Cancer Treatments

Question 1

3 ways to treat cancer

Answer 1

Surgery
Radiation
Chemo

Question 2

What is the most common type of treatment? How long do you have to wait in relation to chemo? Why?

Answer 2

Surgery - wait 2 months - because chemo delays healing

Question 3

Types of surgery

Answer 3

Diagnostic , primary, prophylactic, palliative, reconstructive

Question 4

What is a biopsy for?

Answer 4

Grading (differentiation)

Question 5

What are the types of biopsy’s?

Answer 5

Shave, punch , incisional, excisional , fine needle, core needle

Question 6

What is a shave biopsy used for often?

Answer 6

Skin cancers

Question 7

How far does a punch biopsy go? What do they do? How do they close it? Normally for what type of cancers?

Answer 7

Into dermis, pull out specimen, closed with suture - skin cancers

Question 8

What is an incisional biopsy? How is it closed?

Answer 8

Portion of tumor removed, closed with suture

Question 9

What is an excisional biopsy?

Answer 9

Taking the whole tumor out

Question 10

What is a fine needle biopsy?

Answer 10

30 G needle , aspirate fluid from tumor to look at cells, usually painless

Question 11

What is a core needle biopsy?

Answer 11

12 G needle, core specimen - liver, kidney, sometimes breast , painful

Question 12

Primary - surgery
Debulking

Answer 12

Remove as much of tumor as possible

Question 13

Primary - surgery
Radical excisions

Answer 13

Can be disfiguring or altar functioning

Question 14

Primary - surgery
Salvage surgery

Answer 14

Extensive surgery to site at which previous therapies have failed

Question 15

What is prophylactic surgery?

Answer 15

Removal of tissue (non-vital) / organ that may develop cancer

Question 16

What is palliative surgery for?

Answer 16

Pain relief, not for treating / curing, improve quality of life

Question 17

What is reconstructive surgery for?

Answer 17

“Plastic surgery”
Repair injury or loss of function from curative or radical surgeries

Question 18

How to care for a surgical pt. / things to do

Answer 18

-incision care
-prevent infection
-manage pain
-educate on drains, s/s of infection, dietary intake to promote healing (high protein)

Question 19

What is the goal of radiation and chemo?

Answer 19

Eliminate cancerous cells

Question 20

What cells do radiation and chemo affect?

Answer 20

Rapidly proliferating - hair, skin, GI, bone marrow

Question 21

What is radiation therapy?

Answer 21

Energy to kill / shrink tumors , eliminate cancer cells

Question 22

Can healthy cells be affected by radiation?

Answer 22

Yes

Question 23

How is radiation done (over how long)?

Answer 23

Over weeks to allow healthy tissue to recover and periphery of tumor to re-oxygenate (making it more susceptible to radiation)

Question 24

Radiation toxicity symptoms

Answer 24

1 - fatigue , anemia, n/v, thrombocytopenia

Question 25

What is the external version of radiation?

Answer 25

Teletherapy

Question 26

What is the internal radiation therapy?

Answer 26

Brachytherapy

Question 27

Side effects of brachytherapy (internal) Sealed implants

Answer 27

-body does not give off radiation, but pregnant women and kids should avoid exposure to pt.

Question 28

Side effects of brachytherapy (internal) Unsealed implants

Answer 28

Body will give off radiation Body secretions can be contaminated Isolation

Question 29

Side effects of brachytherapy (internal)

Answer 29

#1 fatigue Anorexia Immunosuppression

Question 30

Pt teaching for brachytherapy

Answer 30

-avoid close contact until treatment done -no contact w / pregnant women -bed rest -balanced diet - small, frequent meals -high fluid intake - 2 - 3 L / day

Question 31

What to do if radiation / brachytherapy becomes dislodged and is found?

