Exam 3 Oncology Flashcards
Osteosarcoma =
= most common primary bone tumor
Osteosarcoma
1) Occurs where? why?
2) Area that is most common?
3) Cause =
1) Growth plate, bc of high proliferation
2) femur
3) some genetic predisposition (lethromany syndrome-devastating genetic mutation that will result in many cancers in their life)
S/S of Osteosarcoma (2)
- Sudden ____ may be a sign*
- X ray =
1) Pain that worsens with activity, constant but sharper w movement
2) Swelling, Tenderness with palpation
- fracture
- “sunburst appearance”
Leukemia =
2
= cancer of the blood
1) Acute Lymphoblastic Leukemia (ALL)
2) Acute Non-Lymphocytic (Myloid) Leukemia (AML)
Acute Lymphoblastic Leukemia =
Overgrowth of lymphoblasts ->
= overproduction of lymphoblasts (immature wbc’s) in bone marrow
-> push out all other normal blood cells -> decreased rbc’s, platelets, wbc (that are mature)
Causes of Leukemia
1) Leukemia is the ___ common form of childhood cancer
2) ALL is ___ common type of leukemia
3) Id____
4) Increased risk for children with?*
1) Most
2) Most
3) Idiopathic
4) Trisomy 21 (Down’s syndrome)
S/S of Acute Lymphoblastic Leukemia (6)
- Fever
- Frequent Infection
- Lymphadenopathy
- Altered CBC -> low h/h, high wbc (but immature so not doing anything to prevent infection)
- Bone pain bc so much activity (lymphoblasts)
- Unintentional weight loss
Acute Nonlymphocytic Leukemia (AML) =
Etiology = __ most common form of childhood cancer, incidence increases w ____*
= overproduction of immature WBCs which interfere with production of normal cells
2nd, AGE*
Acute Nonlymphocytic Leukemia (AML)
- ____ presentation and tx to ALL, but ___ survival rate
- will mostly likely need?
- Similar, Lower
- bone marrow transplant
S/S of AML (5)
- Viral Picture
- Frequent fever, infection
- Abnormal CBC
- Unintenional weight loss
- Pale skin, Fatigue, (anemia) Easy Bruising (low platelets)
Lymphomas =
(2)
Lymphocytes =
Cancer that starts in the lymph nodes as opposed to other cancers which may move to lymph nodes
Hodgkins Lymphoma
Non Hodgkins Lymphoma
= type of wbc (leukocyte) responsible for immune responses - T cells, B cells
Hodgkins Disease =
Hallmark of Illness = *
- Starts w ____ then ->
- Usually in what age?
= Malignant neoplasm of lymph nodes, Mature B cells become malignant - abnormal cell growth
Reed Sternberg Cell (large cell with multiple nuclei)
- one lymph node, then spreads
- teens, young adults
S/S of Hodgkin’s Disease (5)
- Painless lump
- Enlarged Gland
- Fever
- Weight loss
- Night Sweats*
Non- Hodgkin’s Lymphoma =
= Group of malignant tumors of B or T lymphocytes
Etiology*
- Unknown, but thought to be some genetic risk
- EBV is associated with Burkitt’s lymphoma (B cells)
S/S of Non-Hodgkin’s Lymphoma (3)
Location Dependent (5)
- Enlarged Lymph Nodes
- Night Sweats
- Unintentional weight loss
1) Lung = cough, difficulty breathing
2) Abdominal pain
3) Vomiting
4) Urinary difficulties
5) Headache (CNS)
Nervous System Tumors (2)
Brain Tumors
Neuroblastoma
Brain Tumors =
- Most common ___ tumor
- ____ etiology
= benign or malignant mass found in the brain
- Solid
- Unknown
S/S of Brain Tumors =
5
= increased ICP
- Headache
- Vomiting
- Ataxia*
- Bulging fontanels
- Personality changes
- Increased falls
Neuroblastoma =
Often starts where?
