Cancer lecture Flashcards
Primary prevention of cacner
- immunization like HPV and gardasil
- avoiding smoking
- reducing exposure to UV light
secondary prevention of cancer
- early detection and treatment of subclinical, asymptomic or early disease in people without signs or symptoms of cacner
tertiary prevention of cancer
- management of an illness to prevent progression, recurrence or other complications
what are imaging studies to detect cancer
- Xrays
- CT scans
- Ultrasounds
- MRI
- bone scan
- endoscopy
what is a PET scan useful for
it is good to use for measuring metastisis of cancer to different organs
what are treatment decisions made by
tumour boards
what are the various goals of cancer treatment
- cure
- control: prolonging the life with good QoL
- palliation: symptom control with good QOL
what are good prognostic factors for cancer
- early stages of cancer have better responses to surgery and treatment
what are poor prognostic factors when it comes to cancer
- weight loss
- poor performance status
- metastases
- cytogenetic abnormalities
- co-morbidities
- extreme ages
what is invasive ductal carcinoma
- cancer has spread beyond the basement membrane of the duct or lobule and into the surroudning tissue
what are local treatments for breast cancer
- radiation therapy and surgery
what are systemic treatments for breast cancer
- chemotherapies
- hormonal therapies
- immunotherapies
what is the definition of remission
that every tumour cell is killed and there is no evidence of disease
why must we give repeated cycles of chemotherapy
to be able to attempt at killing all of the cells
what is radiotherapy
- use of ionizing radiation in the treatment of patients with benign or malignant diseases
what are the indications for palliative radiation
- symptoms treatment of bone pain from metastasis
- spinal cord compression
- certain brain metastases
- certain lung tumours to increase lung aerartion
- lymph cancers
what should nurses educate for patients undergoing radiotherapy
- gicing them information on what will happen
- onset and duration of aside effects
- self-care measures
- follow-up care
what are the side effects of cancer management
- erythema
- mucositis
- dry and wet desquamation
what is the nursing management for brain radiation
- avoid irritants to the scalp
- help obtaining wigs
- assess neuro functions
- emotional support
what is the nursing management for radiation to head and neck
- soft bland food
- saliva substitutes
- gum and frequent sips of water
- use of humidifier
- PEG insertion
- avoid alcohol and smoking
what is nursing care for radiation to the chest
- corticosteroids
- vicious lidocaine
- high protein soft bland diet
what is nursing care for radiation to the abdomen
- anti-emetics
- bland diet
- maintaining fluids
- small frequent meals
what is nursing care for radiation to the pelvis
- maintain fluids
- anti-diarrheal
- fertility counselling PRN
- vaginal dilators
what is nursing interventions for radiation to the skin
- protect the skins, creams and lotions as prescribed
How is anemia from chemo managed
- monitor hgb
- administer prbcs when needed
- teahc the patient concerning fatigue
how is leukopenia from chemo managed
- monitor ANC, VS, report temperature above 38 for longer than an hour or 38.3 at one instance
- blood cultures, sputum and urine cultures
- initatiane any antimicorbial or antiviral medications
- patient on enutropenic precautions
how is thrombocytopenia from chemo managed
- report blood in cough, stool, urine or bleeding gums
- give platelets as needed
- avoid invasive procesures, use of lubricants for intercourse
- CT head after falls
nursing management for hypeglycemia from chemo
- monitor blood glucose
- monitor a1c levels
nursing management for hyperclcemia post chemo
- monitor serum level
- monitor for constipation, nausea and vomiting
- administer biphopshate
nursing management for cardiac toxicity from chemo
- monitor ejection fraction
- note any cardic hsitory
- monitor for s/s of heart failure
- cytoportectants
nursing management for pulmonary toxicity from chemo
- ensure baseline PFTs done prior to 1st cycle
- monitor for resp. symptoms
nursing management of renal toxicity from chemo
- ensure 2-3L PO/IV intake before and after therapy
- monitor baseline kindye function
- cytoprotectants
what are the principles of immunotherapy
- modulates signaling
- stimulate immune system
- anti-growth activity
- promotes cells death
- inhibitis the growh of new blood vessels
- prevents metastasis
what is the nurses role for cancer patients who are using CAM
- assess if they are using and if yes which one
- refer patient to oncology pharmacist to ensure there is no interactions
- assess side effects or changes in condition
- assess the patient to find reliable information
