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MedSurg > Cellular Aberration > Flashcards

Cellular Aberration Flashcards

1
Q

Disease condition wherin the NORMAL cells becomes ABNORMAL and PROLIFERATES abnormally.

A

Cancer

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2
Q

Incidence of Cancer

A

-Cancer affects every age group though most cancer and cancer deaths occur in people older than 65 years old.

-Cancer ranks 3rd as the cause of morbidity in the Philippines

-Highest incidence of all cancer is Prostate Cancer

-Highest cancer incidence in males in order of frequency: Prostate, Lung, and Colorectal

-Highest cancer incidence in females in order of frequency: Breast, Lung, and Colorectal

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3
Q

Branch of medicine that deals with the study, detection, treatment, and management of cancer.

A

Oncology

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4
Q

Interphase

A

G1 – RNA & Protein Synthesis
S – DNA Synthesis
G2 – Pre mitosis

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5
Q

Mitosis Phase

A

Actual cell division

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6
Q

NEO

A

New

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7
Q

PLASIA

A

Growth

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8
Q

TROPHY

A

Size

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9
Q

OMA

A

Benign Tumor

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10
Q

Stasis

A

Location

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11
Q

A

A

Absence

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12
Q

ANA

A

Lack

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13
Q

Hyper

A

Excessive/increase

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14
Q

META

A

Change

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15
Q

DYS

A

Bad, impaired

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16
Q

SARCOMA

A

Malignant tumor in connective tissues

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17
Q

CARCINOMA

A

Malignant tumor in epithelial tissues

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18
Q

BLASTOMA

A

Malignant tumor that starts in immature cell

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19
Q

Immune System (low)

Cancer cells are already in the body but INACTIVE

Due to stressors:

Cancer cells ACTIVATED

A

Failure of Immune Response Theory

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20
Q

No cancer cells in the body

Due to exposure to CARCINOGENS:

Cancer cells DEVELOPS
A

Cell Transformation Theory

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21
Q

Atrophy

A

Absence/decrease in size

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22
Q

Hypertrophy

A

Excessive/increase in size

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23
Q

Hyperplasia

A

Excessive/Increase in growth

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24
Q

Metastasis

A

Change in location

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25
Q

Dysplasia

A

impaired growth

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26
Q

anaplasia

A

absence of growth

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27
Q

neoplasia

A

new growth

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28
Q

dystrophy

A

bad size

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29
Q

Types of Carcinogens

A

-Chemical Carcinogens
-Physical Carcinogens
-Viral Carcinogens
-Dietary Carcinogens

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30
Q

Chemical Carcinogens

A

Alcoholic beverages
Smoking
Asbestos
Benzene
Arsenic
Pesticides
Sunlight

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31
Q

Physical Carcinogens

A

Radiation
Chronic Irritation of Tissue – GERD

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32
Q

Viral Carcinogens

A

Human Papilloma Virus
Genital Herpes
Hepatitis B

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33
Q

Personal Factors Causing Cancer

A

Immune function
Age
Gender
Genetic risk
Race

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34
Q

Carcinogenesis

A
  1. Initiation
  2. Promotion
  3. Progression
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35
Q

Carcinogenesis:

Occurs when carcinogen damages DNA

A

Initiation

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36
Q

Carcinogenesis:

Occurs with additional assaults to the cell

A

Promotion

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37
Q

Carcinogenesis:

Cell proliferation

A

Progression

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38
Q

NORMAL CELLS vs CANCER CELLS

MITOSIS

A

Normal cells: Leads to 2 daughter cells

Cancer Cells: Leads to multiple daughter cells

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39
Q

NORMAL CELLS vs CANCER CELLS:

APPEARANCE

A

Normal Cells: Homogeneous in size, shape, and growth

Cancer Cells: Larger and grow more rapidly

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40
Q

NORMAL CELLS vs CANCER CELLS:

Apoptosis

A

Normal Cell: Present

Cancer Cell: Impaired

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41
Q

NORMAL CELLS vs CANCER CELLS:

Growth Pattern

A

Normal Cell:
Do not invade to adjacent tissue
Cannot grow outside environment
Cell death = Cell birth

