oncology Flashcards
1
Q
whats cancer
A
abnormal cell growth
ignores growth regulation signals
2
Q
whats benign mean
A
tumor but not cancer yah know
3
Q
whats malignant neoplasms
A
cancer cells
4
Q
whats a tumor
A
can be cancer or can not be cancer
just a little abnormal tissue growth
5
Q
whats metastasis
teehee
A
spread from original site to another one
6
Q
are medical screenings important
A
sure are
7
Q
what are the 3 leading causes of cancer death for men
A
- prostate
- lung
- colorectal
8
Q
what are the 3 leading causes of cancer death for women
A
- breast
- lung
- colorectal
9
Q
what factors can affect cancer death rates
A
- attitudes/lifestyle choices
- cultural beliefs
- socioeconomic status/insurance
- misconceptions
10
Q
whats a carcinogen
A
factors associated with cancer causation
11
Q
read this
A
exposure -> alteration og genetic material of cell -> oncogenes -> produce abnormal cells -> eventually become cancer cells
12
Q
what causes cancer
A
- most causes are unknown
- carcinogens
- failure of immune system
- specific risk factors associated: smoking, UV, obesty, alcohol, sedentary ppl, and diet increased in red meat and processed shit
13
Q
name some different carcinogens
A
- viruses (herp, hep, and HPV)
- physical agents (UV and pollution)
- chemicals (asbestos)
- genetics
- lifestyle factors (tobacco, piercings?)
- hormones (child birth and menopause)
14
Q
whats the G0 phase and how does it relate to cancer
A
- resting phase of cell cycle, no reproduction happening here
- cancer cells are less likely to enter this phase
15
Q
describe cancer cells
A
- complete cell cycle quicker
- less likely to enter G0 phase
- uncontrolled growth patterns and immortality (lack p53 gene)
- rapidly growing and reproducing cells are the targets of chemo and radiation
16
Q
describe primary prevention of cancer
A
- before cancer happens
- reducing risks
- example: HPV immunization
17
Q
describe secondary prevention of cancer
A
- early detection and screening
- screening efforts -> inspction, palpation, and diagnostics
18
Q
describe tertiary prevention of cancer
A
- after diagnosis
- prevention of complications
- treatments considered therapeuti to eradicate or arrest disease and/or prevent further complications
19
Q
which of the following would be considered primary prevention for cancer?
- yearly colonoscopy
- yearly CT scnas after diagnosis
- HPV vaccine
- genetic testing
A
HPV vaccine
primary is all about reducing risks
20
Q
describe the diagnosis of cancer
A
- multidisciplinary
- physical exam findings during examination
- diagnosis of malignancy: tissue biopsy, cytology results, lab results (heme malignancies), CT, Xrays, MRI
must have cells/tissue to make diagnosis
21
Q
when is staging and grading of cancer done
A
immediately after diagnosis and prior to treatment
22
Q
what is staging and grading of cancer
A
categorize tumors accoding to extent of disese and organs involved
23
Q
what is staging
A
determines size, invasion, lymph node involvement, mets
TNM system (tumor, nodes, mets)
24
Q
whats grading
A
pathologic classification
type of tumor cells and differentiation
25
higher the stage/grade =...
decerased prognosis for cure and less chance of successful treatment
26
name and describe some staging of cancers
**0**: insitu CA/very early lesions
**I**: early invasion/no mets
**II**: limited local extension of tumor/minimal node involvement
**III**: extensive local and nodal invasion
**IV**: distant mets/other organs involved
27
name some grades and what they mean
**grades 1 and 2**: well differentiated and deviated minimally from normal cells
**high grades (grades 3-4)**: poorly differentiated and most aberrant compared with normal cells
28
what are some cancer treatment goals
- cure: ereadicate the cancer
- palliation: alleviation of symptoms when disease is beyond treatment
29
describe surgery as a cancer treatment
can be:
primary tx: just cut it out
palliative: make em more comfy
prophylactic: take out the body part b4 it gets there
used alone or with radiation and chemo
30
what are the goals of radiation
cure, control, or prophylactic
31
what cells does radiation affect
rapidly dividing cells like:
- bone marrow
- lymph tissue
- GI lining
- hair
- gonads
32
describe radiation dosage
- super specific
- uses BSA
- person has to try to maintain weight
33
name three types of radiation
- external beam
- internal radiation
- radioactive isotopes
34
describe external beam radiation
- source outside the body
- provides direct hit for local tx (doesnt really attack cells outside of radiated area)
- ALL tissue in pathway is affected
- limited amount the body can tolerate
- given in divided doses over several days-wks
35
describe internal radiation
brachytherapy = use of implants at treatment site
radioactive implants/"seeds":
- sealed source
- site specific (prostate, lungs, thyroid)
- little exposure to nursing staff
- no isolation needed
36
describe radioactive isotopes
- systemic treatment - inject or swallow
- unsealed source
- **patient and body radioactive**
- time, distance, and shielding for staff safety
- body fluid precautions
- isolation precautions
- used for super extensive CA, hospitalized for tx
37
what are some adverse effects of radiation
- skin reactions at entry and exit site of external beam
- bone marrow suppression
- fatigue
- alteration in nutrition (mucositis and stomatitis)
**onset may take several days/wk to begin and may last 2-4wks after tx**
38
describe skin care for external radiation
- NO ointments, powder, soaps, deodorants, or perfurmes
- NO shaving with razor blade
- protect skin from cold, heat, and sun
- loose fitting clothing
- only lotions, etc approved by radiology for skin irritations
- **DO NOT wash off markings**
39
whats included in nursing management of radiation
- skin care
- monitor CBC
- manage sx
- maintain nutrition
40
your chmotherapy pt has the following lab values: WBC 2.5, plts 300,000, and RBC 4.5. which type of precaution would be appropriate?
