[Exam 1/Final] Chapters 57,58,59: Reproductive Cancers Flashcards
What reproductive cancers can women have?
Ovarian , cervical, uterine, vaginal, vulvar.
Ovarian Cancer: Large cause of what?
Death in women
Ovarian Cancer: Difficult to detect why?
Doesn’t show symptoms until later on
Ovarian Cancer: Signs of this?
Increased abdominal birth, back pain, bloating,
Ovarian Cancer: What is the biggest thing you can do fro this?
Prevention. Early screening.
Tx of Reproductive Malignancies: How will this be treated?
Surgery, chemotherapy, radiation, or combination of these
Tx of Reproductive Malignancies: Treatment may be geared toward what?
Curative or palliative
Tx of Reproductive Malignancies: Care of this patient is similar to care of what type of patient?
Patients with other abdominal surgeries
Tx of Reproductive Malignancies: What sort of things will you monitor the patient for after surgery?
Splinting, bleeding, hemorrhaging, and monitoring for infection
What is Tandem and Ovioids?
Used for internal radiation therapy for ovarian cancer. Catheter in place and kept off of vaginal wall.
Nursing Considerations Related to Intracavity Radiation: What will they have inserted?
Foley Catheter.
Nursing Considerations Related to Intracavity Radiation: What will they need to make sure they do?
Get a lot of best rest. Positioning restrictions.
Nursing Considerations Related to Intracavity Radiation: Diet will consist of what?
Low residue diet.
Safety for Intracavity Radiation: This is all about what?
Time, distance, and shielding.
Safety for Intracavity Radiation: What can staff do for safety?
Want to make sure you aren’t exposed. Dosimeters can be placed and can pick up on radiation we are being exposed to and if we’ve had too much.
Also no pregnant caregivers.
Safety for Intracavity Radiation: Who cannot visit?
Those who are pregannt and those younger than 18
Safety for Intracavity Radiation: You should monitor for what here in regards to radiation therapy
That the device has not been dislodged. If dislodged, do not touch it.
Breast Cancer: What are some different types?
Ductal Carcinoma in Situ (In Situ means surrounding tissue not involved)
Invasive Cancer
Pagets Disease (Begins in ductal systems. Moves out to nipple, areola, and surrounding skin.
Breast Cancer: RFs for this?
Female Gender > 40 years old Family HX Hormonals Factors (High Estrogen Level) Radiation Exposure High Fat Diet Alcohol Intake
Breast Cancer: What specific hormonal factors can affect this?
Like early menarche before 12 or late menopause
Guidelines for Early Detection of Breast Cancer: When will breast exams start?
In 20’s and 30’s with breast exam every 3 years and then annually after 45 years old
Guidelines for Early Detection of Breast Cancer: When does mammography start?
Begins at age 45
Guidelines for Early Detection of Breast Cancer: Womans at increased risk may have earlier what?
Screening, shorter screening intervals, and additional screening procedures like MRI
Breast Cancer - Assessment: Where can lumps be found
Anywhere, usually upper outer quadrant
Breast Cancer - Assessment: How willl lumps appear?
Nontender, fixed, and hard lesions with irregular borders
Breast Cancer - Assessment: Advanced signs of this?
Skin dimpling, nipple retraction and skin ulceration
Breast Cancer - Diagnostics: Self Breast exam should be done when?
5-7 days after menses
Breast Cancer - Diagnostics: Mammography started when
At age 45
Breast Cancer - Diagnostics: What is contrast mammography?
Looking for introductory cancers. Radioactive material injected into duct and looking to see if there is tumor
Breast Cancer - Diagnostics: MRI or Ultrasound may be done why?
If breasts are dense or tests on nonconclusive.
Breast Cancer - Diagnostics: What kind of tissue analysis can occur?
Percutaneous Biopsy
Fine-Needle BIopsy
Ultrasound-Guided Core Biopsy
Mammography: What position does this go in?
Top to bottom and side to side view. Compressed to show two views of the breasts
Breast Cancer - Surgical Biopsy: What is a excisional biopsy?
Mass and surrounding tissues are removed. If lump is small, they will do this.
Breast Cancer - Surgical Biopsy: What is a incisional biopsy?
They will only be taking a portion of the tumor out. With a core nedle biopsy, they may be getting a larger sample out.
Breast Cancer - Surgical Biopsy: What is wire needle localiztion?
If there is a nonpalpable mass. Imaging and wire inserted into mass and then go to OR so they can track along the wire to remove sample
Breast Cancer - Diagnosing: Staging is done how?
Using TNM model.
Breast Cancer - Diagnosing: Prognosis is based on what?
Tumor size. Has it spread to lymph nodes.
Breast Cancer - Diagnosing: What gene is seen here?