Cancer Cell:
Invades to adjacent tissue
Able to migrate to another site
Cell death < Cell birth

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42
Q

Ability of cancer cells to spread from the original site of the tumor to distant organs

A

Cancer Metastasis

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43
Q

Modes of Metastasis

A
  1. Lymphatic Spread
  2. Hematogenous Spread
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44
Q

(+) Capsule (Well differentiated)
Slow to grow
High survival rate
Growth: Expansion
Affects surrounding tissues
(+) Pain –Due to compression of surrounding tissues.
Ideal Tx: Surgery

A

Benign

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45
Q

(-) Capsule (Poorly differentiated)
Rapid growing
Low survival rate
Growth: Metastasis / Invasion
Affects other organs
(+) Pain – Due to metastasis

Ideal Tx: Radiation / Chemo

A

Malignant

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46
Q

A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing?

a. Middle-aged woman whose mother died at age 48 of breast cancer
b. Young man who has all the symptoms of rheumatoid arthritis
c. Pregnant woman whose father has sickle cell disease
d. Middle-aged man of Eastern European Jewish ancestry

A

a. Middle-aged woman whose mother died at age 48 of breast cancer

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47
Q

The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells?
a. Benign tumors grow through invasion of other tissue.
b. Benign tumors have lost their cellular regulation from contact inhibition.
c. Growing in the wrong place or time is typical of benign tumors.
d. The loss of characteristics of the parent cells is called anaplasia.

A

c. Growing in the wrong place or time is typical of benign tumors.

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48
Q

A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?
a. “Foods high in vitamin A and vitamin C are important.”
b. “I’ll have to cut down on the amount of bacon I eat.”
c. “I’m so glad I don’t have to give up my juicy steaks.”
d. “Vegetables, fruit, and high-fiber grains are important.”

A

c. “I’m so glad I don’t have to give up my juicy steaks.”

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49
Q

What is the purpose of staging cancer?

A

To determine specific treatment on specific stage

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50
Q

Cancer in situ (in place)

A

Stage 0

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51
Q

Cancer is limited in distal origin (Occupies space to surrounding tissues)
(Pain Starts)

A

Stage 1

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52
Q

Lymph node involvement
(Metastasis Starts)

A

Stage 2

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53
Q

Spread distal or regional

A

Stage 3

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54
Q

Wide spread metastasis
> 1st Priority: Pain Management
DOC: Narcotics (Morphine Sulfate)
> 2nd Priority: Spiritual Care

A

Stage 4

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55
Q

TNM Meaning

A

Tumor
Node
Metastasis

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56
Q

Tumor Classification

A

T0: No tumor found
Tis: Tumor in situ
T1: 0-2 cm
T2: 2-5 cm
T3: >5 cm
T4: Tumor has been broken
Tx: Tumor can’t be measured

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57
Q

Node Classification

A

Nx: Lymph node involvement cannot be assessed
N0: No lymph node involvement
N1: 1-3 nodes involved
N2: 4-6 lymph nodes involved
N3: >7 lymph nodes involved

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58
Q

Metastasis Classfication

A

M0: No metastasis
M1: Positive metastasis

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59
Q

WARNING SIGNS OF CANCER

A

Change in Bowel / Bladder Habits (Colon, Bladder)
A sore that does not heal (Skin Cancer)
Unusual bleeding (Leukemia)
Thickening of the lump (Hodgkin/Non Hodgkin)
Indigestion – Feeling bloated but walay mugawas
Obvious change in warts/moles (Skin Cancer)
Nagging cough (Laryngeal, Lung Cancer)
Unexplainable anemia (Leukemia)
Sudden weight loss

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60
Q

Prevention of Cancer Key Points

A

Prevention is a priority in oncology nursing because at least one third of all cancers are preventable

Cancer is also curable if detected and treated early

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61
Q

PREVENTION TEACHINGS

A

Reduce or avoid exposure to known or suspected carcinogens

Eat a balanced diet that includes fresh fruits and vegetables, whole grains, and adequate fiber

Limit Alcohol Intake

Participate in regular exercise

Maintain a healthy weight

Obtain adequate rest periods (6-8 hours per night)

Eliminate, reduce, or change the perception of stressors and enhance ability to cope

