Oncology Flashcards
Solid tumors include sarcomas which arise from ________ tissues like bone, muscle, tendons and cartilage and carcinomas which arise from _______ tissues that _____ organs like lungs, liver, breast, colon and prostate. ______ are the most common type
Hematologic malignancies arise from _______ or lymphatic cells and include ______, _______ and ______.
______ is the term used to describe the travel of primary cancer to other sites in the body.
connective
epithelial
line
carcinomas
blood
lymphomas, leukemias and myelomas
Metastasis
Risk Factors
_____ is the #1 cause of ______ cancer
_______ + tobacco = co-carcinogenic
obesity contributes to _____% of cancer-related deaths
increased incidence of cancer in the __________
most important risk factor of cancer is ______
african americans have the _____ incidence of cancer
exposure to ___ radiation, carcinogens like _____, _____ and _____ fuel, chronic _____ can cause abnormal cells and uncontrolled growth
tobacco, preventable alcohol 20 immunosuppressed aging highest UV, asbestos soot, diesel, irritants
Primary Prevention includes no _______, exercise and good _____, maintain normal _____, limit/eliminate ______, vaccines like _____ and Hep ___, avoid _____ to known carcinogens
Secondary Prevention is the use of _______ to detect cancer early; women should do _____ breast self exams anytime from day ____ to _____ of their cycle; ______ clinical exams and _____ for women over age _____; colonoscopy for everyone at age _____ then every ____ years; testicular tumors grow _______ so men should do monthly ______, major age group for testicular cancer is ____ to _____
Tertiary Prevention focuses on ________ of long term care for example _____ groups and rehabilitation
smoking
nutrition, weight
alcohol, HPV, B, exposure
screening monthly 7, 12, annual mammograms, 40 50, 10 very fast TSE 15, 36
management
support
General S/S: CAUTION C: \_\_\_\_\_\_ in bowel/bladder habits A: a \_\_\_\_\_ that doesn't heal U: \_\_\_\_\_\_\_\_ bleeding/discharge T: \_\_\_\_\_\_ or lump in breast/elsewhere I: \_\_\_\_\_\_ or difficulty \_\_\_\_\_\_ O: \_\_\_\_\_\_ change in wart/mole N: \_\_\_\_ cough or hoarseness cancer can invade bone marrow, causing \_\_\_\_, \_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_\_\_\_ unexplained weight \_\_\_\_\_, extreme wasting = \_\_\_\_\_\_\_, \_\_\_\_\_ is an early sign with leukemia/lymphoma, \_\_\_\_\_\_\_ is the most frequently reported symptom, PAIN
change sore unusual thickening indigestion, swallowing obvious nagging anemia, leukopenia, thrombocytopenia
loss, cachexia
fever, fatigue
Diagnosis with blood tests will include CBC with _______ which shows the # of _____ types of ________–most concerned with ______; elevated liver _______: AST/ALT; _____ markers
Positive diagnostic studies: ____ x-ray, CT, _____, PET scan, bone marrow/tissue _____
differential
different, WBCs
neutrophils, enzymes
tumor
Chest, MRI, biopsy
Goals of Treatment
cure, control, ______
______ is when two therapies are used together like chemo and ______
neoadjuvant are _____-specific and one has to be done before the next like ______ and chemo
treatment based on recommendations for their _______, _____ of the cancer, client’s ______
TNM = size of ______, lymph _____ involvement, ________
Malignancy is graded __ to __ and means the _______ that cancer cells look like the cells they came from, the more ______ the cancer is
palliate adjuvant radiation time surgery diagnosis grade, wishes
tumor, node
metastasis
1, 3, less
aggressive
Four types of surgery: PDTR
_____, ______, _______, ______
post-op: mastectomy
bleeding–check dressings front and back d/t _______
drains: JP or _______
if lymph nodes were removed, avoid procedures on affected side for ________, including no ____, blouses with ____, cannot wear _____, no ____ or injections
promote development of _____ circulation by squeezing ________, wall _____, flex and extend _____
prevention, diagnosis, treatment, reconstruction
pooling
hemovac
lifetime, BP
elastic, watch, IV
collateral
tennis ball, climbing, elbow
Internal Radiation = _______, where the radiation is _______ the body and they are a _______ to others since they _______ radiation for a period of time
sealed = body fluids \_\_\_\_\_\_ radioactive unsealed = client and body \_\_\_\_\_\_ emit radiation
unsealed given ___ or PO and radioactive for ___ to ____ hours
nursing assignments should rotate ______, nurse should have only _____ client with implant in a shift, client is in a ______ room, _______ badge at all times, restrict ______: _____ minutes/day, stay ____ feet away, no visitors under age _____, no _____ visitors/nurses
Prevent dislodgment of implant by maintaining client on _____, decrease ____ in diet, prevent _____ distention
If implant gets dislodged: ______, _____, ______
They are _______ so can they sleep in same bed as another? __, they also should not use public _____, cannot go back to work _________, cannot share ________, flush toilet ______ times
brachytherapy
inside, hazard
emit
NOT
fluids
IV, 24-48
daily one private, dosimeter visitors, 30, 6 16, pregnant
bedrest, fiber, bladder
gloves, tongs, lead-lined container
immunosuppressed
NO, transport
immediately
utensils, 3
External radiation, client is ______ radioactive
S/S are _____ and ______ related
do not wash off ______, do not use _____ on the markings, protect site from ______/_____ exposure for ___ year
Expected side effects limited to ______ tissues: erythema, shedding, altered _____, #1 = _____, PANCYTOPENIA
NOT location, dose markings, lotion sunlight, UV one
exposed
taste, FATIGUE
