Cancer General Flashcards
1
Q
how many days after chemo are blood and body fluid contaminated
A
3-5 days
2
Q
Mx
A
distant metastasis cannot be assessed
3
Q
M0
A
no distant metastasis
4
Q
M
A
distant metastasis
5
Q
T
A
extent of primary tumor
6
Q
N
A
absence or presence and extent of regional lymph node metastasis
7
Q
M
A
absence or presence of distant metastasis
8
Q
Tx
A
primary tumor cannot be assessed
9
Q
T0
A
no evidence or primary tumor
10
Q
Tis
A
carcinoma in situ
11
Q
T1, T2, T3
A
increasing size and/r local extent of the primary tumor
12
Q
Nx
A
regional lymph nodes cannot be assessed
13
Q
N0
A
no regional lymph node metastasis
14
Q
N1, N2, N3
A
increasing involvement of regional lymph nodes
15
Q
what are the routes of admin of chemotherapy
A
IV, IM, oral, SQ, intrathecal
16
Q
this is the adverse reaction to chemo; could be allergic or hypersensitivity
presents as chills, itching, flushed
A
infusion reaction
17
Q
what does a nurse do if person has infusion reaction
A
stop IV, monitor pt, give benadryl and start it slowly
18
Q
can occur as early as 1 hour after infusion and stop IV, assess pt , infuse normal saline
A
hypersensitivity
19
Q
fluid/drug leaking into surrounding tissue and can cause necrosis
A
extravasation
20
Q
what to do if pt has extravasation
A
stop IV immediately, aspirate, antidote, elevate extremity
21
Q
what is mylosuppression
A
bone morrow suppression
decrease in bone marrow activity that results in reduced production of blood cells. Some blood cell disorders include: fewer red blood cells (anemia) fewer white blood cells (neutropenia)
22
Q
this is low platelet count
A
thrombocytopenia
23
Q
oral dryness due to decreased salvia production
A
xerostomia
24
Q
what are symptoms of radiation toxicity
A
alopecia, stomatitis, xerostomia, thrombocytopenia
25
painful sores and swelling in mouth
stomatitis
26
this is hair loss
alopecia
27
external radiaion
teletherapy
28
internal radiation
bradytherapy
29
this is creating new cells
proliferation
30
differentiating cells from one another. differences in size, shape of cell, etc
differentiation
31
this is characterized by uncontrolled and unregulated cells
cancer
32
new or abnormal growths in tissue
neoplasm
33
how does cancer spread
lymphatic and angiogenesis
34
two kind of cancer
benign and malignant
35
this type of cancer almost never comes back
doesn't metastasis
well differentiated cells
benign cancer
36
this can metastasize
infiltrates into other cells and grows
cells don't look the same
malignant cancer
37
what do tumor suppressor genes do
suppress growth of tumor
38
proto oncogence do what
promote growth
mutated genes
39
what are the diagnostics for cancer
xray
mri
ct
ultrasound
mammogram
colonoscopy
pathology
40
labs done to test for cancer
genetic or tumor markers
cbc
chem panel
41
what are the genetic or tumor markers
brca1 and brca2 - breast, ovarian
psa - prostate
cea - colon/gi, bladder, lung, thyroid
ca-125 - ovarian
afp - liver, testicles
42
TNM classification is for what
tumor, lymphnode involvement, metastasis
43
this is when radiation is implanted into a pt
pt is radioactive for extended period of time
brachytherapy
44
what precautions to take when pt has brachytherapy
limit time with pt - max 30 min in room
no pregnant women allowed near pt
6 ft distance
lead shield while treating pt
45
if brachytherapy implant falls out ..what do you do
this is emergency
-use metal forceps to put in lead container
46
waht are the most common teletherapy radiation reactions
skin reactions and fatigue
damage to skin
47
this is dry, flakey, itchy, scaly skin in response to radiation treatment
dry desquamation
48
how does nurse treat dry desquamation
moisurize skin - aquaphor, hydrocoritsone cream, aloe, no ice on burns, no sun lamps or UV exposure at all
49
this is weeping, oozing, red, warm, tight to touch skin
appearance is shiny and produces drainage
areas scab
wet desquamation
50
how shoud nurse handle wet desquamation
specific dressing for comfort
-hydrocolloid, occlusive transparent, hydrogel
51
this is the loss of hair. may be permanent depending on where radiation is
alopecia
52
what is the most important nursing intervention for alopecia
psychosocial & body image
53
how to help pts with stomatitis
nutrition
-rinse mouth with saline solution to help alleviate ulcers
-no hard bristled toothburshes, flossing
-bland foods, small frequent meals
-hydration assessment
need to have good oral hygiene
54
this restores/stimulates the bodys own immune response to treat the cancer
immune therapy
55
this creates flu like side effects
immune therapy
56
adverse effects of immune therapy
pulmonary edema, heart failure symptoms (weight gain, cp, sob)
57
what is the nursing management of immune therapy
careful monitoring, thorough education on side effects and self care,
assess for possible toxicitities
58
minimizes negative effects on healthy tissue. targets cancer cells
targeted therapy
59
can you put chemo in vein
no only through central line or port
60
can any RN give chemo
no only certified RNs.
