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AHI > Care of Patients with Cancers > Flashcards

Care of Patients with Cancers Flashcards

1
Q

Cancer cells are abnormal mutations of normal cells and are harmful to body tissues
Cancers are either solid or hematologic
Cancers are classified by the type of tissue they arise from or primary site
Cancers are graded based cellular aspects of cancer
Cancers are staged based on the location of the tumor and degree of metastasis at diagnosis

A

Cancer

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2
Q

Cell growth is rapid
Cells can have “infinite” life span
Cells can migrate easily(metastasize)

A

Cancer cells are abnormal mutations of normal cells and are harmful to body tissues - Cancer

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3
Q

Solid: develop from specific tissues
Hematologic: develop from blood cell forming tissues

A

Cancers are either solid or hematologic - Cancer

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4
Q

Some cells are more likely to metastasize - some more malignant so cellular type drive treatment

A

Cancers are graded based cellular aspects of cancer - Cancer

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5
Q

TNM system (Tumor (size); Node (spread to regional); Metastasis) - depending on staging depends on treatment available

A

Cancers are staged based on the location of the tumor and degree of metastasis at diagnosis - Cancer

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6
Q

Always affects a person’s physical and psychological functioning & stresses the family - social; address holistically
Cancers left untreated often cause:

A

Disease related consequences of cancer

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7
Q

Reduced immunity and blood-producing functions
Altered GI structure and function
Motor and sensory deficits-“chemo brain”
Reduced Gas Exchange

A

Cancers left untreated often cause: - Disease related consequences of cancer

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8
Q

Purpose: to prolong survival time or improve quality of life
Cancer therapy includes: - use in combo
Therapies may be used separately or in combination
Types of therapy used depends on the specific type of cancer, whether the cancer has spread, and the health of the patient

A

Cancer management

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9
Q

Surgery
Radiation
Chemotherapy
Hormonal therapy - manipulate certain hormones because affect certain tissues
Photodynamic therapy - laser; reduce tumors
Immunotherapy - immunosuppressants to trigger immune sys to target cancer
Molecularly targeted therapy - less AE on other body tissues; block blood supply to tumors
Gene therapy - alter genes and put back in so not cont produce

A

Cancer therapy includes: - use in combo - Cancer management

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10
Q

Removal of diseased tissue - lymph nodes and prophylactic tissues
Prophylactic surgery
Diagnostic surgery (biopsy)
Curative surgery
Surgery alone can result in a cure rate of 30%

A

Surgery

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11
Q

Removes “at-risk” tissue to prevent cancer development

A

Prophylactic surgery - Surgery

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12
Q

Removal of all or part of a suspected lesion for examination and testing

A

Diagnostic surgery (biopsy) - Surgery

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13
Q

Removes all cancer tissue
Often do something else with it

A

Curative surgery - Surgery

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14
Q

Physical needs are similar to those related to surgery for other reasons
Provide emotional and spiritual support
Encourage expression of concerns
Monitor for bleeding, infection, dehiscence
Consider chemo and psychosocial impact
Help the patient accept changes in appearance or function
Provide information about support groups
Coordinate with PT/OT to plan strategies for regaining or maintaining optimal function

A

Surgery: post-op care

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15
Q

Purpose:
Types:
Radiation delivery types
Side effects:

A

Radiation therapy

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16
Q

Destroy cancer cells and have minimal damaging effects on the surrounding normal cells
Target rapidly producing cells

A

Purpose: - Radiation therapy

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17
Q

Most radiation is ionizing radiation
Causes cells to die or become unable to divide

A

Types: - Radiation therapy

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18
Q

Teletherapy:
Brachytherapy:

A

Radiation delivery types - Radiation therapy

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19
Q

Radiation delivered from a source outside of the patient
Delivered in small doses on a daily basis for a set time period - minimal amount of tissue damage
Patient is not radioactive - nothing inside of them

A

Teletherapy:

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20
Q

Radiation source is within the patient
Sealed or Unsealed
In brachytherapy the patient emits radiation for a period of time and is a potential hazard to others
Sealed: patient emits radiation when implant in place
Unsealed: patient body fluids are radioactive and must be handled according to guidelines

