast
  • Parathyroid, Thyroid, Adrenal Glands
  • Gastrointestinal (esophagus, stomach, gallbladder/biliary tract, appendix, pancreas, liver, intestine)
  • Genitourinary (kidney, bladder, prostate, ovaries, testicles, uterus, cervix)
  • Blood/Bone Marrow (Leukemia)
  • Lymph System (Lymphoma)
  • Plasma (Myeloma)
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11
Q

Risk factors for cancer

A
  • Tobacco Use & Smoking
  • Diet/Obesity/lack of physical activity
  • Genetic predisposition
  • Occupational and Environmental Exposure
  • Infectious Agents
  • Age
  • Race
  • Gender
  • Sunlight
  • Gender
  • Immune function
  • Chronic irritation and tissue trauma
  • Alcohol use
  • Sexual Lifestyle
  • Socioeconomic
  • Geographic Location
  • Hormones
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12
Q

Seven major warning signs of cancer (Caution): C

A
  • Change in bowel of bladder habits
  • (Colon, Rectal, Urinary, Prostate, Bladder)
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13
Q

Seven major warning signs of cancer (Caution): A

A
  • A sore that does not heal
  • Skin cancer
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14
Q

Seven major warning signs of cancer (Caution): U

A
  • Unusal bleeding or discharge
  • GU, Vaginal/rectal bleeding
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15
Q

Seven major warning signs of cancer (Caution): T

A

Thickening or lump in the breast or elsewhere

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16
Q

Seven major warning signs of cancer (Caution): I

A

Indigestion

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17
Q

Seven major warning signs of cancer (Caution): O

A

Obvious change in wart or mole

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18
Q

Seven major warning signs of cancer (Caution): N

A

Nagging cough or hoarsness

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19
Q

Other S/S Which May Indicate Cancer: General

A
  • night sweats
  • fevers
  • unaccounted weight loss
  • fatigue
  • weakness
  • cachexia
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20
Q

Other S/S Which May Indicate Cancer: Neuro

A
  • unrelenting headache
  • vision changes (diplopia, blind spots, loss of vision), focal weakness
  • paresthesias
  • slurred speech
  • cranial nerve deficits
  • seizures

Stroke Like S+S

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21
Q

Other S/S Which May Indicate Cancer: Pain

A

Unrelenting or worsening

22
Q

Other S/S Which May Indicate Cancer: Integumentary

A

New lumps or bumps not associated with illness (LNs or tumor)

23
Q

Other S/S Which May Indicate Cancer: Lung

A

New or worsening SOB, hemoptysis

24
Q

Other S/S Which May Indicate Cancer: GI

A
  • Loss of appetite
  • N+V
  • Abd distension
25
Other S/S Which May Indicate Cancer: GU
* Enlarged prostate symptoms (Men) * (Slow stream, difficulty initiating stream, stream starts and stops)
26
Other S/S Which May Indicate Cancer: Heme
* Easy bruising (Like brushing against them causes a bruise) * Easy bleeding * DVT or PE
27
Screening Test: Breast Cancer
* Mammogram+ Self breast exam * Starting at age 40
28
Screening Test: Cervical cancer
* Pap smear + HPV DNA * Starting at age 21
29
Screening Test: Colorectal cancer
* Starting at age 45 * Highly sensitive guaiac based fecal occult blood test * Highly snesitive fecal immunochemical test * Multi targeted stool DNA test * Flexible sigmoidoscopy * Colonoscopy * CT colonography
30
Screening Test: Lung
* Low dose CT scan anually * Current or former smokers (Quit within the last 15 years primarily) * Ages 55-74 * 30 pack year or more
31
Screening Test: Prostate Cancer
* Digital rectal exam (DRE) and PSA (Prostate specific antigen) * Starting at age 50 (White men) * Starting at age 45 (Black men)
32
Diagnosis and staging
* Diagnosis: cancer screening, symptoms or incidentally found * Extensive work up to determine presence and extent of cancer * History and Physical Exam * Symptoms? Abnormal exam? * Palpable/visible lymph nodes, tumors Skin lesions, evidence of bleeding, DVT * Enlarged spleen, liver * Imaging—localized or metastatic? * Blood work * Biopsy
33
Lab testing
* Blood (CBC, CMP) * Biomarkers/Tumor markers * Cytology (any body fluid), sent to pathology * Genetic testing (Done last)
34
Imaging studies: Diagnosis and staging, and restaging
* Detect tumors, lymph nodes and metastases * Typically multiple scans used * Mammogram * CT scans * MRI * Ultrasound * Nuclear imaging * (I-123 or I-131 scan in Thyroid cancer) * Bone scans * Sentinel Lymph Node biopsy * Gallium scan * PET (positron emission tomography)/CT scan * Uses radioactive tracer glucose (FDG) * Images fused to show correlation between abnormal uptake on PET and +/- finding on CT
35
Biopsy
* Needle biopsy * Fine needle aspirate—cells only * Core needle (includes bone marrow biopsy) * Shave (using a blade and removing a layer) * Brush (Cervical, vaginal, lung) * Excisional * Incisional (open) * Sentinel lymph node (Before or during surgery) * Liquid biopsy (Finding tumor shed in the blood system)
36
Nurses Role: Pre: Biopsy
* Teach patient and family members about procedure and any pre-procedure instructions (Mainly a doctor thing, she just added it) * NPO, restrict fluids, light breakfast * Hold blood thinners (Dont want them to bleed out) * Meds to hold or take and timing of each * Assist pt and family to manage anxiety * Provide teaching hand out to patient and family
37
Nursing role: Day of biopsy
* Administer pre-procedure medications after IV placed * Positioning of the client * Monitoring patient and providing any medications during procedure * Provide safe environment * Assist patient and family to manage anxiety * Post-procedure Instructions *
38
Nursing role: post biopsy
Phone call for follow up with pt
39
Stages of solid tumors
* Based on imaging results and cytology and/or pathology results * Stage of cancer determined—tumor size, extent of local invasion, lymph node involvement and distant metastases * Treatment based on the stage and type of cancer
40
Stages of solid tumors: Stage 0
Carcinoma in situ (Preinvasive)
41
Stages of solid tumors: Stage I
Early stage Localized
42
Stages of solid tumors: Stage II
* Early locally advanced
43
Stages of solid tumors: Stage III
Late locally advanced
44
Stages of solid tumors: Stage IV
Metastized Late stage
45
TNM Stageing
* T: Extent of primary **tumor** * N: Absesnce or presence and extent of regional lymph **node** metastasis * M: Absence or presence of distant **metastasis**
46
TNM Staging: Primary tumor
Tx: Primary tumor cannot be assessed T0: No evidnce of primary tumor Tis: Carcinoma in Situ T1-T4 increasing size and/or local extent of primary tumor
47
TNM Staging: Regional lymph nodes (N)
* Nx: Regional lymph nodes cannot be assessed * N0: No regional lymph node metastasis * N1-N4 increasing involvement of regional lymph nodes
48
TNM Staging: Distant Metastasis (M)
* Mx: Distant metasitasis cannot be assessed * M0 No distant metastasis * M1 Distant metastasis
49
Grading and Diffrentation: GX
Grade cannot be determined
50
Grading and Diffrentation: G1
Well differentiated
51
Grading and Diffrentation: G2
Moderately differentiated
52
Grading and Diffrentation: G3
Poorly differentiated

NSG 478 (23 decks)

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