61
common chemo side effects
oxygentation, bleeding, infection
follicular rash
myeloid suppression
n/v
fatigue
infection
62
low RBC =
decreased WBC
63
if person has myeloid suppression - what do you need to watch for
bone marrow suppression
increased risk of infection
assess for bleeding, infection
assess oxygenation
64
what is neutropenia
low neutrophils
keep on isolation precautions
65
symptoms of infections with chemo
open lesions on skin,
skin integrity
temp
66
these are medical emergencies for chemo
fever + nadir
fever + neutropenia
67
what is nadir
lowest amount of absolute neutrophils during period of time after chemo
happens 7-110 days after chemo, takes weeks to recover
strict guidelines at bedside - no visitors
68
what labs do you monitor for bleeding
hct - 40-50%
hgb 12-18
wbc 5000-10000
rbc 4.5m-5.5m
platelets 150k-450k
69
open wound - what do you do...
culture
70
what do you do before giving antibiotics
culture everything everytime before antibiotics
71
if chemo pt has fever - it means...
infection
72
what are the nursing interventions for infection
handwashing
check labs and temp
avoid anything invasive
teach - s/s of infection
monitor temp
73
what nutrition information do you give
high protein meals (albumin)
small frequent meals
74
preventative measures for breast cancer
diet, exercise, maintain normal body weight
BRCA1 and BRCA2 genetic testing
75
biggest risk factors for breast cancer
age and women
76
what is a lumpectomy
biospy to remove certain lesion
-will take normal tissue surrounding lesio nto make sure no cancer cells have infiltrated cells
77
what is mastectomy
removal of breast with NO lympth node removal
78
when do you do a sentinel lymph node biopsy
done in pts with more aggressive cancer
79
this is a complication due to impaired flow of the lymph fluid after lymph dissection
lymphedema
80
this is the accumulation of fluid leads swelling, fibrosis of tissues
assess area continuously
always one sided
lymphedema
81
what are the nursing interventions for lymphedema
arm elevated toheart
sign placed above bed no IVs, BPs to that arm
diuretics
isometric exercises
fitted sleeve to help with compression
no tight clothing
82
this is blood collection in surgically cavity
-swelling, tightness, pain, bruising of skin
hematoma
83
this rarely produces symtoms
DRE and PSA are the tests
need a biospy to confirm diagnosis
prostate cancer
84
prostate cancer marker test
psa
85
what is an abnormal DRE
hardness, nodular and asymmetric
86
what are the two procedures for prostate surgery
TURP and prostatectomy
87
-this is carried out throughout endoscopy
-sexual side effects - retrograde ejaculation
-delayed bleeding
-dribbling
-monitor for hemorrhage
transurethral resection of the prostate (TURP)
88
removal of prostate
prostatectomy
89
what are the treatment of prostate cancer
brachytherapy
estrogen treatments - blocks androgens to prevent cancer from spreading
90
what are the post op assessments of prostate cancer
fluid volume balance
pain
ADLs
complications - hemorrhage, infections, catheter obstruction, DVT, s exual dysfucntion
91
what is an orchicetomy used for
testicular cancer
-remove of one or both testicles
92
what are the testicular cancer risk factors
undescended testicle
white caucasian male
93
nursing management of testicular cancer
body image issues
phyiological aspects
sexual issues
radiation
94
this is a group of cancerous disorders that affect the blood and the blood forming tissue and organs
-unsure of full cause
-often secondary cancer
leukemia
95
diagnostics of leukemia
peripheral blood eval
bone marrow eval
96
what do we need to eat to prevent cancer
high fiber
veggies (broccoili, beans, cabbage)
fruit and whole grains
97
what bad habits to avoid to prevent cancer
limit alcohol
tobacco - smoking cessation (including chewing tobacco)
obesity
98
8 warning signs of cancer