what is spinal cord compression
direct injury to compression to the spinla cord or causa equina
what are the risk factors of spinal cord compression
- solid tumour metasteses in the lung, breast, prostate
what are symptoms of SCC
- back pain
- parathesisas in extremities
- decreased sensation to pain and temp
- sexual dysfunction
what are the signs of SCC
- muscle weakness
- loss of bowel and bladder control
what are the non-pharmacological treatments for SCC
- surgery
- mobility and safety
- skin integrity
- pain management
what is superior vena cava syndrome
- cluster of symptoms and physical findings associated with compression or obstruction to the SVCA
risk factors for SVC
- right sided lung cancer
- CVAD and pacemakers
- radiation to medistinum
- metastases to mediastinal area
signs and symptoms of SVC
- edema
- neck and thoracic vein distention
- dyspnea and non-productive cough
- cyanosys to upper torso
late signs of SVC
- severe headache
- irritsbility
-changes in loc - visual disturbances
- stridor
pharmacological treatment for SVC
- chemotherapy
-diuretics - anticoagulation
-corticosteroids
what are non-pharmacological treatments for SVC
- radiotherapy
- removal of CVAD
- endovacualr stent or SVC bypass surgery
- Oxygen tharpy, elevated head of bed
- decrease activities involving increased intrathoracic intracerebral pressure
- anxiety reduction
what is considered an urgent assessment when it comes to febrile neurtropenia
fever greater than 38.2 once or fever sustained at 38 for more than one hour
what is neutropenia classified as
ANC less than 1.0x10-6
what sites could bacterial pathogens be present at
- UTI
- Pneumonia
- wound related
- at drains or catheters
what sites could fungal infection be present at?
- cindidiasis in the mouth, vagina or bladder
- skin ulcer, sinusitis, and pneumonia
what sites can viral pathogens be found at
- herpes simplex
- varicella zoster virus
- CMV and EBV
what are nursing interventions for febrile neutropenia
- assessment of vitals
- Blood cultures
- urine cultures
- swab any wounds
- sputum cultures
- isolate the patient and implement strict infection control precautions
what is the treatment for febrile neutropenia
- treatment with antibiotics and antifungals
- initiation of broad-spectrum ATBX until pathogen established
- considered catheter removal
how much acetaminophen for those with liver damage and then regulary
- 2g for liver damage
- 4g for normal
if the patient is on chemo or immunosupression, what should you do before administering acetominophen
- take temperature before each dose since it can maskl fever
what is acute CINV
- occurs within 24 hours of chemotherapy administration
what is delayed CINV
- occurs 24 hours after administration and can persist for 6-7 days
what is anticipatory CINV
- occur before the administration of the scheduled chemo
what should be done when unexpected nausea or vomiting happens
- diagnostic tests done to rule out causes of nausea and vomiting
- blood work that includes, CBC, electrolytes, LFTs, BUN and creatinine
what are pharmacological interventions for anorexia and cachexia
- progestational agents
- corticosteroids
- dietary supplements
- treat hypercalcemia if present
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what are non-pharmacological intervention for anorexia ad cachexia
- provide information and education to the family
- refer to nutritionist
- screen weight, dietary intake, physical exam and lab values
- increase food intake and value of intake
- evaluate any constipation, nausea etc
what is the cause of mucositis
production of free radicals by chemo or radiotherapy that damages cell DNA
risk factors for mucositis
- history of mucositis
- poor dental hygiene
- ill-fitting dentures
- hsitory of etoh and tobacco use
pharmacological interventions for mucositis
- biotene
- magic mouthwash
- antifungals
- opioid narcotics
what is the non-pharmacological treatment for mucositis
- nutrition consult
- ice chips
- saldt and soda rinses
- soft toothbrushes
- no prostheses until reolved
- avoid sharp or spicy foods
seconday lympedema
selling from:
- abnormal production of lymph
- obstruction in lymphatic circulation
- lymph node dissection
signs and symptoms of lympedema
- swollen limb
- swollen axilla or groin
- edema in the face, neck, or genitals
- pain may or may not be present
nursing interventions for lymphedema
- pre-op limb measurement
- clinical history
- pain assessment
- psychosocial assessment
- measure the affected limb
- assess for signs and symptoms of infection
- pulses and ROM
- strength of affected limb
how is lymphedema managed
- complete decongestive physiotherapy
- elevation of effected limb
- pain manegement
- prevention is key - exercise, good hygiene, ideal body weight