Have a regular physical exam

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62
Q

TREATMENTS

A

Oral Therapy
Radiation Therapy
CHImotherapy
D Bone marrow aspiration
Surgery – Most common mode of treatment

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63
Q

Reduces the size of tumor
Relieves obstruction
Targets: Cancer Cells

A

Radiation Therapy

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64
Q

Types of Radiation Therapy

A

Internal
External

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65
Q

Types of Internal

A

Sealed
Unsealed

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66
Q

(+) Container
Implants:
- Cobalt
- Cervical

A

Sealed

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67
Q

(-) Container
Oral & IV

A

Unsealed

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68
Q

Brachytherapy

A

Internal Radiation therapy

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69
Q

(+) Residual Radiation
Flush the CR at least 3 times
Lock the door at all times
Avoid exposure to child and pregnant

A

Internal Radiation Therapy

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70
Q

Uses beam of light (UV Rays)
S/E: Dermatitis (Temporary)

A

External

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71
Q

Teletherapy

A

External

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72
Q

(-) Residual Radiation

A

External

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73
Q

BETA Rays
Penetrates into the skin
Use: RUBBER GLOVES & LEAD APRON

A

Internal

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74
Q

GAMMA Rays
Penetrates into the bones
Use: LEAD APRON

A

External

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75
Q

Factors Affecting Exposure to Radiation

A

S hielding
T ime
D istance

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76
Q

Private room
Farthest room available
Avoid pregnant & children
Wear lead apron
Handling secretions & discharges:
1. Wear rubber gloves when handling bedpan
2. Flush the toilet at least 3 times
Patient with implants:
1. Bedrest – Flat/Supine position
2. Offer bed pan to maintain bed rest
3. Log roll to turn the patient
4. Patient facing opposite the door
5. Nurse must stand opposite to the implant
6. Sexual activity may resume 3 weeks after removal of implant.
In case of DISLODGE:
1. Pick up with long handled forcep
2. Place implant in LEAD CONTAINER
If not found:
1. Close the door and leave the room
2. Call the radiology department

A

Shielding

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77
Q

30 minutes per shift
5 mins per exposure
6 times per shift
Care only 1 patient at a time
Wear a dosimeter badge to measure exposure and amount of radiation

A

Time

78
Q

Maintain at least 6 feet when not performing procedures.
Pwede mu doul if mag perform ug procedures.

A

Distance

79
Q

Use of a vesicant drug to interrupt the cell cycle
Targets: Normal & Cancer Cells

A

Chemotherapy

80
Q

Routes of Chemotherapy

A

ORAL - mouth
IM - muscle
IV - vein
Intracavitary – body cavities
Intrathecal – CSF pathway
Intraarterial - Arteries
Topical - Skin

81
Q

Chemotherapy Drugs

A

-Alkylating Agents
-Antimetabolites
-Anti tumor Antibiotics
-Plant Alkaloids
-Corticosteroids

82
Q

Cell Cycle Non-Specific Drugs

A

Alkylating Agents
Anti tumor antibiotics
Corticosteroids

83
Q

Cell Cycle Specific Drugs

A

Antimetabolites (S Phase)
Plant Alkaloids (M Phase)

84
Q

Alkylating Agents

A

Cyclophosphamide (Cytoxan)
Busulfan (Myleran)
Cisplastin (Platinol)
Mechlorethamine (Mustargen)

85
Q

AE: Hemorrhagic Cystitis
- Route: PO on empty stomach

A

Cyclophosphamide (Cytoxan)

86
Q

Myleran
- Taken at same time every day
- Route: PO on empty stomach

A

Busulfan (Myleran)

87
Q

Platinol
AE: Tinnitus

A

Cisplastin (Platinol)

88
Q

-Vesicant Drug

A

Mechlorethamine (Mustargen)

89
Q

Antimetabolites

A

Fluorouracil (5 FU, Adrucil)
Methotrexate (Folex)
Mercaptoprine (Purinethol)

90
Q

5 FU, Adrucil

A

Fluorouracil

91
Q
  • Follic Acid Antagonist
    - Antidote: Leucovorin
A

Methotrexate

92
Q

Purinethol
Maintenance for all leukemia

A

Mercaptoprine

93
Q

Anti Tumor Antibiotics

A

Bleomycin (Blenoxane)
Doxorubicin (Adriamycin)

