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XIO > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Irreversible (abnormal to ana is irreversible)

A

Anaplasia
- Loss of differentiation
- Lack normal cellular characteristics
and are nearly always malignant

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2
Q

Proto-oncogenes (proto locks) and ex.

A

Regulate normal cellular processes such as promoting growth (loss of liver tissue ex.)
Genetic locks that keep cells functioning normally

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3
Q

Tumor suppressor genes (suppress growth)

A

puts the brakes on cell growth
Exist in normal cells and fx to control cell growth (supress growth)

When genes mutate, normal constraints on cell growth removed
Refer to McCance 12-4, 12-5 for comparison of gene types

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4
Q

Surveillance Network (surveillance kills)

A

Surveillance Network
Destroys cells before grow into detectable masses
Tumor antigens assist in recognition process

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5
Q

External Risk Factors - (CCRD is external to the office) and ex.

A

Chemicals - formaldeyhde

Radiation - sunlight

Chronic Irritation - acid reflux, smoking

Dietary Influences - nitrates

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6
Q

internal factors (SIG is internal to me)

A

Immune Function
Immunosuppressed = increased risk
Surveillance Failure
Genetic Predisposition
Has influence on efficiency of carcinogenic process
Breast CA, Colorectal CA

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7
Q

Nutrition (how many fruits and veggies a day? :)

A

Nutrition
- Five servings of fruit and vegetables q day
- Limit red meats, processed high fat meats
- Whole grains

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8
Q

Physical Activity (physical for 120 minutes)

A

Physical Activity
- Engage in at least 150 minutes of moderate intensity or 75 min of vigorous intensity physical activity each week, or equivalent combination
- Children engage in 60 min moderate- vigorous activity each day with vigorous activity at least 3x week.

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9
Q

Regular screening and self examinations could increase 5 yr survival rate to…

A

82%
If all Ca dx at localized stage through regular screening, 5 yr survival rate could increase to 95%

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10
Q

7 warning signs of cancer (CAUTION) (bowel, throat, bleeding, lump, indigestion, mole. cough)

A

Change in bladder or bowel habits
A sore throat that does not heal
Unusual bleeding or discharge
Thickening or lump
Indigestion or difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

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11
Q

diagnostic tests (diagnose my cyte, is it a genetic tumor or bone marrow?)

A

Cytology studies
Tumor Markers
Genetic Markers
Bone Marrow Exam

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12
Q

classification of cancer - Histologic (study tissue under a microscope) classification

A

Appearance of cells and degree of differentiation are evaluated to determine how closely cells resemble tissue of origin.

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13
Q

histological grade (how is history looking?)

A

Evaluation of appearance of cells and degree of differentiation

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14
Q

staging

A

TNM classification for a 4cm lung cancer with 3 involved lymph nodes and metastasis would be as follows:
T2N2M1(bone).

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15
Q

clinical staging (get situated in staging)

A

Stage O
Stage I
Stage II
Stage III
Stage IV

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16
Q

surgical therapy

A

Nursing Considerations
Same as perioperative specific care for organ dysfunction
Nutritional deficits
Risk for Infection
Psychosocial issues (important at Julia’s stage)

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17
Q

radiation therapy

A

May be used to cure or with other modalities, i.e. Surgery

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18
Q

radiation internal (aka brachytherapy)

A

Requires less dosage***
Implant place directly in tumor or in close proximity
Will emit radiation when implant in place

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19
Q

radiation safety - limit visiting time to what? And under what age?

A

Safety Precautions (ALARA: As low as reasonably achievable)
Principles of time, distance, shielding
Limit visitors to 30 min
No children under 16, pregnant women

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20
Q

radiation systemic affects - what areas of the body impacted? (radiation affects my bones, mucus, and skin)

A

Usually localized to region being irradiated
Affects rapidly proliferating cells
bone marrow
gastrointestinal mucosa
skin

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21
Q

radiation late effects (late radiation scars me and causes other cancers)

A

May be chronic
Fibrotic changes (thickening or scarring of the tissue)
Increased risk for other malignancies (ex. lymphoma)

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22
Q

radiation nursing considerations

A

Provide appropriate education
Monitor response to tx
Assure that radiation protection measures are followed
inspection of the skin

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23
Q

chemotherapy - (do not replicate chemo)

A

The use of various chemical agents that interfere with the replication and other normal functions of cancer cells.
Should result in malignant cell death and tumor shrinkage

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24
Q

chemo risk of (your mom is extravagant)

A

Risk of Extravasation (occurs with vesicant drugs)
Can cause blistering or tissue necrosis. monitor for signs of redness, necrosis, tenderness.

