Cellular Regulation : Nursing Care Flashcards
zimpaired cellular regulation : general info
what is the one thing we do first ?
make the diagnosis : we do this thorugh biopsy
recall that one thing we have to do is make the diagnosis when it comes to impaired cellular regulation, what else?
further testing to help with grading and staging, TNM classification
what is our goal of treatment ? for impaired cellular regulation ?
cure, control, or palliation, minimize tx side effects
what is the methods of treatment when it comes to impaired cellular regulation
surgery, radiation therapy, chemotherapy, hormonal therpahy, targeted theraphy, biologic theraphy, and bone marrow or hematopoietic stem cell transplants
identify if below are methods of treatments when it comes to impaired cellular regulation:
surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy, biologic therapy, and bone marrow or hematopoietic stem cell transplants
yes all of the above
methods of tx : are surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy, biologic therapy, and bone marrow or hematopoietic stem cell transplants
these support cel recovery with hematopoietic growth factors
recall that surgery could be a use of treatment of cancer, what determines this ?
surgery is dependent on where the cancer is
true or false. people with cancer are not only in one unit, they are scattered everywhere in terms of placements.
true
_____ is one of the things help suppress bone marow to get good cells , we are talking to immunity here and less damage to the body as possible.
gastrin
effects of cancer and cancer treatments :
immunity and clotting what undergoes this
WBC - neutrophil - neutropenia - nadir- absolute neutrophil count” ( ANC )
- anemia
-thrombocytopenia
thinking abt anemia , along with low WBC they typically have low blood cells count why ?
due to the chemo
what are symptoms of anemia ?
this is a low hemoglobin ( therefore they may feel tired, SOB, no energy )
what does nadir mean ?
lowest point of white blood cell count
why is absolute neutrophil count important ?
its important since it shows us how immunocompoms the patient is
true or false. we could get an ANC at 0 which means the pt has 0 immune system.
true
true or false. Cancer treatment could also cause imapired clotting, they do not have platelets, which means they do not stop the body from bleeding.
true
is gi affected during cancer treatments ?
yes : cachexia, functioning of gi tract, and liver is affected as well
why is cachexia occurring ?
the body spends a lot of energy and not able to absorb food and give energy
( people become thin )
functioning of gi tract , how does this affect the body ?
high metabollic rate, no appetite, and ability to change and can be nauseated
( they really have to fight themselves to get nutrients in )
functioning of the liver : how does this impact the body
impacts metabolic functioning ( they cannot give food, and keep fat and get energy )
what undergoes peripheral nerve sensory perception
as an effect of cancer treatment
( rare ) pt may have tumor in spine
( common neurotoxic chemo - reduced sensory perception )
( rare ) pt may tumor in spine ( can u explain this )
change in their peripheral nerve, peripheral system , because of the tracts running in the core
true or false. sensation in their feet, numbers and going downstairs ( more likely to trip )
neuropathic pain ( terrible pain )
true
central motor and sensory function is one of the effects of cancer/cancer treatments what undergoes this
cancer invades bone or brain ( bone fractures, ) hypercalcemia
what happen in central motor and sensory function
much more likely to have a bone fracture , even if they trip ( what there bone from treatment ) much more likely going to break
true or false. patients mobility of the pt ( anything that has to do with central or sensory ) think abt walking and moving.
true
what undergoes resp function
moving and expanding of the lungs will be affected
what undergoes resp funcion
tumor in lung
pleural effusion
compression on vessels, lymph glands
what could tumor in the lung do in terms of resp?
can impair their breathing , very common in cancer ( even if it has nothing to do with the lungs )
What is happening within the pleural effusion
very common in cancer, ( even if it has nothing to do with the lungs ) , if there is a tumour compressing on vessels ( impairs their lungs, their breathing )
true or false. is cancer of the heart common ?
no it’s usually not common
can drugs be somehow cardiac toxic ( hard on the heart ) what can happen ?
can make scar tissue, or make a valve not work as it should
if it’s a severe impact , the pt may impact a heart failure related to the treatment to their cancer.
cardiac function
comfort and quality of life is very important. why is it important for our pt ?
cancer pain - management of the pain and the side effects of the meds to treatments ( drowsiness, constipation )
true or false. if we treat cancer , we have to treat side effects that comes with the drugs ) what typically goes away ?
drowsiness typically goes away however constipation doesnt go away
cancer pain
- can be severe , think of pt’s quality of life
what meds do u think they’ll be on in terms of pain?
narcotics ( morphine, hydromorphone/dilaudid, fentanyl )
adjuvants ( additional meds )
doses can be large
what do u consider in cancer pain ?
