Exam 3 Cancer Flashcards
Common Cancers in the US (excluding non-melanoma skin cancers)
Bladder Cancer Breast Cancer Colon and Rectal Cancer Endometrial Cancer Kidney Cancer Leukemia Lung Cancer Melanoma Non Hodgkin Lymphoma Pancreatic Cancer Prostate Cancer
Consequences of Cancer
- Reduced _____ and _____ producing function
- Altered __ structure and function
- M____ and S____ deficits
- Decreased R_____ function
- Immune, blood
- GI
- Motor, Sensory
- Respiratory
Surgery as Cancer Treatment = _____ form of cancer treatment
- Pr____, Di_____, C____
- Control, Pa____, ____ look surgery
- Rec____ or Reh____
= Oldest form of cancer treatment
- Prophylaxis, Diagnosis, Cure
- Control, Palliation, Second look
- Reconstruction, Rehabilitation
Radiation Therapy for Cancer
1) Purpose is to =
- Teletherapy =
- Brachytherapy =
1) to destroy cancer cells with minimal damaging effects of surrounding normal cells
- radiation from outside source
- radiation from inside source
SE of Radiation Therapy
1) _____ according to site
2) Local s___ changes and ____ loss: likely ____ depending on total absorbed dose
3) Altered _____ sensations
4) F_____* related to increased energy demands
5) Inflammatory responses that cause tissue ____ and ____
1) Varies
2) Skin, Hair loss, permanent
3) Taste
4) Fatigue* (most common)
5) Fibrosis, Scarring
Nursing Care of Patients Undergoing Radiation Therapy
1) _____ accurate objective ____ to help patient ____
2) ______ remove markings*
3) Administer ____ care, use ____ to protect skin according to department policy
4) Avoid direct skin exposure to _____
5) Care for ______ (dry mouth)
6) Bone exposed to radiation is more vulnerable to _____
1) Teach, facts, cope
2) Do not
3) Skin, lotions
4) sunlight
5) Xerostomia
6) fracture
Nursing Care of Patients Undergoing Radiation
1) Avoid direct skin exposure to _____
2) Care for ______ (dry mouth)
3) Bone exposed to radiation is more vulnerable to _____
1) sunlight
2) Xerostomia
3) fracture
Chemotherapy =
- _____ and ____ survival time
- some _______
- Normal cells most affected (5)
= Treatment of cancer with chemical agents (major role in cancer therapy)
- cures, increases survival time
- selectivity
- skin, hair, intestinal tissues, spermatocytes, blood-forming cells
Treatment Issues
- Dosage: based on what? usually given _____, draw ___ for peak and trough
- Scheduling
- Administration (2)
Note: More toxic chemo chemicals need =
- based on Body surface area, combination, blood
- Extravasation = leakage of certain drugs (“vesicants”) out of the vein and to surrounding tissue -> can lead to tissue necrosis
- Vesicants = solutions that cause really bad blisters
= higher trained nurses to administer
Most common nursing intervention for Extravasation is?
PREVENTION!
- close observation, patient teaching, assessing for patency, monitor for early s/s (burning, swelling, itching), use a larger vein (e.g antecubital), use a larger bore IV (less risk)
Chemotherapy
- Nurses must have _____ about ___ use, ___ ranges, __/___ effects, sch____, specific ______
- What must be used when administering oral and IV chemotherapy? why?
- knowledge about drug, dosage, side/adverse, schedule, precautions
- PPE!* , its damaging and harmful to our skin when we touch it
Nursing Care of Patients Undergoing Chemotherapy
1) _____ risk
2) CINV =
3) M______
4) A______
5) Changes in ____ function
6) Peripheral _____
7) ____ penia
1) Infection
2) Chemotherapy induced nausea and vomiting
3) Mucositis = painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemo/radiation
4) Alopecia (hair loss)
5) Cognitive (depression, altered mental status, “chemo fog”, “chemo brain”, memory lapses, trouble finding words)
6) Neuropathy
7) Thrombocytopenia
Nursing Interventions for Peripheral Neuropathy =
Nursing Interventions for Thrombocytopenia =
= use of thermometer before bath, supportive/good foot care for prevention
= low platelets -> bleeding -> soft bristled tooth brush, prevent injury
Antiemetic Therapy for CINV (don’t need to know drugs)
- Drug ____ are ____ for best effect (5)
What is given after zofran to potentiate its effects?
- Combinations, individualized
- Odansetron (Zofran)
- Granisetron (Kytril)
- Gransietron transdermal (Sancuso)
- Dolasetron (Anzemet)
- Palonosetron (Aloxi)
- dexamethasone
Hormonal Manipulation
- Some hormones make hormone sensitive tumors ?