1. unusual bleeding
2. unusual weight loss
3. change in urine and bowel habits
4. non healing sore or thickened lump
5. cough - nagging, constant persistent (hoarse for months)
6. skin changes - irregular or uneven growth of lesions. or orange peel with small indented areas
7. difficulty swallowing or indigestion
8. fever & fatigue (night sweats)
99
risk factors for prostate cancer
older than 50
male
african american
family history
diet high in red meats
100
s/s of prostate cancer
anemia
pallor skin
general weakness/fatigue
difficult & painful urination
101
diagnostics of prostate cancer
blood sample
transrectal ultrasound
digital rectal exam
102
s/s breast cancer
red & warm
orange peel skin
pitting appearance small indented areas
hard painless swelling "immobile"
103
risk factors for breast cancer
female
over age 50
persona family history of ovarian/uterine cancer
genetic mutation of BRCA
obese
taking oral contraceptives
diet is high in fat and low in fiber
alcohol
smoking
104
is a cancer cell well differentiated or poorly differentiated
poorly differentiated
105
what does a pet scan do
looks for metastasis. shows areas of rapid cell growth/reproduction
106
what is angiogensis
growth of new blood vessels. this creates interface btwn tumor and vascular surface
107
when should women start mammograms
45-54 - annual
55+ every other year
108
when should ppl get checked for colon cancer
50+ - colonoscopy every 10 years
109
when should men get checked for prostate cancer
50+ - discuss getting screened
110
when should women be tested for cervical cancer
21-29 every 3 years
30-65 every 5 years + HPV test
65+ - no further testing for women who've had normal PAPs
111
who should receive the HPV vaccine
all women - per lippincott. fuck them. men should too.
112
who should be tested for lung cancer
male and female
55-74 years
30 pack/year and are still smoking or quit within last 15 years
screening is low dose CT scan of chest
113
to prevent lymphedema after mastectomy - what do you teach pt
avoid trauma to affected arm, dont let that arm be dependent
114
what exercises do you teach pt who had masectomy to prevent lymphedma
wall climbing, pulling, isometric exercises, tugging
115
this shrinks cancer cells and is typically done for months
chemo
116
this kills cancer cells in a specific area. time frame depends on type of cancer
radiation
117
waht medication is important to avoid if on chemo
avoid aspirin
could increase risk of bleeding
118
what pill can reduce risk of developing breast cancer again but not guarentee
tamoxifen - taken 5-10 years after
119
this blocks estrogen receptors in breast to stop estrogen dependent cancer
used in hormonal therapy
tamoxifen
120
what are the risks of tamoxifen
clots
121
what is contraindication of tamoxifen
history of Dvt or PE
122
when preparing to administer tamoxifen to a pt with breast cancer, the nurse is most concerned by which pt report
1. i have been experiencing really heavy menstrual cycles recently
2. my hot flashes seem to be decreasing in frequency
3. i feel like i may be developing a sinus infection
4. i just dont have the energy for sex the way that iused to
1. i have been experiencing really heavy menstrual cycles recently
123
what are complications of prostatectomy
hemorrhage, infection, catheter obstruction, Dvt, sexual/bladder dysfunction
124
what would home health needs be for pt who has prostatectomy
incontinence help
visiting nurse
will be discharged with catheter
wound care*
125
how are markers/suppressors aid in treatment
used to estimate prognosis, determine stage of cancer, detect cancer remains after treatment
126
what is postoperative assessment for prostate surgery
maintenance of fluid volume balance
relief of pain and discomfort
ability to perform ADLs
absence of complications
127
preoperative assesmeent of prostate surgery
