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PNUR 151 - Variations in Health > Class 6 - Immune System And Cancer > Flashcards

Class 6 - Immune System And Cancer Flashcards

0
Q

Modifiable risk factors

A 
Smoking
Obesity
Lack of exercise
Poor eating habits
Sun exposure
Heavy alcohol consumption
Exposure to carcinogens
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1
Q

Prevalence

A

Total number of people who are living with a disease

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2
Q

The increased incidence of cancer with age could result from?

A

Age related changes that reduce the ability to resist disease or prolonged exposure to carcinogens.

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3
Q

Classifications systems for for cancer provide a standardized way to?

A 
Communicate with the health care team
Assist in determining the most effective treatment plan
Evaluate treatment plan
Determine prognosis
Compare group statistics
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4
Q

There are 4 types of classification systems. What are they?

A

Anatomic site classification:
Identified by tissue of origin

Histological analysis classification:
Appearance of cells and the degree of differentiation
Poorly differentiated tumours have a worse prognosis

Clinical staging classifications:
Stage 0- cancer in situ
Stage 1- limited to tissue of origin
Stage 2- limited local spread
Stage 3- extensive local and regional spread
Stage 4- metastasis

TNM classification:
T- Tumor size
N- spread to lymph nodes
M- metastasis

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5
Q

define cancer

A

characterized by uncontrolled and unregulated growth of cells.

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6
Q

define carcinoma in situ

A

cancer that has stayed in place where it began and has not spread to neighbouring tissue.

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7
Q

define carcinomas

A

a cancer arising in the epithelial tissue of the skin or of the lining of the internal organs.

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8
Q

define benign neoplasm

A

non cancerous forms of tissue proliferation such as skin moles or uterine fibroids. These do not become cancerous and mainly cause problems due to their space occupying nature.

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9
Q

define malignant neoplasm

A

this is cancer.

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10
Q

define chemotherapy

A

the treatment of disease by the use of chemical substances, especially the treatment of cancer by cytotoxins and other drugs.

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11
Q

define biopsy

A

involves histological examination by a pathologist of a pice of tissue.

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12
Q

define angiogenesis

A

process of the formation of blood vessels within the tumor itself.

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13
Q

define TAAs or tumor associated antigens

A

changes in the cancer cells surface as a result of malignant transformation.

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14
Q

define immunological surveillance

A

response of the immune system to antigens of the malignant cells.

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15
Q

define immunological escape

A

process by which cancer cells evade the immune system

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16
Q

define staging

A

classifying the extent and spread of the disease

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17
Q

define needle biopsy

A

cells and tissue fragments are obtained through a large-bore needle guided into the tissue

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18
Q

define incisional biopsy

A

performed with a scalpel or dermal punch is a common technique for obtaining a tissue sample

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19
Q

define excisional biopsy

A

removal of the entire tutor. Usually done a tutor less than 2cm in diameter, skin lesions, intestinal polyps and breast masses

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20
Q

define colony-stimulating factors

A

a family of glycoproteins produced by various cells. These cells stimulate production, maturation, regulation and activation of cells

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21
Q

define aneuploidy

A

condition in which the number of chromosomes in the nucleus of a cell is not an exact multiple of the monoploid number of a particular species. An extra or missing chromosome is a common cause of genetic disorders including human birth defects.

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22
Q

define autoimmune disease

A

when the body produces antibodies that attack its own tissues. Ex: psoriasis, lupuis

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23
Q

define opportunistic infections

A

an infection that takes advantage of a person with a weakened immune system.