Answer 31

Use Long handled forceps , put in lead lined container

Question 32

#1 side effect of radiation

Answer 32

Fatigue

Question 33

Other side effects of radiation

Answer 33

-Skin changes -alopecia -immunosuppression -radiation pneumonia -ulcerations of oral mucous membranes -nausea / vomiting , diarrhea

Question 34

Pt. Read it for teletherapy (external)

Answer 34

-wash treated area only w / tepid water and soft wash cloth -no applications of heat or cold packs -use electric razor only -no products on treatment site -do not remove treatment markers on skin -avoid tight / fitting , starcher or stiff clothing over treatment area

Question 35

Radiation Do not use -

Answer 35

Adhesive tape - use paper type only (outside treatment area)

Question 36

Radiation Protect the

Answer 36

Skin from sun exposure

Question 37

Radiation Pt. Must get proper

Answer 37

Rest, diet, fluids

Question 38

Radiation If hair loss occurs,

Answer 38

Protect head

Question 39

What is the purpose of chemo?

Answer 39

Eliminate cancer cells (cytotoxic)

Question 40

How is chemo administered?

Answer 40

In cycles - daily, weekly, monthly

Question 41

Chemo can be excreted in body fluids up to how many hours after treatment ? What should pt. / family do?

Answer 41

48 hours Flush toilets 2x, rinse toilet w bleach once/day, caregiver wear gloves, avoid sex, wash hands!!!!!!!

Question 42

What lab values should be monitored during chemo?

Answer 42

WBC, RBC, H&H, platelets , etc.

Question 43

How is chemo usually given?

Answer 43

Through a port a cath

Question 44

How do you access a port a cath? What should you do BEFORE administering anything ?

Answer 44

Huber needle, CHECK FOR BLOOD RETURN

Question 45

What is the #1 side effect of chemo?

Answer 45

Nausea and vomiting

Question 46

Other side effects of chemo?

Answer 46

Alopecia, stomatitis , pain, enteritis, diarrhea, anemia, fatigue, panctyopenia, myelosuppression

Question 47

What is stomatitis ?

Answer 47

Ulcers in mouth through GI tract

Question 48

Med used to help with n/v related to chemo

Answer 48

Ondansetron

Question 49

What happens with immunosuppression?

Answer 49

Decreased ability to fight infection

Question 50

Immunosuppression Risk for infection increases when …

Answer 50

Low WBC, low neutrophils

Question 51

Immunosuppression Risk for anemia increase when ..

Answer 51

Low RBC, low H&H

Question 52

Immunosuppression Risk for bleeding increases when..

Answer 52

Low platelets

Question 53

Treatments are based off of what? This determines what?

Answer 53

NADIR how often treatment is given

Question 54

What is the NADIR?

Answer 54

Blood cell count at lowest point

Question 55

S/s of neutropenia What labs are check? What tests are done?

Answer 55

Tachycardia, fever of 100.5 or higher, fatigue, body aches, chills, sweating, hypotension WBC, neutrophil CXR, blood and urine cultures

Question 56

What is neutropenia?

Answer 56

Low neutrophils (white blood cells)

Question 57

Neutropenic precautions

Answer 57

Wash hands !!!!!! Low bacteria diet (no fresh fruits / veggies) No fresh flowers, plants , pets Avoid crowds No visitors w infections No vaccines

Question 58

What is thrombocytopenia? Which affects what?

Answer 58

Low platelet count Clotting

Question 59

What temp should platelets be when administering?

Answer 59

Room temperature

Question 60

Pt. Teaching for thrombocytopenia

Answer 60

-monitor stools/urine for blood -electric razor only -apply ice to affected area if trauma -no dental work / invasive procedures -no aspirin or aspirin - containing products -soft toothbrush / no flossing

Question 61

Nursing management for thrombocytopenia

Answer 61

-monitor platelet count -check stools/urine for blood -asses skin -educate client abt bleeding safety precautions -avoid IM injections & limit venipuncture

Question 62

What to watch for when giving pain meds?

Answer 62

Respiration & constipation