= overproduction of neuroblasts in the bone marrow; neuroblasts = embryonic cell from which nerve fibers orginate
- In adrenal glands
S/S of Neuroblastoma (2)
Location Dependent
1) Abdomen (2)
2) Chest (1)
3) Bone (2)
4) Facial (1)
5) Spinal Cord (2)
- Fever
- Unintentional weight loss
1) usually starts here bc starts in adrenal gland: swelling, constipation
2) Difficulty breathing
3) Pain, limping
4) abnormal eye movements
5) weakness, movement issues
Old Solid Tumors (1)
Retinoblastoma
Retinoblastoma =
Cause is often ______
Screen in what age?
= Malignant Glioma of the Retina
Hereditary
Young children, infants
S/S of Retinoblastoma
1) Leukocoria
- white glow in pupil
- no red eye reflex
2) Strabismus
3) Abnormal eye deviation
General Oncologic Nursing Interventions (3)
1) Blood draws
2) Give Antibiotics, Antifungals
3) Teaching
Why do we draw blood?
To makes sure labs are at a certain threshold before giving chemo/other tx
Why do we give antibiotics/antifungals?
- Obtain what before administering?
Prophylactically bc chemo suppresses immune system
- blood culture
Teaching about 1) Alopecia = 2) A\_\_\_\_ = teach s/s 3) C\_\_\_\_\_/D\_\_\_\_\_ dt chemo 4) Extravasation = 5 Oral m\_\_\_\_\_ =
1) Hair Loss
2) Anemia
3) Constipation/Diarrhea
4) Drug leakage of chemo into tissues
5) Mucositis = ulceration, inflammation of mucous membranes of GI tract
Education about Constipation (3)
- Lots of Fluids
- High Fiber foods
- Avoid bananas, cheese
Education about Diarrhea (3)
- Drink lots of fluids
- Eat bananas, potatoes (for potassium)
- Lay down after eating to slow digestion
Education about Mucositis (4)
- Soft tooth brush
- Mouthwash with lidocaine
- Pain meds
- Avoid hot, spicy foods
Education about Neutropenia (2)
Thrombocytopenia =
- Wash hands
- Go to ED for fever
= decreased platelets
Education about N/V
1) _____ at home
2) ____, __ to digest foods
3) ____ feedings out
4) Meds (3)
1) Antiemetics
2) Soft, easy
3) Spread
4) Ativan, benadryl, zofran
Oncologic Tx (6)
1) Hematopoietic stem cell transplantation
2) Radiation therapy
3) Surgery
4) Transfusion
5) Venous access devices
6) Chemo
Hematopoietic Stem Cell Transplantation =
- treats l____, l____ and others
- Bone marrow can be from (3)
= cells from bone marrow are given to help bone marrow function return
- lymphoma, leukemia
- patient, donor, stem cells from umbilical cord blood
Radiation Therapy =
- ___ sometimes necessary, why?
- most often used for ___ tumors, ___ tumors
= high energy x-rays to cancerous regions
- sedation, don’t want pt to move bc need to target one area
- solid, brain
Chemotherapy
- Kills ____ and ____ cells
- Know ____ with other _-____
- Storage, schedule, monitoring
- cancer, and normal
- compatability w IV fluids
Surgery =
- Often used for __-____ masses
- can do __-____ to __ tumor before removal
Venous Access Devices =
= surgical removal of tumor
- non-cancerous
- neo-adjuvant, shrink
= Central lines inserted
Transfusion of blood/blood products
1) Types of blood products = (4)
2) Know institutional _____
3) Monitor closely for ____
- Signs of reaction (7)
1) whole blood, packed RBCs, Platelets, Plasma
2) policy
3) reaction
- Back/chest pain, hypotension, fever, chills, tachycardia, tachypnea, rash
Nursing Diagnoses for Hematologic + Oncologic Disorders
- Risk for knowledge deficit
- Ineffective peripheral tissue perfusion
- Imbalanced nutrition: less than body requirements
- At risk for infection
- Risk for impaired coping mechanism
