1
Q
Leading causes of death in the world
A
Cancer
2
Q
Enumerate the 3 schema of cancer development
A
Initiation
Promotion
Progression
3
Q
schema of cancer development: Initiation
A
carcinogens bind and cause mutation to target cell resulting to the dysfunction in differentiation and proliferation
4
Q
schema of cancer development: Promotion
A
initiated cells are stimulated by promoters which results in these cells on becoming cancerous
5
Q
schema of cancer development: Progression
A
stimulates angiogenesis which makes this cancer cell to infect adjacent tissue and travel to other areas, or metastasis
6
Q
Primary detection and prevention (4)
A
- health promotion
- immunization
- HPV vaccine
- risk reduction strategies
7
Q
Secondary detection and prevention
A
- screening and early detection for precancerous and asymptomatic px
8
Q
Tertiary detection and prevention (2)
A
- monitoring and preventing recurrence of primary cancer
- screening for the development of second malignancies (leukemia, lymphoma)
9
Q
Family history assessment (3)
A
- both maternal and paternal sides
- cancer history of at least three generations
- look for clustering of cancers
10
Q
signs and symptoms of cancer (9)
A
CAUTION US C - change in bowel or bladder habits A - a sore that does not heal U - unusual bleeding or discharge T - thickening or lump in the breast I - indigestion or difficulty swallowing O - obvious change in wart or mole N - nagging cough or hoarseness
U - unexplained anemia
S - sudden weight loss (5kg or more)
11
Q
S&S Bladder , Kidney
A
Blood in urine; pain and burning with urination; increased frequency or urination
12
Q
S&S Breast
A
Lump (s), thickening, physical changes in the breast; itching, redness, nipple
soreness not associated with breast-feeding or menstruation
13
Q
S&S Cervical and
Uterine
A
Bleeding between menstrual periods; unusual discharge; painful menstrual
periods; heavy periods
14
Q
S&S Colon
A
Rectal bleeding; bloody stool; changes in bowel habits constipation
15
Q
S&S Endometrial
A
Same signs as for cervical and uterine cancers above
16
Q
S&S Laryngeal
A
Persistent cough; hoarse throat
17
Q
S&S Leukemia
A
Paleness; fatigue; weight loss; repeated infections; easy bruising; bone and joint pain; nosebleeds
18
Q
S&S Lung
A
A persistent cough, sputum with blood; heavy chest and or chest pain
19
Q
S&S Lymphoma
A
Enlarged, rubbery lymph nodes; itchy; night sweats; unexplained fever, weight loss
20
Q
S&S Mouth and
Throat
A
A chronic ulcer of the mouth, tongue, or throat that does not heal
21
Q
S&S Ovarian
A
Often no obvious symptoms until it is in later stages of development
22
Q
S&S Prostate
A
Weak ,interrupted urine flow; continuous pain in lower back, pelvis, upper thighs
23
Q
S&S Skin
A
Tumor or lump under the skin, resembling a wart of an ulceration that never heals; moles that change color or size, flat sores; lesions that look like moles
24
Q
S&S Stomach
A
Indigestion and pain after eating; weight loss; blood in vomit
25
the leading cause of cancer deaths in both men and women
Lung cancer
26
the overwhelming risk factor for developing lung cancer
Cigarette smoking
27
Clinical manifestations of lung cancer (7)
chronic cough, pleuritic chest pain, hoarseness, weight and/or appetite loss, hemoptysis, dyspnea, and recurring pulmonary infections
28
Diagnostic tests for lung cancer (3)
chest x-ray, sputum test, biopsy
29
confirmatory test for cancer
tissue biopsy
30
Lung cancer intervention: lifestyle modification (4)
healthy diet, smoking cessation, decreased alcohol consumption, and exercise
31
Lung cancer: food intake (2)
- Increasing calories to 2500 daily
| - five or six small meals a day more easily tolerated, and it may minimize the nausea effects of chemotherapy
32
Lung cancer: fluid intake
- monitor for fluid overload and especially for pleural effusions
33
thoracotomy nursing post-care
- practice arm exercises to ensure continued mobility and promotion of lung expansion.
34
these interventions will assist in the removal of
| organisms in the lungs.
Cough and deep breathing exercises every one to two hours while awake
35
these interventions use gravity to clear secretions,
| while percussion uses vibrations to loosen secretions. (2)
Chest physiotherapy and postural drainage
36
this intervention will not only promote mobility but also increase patient outcomes from chest
physiotherapy and cough and deep breathing exercises
Effective pain control
37
Close monitoring of pain medication side effects include: (2)
risk of falls and aspiration secondary to CNS effects
38
e an effective method
| to maintain mobility and provide rest.
