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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
Q

Other S/S Which May Indicate Cancer: GU

A
  • Enlarged prostate symptoms (Men)
  • (Slow stream, difficulty initiating stream, stream starts and stops)
26
Q

Other S/S Which May Indicate Cancer: Heme

A
  • Easy bruising (Like brushing against them causes a bruise)
  • Easy bleeding
  • DVT or PE
27
Q

Screening Test: Breast Cancer

A
  • Mammogram+ Self breast exam
  • Starting at age 40
28
Q

Screening Test: Cervical cancer

A
  • Pap smear + HPV DNA
  • Starting at age 21
29
Q

Screening Test: Colorectal cancer

A
  • 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
Q

Screening Test: Lung

A
  • 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
Q

Screening Test: Prostate Cancer

A
  • Digital rectal exam (DRE) and PSA (Prostate specific antigen)
  • Starting at age 50 (White men)
  • Starting at age 45 (Black men)
32
Q

Diagnosis and staging

A
  • 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
Q

Lab testing

A
  • Blood (CBC, CMP)
  • Biomarkers/Tumor markers
  • Cytology (any body fluid), sent to pathology
  • Genetic testing (Done last)
34
Q

Imaging studies: Diagnosis and staging, and restaging

A
  • 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
Q

Biopsy

A
  • 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
Q

Nurses Role: Pre: Biopsy

A
  • 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
Q

Nursing role: Day of biopsy

A
  • 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
Q

Nursing role: post biopsy

A

Phone call for follow up with pt

39
Q

Stages of solid tumors

A
  • 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
Q

Stages of solid tumors: Stage 0

A

Carcinoma in situ (Preinvasive)

41
Q

Stages of solid tumors: Stage I

A

Early stage
Localized

42
Q

Stages of solid tumors: Stage II

A
  • Early locally advanced
43
Q

Stages of solid tumors: Stage III

A

Late locally advanced

44
Q

Stages of solid tumors: Stage IV

A

Metastized
Late stage

45
Q

TNM Stageing

A
  • T: Extent of primary tumor
  • N: Absesnce or presence and extent of regional lymph node metastasis
  • M: Absence or presence of distant metastasis
46
Q

TNM Staging: Primary tumor

A

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
Q

TNM Staging: Regional lymph nodes (N)

A
  • Nx: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1-N4 increasing involvement of regional lymph nodes
48
Q

TNM Staging: Distant Metastasis (M)

A
  • Mx: Distant metasitasis cannot be assessed
  • M0 No distant metastasis
  • M1 Distant metastasis
49
Q

Grading and Diffrentation: GX

A

Grade cannot be determined

50
Q

Grading and Diffrentation: G1

A

Well differentiated

51
Q

Grading and Diffrentation: G2

A

Moderately differentiated

52
Q

Grading and Diffrentation: G3

A

Poorly differentiated

NSG 478 (23 decks)

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