Health promotion and Scientific Basis Flashcards
Test Strategies
- “guarantee/always” is not the answer
- take out the ones absolutely wrong
- Debate over 2 correct answers, re-read and choose correct one
- do T/F w/each question
- If things look the same put your fingers on the words
- Go with the answer you think is right
- General concepts about all instead of all details about everything
Cancer incidence
- rates continue to rise
- gap btwn incidence/death is widening (more cured than dying)
- Male more than female
- Top: Lung, prostate, breast
- Male: H/N
- Female: Thyroid
- Hereditary disposition: 5-10%
Carcinogenesis
- Oncogenes: gene w/potential to cause cancer
- protooncogenes: “GAS PEDAL”
- Exposure to factor will cause activation of protoncogenes and inactivation of tumor suppressor genes (P53=brake)
- Plasia
- Anaplasia
- Dysplasia
- Hyperplasia
- Plasia: “formation”
- Anaplasia: loss of
- Dysplasia: abnormal
- Hyperplasia: excessive
- Carcinoma
- Sarcoma
- Germ cell
- Carcinoma in situ
- Carcinoma: Arising from epithelial cells
- Sarcoma : Arising from muscle/bone/connective tissue
- Germ cell: Arising from embryonic cells
- Carcinoma in-situ: non-invasive, not crossed basement membrane
Malignant vs Benign
Malignant: can invade/metastasize
Benign: cannot invade
Adenocarcinoma Squamous cells Differentiation Metastasis Angiogenesis Apoptosis
- Adeno: GLANDULAR epithelial cells
- Squamous: pancake cells that line the canals and cavities of the body
- Differentiation: cell maturation
- Metastasis: move to other places
- Angiogenesis: leaching to existing blood supply
- Apoptosis: programmed cell death
Incidence
Prevalence
Mortality
- Incidence: # of CANCERS that develop in a population during a DEFINED period
- Prevalence: Actual # of cancers that exist at a given time #/100k people
- Mortality: # of people die of a particular cancer during a defined period
Ethical Theory: Utilitarianism
overall balance of positive and negative effects of your actions; all actions are considered on the basis of consequences
Primary Prevention
Secondary Prevention
Tertiary Prevention
- Primary: This could PREVENT the cancer, Ex: Vaccines, exercise, smoking cessation
- Secondary: This could CATCH IT EARLY, ex: mammogram, colonoscopy
- Tertiary: LTFU, SURVIVORSHIP, for people who already had cancer, Ex: maintenance, scans, hormone blocking agent
Relative risk
Absolute risk
Attributable risk
Cumulative risk
- Relative risk: probability of getting cancer based on the risks
- Absolute risk: Cancer incidence or mortality
- Attributable risk: amount of disease in a population that could be avoided by reducing or eliminating risk
- Cumulative risk: the total amount of risk of developing a disease over time ex: 1in4 men develop prostate their whole life
Types of risk factors: Lifestyle Occupational Environmental Viral Iatrogenic
- Lifestyle: smoking, alcohol, diet
- Occupational: chemicals
- Environmental: Sun tanning beds, radiation
- Viral: HBV/HCV, HPV, EBV, HIV
- Iatrogenic: Immunosuppression, Hormone replacement, Radiation/Chemo
Hereditary cancers: BRCA1&2 HER2 HNPCC FAP (APC gene) Dysplastic Devi Von hippel landau
- BRCA1&2: breast ovarian
- HER2: breast, ovarian, GI
- HNPCC: GI, liver, upper urinary, brain, skin, ovary, endometrial
- FAP (APC gene): colon
- Dysplastic Devi: melanoma
- Von hippel landau: cancer in fluid filled sacs
Secondary Screening:
Pap smear start
Screening year
Familial history
- Pap smear start - sexually active
- Screening year=50yo
- Familial history start screening 10yrs prior
Cancer stages: Stage 1 Stage 2 Stage 3 Stage 4
- Stage 1: Tumor only, surgery/radiation main tx