94
Q

Bleoxane

A

Bleomycin

95
Q

Adriamycin
- Needs cardiac monitoring
- Harmful to bone marrow

A

Doxorubicin

96
Q

Plant Alkaloids

A

Vinblastine (Velban)
Vincristine (Oncovin)

97
Q

Bone marrow friendly but can cause neuropathy

A

Plant Alkaloids

98
Q

Velban

A

Vinblastine

99
Q

Oncovin

A

Vincristine

100
Q

Corticosteroids

A

Prednisone
Dexamethasone

101
Q

COMPLICATIONS OF RADIATION & CHEMOTHERAPY

A
  1. Bone Marrow Depression
  2. Sterility
  3. Skin Problems
  4. Nausea & Vomiting
  5. Stomatitis
  6. Xerostomia
  7. Dryness of Vagina
  8. Alopecia
102
Q

Bone Marrow Depression (radiation and chemotherapy)
low RBC

A

Aplastic Anemia

103
Q

Bone Marrow Depression (radiation and chemotherapy)
low WBC

A

Prone to Infection

104
Q

Bone Marrow Depression (radiation and chemotherapy)
Low Platelet

A

Risk for Bleeding

105
Q

Bone Marrow Depression
Aplastic Anemia

A

-Blood transfusion
-Fatigue - do non-strenous activities with frequent rest
-Dyspnea - o2 administration
-Diet - increase iron intake

106
Q

Bone Marrow Depression
Prone to Infection

A

-Place in private room
-Hand washing
-Avoid crowded place
-Avoid fresh fruits and vegetables
-Processed foods are okay

107
Q

Bone Marrow Depression
Risk For Bleeding

A

-Avoid IM, but if given, apply pressure
-Avoid contact sports, pwede swimming
-Avoid anticoagulants
-Soft bristle toothbrush
-Use electric razor
-Wear non-slip slippers
-Avoid walking barefooted

108
Q

Sterility (radiation only)

A

-Female: Oopherexy - Elevate ovaries para dili ma igo sa external radiation - Egg freezing

-Male: Orchiopexy - Elevate testes para dili maigo sa external radiation - Sperm banking

109
Q

Skin Problems
Radiation

A

Dermatitis

110
Q

Skin Problems
Chemotherapy

A

Extravasation

111
Q

Skin Problems:
-Localized skin reaction
-Cold application
-Mark the area prior to therapy
-Wash with plain water and mild soap
-Avoid:
Lotion
Powder
Alchohol
-Pat dry; do not rub
-Avoid constrictive clothing
-Avoid direct sunlight on site

A

Dermatitis

112
Q

Skin Problems:
-Redness
-Swelling
-Burning sensation on site
-Prior to administration:
1. Ensure IV patency
2. Maintain vision during administration
-When preparing, nurse must wear:
1. Mask
2. Goggles
3. Gown
4. Gloves

A

Extravasation

113
Q

-Chemotherapy only
-Plan of care:
1. Give on empty stomach
2. Administer anti-emetics 30 minutes – 1 hour prior to chemo.

A

Nausea and Vomiting

114
Q

-Indicates immunosuppression
-Management:
1. Assess for sore, blisters, discharges
2. Avoid alcohol-base products
3. Gargle with a pinch of salt

A

Stomatitis

115
Q

Dryness of the mouth
Management:
1. Apply petroleum jelly
2. Offer ice-cold fluids (popsicles)

A

Xerostomia

116
Q

Management:
1. Avoid alcohol-base products (feminine wash)
2. Apply KY jelly (water-based lubricant)
3. Apply cornstarch with water as mud pack

A

Dryness of Vagina

117
Q

Temporary
Assure that it will grow 6 months after chemotherapy
But it may change qualities
Offer wig before alopecia occurs aron dili mahalata na wala nay buhok

A

Alopecia

118
Q

A male client with nagging cough makes an appointment to see the physician after reading that this symptom is one of the warning sign of cancer. What is another warning sign of cancer?