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25
Q

chemo systemic effects - affects which cells? (just rapid)

A

Affects cells with rapid growth rates

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26
Q

chemo nursing dx

A

Cardiac output, decreased
Nutrition, less than body requirements
Infection, risk for
Pain
Fatigue
Body Image, disturbed (hair loss)

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27
Q

chemo nursing interventions - what is the most common cause of death among cancer patients?

A

Infection: Most frequent cause of morbidity and death in CA pts.
Neutropenic (bones) precautions if indicated
Assess for signs of infection
May need WBC growth factors (i.e Neupogen)

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28
Q

chemo nursing interventions - bleeding

A

Bleeding (thrombocytopenia)
Soft bristle toothbrush

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29
Q

chemo nursing interventions - nutrition (hard candy, no oj, avoid what?)

A

Minimize effects of altered taste sensations (ex metallic taste)Ii.e. Hard candies
Mechanical soft, avoid citrus with stomatitis***
Anorexia - small frequent meals, liquid supplements
High calorie, high protein foods: examples? nuts, ensure, yogurt. try to avoid carbs.

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30
Q

chemo nursing interventions - pain (pain based on WHO? And long or short?)

A

Requires comprehensive assessment
Make appropriate referrals
Use WHO ladder
Preference for long acting, SR preparations
AVOID Injections

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31
Q

chemo nursing interventions cont - Stomatitis (don’t forget saline)

A

Avoid citrus
Saline rinses
Lidocaine swishes
Rapidly dividing cells of mucous membranes being destroyed

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32
Q

chemo biologic therapy (immune system is biology)

A

uses body’s own immune system.
Now established as a major category of cancer therapy
Focus is manipulation of immune system through use of naturally occurring biologic substances (cells, cell products) or genetically engineered agents that modify immune response

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33
Q

chemo biologic therapy - May affect host-tumor response in three ways: (biology is direct, to the immune system, and may mess with CA)

A

Direct antitumor effects
Restore, augment, or modulate host immune system mechanisms
Have other biologic effects, such as interfering with CA cells’ ability to metastasize or differentiate

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34
Q

types of chemo biotherapy - interferon (junkies change metabolism bc they’re nk)

A

interferon
- Alters cellular metabolism in normal & CA cells
- Inhibits function of several oncogenes
- Can activate NK cells

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35
Q

targeted therapy (tyrone targets clones, angie, and tease)

A

Tyrosine kinase inhibitors
Monoclonal antibodies
Angiogenesis inhibitors
Proteasome inhibitors

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36
Q

biologic therapy - Hematopoietic Growth Factors (biology is HeMan in a colony with ears)

A

Hematopoietic Growth Factors
Colony Stimulating Factors
Erythropoietin

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37
Q

should try and get which lymph node? (sentinal node is the best)

A

sentinal node - just this one because it can identify cancer and you want to get as few lymph nodes as possible d/t lymphodema

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38
Q

during surgery, primary staging is…(primary is TNT - and what it stands for)

A

TNMdetermine prognosis, treatment, and to report to registry for statistics
T - tumor size
N - lypmph nodes
M - matastesties

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39
Q

dry desquamation

A

red raw skin from radiation

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40
Q

vancomyicin is a

A

250 mL dilute, infusion rate is longer due to risk of exstravigation.

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41
Q

nursing interventions

A

fatigue
body image and self esteem
progressing through the grieving process

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42
Q

Targeted therapy

A

Targeted therapy
Aims at a cancer’s specific genes or proteins that contribute to cancer growth and survival
Biopsy can help determine whether a tumor has the specific target

43
Q

biologic therapy - Toxic and Side Effects (think interferon and the flu - you used to know this)

A

Systemic immune and inflammatory response
Rash
Flu like symptoms (rakers - sever shivering - same with hep C)
Symptoms decrease over time
Tachycardia, orthostatic hypotension

44
Q

biologic therapy - Nursing Considerations (biology is capillaries and craziness)

A

Teaching
Acetaminophen
Demerol - good for riggers
Observe for neurologic deficits
Assess for complications, such as capillary leak syndrome

45
Q

Hematopoietic Stem Cell Transplantation (Review in Reading)

A

Harvest Procedures - draw out and seperate wbc

Preparation - remove blood and then return it

Complications - bleeding infection

Stem Cell

Cord Blood Stem Cells - unbelical cord

46
Q

Oncologic Emergencies - (emergencies are shocking to my superior, and diuretic)

A

Septic Shock
Superior Vena Cava Syndrome
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

47
Q

Gerontologic Considerations - what about the dose?