ERBB2. Is a more aggressive cancer.
Breast Cancer - Surgical Mx: What is a Modified Radial Mastectomy?
Removal of breast tissue, nipple, areola complex and axillary lymph nodes.
Breast Cancer - Surgical Mx: What is a Total Mastectomy?
All breast tissue is removed
Breast Cancer - Surgical Mx: What is Breast Conservation Treatement?
Lymphectomy. Remove the lump that has been found and only that
Breast Cancer - Surgical Mx: What is Sentinel Node Biopsy?
They will take a needle and will remove the first lymph node they find. Then determine if it is cancerous or not. If it hasn’t, they can assume cancer hasn’t spread.
Breast Cancer - Surgical Mx: What is Axillary Lymph Node Dissection?
They go in and remove all of the lymph nodes. If removed, that is when you see complications of lymphedema and arm swelling.
Care of Patient Undergoing Breast Cancer Surgery - Assessment: What will you assess?
How did they respond to diagnosis
What emotional support to they use
If there family available?
Are they experiencing discomfort?
Breast Cancer - Nursing Diagnosis PostOp: This includes what?
Acute Pain
Peripheral Neurovascular Dysfunction
Disturbed Body Image
Deficient Knoweldge R/T Drain Mx, Arm Exercises, Hand/Arm Care.
Breast Cancer Surgery Problems: What problems may occur?
Lymphedema (Use Compression Slinging, Moving Arms Up and Down)
Hematoma (Warm Compress, or OR) or Seroma Formation
Infection
Breast Cancer and Surgery: Goals include what?
Increased knowledge about disease
Absence of Complications
Breast Cancer and PreOp Nursing Interventions: What is done here?
Review and reinforce treatment options
Support the patient
Maintain open communication
Be supportive of the patient and family members
Breast Cancer and PostOp Nursing Interventions:
Maintain Privacy
Bra with Breast Form in It
Patient education on what to do at home
Referral to counselors.
Monitor for complications like lymphedema
Breast Cancer and PostOp Nursing Interventions: Exercises after breast surgery?
Wall climbing, rope turning, rod lifting, and pulley tugging
Works muscles in upper chest
Breast Cancer and PostOp Nursing Interventions: How do evluate the patient and what to evaluate?
Can they take care of themselves
Can they cope, verbalize feedings
Can they remove dressings
Nonsurgical Mx of Breast Cancer: What is included here?
Radiation Therapy
Chemo Therapy
Hormonal Therapy
Targeted Therapy
Nonsurgical Mx of Breast Cancer: What is included in radiation therapy?
External Beam and Brachy Therapy
Nonsurgical Mx of Breast Cancer: What hormonal therapy may be done?
Determine if cancer nourished by hormones.
Estrogen/Progestrone REceptor Assay
Selective Estrogen Receptor Modulators
Aromatase Inhibitors (Blocks astrogen from turning into estrogen)
Nonsurgical Mx of Breast Cancer: what is targeted therapy?
Targets HER2 protein . Given with meds to inactive tumor and slow the growth.
Reconstructive Procedures After Mastectomy: What are some different types?
Tissue Expanders Tissue Transfers Nipple-Areola Reconstruction Prosthetics REconsturcitve Breast Surgery
Reconstructive Procedures After Mastectomy: What is a Breast Reconstruction with Tissue Expander?
Expander placed under pectoral muscle and is gradually filled with saline. Once restored, will do nipple-areola reconstriction
Reconstructive Procedures After Mastectomy: What is a TRAM FLap?
Breast mound created by taking abdominal tissue like fat and muscle adn taking it to the mastectomy site.
Breast Cancer - Special Considerations: What are some implications of genetic testing?
How will you react to the news that you are now more at risk?
Breast Cancer - Special Considerations: What are some things to consider?
Pregnancy with Cancer
Quality of Life and Survivorship
How those with disabilities will handle it
Breast Cancer - Special Considerations: Disease of the male breast is what?
Gynecomastia , which is enlarged breast tissue.
Prostate Cancer: How common is this?
Second most common cancer and second most common cause of death hin men
Prostate Cancer: RFs?
Increasing age, familial predisposiiton, african american
Prostate Cancer: Manifestations of this?
Early has few or no symptoms
Later on, symptoms of urinary obstruction, blood in urine or semen, painful ejaculation
Prostate Cancer: What to know for metastasis
Symptoms f metastasis may be the first manifestations
Prostate Cancer: What is vital for this?
Early diagnosing and health screening
Prostate Cancer: Treatment may include what?
Prostatectomy, Radiation Therapy, Hormonal Therapy or Chemotherapy
Prostate Cancer: What does Hormonal Therapy have to do with?