infection, don’t let ppl in there
41
what kind of cells do antineoplastic drugs work on
rapidly dividing cells
42
what are the principles of chemo
- disrupts reproduction of cells by altering biochemical processes
- destroys malignant cells without excess destruction of normal cells
- given in repeated doses or cycles
- functional assessment and other clearance tests done before drugs begin
43
what is chemotherapy
use fo cytotoxic drugs
44
describe the use of chemotherapy
- if widespread/systemic disease
- high risk of undetectable disease
- tumor cannot be resected and is resistant to RT
- primary or combination treatment
45
what are the goals of chemotherapy
- cure
- control
- palliative
46
if gicing chemo IV, what are you gonna watch for
watch for extravasation
47
# chemo adverse effects
hematopoietic changes
- leukplakia
- anemia
- thrombocytopenia
- may interrupt treatment schedule
48
# chemo adverse effects
nausea and vomiting
- fewer episodes than years ago
- major fear of pts and fams
- give antiemetic -> ondansetron
49
# chemo adverse effects
mucositic/stomatitis
- oral, rectal, vaginal
- can effect entire GI tract - severe diarrhea
- irritated and painful
- might need feeding tube
50
# chemo adverse effects
skin changes
- hair loss (alopecia) -> hair will return but no the same
- skin reactions
- nails will fall off???
51
what are some possible major system toxicities
- cardiac: drug thats dose is limited to once in a lifetime bc it sucks ass so bad
- hepatic: liver takes a hit
- renal: need hydration
- neurologic: get some neuropathies goin on
- reproductive: save those eggs and sperm bc theyre not gonna last and your sex drive will be GONE
52
describe nursing management of chemo
- use PPE
- dispose of shit properly and handle spills
- complete special education (how to handle, safe admin, side effects, emergencies, shit like that)
53
what do nonspecific biologic response modifiers do
stimulate the immune system generally (ex, BCG)
54
what do monoclonal antibodies do
destroy specific malignant cells and spare normal cells (MABs)
55
name and describe some cytokines
- interferons: antiviral, antitumor, immunomodulatory
- colony stimulating factors: treat myelosupression (erythropoietin and fligrastim)
- interleukins: immunomodulatory
56
what can gene therapy do for cancer
can have super targeted therapies
controversial tho
57
describe nursing management of the chemo patient
- assess, educate, and evaluate patient and fam understanding
- monitor labs and pts status
- precautions r/t neutropenia, anemia, thrombocytopenia
- assess self care needs and assistance
- nutritional needs
58
# nursing management of onc patients
fatigue
- varies from person to person
- teach energy conservation methods
- encourage rest between activities
- educate on expected fatigue
- educate on safety precautions r/t weakness, falls, and driving
59
# nursing management of onc patients
pain
- pharm and nonpharm treatment
- leads to anxiety
- monitor labs for med choice
60
# nursing management of onc patients
nutritional needs
- administer anti-emetics (**before and/or on schedule**)
- small frequent meals
- supplemental feedings
- educate on taste and small alterations
- meticulous oral care (**rinses with sodium bicarb**)
- pain meds if stomatitis
- bland, non acidic foods
61
describe neutropenia
- increased frequency of infection
- symptoms of infection may not appear
- **fever is cardinal symptom (>38)**
- meticulous handwashing
- **staff wears mask in room and place on patient when patient is leaving room - check agency policy**
- NO fresh flowers, fruits, veggies, yogurt with active cultures
- may need colony stimulating factors (filgrastim) with bone pain expected
62
describe anemia
- fatigue and decreased O2 carrying capacity
- erythropoietin
- watch Hgb/Hct
- may require blood transfusions
63
describe thrombocytopenia
- monitor for bleeding and bruising ( esp GI and oral)
- no razors/toothbrushes
- no aspirin products
- no IM injections
- may require platelet transfusions
64
what are some oncology complications
- infection secondary to neutropenia
- spetic shock
- pain
- bleeding/thrombocytopenia
- hypercalcemia
- tumor lysis syndrome
- SIADH
- DIC
- spinal cord compression