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24
Q

What are some age-reated immune changes

A
  • impaired function of T and B lymphocytes
  • failure of lymphocytes to recognize abnormal cells
  • decreased antibody function
  • suppressed phagocytic immune response
    (phagocytic = cells that ingest harmful foreign debris)
25
Q

What are some age-related GI changes

A
  • decreased gastric secretions and motility
  • decreased phagocytosis by the liver’s Kupffer cells
  • altered nutritional intake wih inadequate protein intake
26
Q

What are some age-related urinary changes

A
  • decreased kidney function and changes in lower urinary tract function
  • altered GU tract flora (ex: higher pH is better for for bacteria growth)
27
Q

What are some age-related pulmonary changes

A
  • impaired cilliary action d/t exposure to smoke and environmental toxins
28
Q

What are some age-related skin changes

A
  • thinning of the skin
  • loss of elasticity
  • loss of adipose tissue
29
Q

What are some age-related circulatory changes

A
  • impaired microcirculation

circulation at the capillary level

30
Q

What are some age-related neurological changes

A
  • decreased sensation

- slowing of reflexes

31
Q

Classification systems provide a standardized way to:

A
  • communicate with health care team
  • assist in determining the most effective treatment plan
  • evaluate treatment plan
  • determine prognosis
  • compare groups statistically
32
Q

What is anatomical site classification

A
  • identified by tissue of origin, the area on the body it is located and the behaviour of the tumor (benign or malignant)
33
Q

What is histological analysis classification

A
  • appearance of cells and the degree of the differentiation are evaluated to determine how closely cells resemble tissue of origin
  • poorly differentiated tumors have a worse prognosis than those closer in appearance to normal cells
34
Q

What is clinical staging classification

A

Stage 0 = cancer in situ
Stage 1 = tumor limited to tissue of origin
Stage 2 = limited local spread
Stage 3 = extensive local and regional spread
Stage 4 = metastasis

35
Q

What is TNM classification

A
  • it is the anatomic extent of the disease based on three parameters:
    1. T = tumor size and invasiveness
    2. N = spread to lymph nodes
    3. M - metastasis
36
Q

Nursing roles related to cancer

A
  • demonstrate discretion
  • encourage healthy lifestyle choices
  • educate patients about screening for cancer
  • facilitate their efforts to obtain tests
37
Q

When patient is experiencing anxiety the nurse should

A
  • give clear explanations and repeat them if necessary
  • give written information for reinforcement
  • actively listen to clients concerns
38
Q

Collaborative care includes:

A
  • goals
  • curative therapy (sx alone or periods of systemc therapy)
  • control treatment
    (initital course and maintenance therapy)
  • palliative goal (relief or control of symptoms and maintain quality of life)
39
Q

Factors that determine the way a cancer is treated

A
  • cell type
  • location /size of tumor
  • extent of disease
  • physiological/psychological status
  • express needs and desires
40
Q

Surgical therapy is

A

removal of the tumor and a margin of the surrounding normal tissue may cure localized tumors, but is ineffective if the cancer has metastasized to other locations

41
Q

Chemotherapy

A
  • use of chemicals as systemic therapy for cancer
  • goal is to reduce number of malignant cancer cells in the tumor
  • most common for solid and hematological cancers
42
Q

Handling chemotherapy agents

A
  • can pose an occupational hazard
  • drugs may absorb through the:
    *skin
    *inhaled during preparation or
    when administered
    *only properly trained personnel should
    handle drugs
43
Q

The effects of chemotherapy on normal tissue

A
  • it cannot tell the difference between normal cells and cancer cells
  • body’s response to cellular destruction (fatigue, anorexia, taste alterations)
44
Q

Older adults and chemotherapy

A
  • advanced age can affect the movement of and distribution of the cytotoxic drugs in the body
  • this increases the risk of complications for (constipation, dehydration, malnutrition, infection)
45
Q

Radiation therapy

A
  • localized treament mode

- has a central role in the treatment of cancer

46
Q

Effects of radiation therapy on the cells

A
  • cellular damage can be lethal or sublethal
  • normall tissues are usually able to recover
  • cancer cells are more likely to be permanently damaged
  • radiation therapy can be delivered externally or internally
47
Q

Radiation therapy can be used in the fight against cancers as?