A

Brachytherapy:

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21
Q

Skin changes - severe; teletherapy more sig
Hair loss
Altered taste sensations - mucous membranes affect
Fatigue
Inflammation of tissue leads to tissue fibrosis and scarring - forever have inflammation and fibrosis
Other effects depend on the area exposed to radiation

A

Side effects: - Radiation therapy

22
Q

Private room/bath
Place a caution sign on the door: “Caution: Radioactive Material”
If portable shields are used, place them between the patient and the door
Keep the door closed as much as possible
Personnel should wear a dosimeter film badge (measures exposure) at all times
Wear a lead apron while providing care
Pregnant nurses should not care for these patients
If attempting to conceive, do not perform direct patient care regardless of whether you are male or female
Pregnant women or children younger than 16 should not visit the patient
Limit each visitor to one-half hour per day
Never touch the radioactive source with bare hands
Save all dressings and bed linens in the patient’s room until after the radioactive source is removed
Other equipment can be removed at any time
Diff - cannot get in and out - sig concern when having these

A

Radiation therapy: practices for pats with sealed radioactive implants

23
Q

Must stay at least 6 feet away

A

Limit each visitor to one-half hour per day

24
Q

Explain the purpose and side effects of radiation therapy
Skin care - essential: burns and irritated skin
Instruct the patient not to remove any temporary ink markings until the entire course of radiation therapy is completed; get radiation in same area; talk about nutrition and maintaining weight
Follow the department’s policy regarding the use and timing of skin care products

A

Radiation therapy: nursing interventions - teletherapy

25
Q

Treatment of cancer with chemical agents
Adjuvant therapy
Drugs used are given systemically and exert cytotoxic (cell-damaging) effects against healthy cells as well as cancer cells
Target rapidly producing cells
Combination chemotherapy

A

Chemotherapy

26
Q

Used to cure and increase survival time
Acts by damaging DNA and interferes with cell division

A

Treatment of cancer with chemical agents - Chemotherapy

27
Q

Chemotherapy used along with surgery or radiation

A

Adjuvant therapy - Chemotherapy

28
Q

More than one specific anticancer drug given in a timed manner

A

Combination chemotherapy - Chemotherapy

29
Q

Schedules will vary
Typically given IV
Administration of these drugs requires special education, handling and specific monitoring
Most chemotherapy drugs (even oral) are absorbed through the skin and mucous membranes - wear gloves and appropriate PPE
Anyone handling excreta from patients within 48 hours of IV chemotherapy must use extreme caution and wear personal protective equipment - same with wastes
Oral drugs are just as toxic to the patient and the person handling the drugs - handle appropriately

A

Chemotherapy: admin

30
Q

Typically given every 3-4 weeks for a specified number of times

A

Schedules will vary - Chemotherapy: admin

31
Q

Extravasation (infiltration) of drug into surrounding tissue is a serious complication
Most important nursing intervention for extravasation (infiltration of drug - adequate IV site is essential) is prevention; close monitoring is critical; make sure working well because damages all tissue
Toxic med and requires special handling and lot edu into it
Other routes may also be used - more PO: make sure handling appropriately - ones cannot be touching with bare hands

A

Typically given IV - Chemotherapy: admin

32
Q

Nurses and pharmacists are at risk for absorbing them and must wear PPE

A

Most chemotherapy drugs (even oral) are absorbed through the skin and mucous membranes - wear gloves and appropriate PPE - Chemotherapy: admin

33
Q

Result of the systemic effects of damaging normal cells as well as cancer cells
Rapid cell production: chemo side effects
Anemia
Neutropenia
Thrombocytopenia
Nausea and vomiting
Mucositis (sores in mouth)
Alopecia/hair loss
Skin changes
Anxiety
Sleep disturbance
Altered bowel elimination
Changes in cognitive function
Psychosocial issues