- Some tumors require specific hormones to ____; decreasing the hormone amounts to hormone sensitive tumors can ___ cancer growth rate
- grow more rapidly
- divide; slow cancer growth
Oncologic Emergencies (2)
Collaborative Management
1) Best measure is?
2) IV ____ therapy (culture first)
2) Anti_____, ___precipitated ____ factors
1) Sepsis (tachycardia*, fever)
2) Disseminated Intravascular Coagulation (DIC)
1) PREVENTION
2) Antibiotic
3) Anticoagulants, Cryoprecipitated clotting factors
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
1) Most commonly found dt what type of cancer, where?
2) What happens to water?
Collaborative Care
1) Patient _____
2) Restore =
3) S____ care
May lead to complications such as?
1) Carcinoma of the lung
2) Water is reabsorbed to excess by kidneys, and put back into systemic circulation
1) Safety
2) Normal Fluid balance
3) Supportive
Pulmonary HTN (fluid overload not good), especially worry about pts with CHF, look for ascites
Collaborative Management of Spinal Cord Compression =
1) Early r_____ and t______
2) P_____
3) High-dose (2)
4) S_____
5) External braces (2) that does what?
May lead to (2)
= tumor near spinal cord that causes compression
1) recognition, treatment
2) palliative
3) Corticosteroids, Radiation (to shrink tumor)
4) Surgery
5) Back, Neck braces to reduce pressure in spinal cord
Pain, Paralysis
Hypercalcemia = occurs most often with?
S/S =
Collaborative Management
1) Oral _____
2) ____ ____ IV
3) D___ therapy (1)*
4) D______
= with bone metastasis (breakdown of bone with bascially “dumps” Ca into system)
= Fatigue, Loss of Appetite, N/V, Constipation, Polyuria, Severe muscle weakness, loss of deep tendon reflexes, paralytic ileus, dehydration, ECG changes (FATAL DYSRHYTHMIAS)**
1) hydration
2) Normal Saline
3) Drugs (diuretics to get rid of calcium)
4) Dialysis
Superior Vena Cava Syndrome =
Can lead to ->
S/S
1) ____ edema
2) _____ * sign
3) Edema of ___ and ____
4) D_____
5) Ery_____
6) Epi____
= Superior venal cava is compressed or obstructed by tumor growth (congested veins + edema is an emergency!)
painful, life-threatening emergency (bc can’t get blood back to heart)
1) Facial edema
2) Stokes sign (swelling of neck)
3) Arms, Hands
4) Dyspnea
5) Erythema
5) Epistaxis (bleeding from nose)
Collaborative Care: SVC Syndrome
- ___ dose ____ therapy
- Metal ____ in vena cava
- what medication?
- High, Radiation
- Stent
- diuretics
Tumor Lysis Syndrome =
Collaborative Management
- P_____
- Hy_____
- D___ Therapy
= Large numbers of tumor cells destroyed rapidly, results in intracellular contents being released into bloodstream than body can eliminate them
- Prevention
- Hydration
- Drug
Tumor Lysis Syndrome can lead to what electrolyte imbalances? (2)
Nursing indication =
Hyperkalemia, Hyperuricemia (uric acid)
want to do BNP to see K+ levels
Hyperkalemia in Tumor Lysis Syndrome can lead to?
Fatal Dysrhythmias: Tall T waves, Flat P waves, Bradycardia, GI hypermotility
Hyperuricemia in Tumor Lysis Syndrome can lead to?
Precipitation of uric acid crystals that get stuck in renal tubules and cause acute renal failure
Drugs for Tumor Lysis Syndrome (4)
1) Kaexelate
2) Calcium Gluconate
3) Insulin -> to push K+ back into cell
4) Allopurinol -> to get rid of acid
What is the priority for SVC syndrome?
AIRWAY!
What are some neutropenic precautions for those receiving chemotherapy?
- No fresh foods
- No flowers
- PPE (depending on hospital protocol)
Nursing considerations for those receiving brachytherapy
- need to be careful with bodily fluids
- separate room
- 30 min max
- rotate nurses
- led shield
- no pregnant women or children
- visitors must stand 6 ft away at all times
Nursing care for xerostomia/stomatitis for radiation
- What medication could you give?
- ice chips, hydration, no spicy food
- Cholinergics (Pilocarpine) -> increases saliva
Skin Care for patients going through radiation
- avoid sunlight*!
- only prescribed lotions
- gentle soap and water
- soft cotton clothing
- use hands not cloth to wash self