Persistent nausea
Rash
Indigestion
Chronic Ache / Pain

A

Indigestion

119
Q

In the client with terminal lung cancer, the focus of nursing care is on which of the following nursing intervention?

Prepare the client’s will
Provide pain control
Provide nutritional support
Provide emotional support

A

Provide pain control

120
Q

Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?

When therapy is completed
Immediately after nausea begins
With administration of chemotherapy
30 minutes before the initiation of therapy

A

30 minutes before the initiation of therapy

121
Q

The staging of the client’s cancer by the TNM classification is T1,N3,M1. What is the nurse’s interpretation of this classification?

a. The client has two tumors that are non responsive to treatment.
b. The client has leukemia confined to the bone marrow.
c. The client has a 2 cm tumor with 1 regional lymph node involved and no distant metastasis.
d. The client has a small primary tumor, tumor extension into three lymph nodes, and one site of distant metastasis.

A

d. The client has a small primary tumor, tumor extension into three lymph nodes, and one site of distant metastasis.

122
Q

The nurse is caring for a client receiving chemotherapy. Which of the client suggest he does NOT understand the side effects of therapy?

a. Using an electric razor
b. Eating a high protein diet
c. Taking his children to see santa at the mall
d. Calling a doctor if there is an increase in temperature

A

c. Taking his children to see santa at the mall

123
Q

Complications Resulting From Cancer

A
  1. Malnutrition
  2. Altered Taste Sensation
  3. Infection
  4. Pain
124
Q

Complications Resulting From Cancer:
Pain Management

A

Instruct to keep a pain management diary
Administer pain relievers: NSAID and OPIOIDs

125
Q

Complications Resulting From Cancer:
Malnutrition Management

A

Soft, non irritating high protein, and high calorie foods
Avoid extremes of temperature, tobacco, alcohol, spicy foods, and other irritants.
Teach the patient to use nutritional supplements

126
Q

Complications Resulting From Cancer:
Altered taste sensation management

A

Avoid foods that are disliked
Experiment with spices and other seasoning

127
Q

Complications Resulting From Cancer:
Infection Management

A

Instruct patient to report temperature of 38c or greater
Avoid crowded places
Avoid people with illness
No live attenuated vaccines or avoid people who received it for at least 3 days from the day of vaccination

128
Q

Unregulated growth of cancer cells in the breast tissue.
Estrogen-dominance cancer

A

Breast Cancer

129
Q

Breast Cancer Risk Factors: (LONGFOE)

A

Late menopause (After 55 y/o)
Obese
Nullipara
Genetics
Female
Obese (fat)
Early menarche (Menstruation before 12 y/o

130
Q

DIAGNOSTIC (BREAST CANCER):
-Detects tumor before it can be felt
-Uses low dose X-ray
-Baseline: 35-39 y/o
Yearly: 40 years old and above
-Pre-procedural teachings:
1. No chemicals to apply
2. Patient may experience discomfort during procedure

A

Mammogram

131
Q

DIAGNOSTIC (BREAST CANCER):
-Start : 20 years old
-Frequency : Monthly
-Schedule : 1 week after menstruation (Start counting on the 1st day)
-Irregular/Menopause: Same day each month
-Position : Standing in shower in front of mirror
Lying in bed in front of mirror

A

Breast Self Exam

132
Q

DIAGNOSTIC (BREAST CANCER):
Gold standard / Confirmatory
2 types:
1. Percutaneos – Fine Needle Aspiration
2. Surgical

A

Biopsy

133
Q

SIGNS OF BREAST CANCER (AVON)

A

Assymetrical
Venous prominence
Orange – peel skin
Nipple dimpling with discharges (pus)

134
Q

MANAGEMENT OF BREAST CANCER

A
  1. Radiation & Chemotherapy
  2. DOC: > Tamoxifen
    - Hormone antagonist
    - To decrease estrogen level
    > Diethyl Stibestrol (DES)
    - Synthetic estrogen
  3. Surgery:
    > Lumpectomy – Excision of breast mass
    > Simple / Total Mastectomy – Removal of entire breast
    - Complication: Lymph Edema
    - POC: Semi-fowlers with 1-2 pillows under affected arm
    - Avoid BP & IV puncture on affected side
    - Avoid lifting, gardening using affected arm
    - Encourage ROM:
  4. Hair combing
  5. Hand wall climbing
  6. Rope rotation
    > Radical Mastectomy – Removal of breast, lymph node, and pectoralis minor
    > Modified Radical Mastectomy
    • “Halstead Procedure”
    • Ibilin ang PECTORALIS MINOR for breast implant
135
Q

