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NUS 210 Cancer & HIV - Test 2 > Cancer General > Flashcards

Cancer General Flashcards

1
Q

how many days after chemo are blood and body fluid contaminated

A

3-5 days

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2
Q

Mx

A

distant metastasis cannot be assessed

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3
Q

M0

A

no distant metastasis

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4
Q

M

A

distant metastasis

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5
Q

T

A

extent of primary tumor

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6
Q

N

A

absence or presence and extent of regional lymph node metastasis

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7
Q

M

A

absence or presence of distant metastasis

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8
Q

Tx

A

primary tumor cannot be assessed

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9
Q

T0

A

no evidence or primary tumor

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10
Q

Tis

A

carcinoma in situ

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11
Q

T1, T2, T3

A

increasing size and/r local extent of the primary tumor

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12
Q

Nx

A

regional lymph nodes cannot be assessed

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13
Q

N0

A

no regional lymph node metastasis

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14
Q

N1, N2, N3

A

increasing involvement of regional lymph nodes

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15
Q

what are the routes of admin of chemotherapy

A

IV, IM, oral, SQ, intrathecal

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16
Q

this is the adverse reaction to chemo; could be allergic or hypersensitivity
presents as chills, itching, flushed

A

infusion reaction

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17
Q

what does a nurse do if person has infusion reaction

A

stop IV, monitor pt, give benadryl and start it slowly

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18
Q

can occur as early as 1 hour after infusion and stop IV, assess pt , infuse normal saline

A

hypersensitivity

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19
Q

fluid/drug leaking into surrounding tissue and can cause necrosis

A

extravasation

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20
Q

what to do if pt has extravasation

A

stop IV immediately, aspirate, antidote, elevate extremity

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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)

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22
Q

this is low platelet count

A

thrombocytopenia

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23
Q

oral dryness due to decreased salvia production

A

xerostomia

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24
Q

what are symptoms of radiation toxicity

A

alopecia, stomatitis, xerostomia, thrombocytopenia

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25
Q

painful sores and swelling in mouth

A

stomatitis

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26
Q

this is hair loss

A

alopecia

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27
Q

external radiaion

A

teletherapy

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28
Q

internal radiation

A

bradytherapy

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29
Q

this is creating new cells

A

proliferation

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30
Q

differentiating cells from one another. differences in size, shape of cell, etc

A

differentiation

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31
Q

this is characterized by uncontrolled and unregulated cells

A

cancer

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32
Q

new or abnormal growths in tissue

A

neoplasm

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33
Q

how does cancer spread

A

lymphatic and angiogenesis

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34
Q

two kind of cancer

A

benign and malignant

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35
Q

this type of cancer almost never comes back
doesn’t metastasis
well differentiated cells

A

benign cancer

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36
Q

this can metastasize
infiltrates into other cells and grows
cells don’t look the same

A

malignant cancer

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37
Q

what do tumor suppressor genes do

A

suppress growth of tumor

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38
Q

proto oncogence do what

A

promote growth

mutated genes

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39
Q

what are the diagnostics for cancer

A

xray
mri
ct
ultrasound
mammogram
colonoscopy
pathology

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40
Q

labs done to test for cancer

A

genetic or tumor markers
cbc
chem panel

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41
Q

what are the genetic or tumor markers

A

brca1 and brca2 - breast, ovarian
psa - prostate
cea - colon/gi, bladder, lung, thyroid
ca-125 - ovarian
afp - liver, testicles

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42
Q

TNM classification is for what

A

tumor, lymphnode involvement, metastasis

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43
Q

this is when radiation is implanted into a pt
pt is radioactive for extended period of time

A

brachytherapy

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44
Q

what precautions to take when pt has brachytherapy

A

limit time with pt - max 30 min in room
no pregnant women allowed near pt
6 ft distance
lead shield while treating pt

