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oncology Flashcards

1
Q

whats cancer

A

abnormal cell growth

ignores growth regulation signals

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2
Q

whats benign mean

A

tumor but not cancer yah know

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3
Q

whats malignant neoplasms

A

cancer cells

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4
Q

whats a tumor

A

can be cancer or can not be cancer

just a little abnormal tissue growth

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5
Q

whats metastasis

teehee

A

spread from original site to another one

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6
Q

are medical screenings important

A

sure are

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7
Q

what are the 3 leading causes of cancer death for men

A
  • prostate
  • lung
  • colorectal
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8
Q

what are the 3 leading causes of cancer death for women

A
  • breast
  • lung
  • colorectal
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9
Q

what factors can affect cancer death rates

A
  • attitudes/lifestyle choices
  • cultural beliefs
  • socioeconomic status/insurance
  • misconceptions
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10
Q

whats a carcinogen

A

factors associated with cancer causation

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11
Q

read this

A

exposure -> alteration og genetic material of cell -> oncogenes -> produce abnormal cells -> eventually become cancer cells

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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
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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)
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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
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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
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16
Q

describe primary prevention of cancer

A
  • before cancer happens
  • reducing risks
  • example: HPV immunization
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17
Q

describe secondary prevention of cancer

A
  • early detection and screening
  • screening efforts -> inspction, palpation, and diagnostics
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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
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19
Q

which of the following would be considered primary prevention for cancer?

  1. yearly colonoscopy
  2. yearly CT scnas after diagnosis
  3. HPV vaccine
  4. genetic testing
A

HPV vaccine

primary is all about reducing risks

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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

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21
Q

when is staging and grading of cancer done

A

immediately after diagnosis and prior to treatment

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22
Q

what is staging and grading of cancer

A

categorize tumors accoding to extent of disese and organs involved

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23
Q

what is staging

A

determines size, invasion, lymph node involvement, mets

TNM system (tumor, nodes, mets)

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24
Q

whats grading

A

pathologic classification

type of tumor cells and differentiation

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25
Q

higher the stage/grade =…

A

decerased prognosis for cure and less chance of successful treatment

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26
Q

name and describe some staging of cancers

A

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
Q

name some grades and what they mean

A

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
Q

what are some cancer treatment goals

A
  • cure: ereadicate the cancer
  • palliation: alleviation of symptoms when disease is beyond treatment
29
Q

describe surgery as a cancer treatment

A

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
Q

what are the goals of radiation

A

cure, control, or prophylactic

31
Q

what cells does radiation affect

A

rapidly dividing cells like:
- bone marrow
- lymph tissue
- GI lining
- hair
- gonads

32
Q

describe radiation dosage

A
  • super specific
  • uses BSA
  • person has to try to maintain weight
33
Q

name three types of radiation

A
  • external beam
  • internal radiation
  • radioactive isotopes
34
Q

describe external beam radiation

A
  • 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
Q

describe internal radiation

A

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
Q

describe radioactive isotopes

A
  • 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
Q

what are some adverse effects of radiation

A
  • 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
Q

describe skin care for external radiation

A
  • 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
Q

whats included in nursing management of radiation

A
  • skin care
  • monitor CBC
  • manage sx
  • maintain nutrition
40
Q

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?

A

infection, don’t let ppl in there

41
Q

what kind of cells do antineoplastic drugs work on

A

rapidly dividing cells

42
Q

what are the principles of chemo

A
  • 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
Q

what is chemotherapy

A

use fo cytotoxic drugs

44
Q

describe the use of chemotherapy

A
  • if widespread/systemic disease
  • high risk of undetectable disease
  • tumor cannot be resected and is resistant to RT
  • primary or combination treatment
45
Q

what are the goals of chemotherapy

A
  • cure
  • control
  • palliative
46
Q

if gicing chemo IV, what are you gonna watch for

A

watch for extravasation

47
Q

chemo adverse effects

hematopoietic changes

A
  • leukplakia
  • anemia
  • thrombocytopenia
  • may interrupt treatment schedule
48
Q

chemo adverse effects

nausea and vomiting

A
  • fewer episodes than years ago
  • major fear of pts and fams
  • give antiemetic -> ondansetron
49
Q

chemo adverse effects

mucositic/stomatitis

A
  • oral, rectal, vaginal
  • can effect entire GI tract - severe diarrhea
  • irritated and painful
  • might need feeding tube
50
Q

chemo adverse effects

skin changes

A
  • hair loss (alopecia) -> hair will return but no the same
  • skin reactions
  • nails will fall off???
51
Q

what are some possible major system toxicities

A
  • 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
Q

describe nursing management of chemo

A
  • use PPE
  • dispose of shit properly and handle spills
  • complete special education (how to handle, safe admin, side effects, emergencies, shit like that)
53
Q

what do nonspecific biologic response modifiers do

A

stimulate the immune system generally (ex, BCG)

54
Q

what do monoclonal antibodies do

A

destroy specific malignant cells and spare normal cells (MABs)

55
Q

name and describe some cytokines

A
  • interferons: antiviral, antitumor, immunomodulatory
  • colony stimulating factors: treat myelosupression (erythropoietin and fligrastim)
  • interleukins: immunomodulatory
56
Q

what can gene therapy do for cancer

A

can have super targeted therapies
controversial tho

57
Q

describe nursing management of the chemo patient

A
  • 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
Q

nursing management of onc patients

fatigue

A
  • 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
Q

nursing management of onc patients

pain

A
  • pharm and nonpharm treatment
  • leads to anxiety
  • monitor labs for med choice
60
Q

nursing management of onc patients

nutritional needs

A
  • 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
Q

describe neutropenia

A
  • 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
Q

describe anemia

A
  • fatigue and decreased O2 carrying capacity
  • erythropoietin
  • watch Hgb/Hct
  • may require blood transfusions
63
Q

describe thrombocytopenia

A
  • monitor for bleeding and bruising ( esp GI and oral)
  • no razors/toothbrushes
  • no aspirin products
  • no IM injections
  • may require platelet transfusions
64
Q

what are some oncology complications

A
  • infection secondary to neutropenia
  • spetic shock
  • pain
  • bleeding/thrombocytopenia
  • hypercalcemia
  • tumor lysis syndrome
  • SIADH
  • DIC
  • spinal cord compression

adults (51 decks)

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