Helen, a leukemia patient, has entered the phase known as “the nadir.” As a nurse, you ste aware of the following facts regarding this time period:
A. Patient helen is most vulnerable to blood clots and may have platelet count of 500,000 or higher
B. During this time Helen is most vulnerable to bleeding and may have a platelet count of 50,000 or fewer
C. Patient Helen is at risk for increase hemoglobin and hematocrit
D. Because of the low WBC count, Helen will beed to be placed in reverse isolation

A

Answer: B Nadir is extemely low ang BC, wbc, ug platelet So asa ana na choice ang naghisgot abot nadir, so letter B.

136
Q

You are a senior nurse at Manuel J. Doctors Provincial Center delegating patients for the upcoming shift, how would you care for a patient who has had a sealed radiation source placed?
A. Nurse Charlotte is responsible for providing continuity of care to all patients having sealed radiation therapy.
B. Nurse Sasha, who was the same nurse yesterday, will continue to provide excellent treatment.
C. Nurse Bayley who had her duty on the neurologic ward yesterday
D. Nurse Becky who is 5 weeks pregnant on her 3rd child

A

Answer: C. B and C are both correct. But ang pinaka correct is si C its because wala pa siyay exposure to radiation compared to B

137
Q

Nurses in preventative health care are tasked with improving the health of patients through evidence-based recommendations while encouraging individuals to receive preventative services such as screenings, counseling and precautionary medications. Mr. April Graham, a 34-year-old Chinese instructor, is learning about testicular cancer through you. What is Mr. Graham’s correct remark about a testicular exam?
A. “I do a self-testicular exam every six months.”
B. “Due to monthly hormonal changes, the testicle may have small bumps or enlargement.”
C. “After a shower is the ideal time to undertake a self-examination.”
D. “The testicle should be tight but hard.”

A

Answer: C
Option A: wrong. every month mag self-testicular
Option B: naa bay bumps ang testicles? WALA
Option D: si D? hard ba ang testicle? DILI HUHU iba yung hard

138
Q

You are assigned to Juan Dela Cruz, a 36-year-old who underwent Bone marrow transplant. What important assessment should you anticipate?
A. Hematocrit of 44%
B. INR of 5.0
C. Blood Pressure of 110/85mmHg
D. Intracranial pressure of10mmHg

A

Answer: B. INR of 5.0
Option A, C, D: Hematocrit is normal, so wala tay dapat ikabahala as well as the bp and icp Option B: correct. pinaka abnormal diha na kailangan nato e’report is the INR because normal value of INR is 1.0 only

139
Q

You teach Ms. George with chronic cancer pain about optimal pain control. Which of the following recommendations is most effective for pain control?
A. Get used to some pain and use a little less medication than needed to keep from being addicted.
B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.
C. Take analgesics only when pain returns.
D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day to block the pain.

A

Answer: B. kay chronic na nga pain, so expected na naay round the clock pain reliever.

140
Q

Ramon is receiving vincristine. Client teaching by the nurse should include instructions on:
A. Use of loperamide.
B. Fluid restriction.
C. Low-fiber, bland diet.
D. Bowel regimen.

A

Answer: A. its because and loperamide is a medication to control our bowel movement. Kaya nga nagka lack of bowel control dahil sa paralysis, so para ma control ang bowel, tagaan nato ug loperamide.

141
Q

Jessy who is receiving chemotherapy is not eating well but otherwise feels healthy. Which meal suggestion would be best for this Kris John?
A. Cereal with milk and strawberries.
C. Toast, gelatin dessert, and cookies.
B. Broiled chicken, green beans, and cottage cheese.
D. Steak and French fries.

A

Answer: B. Kay high fiber tapos wala sad siyay fresh fruits and vegetables.