reduce anxiety and learn about prostate disorder
128
nursing considerations for breast cancer surgery
knowledge of disease
reduction of fear, anxiety
improve decision making
pain management
improve coping ablities
improve sexual function
absence of complications
129
what to know about filgrastim
IV bolus or SQ
side effects: decrease risk of infection, increases neutrophil production
nursing concern: bone pain
teaching: monitor CBC and use tylenol for pain
130
erythropoietin
IV bolus or SQ
side effects: increases production of RBCs
nursing concern: increased BP, body aches
teachging: monitor hgb, headaches, watch for HTN and thrombotic events
131
oprelvekin
SQ
side effects: increases platelet production
nursing concerns: may increase fluid retention, use cautiously in pts with HF with history of cardiac dysrhythmia
teaching: monitor CBC, platelet count & electrolytes, monitor I&O
132
tamoxifen
given: PO
side effects: n/v, hot flashes, PE
pt teaching: monitor for abnormal bleeding, cataracts, monitor CA+2 levels
133
ondansetron
PO, IM, IV
side effect: head aches, dizziness, diarrhea
nursing considerations: monitor ECG in pts with cardiac disorders, admin 1 hour before chemo admin and use 3x daily orally for radiation pts
134
waht does ondansetron prevent
emesis - n/v - by blocking receptors at chemoreceptor trigger zone
135
clinical manifestations of testicular cancer
painless lump on testicle
heaviness in scrotal area
backache
weight loss and weakness
hcg levels are elevated
136
what are the two types of lung cancer
small cell carcinoma - aggressive
non-small cell carcinoma
137
clinical manifestations of lung cancer
pneumonitis
persistent cough with sputum
hemoptysis
sob
wheezing
chest pain
anorexia
fatigue
weight loss
n/v
trouble swallowing
138
what do you assess for when someone has lung cancer
their ability to swallow *
139
what is the hallmark symbol of lung cancer
persistent cough with sputum
140
what is a pneumonectomy
partial or total removal of lung
141
what is a lobectomy
removal of lobe
142
what is a segmental resection
removal of segment of a lobe
143
this is more common lung cancer procedure
minimally invasive
used to diagnose/treat different types
thoracoscopy or video assisted thoracoscopy (VATS)
144
this procedure removes small lung nodules for biopsy
requires chest tubes after procedure
preserves healthy lung tissue
thoracoscopy or video assisted thoracoscopy (VATS)
145
this is the primary therapy for those who can't tolerate surgery
radiation
146
this relieves symptoms of sob, hemoptysis, pain for lung cancer
considered pallative care
radiation
147
what do you monitor for when lung cancer pt gets radiation
skin assessment
n/v
fatigue
anorexia
esophagitis
148
#1 treatment for lung cancer due to its ability to grow fast
chemo
149
this is less toxic than chemo and blocks tumor growth
lung biologic and targeted therapy
150
route of medication for trastuzumab and what is it used for
IV
targets breast cancer cells
151
what are the side effects, nursing considerations an d pt teaching for trastuzumab
s/s: n/v
considerations: monitor for cardio toxicity, CHF, monitor flued status
pt teaching: report sob and chest pain
152
what does imatinib treat and what is the route
chronic myelogenus leukemia
via PO
153
side effects, nursing considerations and pt teaching of imatinib
s/s: gi discomfort, n/v, flu like
considerations: take with food, Tylenol for symptoms,
pt teaching: hygiene to prevent infection
154
this stops testes from producing testosterone
used instead of surgical castration
leuprolide
155
what route is leuprolide given
SQ or IM
156
what are the side effects and pt teaching of leuprolide
side effects: hot flashes, decreased libido, dysrhythmias, man boobs, gynecomastia
pt teaching monitor psa, increase Ca+ and Vit D in diet and exercises to increase bone density
157