- Stage2: Tumor+lymph node, local+systemic therapy “adjuvant: surgery then systemic”
- Stage 3: Tumor+many lymph nodes that drain that organ, reduce tumor first before surgery “neoadjuvant”
- Stage 4: Tumor in other areas, shrink tumor before surgery/Radiation
Metastatic sites:
Above diaphragm
Abdominal cancers
- Above diaphragm cancers are metastatic ALL OVER
- Abdominal cancers are metastatic to mostly abdominal area
Lab tests:
- LDH
- Alk phos
- Lab tests monitor the disease, they are mostly prognostic
- LDH: increased is a marker for proliferation
- Alk phos: increased is a marker for bone metastasis
Tumor markers: Liquid biopsies CEA HCG AFP CA-125 CA27-29; 15-3 CA9-19 B2M PSA
Liquid biopsies: circulating tumor cells CEA: GI HCG: Reproductive AFP: testicular, liver CA-125: Ovarian CA27-29; 15-3: Breast CA9-19: Pancreatic B2M: Lymphocytic PSA: Prostate
Diagnostic Imaging: CT MRI PET Bone scan
- CT: visualize mass, solid tumors, PE, infection, bleed
- MRI: More dense organs, bone, brain/CNS, abdominal tumors, dense breast
- PET: shows activity, faster growing cancers, lymphoma, esophageal, cancer cells take up contrast and light up scan
- Bone scan: shows bone mets
Pain
Somatic
Neuropathic
Visceral
Somatic pain
- well localized: aching, throbbing or gnawing
Neuropathic pain
- pain cause by damaged or alteration of
Nervous system
Visceral pain
- not localized
- vague -pain receptors in pelvic, chest, abd or intestine
- feel as deep squeeze pressure or aching
TNM staging
T=Tumor X:No info 0:No primary tumor is:Pre-cancer 1-4:staging
N=Lymph nodes X:Not assessed 0:None 1-3:staging
M=Mets 0:No 1:Yes
Nursing Role in Accreditation Process
- Participate in QI at micro, meso, and macrosystem level
- Vigilant focus on patient SAFETY and creating a HEALTHY work environment
- Participation in ongoing surveillance programs thr data collection, management, and analysis
- Preparatory activities
Sheridan-Leos
5 qualities of high reliability teams and organisation
to maintaining quality and accreditation to promote safety across all care
- Preoccupation with failure
- Reluctance to simplify
- sensitivity to operations
- Resilience
- Deference to expertise
what the hell is this!
Benefits of Magnet Recognition for institution
defined by ANCC
- Attract and retain top talent
- Improve pt care, safety and satisfaction
- Foster a collaborative culture
- Adv nursing standards and practice
-Grow the business, resulting in FINANCIAL success
Mission of Joint Commission
Continuously improve health care for the PUBLIC
Accreditation of Cellular Therapy signifies quality in
Patient care and LABoratory practices in cellular Tx
Magnet model component
New Knowledge
Innovation
Improvements
Excellence - in patient care and the nurses who provide that care
Principles of Biomedical Ethics
- Autonomy
- Beneficence
- Nonmaleficence
- Justice
Autonomy:
INDIVIDUALs have the ability to make decisions consistent with their own values
Beneficence:
Tx should be of BENEFIT to the recipient
NOnmaleficence
AVOIDance or MINimization of harm
JUSTICE:
Fair allocation of healthcare resources based on need and expected outcome
Anticipatory grief
Is unconscious process
That can be brought on by receiving bad news
Adjuvant radiation BC
Is for?
Adj radiation therapy
in early stage breast cancer
to destroy gross or microscopic residual disease
with the goal of preventing tumor recurrence
Which antibody is responsible for type I hypersensitive reaction
IgE
Myelosupression
Chemo will decrease the response by immune system by causing neutropenia, anemia,and thrombocytopenia, collectively known as myelosuppression
Ovarian cancer
Will likely to develop what secondary cancer
O-O
Ocular melanoma