A
  • the primary therapy
  • as an adjuvant with another therapy
  • as a prophylaxis
  • for disease control
  • palliative
48
Q

Common side effects of radiation therapy

A
  • fatigue
  • anorexia
  • pulmonary effects
  • GI disturbances
  • reproductive effects
49
Q

Biological therapy

A
  • effective alone or with surgery, radiation and/or chemotherapy
  • biological therapies (agents alter biological response to tumor cells)
50
Q

Targeted therapy

A
  • targets and binds to cell receptors important to the tumors growth
51
Q

Bone marrow and stem cell transplantation

A
  • allows high doses for treatment to clients where tumors are:
    *failing to respond to standard doses of
    chemotherapy or radiation
    *or have developed a resistance
52
Q

Effects of bone marrow/stem cell transplantation

A
  • has many risks including death
  • highly toxic
  • overall cure rates still low, but increasing
53
Q

Gene therapy is

A
  • transfer of genes from somewhere else into cells of a client in an effort to correct defective gene
  • this approach is currently still in the investigative stages
54
Q

The development of cancer has three stages what are they?

A

Stage 1 - Initiation
this is the mutation in the cells genetic structure from an error that occurs during DNA replication or after exposure to a carcinogen

Stage 2 - Promotion
this is the reversible proliferation of the altered cells.

**NOTE: an important distinction btw inititation and promotion is that the activity of the promotors is reversible. Promotors are, diet, obesity, smoking, alcohol consumption

Stage 3 - Progression
this is the increased growth rate of the tumoras well as the increased invasiveness and spread of the cancer (metastasis)

55
Q

Histological grading is grade 1 through 4, what are they

A

Grade 1 - cells differ slightly from normal cells (mild dysplasia) and are well differentiated

Grade 2 - cells are more abnormal (moderate dysplasia) and moderately differentiated

Grade 3 - cells are very abnormal (severe dysplasia) and are poorly differentiated

Grade 4 - cells are immature and primitive (anaplasia) and undifferentiated; cell of origin is difficult to determine

56
Q

Seven warning signs of cancer are

A

C A U T I O N

C = change in bowel or bladder habits
A = a sore that does not heal
U = unusual bleeding or discharge from any               
          body orifice
T = thickening or a lump in the breast or  
          elsewhere
I = indigestion or difficulty swallowing
O = obvious change in a wart or mole
N = nagging cough or hoarseness
57
Q

diagnostic studies that could be used in cancer detection

A
  • cytology
  • hematology
  • sigmoidoscopy/colonoscopy
  • CXR
  • biopsy
58
Q

nursing management of cancer pain

A
  • accept pain as patient reports it
  • drug therapy includes: NSAIDS, opioids and
    adjuvant analgesics
  • analgesics should be given around the clock with a breakthrough doses as needed.
  • pain meds are given in a large enough dose to keep pain under control
  • non pharmacological therapies include
    (relaxation therapy and imagery)
59
Q

What factors may determine how a client will cope with a diagnosis of cancer?

A
  • ability to cope with stressful events
  • availablility of significant other
  • ability to express feelings and concerns
  • age at the time of Dx
  • extent of the disease
  • disruption of body image
  • presence of symptoms
  • past experience with cancer
  • attitude associated with cancer
60
Q

nursing centered care for the patient would include

A
  • being available for discussion with the patient and family, especially in difficult times
  • actively assess patients needs for counselling or other services
  • listen actively for fears and concerns
  • provide essential information as the patient asks for it and be sensitive to information overload
  • offer strategies for enhanced coping abilities
  • establish a therapeutic relationship
  • be “present” with the patient to offer comfort and assistance
  • encourage normal ADLs
  • consider spiritual aspects of care
  • encourage patient to participate in their care.
61
Q

Characteristics of cancer cells

A
  • divide rapidly
  • they are indiscriminate
  • nucleus in cancer cells is larger than in normal cells
  • cancer cells have no function
  • they can break away from each other easily
  • they grow by invasion
  • they are contact inhibited (they keep dividing even when they hit a wall, they keep going)
  • they can metastasis (move or migrate)

PNUR 151 - Variations in Health (5 decks)

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