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45
Q

if brachytherapy implant falls out ..what do you do

A

this is emergency
-use metal forceps to put in lead container

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46
Q

waht are the most common teletherapy radiation reactions

A

skin reactions and fatigue

damage to skin

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47
Q

this is dry, flakey, itchy, scaly skin in response to radiation treatment

A

dry desquamation

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48
Q

how does nurse treat dry desquamation

A

moisurize skin - aquaphor, hydrocoritsone cream, aloe, no ice on burns, no sun lamps or UV exposure at all

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49
Q

this is weeping, oozing, red, warm, tight to touch skin
appearance is shiny and produces drainage
areas scab

A

wet desquamation

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50
Q

how shoud nurse handle wet desquamation

A

specific dressing for comfort
-hydrocolloid, occlusive transparent, hydrogel

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51
Q

this is the loss of hair. may be permanent depending on where radiation is

A

alopecia

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52
Q

what is the most important nursing intervention for alopecia

A

psychosocial & body image

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53
Q

how to help pts with stomatitis

A

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

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54
Q

this restores/stimulates the bodys own immune response to treat the cancer

A

immune therapy

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55
Q

this creates flu like side effects

A

immune therapy

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56
Q

adverse effects of immune therapy

A

pulmonary edema, heart failure symptoms (weight gain, cp, sob)

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57
Q

what is the nursing management of immune therapy

A

careful monitoring, thorough education on side effects and self care,
assess for possible toxicitities

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58
Q

minimizes negative effects on healthy tissue. targets cancer cells

A

targeted therapy

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59
Q

can you put chemo in vein

A

no only through central line or port

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60
Q

can any RN give chemo

A

no only certified RNs.

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61
Q

common chemo side effects

A

oxygentation, bleeding, infection
follicular rash
myeloid suppression
n/v
fatigue
infection

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62
Q

low RBC =

A

decreased WBC

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63
Q

if person has myeloid suppression - what do you need to watch for

A

bone marrow suppression
increased risk of infection
assess for bleeding, infection
assess oxygenation

64
Q

what is neutropenia

A

low neutrophils

keep on isolation precautions

65
Q

symptoms of infections with chemo

A

open lesions on skin,
skin integrity
temp

66
Q

these are medical emergencies for chemo

A

fever + nadir
fever + neutropenia

67
Q

what is nadir

A

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
Q

what labs do you monitor for bleeding

A

hct - 40-50%
hgb 12-18
wbc 5000-10000
rbc 4.5m-5.5m
platelets 150k-450k

69
Q

open wound - what do you do…

A

culture

70
Q

what do you do before giving antibiotics

A

culture everything everytime before antibiotics

71
Q

if chemo pt has fever - it means…

A

infection

72
Q

what are the nursing interventions for infection

A

handwashing
check labs and temp
avoid anything invasive
teach - s/s of infection
monitor temp

73
Q

what nutrition information do you give

A

high protein meals (albumin)
small frequent meals

74
Q

preventative measures for breast cancer

A

diet, exercise, maintain normal body weight
BRCA1 and BRCA2 genetic testing

75
Q

biggest risk factors for breast cancer

A

age and women

76
Q

what is a lumpectomy

A

biospy to remove certain lesion
-will take normal tissue surrounding lesio nto make sure no cancer cells have infiltrated cells

77
Q

what is mastectomy

A

removal of breast with NO lympth node removal

78
Q

when do you do a sentinel lymph node biopsy

A

done in pts with more aggressive cancer

79
Q

this is a complication due to impaired flow of the lymph fluid after lymph dissection

A

lymphedema

80
Q

this is the accumulation of fluid leads swelling, fibrosis of tissues
assess area continuously
always one sided

A

lymphedema

81
Q

what are the nursing interventions for lymphedema

A

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
Q

this is blood collection in surgically cavity
-swelling, tightness, pain, bruising of skin

A

hematoma

83
Q

this rarely produces symtoms
DRE and PSA are the tests
need a biospy to confirm diagnosis