effectiveness and side effects
regular dosing and PRN for breakthrough
- oral ( po-pll, liquid ) easiet
true or false. we want to be consistent ( q-4 -q6 ) for breakthrough ( alot of infuse tranfusions especially if its palliative pain )
true
continious, infusions, fentanyl transdermal patch are typically seen in cancer pain
yep true
chemo adminsitration
protocol
handling precautions
specific RN training
often combo of drugs given
timing is really important
is true in terms of chemo admin
yes true
what are routes for chemo to go through
IV- peripheral IV, tunneled catheters, PICC, port a cath
what are the complications for chemo?
extravasation injury from infiltration of chemo meds
irritant/vesicant
pros/cons to peripheral IV access compared to venous access device
true or false. when you have a PICC line u do not want to be wet ( the insertion site ) because why ?
true, because it increases the risk of infection
could we take bloodwork from picc line?
yes we can
what is the line that is known to be “ little kid friendly “
port a cath
port a cath has no ____ coming
primarily what they do for kids
line , port a cath
effects of chemo on normal tissue
what is ur body feeling
body responds to the destruction of cells
fatigue, anorexia, taste alteration
effects of chemo on normal tissue
what are some adverse effects
acute, delayed, or chronic, alopecia
what is a cold cap therpahy intially help?
decrease the chance of losing hair ( encourage wearing hats, wigs, scarfs )
true or false. a good example of a chronic side effect of chemo on normal tissue is heart failure : peripheral neuropathy ( there feet is numb and tightly and cannot walk downstairs feeling normal )
true
can these all occur during cancer ?
nausea and vomitting
diarrhea
nutrition
what undergoes eating and food choice?
eating
- food appearance and smell
food choice
-diarrhea-food, fluid intake——– imodium
-nutritious & able to eat/tolerate
what is one antiemetic that is used during cancer treatments?
ondansetron
what is the route given for ondansetron ?
either PO or IV
what is the appearance like typically in cancer
cachexic, muscle mass, moon face
during weight assesment we have to think “ weight “ is it body mass or retained fluid ?” ( calorie counts )
yes
Recall that focusing on muscle mass and see if they maintain there weight is important
small frequent meals ( avoid fatty foods ) since it could bring in more nausea, avoid hot foods, or spicy foods, another thing is DO NOT LAY DOWN after eating.
JUST READ : to avoid hot food
- eat more cold or luke warm food
- hot food carries strong smells and people going through treatments have strong smell ( make them sick )
milkshake, ensure, and thing u can add to add extra protein or calories should be encourage
yes
what is a better position after eating ?
sitting up is better when it starts to digest- clears your stomach dont drink ur fluid with the meal ( fill ur stomach ) try to have nutrients and then drink ur water
is radiation theraphy painful ?
yes it is painful
what is radiation therapy ?
kill cancer cells, want minimal effect on surrounding ( normal ) cells
can radiation therapy be local or systemic ?
yes it can be local or systemic
radiation therapy method of delivery :
external radiation
internal radiation - brachytherpahy ( seeds, ribbons, capsules )
radiosurgery, gamma knife
during an external beam radiation , there is a tattoo, what does that indicate?
permanent tattoo as part of tattoo and done the treatment they turn into a different type of tattoo
radiation effects & treatment acute & long term
site of radiation– organ or body site with cancer
what is skin for radiation effects & treatment : acute & long term
skin– radiation dermatitis; dry, itchy ( pruritis ), may break down
what undergoes radiation effects and treatment
under skin of radiation – organ or body site with cancer
tattoo/ink markings
skin protection- cleaning
—- avoid friction
—-photosensitive & heat sensitive
head and neck – xerostomia ( dry mouth, ) tooth decay- dental care prior to tx
true
what is the systemic effects
fatigue
altered taste
bone marrow suppression
where are beams going through?
through our skin , ( think abt their skin ) they can develop radiation dermatitis
what can radiation dermatitis lead to ?
lead to an open wound because radiation has broken down into those skin cells
if they have a tattoo or ink marking ( do not wash ) why do we want not wash it ?
we need it for treatment
when it comes to cleaning, be careful !
don’t exfoliate and scented things ( do not use them ) !it got dyes –> so be careful!
how do we avoid friction ?
lose fitting clothing is good, no tight belts, breast cancer have problems ( wearing a bra ( friction of the material ) have to find alternative
head and neck cancer - use radiation is their mouth ( they have tooth decay from it )
true
skin should be moisturized ( external beam radiation )
yes this is true
true or false. avoid alcohol-based cleaners/creams, avoid retinol creams
true
true or false. avoid exposure to sun and heat.
true
radiation therapy : sealed implant “
safety -
reduce exposure to ionizing radiation
– intensity, duration, closeness
radiation therapy “sealed implant”
if they have implant in them
they are radioactive, with the hope of consistently killing the cancer
is it true or false. implant cannot be shut off anytime–> we have to be aware of following policies from xray exposure and any visitors
true