Walking three to four times a day with rest periods of at least two hours
39
interventions used to decrease the body’s oxygen demands
Rest periods and limiting activity
40
Patient safety for fall prevention (2)
- bathroom is accessible or that a
commode is placed near the bed
- Avoid clutter in the room or floor that the patient may have to step over and possibly fall.
41
can occur as a result of the chemotherapy effects
Confusion
42
used to treat the cancer or decrease side effects of tumor compression or metastasis.
laser
| surgery
43
selectively places a thin tube into the artery that supplies the tumor
embolization
44
Support groups for lung cancer (3)
- American Cancer Society,
- American Lung Association, and
- National Comprehensive Cancer Network
45
used as the main treatment of lung cancer to relieve such
| symptoms as pain, bleeding, or passages blocked by the cancer
External beam radiation
46
External beam radiation dosage
usually given in daily doses five days a week for six to eight weeks.
47
places radioactive material inside the lung but may lead to lung damage.
Brachytherapy or internal radiation
48
most common type of cancer in women
Breast cancer
49
Although men are diagnosed with this
| cancer, it remains a predominately female disease
Breast cancer
50
Besides being female, age is the most important risk factor for this cancer
Breast cancer
51
history taking of a breast mass includes (3)
- length of time it has been present,
- whether it has changed in size, and
- any associated
tenderness
52
physical examination for breast cancer
Evaluation of the skin, nipples, breast tissue, and axillary and supraclavicular lymph nodes.
53
Clinical manifestations for breast cancer (6)
- Nipple retraction/ elevation
- Nipple discharge or erosion
- Skin dimpling /retraction
- Heat and erythema of the breast skin may be r/t inflammation
- Skin edema, or peau d’orange, “skin of the orange”
- Palpable lesions
54
due to tumor fixation or infiltration into the underlying tissues of the breast
Nipple retraction/ elevation
55
due to invasion of the suspensory ligaments and fixation to the chest wall.
Skin dimpling /retraction
56
is thought to be due to the invasion and obstruction of dermal lymphatics by tumor
Skin edema, or peau d’orange, “skin of the orange”
57
Diagnostic tests for breast cancer (3)
- mammography
- breast utz
- fine needle aspiration biopsy
58
developed at the start of hormonal
| therapy or with the discontinuation of HRT at the time of diagnosis of breast cancer.
hot flashes
59
Measures that
| may help with symptoms of hot flashes include: (3)
a. Clonidine, belladonna/ ergotamine/phenobarbital, antidepressants.
b. Various supplements and herbs
c. Progesterone
60
complication characterized by a chronic swelling of an extremity due to
interrupted lymphatic circulation.
Lymphedema
61
due to the accumulation of protein-rich fluid in the interstitial space and is a somewhat common postoperative complication after ALND.
Swelling
62
is associated with a painful swelling of the arm as well as, weakness, shoulder pain, and tingling sensations in the arm and shoulder.
Lymphedema
63
results if functioning lymphatic channels are inadequate to ensure a return flow
of lymph fluid to the general circulation.
Lymphedema
64
intervention to help reduce the transient edema
Teach ROM exercises like elevating the arm above the heart several times a day, and gentle muscle pumping
65
may occur after either mastectomy or
| breast conservation within the first twelve (12) hours after surgery
Hematoma formation (collection of blood inside a cavity)
66
signs and symptoms of hematoma at the surgical site (4)
swelling,
| tightness, pain, and bruising of the skin.
67
a collection of serous fluid, may accumulate under the breast incision after mastectomy or breast conservation or in the axilla
seroma
68
Signs and symptoms of seroma (4)
swelling, heaviness, discomfort, and a sloshing of fluid
69
signs and symptoms of infection for patient education (5)
(redness, warmth around incision, tenderness, foul-smelling drainage, temperature greater than 40 degrees Celsius [100.4 degrees Fahrenheit] chills)
70
What are Health Teachings about Monitoring and Managing Potential Complications for Breast Cancer? (9)
The nurse instructs the patient to:
Avoid blood pressures, injections, and blood draws in affected extremity;
Use sunscreen (higher than 15 SPF) for extended exposure to sun;
Apply insect repellent to avoid insect bites
Wear gloves for gardening
Use cooking mitt for removing objects from oven
Avoid cutting cuticles; push them back during manicures
Use electric razor for shaving armpit
Avoid lifting objects heavier that 5-10 pounds
If a trauma or break in the skin occurs, was the area with soap and water, and apply an over-the-counter antibacterial ointment (Bacitracin or Neosporin). Observe the area and
extremely for 24 hours; if redness, swelling, or a fever occurs, call the surgeon or nurse.