A

More than 57% of cancers occur in persons over age 65
Chemotherapy - maybe a lower dose
Radiation Considerations
Surgery
Pain Management
Nutritional Considerations

48
Q

Care of the Patient with Advanced Cancer

A

Focus on promoting comfort and improving quality of life
Pain management
Provide support for family and pt
Multidisciplinary approach
Bereavement counseling

49
Q

Kubler-Ross: focuses on behavior & includes 5 stages (I DABDA in kubla)

A

Denial
Anger
Bargaining
Depression
Acceptance

50
Q

Bowbly’s Phases of Mourning

A

Bowbly’s Phases of Mourning
Numbing
Yearning & Searching
Disorganization & despair
Reorganization

51
Q

Worden’s Four Tasks of Mourning

A

Task I
Task II
Task III
Task IV

52
Q

cancer 55 and older - why?

A

more exposure to carcinogens, more cell damage, more immune problems, more screening.

53
Q

mortality rate declining with what cancers? (BLOC is declining)

A

lung, colrectal, breast and oral

54
Q

reversible disorders with cell growth (MAHH, hypertrophy is reversible)

A

atrophy
hypertrophy
hyperplasia
metaplasia

55
Q

failure of immune response in what groups? (think vulnerable)

A

children less than 2 yrs old
adults older than 60 yrs
organ transplants
AIDS

56
Q

Carcinogens

A

Carcinogens: substances or agents that damage genetic material

57
Q

viral carcinogens (HHHE is viral - think pap)

A

The are anko!
epstein-barr - burkitt’s lymphma
HIV - Kaposi sarcoma
Hep B - Hepatocellular carcinoma
Human pap - squamous cell carcinoma

58
Q

promotion is reversible or not? (the promoter can be stopped)

A

reversible. if cell goes on to develop more cells.

59
Q

cigs have both

A

initiating and promoting factors

60
Q

progression

A

cluster of cells, evidence of disease. Irrereversible.

61
Q

malignant v. benign

A

malignant travel and metastisize, benign - non cancer, rarely regrow.

62
Q

prevention

A

Smoking Cessation
-The deadliest form of CA can be prevented by smoking cessation
- Also attributed to other Ca i.e. Mouth, esophageal, bladder

63
Q

prevention - Behavioral Modification

A

Behavioral Modification
- Certain CA related to infectious exposures including Hep B, HIV, HPV and others could be prevented through behavioral changes, vaccines

64
Q

when proto-oncogenes become mutated….

A

they alter their expression can activate them to function as oncogenes, causing unrestrained growth (cancer)

65
Q

tumor suppressor genes may

A

May also play role in carcinogenesis

66
Q

ex of tumor suppressor genes (please suppress the B52s and Braca)

A

P53 supressor gene - mutation could be a risk of colon cancer. Braca 1 or 2 - breast and ovarian cancer.

67
Q

Types of Biopsies: Only definitive means of dx (NIE biopsies)

A
  1. Needle Bx
    2. Incisional Bx (portion of mass taken out)
    3. Excisional Bx (remove entire mass and boarders)
68
Q

Poorly differentiated tumors have a

A

worse prognosis than those closer in appearance to normal cells.