Androgen depreivation therapy. Decreases level of testosterone and prostate will atrophy
Prostate Cancer: Why is watchful waiting used here?
For older adults were they monitor PSA levels. Especially those who are expeced to live less than 5 years.
Prostate Surgery Procedures: What is a TURP?
Will be done when prostate is small. Low complications. Needle goes in and is removed.
Prostate Surgery Procedures: What is super pubic prostacteomy?
Opening made through abdomen and reatched in there
Prostate Surgery Procedures: What is a Perineal Prostatectomy?
Done when other approaches aren’t available, usually due to incontinence. Go through the bottom.
Prostate Surgery Procedures: Retropubic is used when?
Higher chance of infection. When the prostate is higher up than normal.
Prostatectomy - Assessment: What should we assessed?
How this affects their lifestyle
Urinary/Sexual Function
Health Hx
Nutritonal Status
Prostatectomy - Assessment: Diagnosis for this?
Anxiety Acute Pain PreOperatively Acute Pain PostOp RF Imbalanced Fluid Volume PostOp Deficient Knowledge
Prostatectomy - Complications: What does this incude?
Hemorrhage and Shock Infection VTE (TED Hose, Prophylaxis) Urinary Incontinence Sexual Dysfunction Catheter Obstruction
Prostatectomy - Planning: What are the goals for this before surgery?
Include adequate preparation and reduction in anxiety and pain
Prostatectomy - Planning: What are some major goals after surgery?
Maintenance of fluid volume balance, relief of pain and discomfort, ability to perform self-care, and absence of complications
Prostate Cancer - Relief of Pain: After surgery, what should be monitored?
Urinary drainage and keeping catheter patent
Prostate Cancer - Relief of Pain: How to assess pain?
Bladder spasms cause feeling of pressure and fullness, urgency to void, and bleeding from the urethra around the catheter
Prostate Cancer - Relief of Pain: How to help rleieve this?
Medication and warm compressed or sits baths for spasms
Administer analgesics and antispasmodics
Encourage patient to walk and not sit for long periods. Trying to prevent constipation
Prostate Cancer - Relief of Pain: What is always ordered after TERP?
Continuous Bladder Irrigiation, is a three-way system
Prostate Cancer - Relief of Pain: What is in teh three-way system?
Irrigation solution, triple lumen catheter, and drainage bag.
Prostate Cancer - CBI: How long will you keep this flowing?
Want to keep it flowing until you see a light pink color. Usually discontinued after 24 hours if no clots.
Prostate Cancer - TURP: What should you closely monitor for with drainage system?
The increase in bladder distention that causes pain and bleeding
Prostate Cancer - TURP: How to control pain?
Analgesics and decrease activity for first 24 hours
Prostate Cancer - TURP: What complications can occur?
Hemorrhage
Urinary Incontinence (Kegel Exercises)0
Infections (Increase Fluids)
Prevent DVT
Prostate Cancer - Interventions: How to reduce anxiety?
Be sensitive to embarassing changed issues. Provivde privacy, allow them to verbalize concerns
Prostate Cancer - Interventions: Patient education should incldue what?
Explanations of anatomy, and function, and diagnostics tests and surgery.
Prostate Cancer - Interventions: Patient education should incldue what?
Explanations of anatomy, and function, and diagnostics tests and surgery.
Prostate Cancer: Rehabilitation and Home Care: Care at home includes what?
Of the urinary devices and recognition and preventing complications like UTI
Prostate Cancer: Rehabilitation and Home Care: How to regain bladder continence
Tell them its gradual and may take a 1 year. SHould do perineal exercises
Prostate Cancer: Rehabilitation and Home Care: What should they avoid?
Straining, heavy lifting, long car trips,
Prostate Cancer: Rehabilitation and Home Care: Diet would include what?
Encourage fluid and avoid coffee, alcohol, and spicy foods.
Testicular Cancer: Most common with what age group
15-40 , most common cancer in men
Testicular Cancer: RFs?
Crytogenism (undescended testicles), family history, HIV positive, caucasian , occupational hazards
Testicular Cancer: Manifestations?
As a lump on the testicle that is painless. Pain back, abdominal pain, weight gain, generalized weakness with metastasis
Testicular Cancer: Early diagnosis inlcudes what?
Teaching men to do testicular self exam . Tumor markers to check as well.
Testing to see if it has metastasized.
Testicular Cancer: Treatment includes what?
Removal of the testicle. Testectomy.
Testicular Cancer: What should be done before testicle removed?
They should save sperm if they want children later on
Testicular Cancer: Nursing MX includes what?
Assessing physical and psychosocial status
Support of coping
Addressing issues of body image and sexuality.
Patient education
TSE and Follow-Up Care