71
Exercise After Breast Surgery (4)
- Wall handclimbing
- Rope turning
- Rod or broomstick lifting
- Pulley tugging.
72
Stand facing the wall with feet apart and toes as close to the wall as possible. With elbows slightly bent, place the palms of the hand on the wall at shoulder level. By flexing the fingers, work the hands up the wall until arms are fully extended. Then reserve the process: hands down to the starting point.
Wall handclimbing.
73
Tie a light rope to a doorknob. Stand facing the door Take the free end of the rope in the hand on the side of surgery. Place the other hand on the hip. With the rope-holding arm extended and held away from the body (nearly parallel with the floor), turn the rope, making as wide swings as possible. Begin slowly at first; speed up later.
Rope turning.
74
Grasp a rod with both hands, held about two (2) feet apart. Keeping the arms straight, raise the rod over the head. Bend elbows to lower the rod behind the head. Reverse maneuver, raising the rod above the head, then return to the starting position.
Rod or broomstick lifting
75
Toss a light rope over a shower curtain rod or doorway curtain rod. Stand as close to the rope as possible. Grasp an end in each hand. Extend the arms straight and away from the body. Pull the left arm up by tugging down with the right arm, then the right arm up and the left down in a see-sawing motion.
Pulley tugging
76
Wall handclimbing.
Stand facing the wall with feet apart and toes as close to the wall as possible. With elbows slightly bent, place the palms of the hand on the wall at shoulder level. By flexing the fingers, work the hands up the wall until arms are fully extended. Then reserve the process: hands down to the starting point.
77
Rope turning.
Tie a light rope to a doorknob. Stand facing the door Take the free end of the rope in the hand on the side of surgery. Place the other hand on the hip. With the rope-holding arm extended and held away from the body (nearly parallel with the floor), turn the rope, making as wide swings as possible. Begin slowly at first; speed up later.
78
Rod or broomstick lifting
Grasp a rod with both hands, held about two (2) feet apart. Keeping the arms straight, raise the rod over the head. Bend elbows to lower the rod behind the head. Reverse maneuver, raising the rod above the head, then return to the starting position.
79
Pulley tugging
Toss a light rope over a shower curtain rod or doorway curtain rod. Stand as close to the rope as possible. Grasp an end in each hand. Extend the arms straight and away from the body. Pull the left arm up by tugging down with the right arm, then the right arm up and the left down in a see-sawing motion.
80
Follow-up for breast cancer
seen every 3 mos for the first 2 yrs,
every 6 mos for the next 3 yrs, and
once per yr after 5 yrs.
81
it important to have mammogram
yearly
82
a medical management for breast cancer that yields long-term survival equivalent to that associated with modified radical mastectomy.
Lumpectomy coupled with axillary dissection and radiation
83
carcinogens bind and cause mutation to target cell resulting to the dysfunction in differentiation and proliferation
schema of cancer development: Initiation
84
initiated cells are stimulated by promoters which results in these cells on becoming cancerous
schema of cancer development: Promotion
85
stimulates angiogenesis which makes this cancer cell to infect adjacent tissue and travel to other areas, or metastasis
schema of cancer development: Progression
86
disease that occurs in younger men between age 15 and 35. I
Testicular cancer
87
is the most treatable form of urologic cancer.
Testicular cancer
88
Clinical Manifestations: Testicular cancer (3)
1. Painless swelling or enlargement of the testis; accompanied by sensation of heaviness in scrotum.
2. Pain in the testis (if patient has epididymitis or bleeding into tumor).
3. Symptoms of metastatic disease: cough or dyspnea, lymphadenopathy, back pain, GI symptoms,
lower-extremity edema, or bone pain.
89
Diagnostic Evaluation: Testicular cancer (4)
1. Elevated serum markers
2. Scrotal ultrasonography
3. Chest x-ray
4. CT scanning of chest, abdomen, and pelvis
90
Diagnostic Evaluation: Testicular cancer Elevated serum markers (3)
1. human chorionic gonadotropin
2. lactic acid dehydrogenate, and
3. alpha-fetoprotein
91
Testicular cancer: used to identify location of lesion and differentiate bet solid and cystic lesion
Scrotal ultrasonography—
NCM 111 - Medical-Surgical Nursing
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