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Adults Exam 4 > Oncology > Flashcards

Oncology Flashcards

1
Q

cancer (CA)

A

abnormal cell growth; cells ignore the growth regulation signals

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2
Q

Benign

A

tumor that is noncancerous

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3
Q

Malignant neoplasms (cancer cells)

A

cancer cell growth

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4
Q

tumor

A

can be cancerous or noncancerous; abnormal tissue growth

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5
Q

metastasis

A

spread of cancer from original site to another site

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6
Q

what is the second leading cause of death?

A

cancer! second to cardiovascular disease

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7
Q

3 leading causes of cancer death in men

A

prostate, lung, colorectal

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8
Q

3 leading causes of cancer death in women

A

breast, lung, colorectal

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9
Q

rates of cancer death are higher in men or women?

A

men

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10
Q

cancer death rates are higher in which specific gender & race & lower is which specific gender & race?

A

higher: African American men
lower: Asian / Pacific Islander women

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11
Q

factors affecting cancer death rates (4)

A
  1. attitudes / lifestyle choices
  2. cultural beliefs
  3. socioeconomic status / insurance coverage
  4. misconceptions
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12
Q

what causes cancer?
- factors associated w cancer causation
- describe exposure
- list another cause

A

causes of most cancers are unknown
carcinogens: factors associated w cancer causation
exposure: alteration of genetic material of cell = oncogenes = produce abnormal cells = eventually become cancer cells
- failure of immune system can be another cause

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13
Q

lung cancer is often associated with _____

A

smoking

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14
Q

skin cancer is often associated with ____

A

UV light rays

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15
Q

examples of controllable risk factors (preventable concerns for cancer)

A

smoking, tanning beds, wearing sunscreen

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16
Q

list specific risk factors associated w increase incidence of cancer (4)

A

obesity, sedentary lifestyle, diet high in red meats & processed foods, diet high in alcohol

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17
Q

list & briefly describe specific carcinogens (6)

A
  1. viruses (HPV, hepatitis)
  2. physical agents (smoking, exposure to chemicals)
  3. chemicals
  4. genetic / familial factors (Broca 1 & 2 genes)
  5. lifestyle factors (diet high in red meats, processed foods, alcohol)
  6. hormones (childbirth, menopause)
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18
Q

role of the immune system R/T oncology (3)

A

surveillance, intact immune system, immune system invasion

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19
Q

how is cancer cell division & cancer cells different from the normal cell cycle? which specific gene is lacked?

A
  • complete the cell cycle quicker
  • less likely to enter in G0 phase
  • uncontrolled growth patterns & immortality (lack p 53 gene)
  • rapidly growing & reproducing cells are the targets of chemo & radiation
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20
Q

describe primary cancer prevention & give an example

A

reducing the risks
EX: HPV immunization

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21
Q

describe secondary cancer prevention & give examples

A

early detection & screening
examples: screening efforts like inspection, palpation, & diagnostic tests

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22
Q

describe tertiary cancer prevention

A

after diagnosis; prevention of complications
treatments considered therapeutic to eradicate or arrest disease and/or prevent further complications

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23
Q

how is cancer diagnosed?

A
  • multidisciplinary
  • physical exam findings during examination
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24
Q

diagnosis of malignancy (4)

A
  1. tissue biopsy
  2. cytology results
  3. lab results (hematological malignancies)
  4. CT, X-rays, MRI (scans body for tumors)
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25
Q

what must patients have to make cancer & malignancy diagnosis?

A

must have cells / tissue!!!

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26
Q

staging & grading of cancer
- when is it done?
- how are tumors categorized?

A
  • Done immediately after diagnosis / prior to treatment
  • Categorize tumors according to extent of disease & organs involved
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27
Q

describe staging vs grading

A

staging: determines the size, invasion, lymph node involvement, metastasis (how far it has spread); uses TNM system (tumor, nodes, mets)

grading: pathologic classification (Type of tumor cells & differentiation) Evaluation of extent to which tumor cells differ from normal cells

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28
Q

higher the stage or grade….

A

decreases prognosis for cure

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29
Q

higher the grade….