142
Q

Mang Kanor is receiving monthly doses of chemotherapy for treatment of colon cancer. You should report which of the following laboratory results to the oncologist before the next dose of chemotherapy is administered? Select all that apply.
A. Hemoglobin of 14.5 g/dL
B. BUN of 12 mg/dL
C. Temperature of 38.4°C
D. Platelet count of 40,000
E. White blood cell count of 2,300
F. PaCO2 of 88mmHg

A

Answer: DEC (Note: Class yes taas ang PACO2 but wala shay connect sa question)

143
Q

Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries. Which of the following client is at highest risk for colorectal cancer?
a. Client Eve a 26-year -old who has been a smoker for almost a decade
b. Client Maryse a 24-year-old who has a history with Crohn’s disease
c. Client Bella a 20-year-old who was diagnosed with pancreatitis
d. Client Alicia a 27-year-old who loves fresh fruits and is a vegan

A

Answer: B. Chrons disease kay at risk sha magka colorectal cancer.

144
Q

A Greg Marvin 21-year-old male undergoes bone marrow aspiration to establish a diagnosis of possible cancer. Which statement made by Greg demonstrates proper understanding of discharge teaching?
a. “I will take morphine for pain.”
b. “I do not need to inspect the puncture site to let it heal.”
c. “I will not be able to play basketball for the next 2 days.”
d. “I can apply a warm compress only to the puncture site.”

A

Answer: C. Risk sha for lipong since RBCs carries oxygen bya sir tapos RBCS kay gkan sa bone marrow

145
Q

Other term for lung cancer

A

Bronchogenic Carcinoma

146
Q

Risk factors of lung cancer

A
  1. smoking (Pack years = #packs/day x years of smoking)
  2. Underlying Respiratory disease (COPD/PTB)
  3. Radon Gas
  4. Genetics
  5. Environmental/Occupational- Asbestos and Radiation Exposure
    
147
Q

how to calculate pack years

A

Pack years = #packs/day x years of smoking

148
Q

Signs and symptoms of lung cancer

A

-Initial: Asymptomatic
-Early: Non productive cough (later becomes productive)
-Recurring fever
-Dyspnea
-Late: Blood-tinged cough and hoarseness of voice

149
Q

Diagnostic tests for Lung Cancer

A

-Chest X-ray
-CT Scan
-MRI
-Sputum Culture
-Bronchoscopy

150
Q

Management for Lung Cancer

A

-Radiation
-Chemotherapy
-Surgery:
1. Lobectomy
2. Bilobectomy
3. Pneumonectomy

151
Q

Purpose of Post op position in patient with Lung Cancer

A

To promote lung expansion

152
Q

Post Op position in lung cancer (LUPA)

A

Lobectomy
Unaffected
Pneumonectomy
Affected

153
Q

Nursing Interventions for Lung Cancer

A

-Monitor breathing pattern and breath sounds
-administer analgesics as prescribed for pain management
-Semi-fowler’s position
-Dyspnea: Administer O2

154
Q

Common site of Colon Cancer

A

Sigmoid Colon

155
Q

Stool in Ascending and Transverse Colon

A

Watery Stool

156
Q

Predisposing factors of Colon Cancer

A

-Increase Fat Intake
-Low fiber intake
-Aflatoxins consumption
-Benzopyrine consumption
-History of GI polyps and Ulcerative Colitis 

157
Q

Manifestations of Colon Cancer

A

Depends on what site

158
Q

Ascending Colon Manifestations

A

(-) Obstruction kay liquid paman ang stool
Cauliflower mass
Occult Blood

159
Q

Descending Colon Manifestation

A

(+) Obstruction kay solid naman ang stool
Feeling of incomplete emptying
Abdominal pain LLQ
Ribbon-like stool
Gross bleeding stool

160
Q

Diagnostics in Colon Cancer

A

-Colonoscopy
-Increase CEA (protein) tumor marker

161
Q

management of Colon Cancer

A
  1. Chemotherapy - 5FU (Fluorouracil)
  2. Radiation to decrease tumor size
  3. Antibiotic - Neomycin Sulfate
  4. Surgery - Hartmann Procedure with colostomy creation (tanggal ang sigmoid)
162
Q