A

prostate cancer

84
Q

prostate cancer marker test

A

psa

85
Q

what is an abnormal DRE

A

hardness, nodular and asymmetric

86
Q

what are the two procedures for prostate surgery

A

TURP and prostatectomy

87
Q

-this is carried out throughout endoscopy
-sexual side effects - retrograde ejaculation
-delayed bleeding
-dribbling
-monitor for hemorrhage

A

transurethral resection of the prostate (TURP)

88
Q

removal of prostate

A

prostatectomy

89
Q

what are the treatment of prostate cancer

A

brachytherapy
estrogen treatments - blocks androgens to prevent cancer from spreading

90
Q

what are the post op assessments of prostate cancer

A

fluid volume balance
pain
ADLs
complications - hemorrhage, infections, catheter obstruction, DVT, s exual dysfucntion

91
Q

what is an orchicetomy used for

A

testicular cancer

-remove of one or both testicles

92
Q

what are the testicular cancer risk factors

A

undescended testicle
white caucasian male

93
Q

nursing management of testicular cancer

A

body image issues
phyiological aspects
sexual issues
radiation

94
Q

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

A

leukemia

95
Q

diagnostics of leukemia

A

peripheral blood eval
bone marrow eval

96
Q

what do we need to eat to prevent cancer

A

high fiber
veggies (broccoili, beans, cabbage)
fruit and whole grains

97
Q

what bad habits to avoid to prevent cancer

A

limit alcohol
tobacco - smoking cessation (including chewing tobacco)
obesity

98
Q

8 warning signs of cancer

A
  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
Q

risk factors for prostate cancer

A

older than 50
male
african american
family history
diet high in red meats

100
Q

s/s of prostate cancer

A

anemia
pallor skin
general weakness/fatigue
difficult & painful urination

101
Q

diagnostics of prostate cancer

A

blood sample
transrectal ultrasound
digital rectal exam

102
Q

s/s breast cancer

A

red & warm
orange peel skin
pitting appearance small indented areas
hard painless swelling “immobile”

103
Q

risk factors for breast cancer

A

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
Q

is a cancer cell well differentiated or poorly differentiated

A

poorly differentiated

105
Q

what does a pet scan do

A

looks for metastasis. shows areas of rapid cell growth/reproduction

106
Q

what is angiogensis

A

growth of new blood vessels. this creates interface btwn tumor and vascular surface

107
Q

when should women start mammograms

A

45-54 - annual
55+ every other year

108
Q

when should ppl get checked for colon cancer

A

50+ - colonoscopy every 10 years

109
Q

when should men get checked for prostate cancer

A

50+ - discuss getting screened

110
Q

when should women be tested for cervical cancer

A

21-29 every 3 years
30-65 every 5 years + HPV test
65+ - no further testing for women who’ve had normal PAPs

111
Q

who should receive the HPV vaccine

A

all women - per lippincott. fuck them. men should too.

112
Q

who should be tested for lung cancer

A

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
Q

to prevent lymphedema after mastectomy - what do you teach pt

A

avoid trauma to affected arm, dont let that arm be dependent

114
Q

what exercises do you teach pt who had masectomy to prevent lymphedma

A

wall climbing, pulling, isometric exercises, tugging

115
Q

this shrinks cancer cells and is typically done for months

A

chemo

116
Q

this kills cancer cells in a specific area. time frame depends on type of cancer

A

radiation

117
Q

waht medication is important to avoid if on chemo

A

avoid aspirin
could increase risk of bleeding

118
Q

what pill can reduce risk of developing breast cancer again but not guarentee

A

tamoxifen - taken 5-10 years after

119
Q

this blocks estrogen receptors in breast to stop estrogen dependent cancer

used in hormonal therapy

A

tamoxifen

120
Q

what are the risks of tamoxifen

A

clots

121
Q

what is contraindication of tamoxifen

A

history of Dvt or PE

122
Q

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
A
  1. i have been experiencing really heavy menstrual cycles recently
123
Q

what are complications of prostatectomy

A

hemorrhage, infection, catheter obstruction, Dvt, sexual/bladder dysfunction

124
Q

what would home health needs be for pt who has prostatectomy

A

incontinence help
visiting nurse
will be discharged with catheter
wound care*

125
Q

how are markers/suppressors aid in treatment

A

used to estimate prognosis, determine stage of cancer, detect cancer remains after treatment

