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Surgical Nursing > Oncology > Flashcards

Oncology Flashcards

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1
Q

How is a tumour classified?

A

Benign vs malignant
tissue of origin
location

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2
Q

List the four categories of tumour

A

epithelial
mesenchymal
round cell
melanoma

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3
Q

What tumours can you get that are epithelial in origin?

A 
Squamous cell carcinoma 
Adenoma/adenocarcinoma
Basal cell carcinoma
Carcinoma
Begin lesions (warts, cysts,)
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4
Q

What tumours can you get from mesenchymal origin?

A 
Lipoma/liposarcoma
Fibroma/fibrosarcoma
Haemangiosarcoma/haemangioma
Leiomyoma/ leiomyosarcoma (soft tissue)
Soft tissue sarcoma 
Begnin and malingnent nerve sheath tumour
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5
Q

what tumours can you get that are round cell in origin?

A

Lymphoma
Histiocytic tumours (mononuclear phagocytes)
Mast cell tumours
Plamactoma (monoclonal cells)

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6
Q

How should we deal with cuteanous and subcutaenous masses?

A

History
When did it occur, rate of growth, change in apperance, any other masses
FNA
biopsy

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7
Q

How do yo preform a FNA?

A

21g-23g needle
aspirate
submit cytology
aim for multiple angles

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8
Q

How and when should you preform a biopsy for masses?

A 
Failure of FNA 
determines tumour grade 
Tru-cut biopsy
Incisional biopsy 
excisional biopsy (entire abnormality removed)
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9
Q

What do we need to know before surgery of a mass?

A 
Metastasis (chest radiographs) 
Type of tumour (Begin malignant) 
Cell type involved 
Tumour grading (TNM) 
T- size and extent of main tumour
N_ the number of local lymph nodes 
M-metastasised
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10
Q

When assessing TNM what should we look at for T?

A 
Size of tumour 
 type of cell (Histological)
rate of growth 
location 
local invasion
Histological grade
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11
Q

When assessing TNM what must be considered for N?

A

Assess draining nodes
palpation
FNA
surgical biopsy

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12
Q

What should we look at when assessing metastasis in tumour grading?

A

Inflated lung radiographs
abdomen, lymph nodes, liver, spleen
bone skin brain

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13
Q

What must be considered before surgery to remove a mass?

A

Tumour type and grade
tumour stage
size and location

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14
Q

List the four common types of tumours

A

Mammary tumour
mast cell tumour
soft tissue sarcoma
lipoma

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15
Q

What are the five types of surgery that can be preformed on tumours?

A

Incisional biopsy
Debulking/ intracapsular recection
Excisional/ marginal excision
wide/oncological excision (resection margin)
Radical excision (removal of lymph nodes, blood supply adjacent structures)

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16
Q

What must you do when filling out a histopathology form?

A

Ink the margins the tumour was removed from
Positive-cancer cells lye within that margin
negative- no cancer cells are found within the ink
close margin anything that lie between the two

17
Q

How do you close a tumour removal wound?

A 
May require skin graft 
avoid too much tension 
may need drain to minimise dead space
post-op adjuvent therapy 
radiation and chemo
18
Q

What two types of drains can be used to minims dead space after tumour removal?

A

Passive-penrose

active-grenade, creates negative pressure

19
Q

What are the intrinsic and extrinsic factors of wound breakdown?

A

Intrinsic-concurrent disease, nutrition

Extrinsic-chemotherapy, steroids, radiotherapy

20
Q

Why does wound break down occur?

A 
infection 
tension(dehiscence) 
Patient interference
motion 
tissue handling/haemostasis
sutures
21
Q

What are the common areas that cause problems during wound healing?

A

distal limb
axilla /inguinal region
over boney prominences
consider axial pattern flaps

22
Q

How should wound break down be managed?

A

do not re-suture

allow to heal via secondary intention

23
Q

How do you prevent seroma formation after tumour removal?

A 
Minimise dead space, drain 
Halstead principles
rest 
leave alone 
pressure bandage 
provide further drainage
24
Q

What are the seven halstead principles?

A 
Limit tension 
Haemostasis 
gentle tissue handling 
preserve blood supply 
strict aspesis 
appose tissues accurately 
eliminate dead space
25
Q

what should you do when a tumour wound becomes infected?

A 
Swab, culture and sensitivity 
Anti-biotics 
increase drainage 
allow healing via secondary intention 
explore the wound
26
Q

When does tumour recurrence occur?

A

Dirty margins
Revision surgery
radiotherapy

Surgical Nursing (24 decks)

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