69
Q

Stage O (zero situations)

A

Stage O - Carcinoma In Situ (hasn’t spread)

70
Q

Stage I (one is the origin)

A

Stage I - tumor limited to tissue of origin

71
Q

Stage II (limited 2 locals only)

A

Stage II - limited local spread

72
Q

Stage III (mom)

A

Stage III - extensive local and regional spread

73
Q

Stage IV

A

Stage IV - metastasis

74
Q

External Radiation (I need a few weeks externally)

A

Total dose may be delivered over several weeks to allow healthy tissue to repair

75
Q

where is internal radiation used? (HNG the P internally)

A

Commonly used in head, neck and gynecologic tumors, prostate

76
Q

systemic effects - chemo - epithelium

A

Affects cells with rapid growth rates
i.e. Epithelium, bone marrow, hair follicles, sperm
Integumentary System (hair loss)

77
Q

systemic effects - chemo
GI

A

GI (esophagitis, diarrhea, N/V)

78
Q

systemic effects - chemo - Hematopoietic System

A

Hematopoietic System (bone marrow - WBC, RBC, bleeding)

79
Q

systemic effects - chemo - renal

A

Renal System (dead cells can accumulate in kidneys)
Cardiopulmonary System

80
Q

systemic effects - chemo - Reproductive System

A

birth control up to 2 years after therapy. have genetic counseling if you’re having kids

81
Q

if neutrophils low and neutropenic low, what precautions?

A

put on neutropenic precautions - few visitors, no flowers, no plants, no raw fruits veggies, eggs. assess for signs of infection - low grade fever more dangerous for neutropenic person. private room.

82
Q

chemo nursing interventions - BM

A

Stool softeners (to prevent straining)

83
Q

chemo nursing interventions - bloodwork?

A

Assess CBC, platelet ct

84
Q

chemo nursing interventions - injections?

A

AVOID IM, SQ injections
Tissue Integrity (especially with radiation, surgery)

85
Q

chemo nursing interventions - ice or heat?

A

No ice or heat on radiation sites
Susceptible to breakdown, pressure ulcers
May require wound care

86
Q

interferon approved for what types of cancer? (interferon for MCK jag)

A
  • Approved for tx of Kaposi sarcoma (KS), Chronic myeloid leukemia (CML), Melanoma
87
Q

Cancer cells can become resistant to what?

A

target therapies

88
Q

(Biologic therapy) Hematopoetic growth factors - Colony stimulating factors - (the colony of white)

A

Stimulate production, maturation, regulation and activation of cells in hematologic system i.e. Neupogen (med that stimulates WBC count)

89
Q

if you need Erythropoietin (this is biologic therapy), you can take what drug?

A

i.e. Epogen for tx of chemo-related anemia

90
Q

biggest danger of biologic therapy?

A

***Capillary Leakage Syndrome - biggest danger - inflammation and leaking

91
Q

oncologic emergencies - (THC_D for oncology)

A

Hypercalcemia
Tumor Lysis Syndrome- large number of cancer cells die within a short period, releasing their contents in to the blood
Disseminated Intravascular Coagulation (DIC)
Cardiac Tamponade Syndrome - fluid sac around your heart fills with blood or other fluid, putting pressure on your heart.

92
Q

atrophy ex. (reversible)

A

atrophy (brain, muscle cells),

93
Q

hypertrophy ex. (reversible)

A

hypertrophy (muscle cells, cardiac muscle)

94
Q

hyperplasia ex. (reversible) (hyper amount of cells)

A

increase in # of cells, tissue regeneration, hormonal

95
Q

metaplasia ex. (reversible) (replace GERD trude at the met)

A

metaplasia (replace one cell for another - chemical insult - GERD - collumnar for squamous cells)

96
Q

dysplasia ex. (the abnormal are displaced) (reversible)

A

abnormal tissue. connection to cancer growth

97
Q

histological grades (history grades for ana)

A

Grade I mild dysplasia
Grade II moderate dysplasia
Grade III severe dysplasia
Grade IV anaplasia -

98
Q

markers used to identify

A

best form of treatment

99
Q

early signs of radiation

A

desquimation, fatigue, esophagitis, cough, pain

100
Q

s/s of capillary leakage syndrome (capillaries crackle and cause edema)

A

tachycardia, ortho hypo, crackles on lungs, edema - urgent action needed

101
Q

main sites of matasties

A

brain, spinal fluid, lungs, adrenal, liver, bones

102
Q

Superior Vena Cava Syndrome

A

group of symptoms that happen when something blocks or compresses your superior vena cava

103
Q

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A

condition in which the body makes too much antidiuretic hormone (ADH)

104
Q

septic shock

A

A widespread infection causing organ failure and dangerously low blood pressure

XIO (372 decks)

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