126
Q

what is postoperative assessment for prostate surgery

A

maintenance of fluid volume balance
relief of pain and discomfort
ability to perform ADLs
absence of complications

127
Q

preoperative assesmeent of prostate surgery

A

reduce anxiety and learn about prostate disorder

128
Q

nursing considerations for breast cancer surgery

A

knowledge of disease
reduction of fear, anxiety
improve decision making
pain management
improve coping ablities
improve sexual function
absence of complications

129
Q

what to know about filgrastim

A

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
Q

erythropoietin

A

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
Q

oprelvekin

A

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
Q

tamoxifen

A

given: PO
side effects: n/v, hot flashes, PE
pt teaching: monitor for abnormal bleeding, cataracts, monitor CA+2 levels

133
Q

ondansetron

A

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
Q

waht does ondansetron prevent

A

emesis - n/v - by blocking receptors at chemoreceptor trigger zone

135
Q

clinical manifestations of testicular cancer

A

painless lump on testicle
heaviness in scrotal area
backache
weight loss and weakness
hcg levels are elevated

136
Q

what are the two types of lung cancer

A

small cell carcinoma - aggressive
non-small cell carcinoma

137
Q

clinical manifestations of lung cancer

A

pneumonitis
persistent cough with sputum
hemoptysis
sob
wheezing
chest pain
anorexia
fatigue
weight loss
n/v
trouble swallowing

138
Q

what do you assess for when someone has lung cancer

A

their ability to swallow *

139
Q

what is the hallmark symbol of lung cancer

A

persistent cough with sputum

140
Q

what is a pneumonectomy

A

partial or total removal of lung

141
Q

what is a lobectomy

A

removal of lobe

142
Q

what is a segmental resection

A

removal of segment of a lobe

143
Q

this is more common lung cancer procedure
minimally invasive
used to diagnose/treat different types

A

thoracoscopy or video assisted thoracoscopy (VATS)

144
Q

this procedure removes small lung nodules for biopsy
requires chest tubes after procedure
preserves healthy lung tissue

A

thoracoscopy or video assisted thoracoscopy (VATS)

145
Q

this is the primary therapy for those who can’t tolerate surgery

A

radiation

146
Q

this relieves symptoms of sob, hemoptysis, pain for lung cancer
considered pallative care

A

radiation

147
Q

what do you monitor for when lung cancer pt gets radiation

A

skin assessment
n/v
fatigue
anorexia
esophagitis

148
Q

1 treatment for lung cancer due to its ability to grow fast

A

chemo

149
Q

this is less toxic than chemo and blocks tumor growth

A

lung biologic and targeted therapy

150
Q

route of medication for trastuzumab and what is it used for

A

IV

targets breast cancer cells

151
Q

what are the side effects, nursing considerations an d pt teaching for trastuzumab

A

s/s: n/v
considerations: monitor for cardio toxicity, CHF, monitor flued status
pt teaching: report sob and chest pain

152
Q

what does imatinib treat and what is the route

A

chronic myelogenus leukemia

via PO

153
Q

side effects, nursing considerations and pt teaching of imatinib

A

s/s: gi discomfort, n/v, flu like
considerations: take with food, Tylenol for symptoms,
pt teaching: hygiene to prevent infection

154
Q

this stops testes from producing testosterone

used instead of surgical castration

A

leuprolide

155
Q

what route is leuprolide given

A

SQ or IM

156
Q

what are the side effects and pt teaching of leuprolide

A

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
Q
A

NUS 210 Cancer & HIV - Test 2 (4 decks)

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