Exam 4 Blueprint Flashcards
What are risk factors for cancer?
age, immunosuppression, race, genetic disposition, chemicals/tobacco/alcohol, exposure to viruses and bacteria, diet, sun/radiation exposure, sexual lifestyles, poverty/obesity/chronic gerd, chronic disease, air pollution
What does primary cancer prevention mean?
-using preventative measures to prevent cancer occurrence
Examples of primary cancer interventions?
-discontinuing tobacco
-breathing clean air
-diet high in fruits, veggies, complex carbs
-control weight
-reduce fat intake
-stay out of sun during peak hours and use sunscreen
-wear protective equipment
Tamoxifen has shown to reduce the risk of _____ cancer in high risk individuals ?
breast cancer
NSAID use is investigational and may reduce the risk for what type of cancer?
colorectal
What vitamins and plant derivatives have shown in clinical trials they may reduce risk of cancer?
-soy products
-tea and herbs
-vitamins ABCDE and more
What are secondary cancer prevention strategies?
use of screening strategies to detect cancer early
Examples of secondary cancer prevention?
Self examination
mammograms
PSA
What areas of the body should we be teaching our patients to self-examine to identify cancer?
skin
oral cavity
lymph nodes
breasts or chest walls
testicles/ penis
What is the ‘CAUTION’ acronym for signs and symptoms of cancer?
-change in bowel or bladder habits
-A sore that does not heal
-unusual bleeding or discharge
-thickening or a lump in breast or else where
-indigestion or difficulty swallowing
-obvious change in wart or mole
-nagging cough or hoarseness
What is tertiary prevention of cancer?
a set of measures that aim to reduce complications and progression of cancer In those that have been already diagnosed
What are the methods of tertiary prevention?
-surgical tx
-radiation
-chemotherapy
-bone marrow transplants
-hyperthermia
-biologic response modifiers
Review Bladder/lung/breat/skin/prostate
- on page 382 in IGGY book
What can be used to diagnosis cancer?
-history and physical exam
-blood and urine tests
-diagnostic imaging
-biopsies
What is osteoporosis?
chronic metabolic disease causing bone loss/decreased bone density
The first sign of osteoporosis is often?
a fracture
What bones are most likely to be affected in osteoporosis?
spine, hip, and wrist
What is primary osteoporosis?
-caused by losing testosterone and estrogen in older age
what is secondary osteoporosis?
-may result from other medical conditions, long-term drug therapy or prolonged immobility
What is a dexa scan?
the best tool to dx osteoporosis ; assesses bone density via x-ray
When should women begin getting DEXA scans
above age 40
What is BMD? What diagnostic test evaluates this?
-bone mineral density
-DEXA scan
What is a T-score
represents the number of standard deviations above or below the BMD
What BMD t-score is positive for osteopenia ?
-1 to -2.5
What BMD t-score is positive for osteoporosis?
< 2.5
Our goal BMD t-score is ?
to be above -1
What is a z-score?
compares BMI with your age group, BMI, and same sex
A z-score is most commonly used when ?
-premenopausal women
-men less than age 50
-children
An abnormal z-score is used to diagnose primary or secondary osteoporosis?
secondary
A z-score of -1.5 and above indicates
typical bone density for age group
A z-score of less than -1.5 indicates
atypical BMD
What supplements should be taken with osteoporosis and osteopenia to increase bone density?
calcium and vitamin d
Calcium and vitamin d nursing considerations?
-give in divided doses with 6-8 oz of water
-increase fluids to prevent renal calculi
-s/s of hypercalcemia
-take with food to prevent gi upset
Why should clients on calcium take a third of the daily dose at bedtime?
-no weight bearing activity occurs while sleeping
What is the suffix for biphosphonates, given to help with osteopenia?
-dronate
What education should we give patients on how to take bisphosphonates?
-take on an empty stomach first thing in the morning with a full glass of water
-30 minutes before eating
-sit up 30 minutes after taking to prevent esophagitis
Why should patients have dental examinations before starting bisphosphonates
risk of jaw and maxillary osteoporosis especially if dental hygiene is poor
If patients are sensitive to aspirin, why should they not be given a bisphosphonates
bronchconstriction may occur
How does calcium help with osteoporosis?
calcium helps improve bone density
How does vitamin D help prevent osteoporosis
helps the body absorb calcium which is needed to build healthy bones
Method of action for bisphosphonates
they slow bone resorption (breaking down of bones)
S/s of fractures?
-limited mobility
-severe acute or persistent pain
-altered sensory perception
s/s specific to hip fractures?
-inability to move immediately after a fall
-severe pain in hip or grain
-inability to put weight on injured side
-shorter leg on the side of injured hip
-turning outward of leg on side of injured hip
What is the treatment of choice for a fractured hip?
open reduction with internal fixation
What type of traction may be applied before surgery for fractured hip
buck’s traction
In hip fractures of the femoral neck, what are we most concerned for
avascular necrosis ; reduced blood supply to the head of the femur leading to death of bone tissues and decreased mobility
Preoperative care for hip fractures
-IV pain medication upon entering emergency department
-temporary placement in skin traction
-discontinue blood thinning medications
Best practices for care of those with hip fractures
box 44.5 in Iggy textbook pg 1095
What is the most common form of arthritis ?
osteoarthritis