A

Chemotherapy: side effects

34
Q

Decreased numbers of RBCs and hemoglobin
Suppression blood cells

A

Anemia - Chemotherapy: side effects

35
Q

Decreased numbers of WBCs leading to immunosuppression
Suppression blood cells

A

Neutropenia - Chemotherapy: side effects

36
Q

Decreased number of platelets
Suppression blood cells

A

Thrombocytopenia - Chemotherapy: side effects

37
Q

Neutropenia:
Anemia:
Thrombocytopenia:
Nausea and Vomiting:
Mucositis:
Alopecia:
Cognitive changes:
Chemotherapy Induced Peripheral Neuropathy (CIPN):

A

Chemotherapy: nursing interventions

38
Q

Prevention of infection is critical since bone marrow function is suppressed
Encourage look for s/s of infection
Patients with neutropenia are at extreme risk for sepsis
Encourage patient to report any symptoms
Strict handwashing procedures and those around them
Use aseptic technique with any invasive procedure
Consider any temperature elevation a sign of infection
Instruct patients to avoid crowds and sick people and young kids
Monitor WBC and ANC (Absolute Neutrophil Count - indication of neutrophil count: most effective against infection - below certain number then on neutropenic precautions)
Adminster filgrastim (Neupogen) as needed - med SQ stim bone marrow to stim WBC

A

Neutropenia: - Chemotherapy: nursing interventions

39
Q

Sepsis can lead to death during treatment

A

Patients with neutropenia are at extreme risk for sepsis

40
Q

Skin and mucous membrane changes
Cough
Burning on urination
Pain around the venous access site
New drainage from any body area

A

Encourage patient to report any symptoms

41
Q

Monitor patient for anemia - low RBC and HH
Adminstration of erythrocyte stimulating agents (ESA) can prevent or improve anemia
Blood transfusion is common

A

Anemia: - Chemotherapy: nursing interventions

42
Q

Fatigue
Hypoxia

A

Monitor patient for anemia - low RBC and HH

43
Q

Ex. Darbepoetin alpha (Aranesp), epoetin alfa (Epogen) - stim bone marrow to produce more blood cell

A

Adminstration of erythrocyte stimulating agents (ESA) can prevent or improve anemia

44
Q

Monitor patient for thrombocytopenia
Transfusion of platelets may be required
Administer of growth factor for platelet
Follow best practice for prevention of injury for the patient - bleeding precautions

A

Thrombocytopenia: - Chemotherapy: nursing interventions

45
Q

Bruising
Bleeding
Around gum line

A

Monitor patient for thrombocytopenia

46
Q

Es. Oprelvekin (Neumega)

A

Administer of growth factor for platelet

47
Q

Ensure antiemetics are given before chemotherapy - premed imp

A

Nausea and Vomiting: - Chemotherapy: nursing interventions

48
Q

Mouth sores; irritation in mouth
Mouthwashes to coat and soothe it
Frequent mouth assessment and oral hygiene
Use soft-bristled toothbrush, clean weekly, no sharing

A

Mucositis: - Chemotherapy: nursing interventions

49
Q

Reassure patients that hair loss is temporary
Give resources for support coping with changes in body image

A

Alopecia: - Chemotherapy: nursing interventions

50
Q

Support the patient that reports a change in cognitive therapy
“Chemo Brain”: difficulty with concentration, memory loss, difficulty learning new information; safety
Warn patients against participating in activities such as excessive alcohol intake, recreational drug use, and activities that increase the risk for head injury

A

Cognitive changes: - Chemotherapy: nursing interventions

51
Q

COMMON and sometimes chronic
Damage cancer drugs
Teach them how to prevent injury
Protect feet and other body areas where sensation is reduced
Well-fitting shoes
Inspect feet daily
Avoid extremes of temperature
Test water temperature
Use potholders when cooking
Use gloves when washing dishes or gardening
Eat foods high in fiber, increase fluid intake unless restricted
Stand up slowly
Avoid area rugs
Use handrails when using stairs
Not walk around barefoot
Loss sensation - higher risk for falls

A

Chemotherapy Induced Peripheral Neuropathy (CIPN): - Chemotherapy: nursing interventions

AHI (77 decks)

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