Chemotherapy most often affects body systems where cells divide most ______, like ____, ______ and integument = _____ and ____
Handling precautions: ____ pair of chemo gloves, a chemo ___, goggles/mask if ______/_____ can occur
Dispose in _____ waste container/bag
chemo given IV via _____ they are _____ and can cause tissue ______ if it infiltrates; S/S of extravasation include pain, _____ and no ______ return; _____ with client receiving a vesicant, #1 thing to remember is ________; if chemo extravasates: ______ the infusion, use ____ packs for __________; chemo ____ be given orally, still wear ______
rapidly, blood, GI, skin, hair
two
gown, splash, inhalation
YELLOW
port, vesicants necrosis swelling, blood, stay prevention STOP, cold vasoconstriction, CAN gloves
Transplants: ___ cell and ____ marrow
complications include ____, _____ vs _____ disease
signs of rejection include _______ pain and other GI symptoms (cramps, N/V, diarrhea), ____ or other liver problems, _____ (tea-colored) urine, skin _______
stem, bone infection, graft, host abdominal jaundice dark, rash
Major Side Effects of Cancer/Treatment
Body Image: ______, ______, want them to look at incision, weight _____ and puffiness from ______ therapy or weight _____ can affect body image
Fatigue–provide adequate _____
Infection is #_____ cause of cancer-related ______
prevent infection with _____ room, _____ hands, have own _______ in room, limit ______ in room (nurses and visitors), change dressings/IV tubing _____, no fresh _____ or potted _____, avoid _____, don’t share _____, bathe warm, moist areas _____ daily, wash hands after ______ a pet or ______ hands, avoid ______ fruits and veg; watch for _____ increase in temp = ______
tell clients to go to hospital/clinic for oral temp of ______
monitor absolute ______ count–the #1 most important
alopecia, scars
gain, steroid
loss
rest
one, death private, wash supplies, people daily flowers, plants, crowds, utensils twice touching, shaking, fresh slight, sepsis 100.4 neutrophil
Neutropenia is a _______ in number of neutrophils which are ______ WBCs–ANC or _______ neutrophil count is the best way to asses for neutropenia
NADIR is the ____ point, neutrophils are the ________ defense in the body to protect from _______
_________ + infection = _______, septic shock, death
risk factors include very _____ and very _____, advanced _______ disease, malnourishment, B12 and ______ acid deficiencies, impaired _____ integrity, other diseases like _________, HIV/AIDS, COPD, ______, result of _________ treatments
Treat neutropenia with ________ and implement _______ precautions with VS every ___ hours, _____ room with door closed/sign posted, use of _________ soap, no _______ procedures (__ injections, ______ exam/meds, _______ catheters and ____ tubes), limit use of ______ due to toxicity to liver
decrease
mature absolute
lowest, first-line infection neutropenia, sepsis old, young metastatic folic, tissue DM, HF cancer
antibiotics neutropenic, 4, private antimicrobial invasive, IM, rectal indwelling, NG acetaminophen
DVT is the ________ leading cause of death in cancer clients–malignancy is a risk factor due to prolonged _______, surgery, use of a ______ line, tumor ______ on vessels or invasion of _______, certain chemo drugs
BIGGEST FEAR WITH DVT = _________
second
bedrest, central, compression
vessels
PULMONARY EMOBOLUS
Thrombocytopenia is a _________ in the number of ________ which are responsible for _______; risk factors include ______ disorders, hematological _________, _______ infections, anticoagulant use like _____, ______, ______, or _______, result of cancer ________
Bleeding assessment includes history, VS, SpO2, changes in _______, reporting _______, pupil _______, conjunctival _______, petechiae, eccyhmosis, purpra, oozing from _______/______ sites, bleeding from _______, ears, nose, mouth
Treatment is to give __________
NEVER WANT TO INFUSE _________ PLATELETS! THE ______ WILL REJECT THEM
decrease platelets, clotting bleeding, malignancies bacterial, aspirin clopidogrel, heparin, warfarin, treatments
LOC, headache, changes
hemorrhage
puncture, surgical
rectum
platelets
COLD
SPLEEN
Considerations for blood products with oncology pt.
RBCs are for clients with __________ anemia, do not want H/H below _____ and _____%
Platelets given to control or prevent ______ associated with ________
Want CMV ________ or CMV ________ RBCs/Platelets
Leukoreduction = CMV _____
symptomatic
8, 24
bleeding
thrombocytopenia
negative, safe
safe
N/V is the most _____ side effect of _____, it’s also a side effect of ______
Chemo has a rating based on its ______ risk
Prevention includes giving _________ BEFORE treatment, behavioral ______, acupressure/acupuncture
Antiemetic drugs include _________ which blocks ________, all serotonin receptor antagonists end in ______; netupitant/palonosetron is an oral _______ antiemetic that requires ______ dose _____ hour before chemo, it prevents acute and ______ N/V
Non-pharm treatments for N/V include ginger (______ ginger ale), aromatherapy (______, _______, ______, _______), acupuncture/acupressure, distraction, ________ techniques
feared, chemo
radiation
emetic
antiemetics
therapy
ondansetron serotonin -tron, combination one, one delayed
real
peppermint, lemon, basil
lavender
relaxation
Pain–treat without regard to risk for _______
______ are considered the GOLD STANDARD for cancer pain
there is ______ ceiling on the dose of an opioid for a cancer patient–it is ______ dependent
Other therapies for pain: complementary/________ therapies, acupressure/_________, cannabis, ________ therapies, hydrotherapy, ________
DEPENDENCE
OPIOIDS
NO
patient
alternative
acupuncture, distraction
massage