A

less chance of successful treatment

30
Q

list & describe the stages of cancer

A

stage 0: in situ cancer / very early lesions (Bump that can be cut out)
stage I: early invasion / no metastasis; No lymph nodes involved
(All in one spot)
stage II: limited local extension of tumor / minimal node involvement; Involvement in muscle wall as well as an organ
(Deeply in one spot)
stage III: extensive local & nodal invasion (Deeply in one spot & lymph node involvement)
stage IV: distant metastasis / other organs involved

31
Q

list & describe the grades of cancer

A

grades 1 & 2: well differentiated & deviated minimally from normal cells
“High grades” (grades 3 & 4): poorly differentiated & most aberrant compared w normal cells

32
Q

list & describe the 2 cancer treatment goals

A
  1. cure: eradictate the cancer
  2. Palliation: alleviation of symptoms when disease is beyond treatment
33
Q

describe surgery cancer treatment

A
  • Primary treatment
  • Palliative
  • Prophylactic: Treatment done before even being diagnosed (kind of a prevention) usually if someone is at a high risk
  • Used alone or with radiation & chemotherapy
34
Q

goals of radiation therapy

A

cure, control (controlling the growth), prophylactic

35
Q

prophylactic meaning

A

Treatment done before even being diagnosed (kind of a prevention) usually if someone is at a high risk for a type of cancer

36
Q

radiation treatment affects rapidly dividing cells such as… (5)

A
  1. Bone marrow
  2. Lymphatic tissue
  3. Epithelium of GI
  4. Hair follicles
  5. Gonads
37
Q

describe the process of radiation dosage; what should patients be educated on?

A
  • BSA (body surface area) often used
  • Patients should be educated on trying not to lose a lot of weight due to accuracy for med dosage
38
Q

list the 3 types of radiation

A

external beam, internal radiation (brachytherapy), radioactive isotopes

39
Q

describe the external beam radiation
- source
- what does it provide?
- what is affected?
- can body tolerate it?
- how is it given?

A
  • Source outside of body
  • Provides direct hit for local treatment
  • ALL tissue in pathway is affected
  • Limited amount that body can tolerate
  • Given in divided doses over several days or weeks
40
Q

describe the internal radiation (bradytherapy)
- what also is this called?
- what type of source?

A
  • also called radioactive implants / “seeds”
  • Sealed source
  • Site specific (prostate, thyroid)
  • Little exposure to nursing staff
  • No isolation needed
41
Q

describe the radioactive isotopes radiation
- what type of treatment? how is it administered?
- what type of source?
- patient & body are ____
- what is required for staff?
- which type of precautions?

A
  • Systemic treatment - inject / swallow
  • Unsealed source
  • Patient & body radioactive
  • Time, distance, & shielding for staff safety
  • Body fluid precautions & Isolation precautions
42
Q

adverse effects of radiation (4)

A
  1. skin reactions at entry & exit site of beam (external beam)
  2. bone marrow suppression
  3. fatigue
  4. alteration in nutrition - mucositis / stomatitis (inflammation of soft tissue in mouth - can be very painful)
43
Q

how long can adverse effects of radiation take to begin & how long can they last?

A

onset may take several days / weeks to begin & may last 2-4 weeks after treatment

44
Q

Nursing care of radiation (4)

A
  1. skin care
    - NO ointments, powder, soaps, deodorant, or perfumes
    - NO shaving w razor blade
    - protect skin from cold, heat, sun
    - loose fitting clothing
    - ONLY lotions, etc approved by radiology for skin irritations
    - do NOT wash off markings
  2. monitor CBC
  3. manage symptoms
  4. maintain nutrition
45
Q

normal lab value of RBCs

A

men: 4.0 - 5.9
women: 3.8 - 5.2

46
Q

Antineoplastic drugs
- what are they also known as?
- describe their function

A
  • also known as chemo drugs
  • work on rapidly dividing cells (but not smart enough to know which types are cancer cells) - why chemo destroys everything in the body!
47
Q

list & describe the 4 principles of chemo

A
  1. Disrupts reproduction of cells by altering biochemical processes
  2. Destroys malignant cells w out excess destruction of normal cells
  3. Given in repeated doses or cycles
  4. Functional assessment & other clearance tests done before drugs begin
48
Q

definition of chemotherapy

A

use of cytotoxic drugs

49
Q

uses of chemotherapy (4)

A
  1. If widespread / systemic disease
  2. High risk of undetectable disease
  3. Tumor cannot be resected & is resistant to radiation treatment
  4. Primary or combination treatment
50
Q

goals of chemotherapy (3)

A

cure, control, palliative

51
Q

chemotherapy adverse effects - Hematopoietic changes (4)

A
  1. Leukopenia (low WBC count)
  2. Anemia
  3. Thrombocytopenia (RBCs & platelets are low)
  4. May interrupt treatment schedule
52
Q

what is a common (but not as much anymore) adverse effect of chemotherapy that patients & families fear?
which med is given to prevent this?

