Exam 1: Cancer development and care/ End of life care

Question 1

Staging of cancer: T

Answer 1

T- Primary Tumor
Tx- Primary tumor cannot be assessed
To- No evidence of primary tumor
Tis- Carcinoma in situ
T1, T2, T3, T4- Increasing size and/or/local extent of the primary tumor

Question 2

Staging of cancer: N

Answer 2

N- Regional lymph nodes
Nx- regional lymph nodes cannot be assessed
No- No regional lymph node metastasis
N1, N2, N3- Increasing involvement of regional lymph nodes

Question 3

Staging of cancer: M

Answer 3

M- Distant Metastasis
Mx- Presence of distant metastasis cannot be assessed
Mo- no distant metastasis
M1- Distant metastasis

Question 4

Tumor lysis syndrome: what is it, symptoms

Answer 4

• Large number of tumor cells are rapidly killed by chemotherapy or radiation
• lymphoma, leukemia, multiple metastatic conditions

symptoms

• Major change in electrolytes and uric acid- potassium, phosphate, and uric acid are released into circulation
• chvostek’s sign, trousseau’s sign- hypocalcemia
• hyperactive Deep Tendon Reflex
• Prolonged QT intervals
• Death from renal failure or cardiac arrest

more fluids

Question 5

Superior Vena Cava syndrome

Answer 5

• superior vena cava compressed or obstructed by tumor growth
• can lead to painful, life-threatening emergency

symptoms
- may begin suddenly or gradually and may worsen when bending over or lying down

Question 6

Cancer Patient education

Answer 6

C.A.U.T.I.O.N

• Changes in bowel or bladder habits
• A sore that does not heal
• Unusual bleeding or discharge
• Thickening or lump in breast or elsewhere
• Indigestion or difficulty swallowing
• Obvious change in wart or mole
• Nagging cough or hoarseness

Question 7

Cancer treatment: Surgery

Answer 7

Oldest form of cancer treatment

• Prophylaxis
• Diagnosis
• Cure
• Control, cytoreductive
• Palliation
• Second-look surgery
• Reconstruction or rehabilitation

Question 8

Radiation therapy safety and education

Answer 8

• Teach accurate objective facts to help patient cope
• Do not remove markings
• Administer skin care
• Use lotions to protect skin according to department policy
• Avoid direct skin exposure to sunlight
• Care for xerostomia (dry mouth)
• Bone exposed to radiation more vulnerable to fracture
• Safety for others

Question 9

Cancer treatment: Chemotherapy

Answer 9

• Treatment of cancer with chemical agents
• Major role in cancer therapy
• Cures and increases survival time
• Some selectivity
• Normal cells most affected—skin, hair, intestinal tissues, spermatocytes, blood-forming cells

Question 10

Chemotherapy drugs: Antimetabolites

Answer 10

• pretends to be other cell and tricks the cancer cell

- 5-fluorouracil (Adrucil)

Question 11

Chemotherapy drugs: Antitumor antibodies

Answer 11

• interrupts the DNA synthesis

- doxorubicin (Adriamycin)

Question 12

Chemotherapy drugs: Antimitotic agents

Answer 12

• slows cell division

- paclitaxel (Toxol)

Question 13

Chemotherapy drugs: Alkylating agents

Answer 13

• inhibit cell division

- cyclophosphamide (Cytoxan)

Question 14

Chemotherapy drugs: Topoisomerase inhibitors

Answer 14

• prevent cell division

- Topotecan

Question 15

Chemotherapy drugs: Miscellaneous chemotherapeutic agents

Answer 15

• Hydroxyurea (Droxia)

Question 16

Chemotherapy patient education

Answer 16

• Avoid food sources containing bacteria
  Fresh fruit, vegetables; undercooked meat, fish or eggs; paprika, raw nuts, yogurt
• Avoid yard work, gardening
• Wash toothbrush daily in dishwasher or bleach solution
• Avoid crowds
• Avoid fluids sitting at room temperature> 1 hour
• Wash glasses and cups after each use

Question 17

Oncologic Emergencies

Answer 17

• Sepsis, disseminated intravascular coagulation

Collaborative management:

• Prevention (best measure)
• IV antibiotic therapy
• Anticoagulants, cryoprecipitated clotting factors

Question 18

Thrombocytopenia treatment

Answer 18

• Platelet transfusion
• romiplostim (Nplate)
• eltrombopag (Promacta, Revolade)
• fostamatrinib (Tavalisse)

Question 19

Palliative

Answer 19

Philosophy of care, organized/structured system delivering care for individuals with life-threatening illness

Question 20

DNR Orders

Answer 20

• By law, health care providers must initiate CPR for a person who is not breathing or pulseless unless DNR exists
• Can be written in advance (portable DNR)

Question 21

Weakness Management

Answer 21

• Aspiration precautions
• Mouth care, moisture for lips
• Altered routes of medication administration if needed—choose least invasive route with most effective treatment

Question 22

Pain Management

Answer 22

• Pain is symptom dying patients fear most
• Schedule pain medications to prevent recurrence of pain
• Consider alternative administration route of pain medication as needed

Question 23

Complementary & Alternative Therapies

Answer 23

• Massage
• Music therapy
• Therapeutic touch
  Reiki therapy
• Aromaterapy

Question 24

• Dyspnea Management (Pharmacologic)

- Treat primary cause, relieve psychological distress that accompanies symptoms

Answer 24

• Opioids
• Anticholinergics
• Bronchodilators
• Sedatives
• Corticosteroids
• Oxygen therapy
• Diuretics
• Antibiotics

Question 25

Nausea & Vomiting Management

Answer 25

• Antiemetic agents
  Prochlorperazine (Compazine)
  Dexamethasone (Decadron, Deronil)
  Metoclopramide (Reglan, Maxeran)
• Remove any source of odors
• Comfortable room temperature

Question 26

Restlessness & Agitation Management

Answer 26

• Assess for pain, urinary retention, constipation, other reversible cause
• Treat underlying cause
• Pharmacologic agents
  haloperidol [Haldol, Peridol]
• Complementary and alternative therapies
  music, aromatherapy-

Question 27

Seizure management

Answer 27

• Pharmacologic therapy
  Benzodiazepines
  Barbiturates (phenobarbital)