Signs of Colostomy Acceptance

A

-Looks the colostomy
-Ask about the colostomy
-Touch the colostomy

163
Q

cause: unknown
also an estrogen-dominance cancer

A

Cervical Cancer

164
Q

Risk factors of Cervical Cancer

A
  1. Multiple Sexual Partner
  2. Oral Contraceptive
  3. Multiparity
  4. Smoking
  5. Early age coitus/pregnancy (16 y/o)
165
Q

Prevention of Cervical Cancer

A

Pap smear - done yearly, starting 21 y/o

166
Q

Early Signs and Symptoms of Cervical Cancer (PAINLESS)

A
  1. Post coidal bleeding
  2. Metrorrhagia - bleeding between menses
  3. Menorrhagia - Prolong menstruation
  4. Malodorous discharges
167
Q

late signs and symptoms of Cervical Cancer (Naa nay PAIN)

A
  1. Bleeding (dark, foul odor)
  2. Anemia
  3. Weight Loss
  4. Pain (Pelvic, Low back, Flank) - signs of metastasis
168
Q

Tumor markers of Cervical Cancer

A

BRCA 1 & BRCA 2

169
Q

Management of Cervical Cancer

A
  1. Radiation and Chemotherapy
  2. Surgery:
    -Conization: Removal of cone-shaped mass
    -Cryotherapy: Freezing and destroying cervical tissue
    -TAHBSO
170
Q

Androgen-dependent cancer

A

Prostate cancer

171
Q

Risk factors of Prostate Cancer

A

-Smoking
-Increase history of sexual activity
-African-American
-Fat/obese
-Family History
-History of STD

172
Q

Diagnostics of Prostate Cancer

A

Digital Rectal Exam
Increase Prostatic Specific Antigen (PSA)
Increase Serum Phosphate

173
Q

Contraindicated to patient with cardiac problems (vagal stimulation) low hr, bp, rr

A

Digital Rectal Examination

174
Q

Normal and Abnormal Prostate when doing Digital Rectal Exam

A

Normal: Soft and Tender, rubbery (bouncy), (+) sulci-scrotum grooves like (kanang sa siko na texture)

Abnormal: Hard and boggy

175
Q

Gold Standard for prostate cancer test
N: 0.4 ng/ml

A

Increase Prostate Specific Antigen (PSA)

176
Q

indicates metastasis to pelvic bone

A

Increase serum phosphate

177
Q

Signs and symptoms of Prostate Cancer

A
  1. Early: Asymptomatic
  2. Urinary Obstruction
  3. Hematuria
  4. Painful urination
  5. Back pain
178
Q

Drug of Choice for Prostate Cancer

A

Lupron
Diethyl stilbestrol

179
Q

Surgery for Prostate Cancer

A
  1. Prostatectomy
  2. Transurethral Resection of the Prostate (TURP)
180
Q

Post op continuous bladder irrigation
Cytoclysis
Fast drip

A

TURP

181
Q

Flushes the bladder with sterile liquid or NSS
Purpose: Remove and prevent blood clots accumulated from TURP procedure

A

Continuous Bladder Irrigation

182
Q

Continuous Bladder Irrigation:

Color of Outflow

A

Reddish-pink during 1st 24 hours WITHOUT CLOT

183
Q

Continuous Bladder Irrigation:

If with clots

A

Increase irrigation flow

184
Q

Continuous Bladder Irrigation:

If with clear color

A

Decrease Irrigation Flow

185
Q

Increase of immature WBC
Common cause: Hypoplasia of bone marrow

A

Leukemia

186
Q

2 types of WBC

A
  1. Bands - Baby/Immature WBC
  2. Segmenters (Segs) - Mature WBC
187
Q

2 Type of Leukemia

A
  1. Acute Myeloid Leukemia (MATANDA)
  2. Acute Lymphoid Leukemia (LIIT)
188
Q

Pathophysiology

A

Decrease Bone Marrow Activity
-decrease RBC: Anemia
-Increase immature cells: Risk for infection
-Decrease Platelet: Risk for bleeding

189
Q

Diagnostics in LEUKEMIA

A

Bone Marrow Aspiration

190
Q

Bone Marrow Aspiration SITE

A

PeDIA - TiBIA
Adult - Ileac Crest

MedSurg (5 decks)

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