A

Nausea & vomiting (Ondansetron is given)

53
Q

chemotherapy adverse effects - Mucosiitis / Stomatitis changes (3)

A
  1. oral, rectal, vaginal
  2. can effect entire GI tract - severe diarrhea
  3. can get ulcers in the mouth, GI tract, or rectum
54
Q

chemotherapy adverse effects - skin (2)

A
  1. Hair loss (alopecia)
    - hair will return but not necessarily the same
  2. skin reactions (finger nails & toe nails typically fall off)
55
Q

which cardiac med is used in chemotherapy as a protectant?

A

Doxorubicin

56
Q

which hepatic med is used in chemotherapy?

A

5-FU floraouracil

57
Q

which 2 renal meds are used in chemotherapy?
what are nursing interventions for these meds?

A

Cisplatin & cytoxan
nursing interventions: need pre-hydration & Mg replacement

58
Q

which 2 neurologic meds are used in chemotherapy?

A

Cisplatin & plant alkaloids (vincristine)

59
Q

how does chemotherapy affect the reproductive system? (3)

A
  1. dysfunction
  2. sperm / egg banking
  3. loss of libido
60
Q

role of nonspecific biologic response modifiers - give an example

A

stimulate the immune system generally
(EX: BCG)

61
Q

role of monoclonal antibodies - give an example

A

Destroy specific malignant cells & spare normal cells (Ex: Trastuzumab)

62
Q

what are the 3 types of cytokines? describe each & give examples

A
  1. Interferons - antiviral, antitumor, immunomodulatory
  2. Colony stimulating factors - treats myelosuppression (Ex: erythropoietin, filgrastim)
  3. Interleukins - immunomodulatory
63
Q

nursing management of the chemotherapy patients (5)

A
  1. Assess, educate, & evaluate patient / family understanding
  2. Monitor labs & patient’s clinical status
  3. Precautions r/t neutropenia, anemia, thrombocytopenia
  4. Assess self-care needs / assistance
  5. Nutritional needs
64
Q

nursing management of fatigue of an oncological patient (5)

A
  1. Teach energy conservation methods (Cluster care)
  2. Encourage rest periods between activities
  3. Educate on expected fatigue
  4. Educate on support groups
  5. Educate on safety precautions r/t weakness, falls, & driving
65
Q

nursing management of pain of an oncological patient (3)
- can lead to ___
- what to monitor?

A
  1. Pharm / non pharm treatment
  2. Leads to anxiety
  3. Monitor labs for med choice
66
Q

nursing management of nutritional needs of an oncological patient (8)
- what to administer?
- meticulous oral care: what does it consist of?
- what type of foods?
- pain meds if ____

A
  1. Administer antiemetics (before and/or on schedule)
  2. Small frequent meals
  3. Supplemental findings
  4. Educate on taste & smell alterations
  5. Meticulous oral care (rinses w/ sodium bicarb) - baking soda (High risk for mouth ulcers)
  6. Pain meds if stomatitis (inflammation of the mouth)
  7. Blood, non-acidic foods
  8. Maintain nutritional needs
67
Q

bone marrow suppression (neutropenia)
- increased frequency of __
- what is the cardinal symptom?
- how to prevent?
- staff must do what?
- may need which type of meds?
- what type of pain is expected & which meds are given for this pain?

A
  • Increased frequency of infection (Symptoms of infection may not appear)
  • Fever is cardinal symptom (>38)
  • Meticulous HANDWASHING!!!
  • Staff wears mask in room & place on patient when patient leaving room (check agency policy)
  • NO fresh flowers, fruits, vegetables, yogurt w/ active cultures
  • May need colony stimulating factors
    (G-CSF (filigrastim) - increases WBCs
  • Bone pain expected - acetaminophen given (no NSAIDS!)
68
Q

bone marrow suppression (anemia)
- characteristics
- what stimulates new production of RBCs?
- what to watch for?
- patient may receive ___

A
  1. Fatigue & decreased O2 carrying capacity
  2. Erythropoietin (Epoetin alfa) - stimulates new production of RBCs
  3. Watch Hgb / Hct
  4. May receive blood transfusions
69
Q

bone marrow suppression (thrombocytopenia)
- what to monitor for
- what are patients not allowed to use?
- what may patients require?

A
  • Monitor for bleeding & bruising (esp. GI / oral)
  • No razors / toothbrushes, no aspirin products, &
    no IM injections
  • May require platelet transfusions
70
Q

oncology complications (9)

A
  1. Infection secondary to neutropenia
  2. Septic shock
  3. Pain
  4. bleeding / thrombocytopenia
  5. Hypercalcemia
  6. Tumor lysis syndrome
  7. SIADH
  8. DIC (disseminated intravascular coagulopathy) - bleeding everywhere
  9. Spinal cord compression

Adults Exam 4 (5 decks)

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