Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NCLEX ( fundamentals/MegSurg) > Oncology > Flashcards

Oncology Flashcards

You may prefer our related Brainscape-certified flashcards:
NCLEX-PN® flashcards NCLEX-RN® flashcards
1
Q

7 signs of Cancer remember pneumonic CAUTION (For O think of what Eric has a lot of on his back :D)

A

C-Change in bowel or bladder habit
A- A lesion that does not heal
U- Unusual bleeding or discharge
T- Thickening or lump in breast or elsewhere
I- Indigestion or difficulty swallowing
O- Obvious changes in warts or mole
N- Nagging cough or persistent hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where else can cancer cells spread

A

Blood and lymph systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is remission

A

Disappearance of abnormal cells in bone marrow or blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of diagnostic tests are taken for cancer

A
  • Biopsy
  • Bone marrow exam
  • Chest x-ray
  • CBC
  • CT scan
  • Cytology (like pap smear)
  • Liver function studies
  • MRI
  • Evaluation of serum tumor markers (Carcinoembryonic and alpha-fetoprotein
  • Guaiac test for occult blood
  • Radiographic (Mammogram)
  • Radioscope scanning ( Liver, brain, bone, lung)
  • Tumor markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is important in cancer Pts in pain

A

ALWAYS assess client pain, how Pt describes the pain, do not under medicate cancer client who is in pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can you give the Pt if in pain medications

A
  • Salicylates
  • Acetaminophen
  • NSAIDS (aspirin, ibuprofen) these three are given in mild - moderate pain

Severe pain
- Opioids (Codeine sulfate, morphine sulfate, methadone and hydromorphone (Dilaudid)

For neuropathic

  • Anticonvulsants
  • Antidepressants
  • Opioids

Subcut inj and cont IV of opioids for rapid pain control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is radiation ?

A
  • Destroys cancer cells (minimal exposure to normal cells)
  • Cells unable to divide because they are damaged
  • Effective on tissues directly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are side/adverse effects of radiation ?

A
  • Alopecia

- Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common types of radiation used ? (2 types)

A
  • External

- Brachytherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is external beam radiation ?

A
  • Radiation is external to the client
  • Uses high - energy rays to kill cancer cells (may be used after breast cancer surgery to wipe out any cancer cells that remain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can radiation be used at the same time as Chemotherapy ?

A

Yes, for treatment of cancer that has spread to other body parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Can external beam radiation be hazardous to others ?

A

No, The client does not emit radiation to others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are side effects of external beam radiation ?

A
  • Fatigue
  • Swelling
  • Itching
  • Redness to peeling skin
  • A sunburned like feeling in the treated area (of radiation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other therapy for radiation ?

A

Hormonal therapy with tamoxifen (anti- estrogen) for positive estrogen effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Side effects of radiation to Abd

A

Nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Side effects of radiation to pelvis

A

Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is redness and sloughing of tissue expected in Pt on radiation ?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How long does radiation treatment therapy take ?

A

5-7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Care for radiation treated area ?

A
  • Wash with plain water and pat dry
  • DO NOT use soap over treated area (dries skin, may wash of markings for radiation)
  • Avoid scrubbing or scratching
  • NO lotions or powders
  • AVOID sun exposure at least for a year after the completion of treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How long do you provide nursing care in a Pt receiving radiation ? what must you wear to determine amount of radiation, Distance between the Pt and nurse ?

A
  • Provide nursing care for 30 min each shift
  • Wear film badge to determine amount of radiation
  • Distance between the Pt and nurse should be at least 4-8 ft
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Brachytherapy ( Internal radiation )

A
  • Direct contact, continuous contact with tumor for a specific time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Does the Pt emit radiation ( can it spread to others) ?

A

Yes, They can emit radiation for a specific amount of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is unsealed radiation ?

A
  • Administer via oral or IV route by instillation into body cavities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Is unsealed radiation completely confined to one body area ?

A

No, It enters body fluids and eventually is eliminated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Explain removal of the seal radiation

A
  • Client is no longer radioactive
  • Inform to the client that cancer is no longer contagious
  • Inform that sexual intercourse may be resumed after 7-10 days (If implant was cervical or vaginal)
  • Provide douche if prescribed, if implant was placed in the cervix
  • Administer ready to use saline enema as prescribed
  • Client needs to notify MD if nausea, vomiting, diarrhea, frequent urination, vaginal or rectal bleeding, hematuria, foul smelling vaginal discharge, Abd pain or distention or a fever occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Explain brachytherapy in cervical cancer (internal radiation) Where is the implant placed and for how many days ?

A
  • Radioactive implants such as pellets, rods, seeds, ribbons, wires, needles, capsules, balloons, or tubes are inserted
  • Directly placed into the cervix for 1-3 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is HDR (high dose rate) brachytherapy ? How long is it applied for ?

A

A newer technique to avoid hospitalization, but not widely available
It is applied for 30 min- 1 Hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is LDR ( low dose rate) brachytherapy ?

A

This is usually used and requires hospitalization but it is not widely available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In what position should you be laying down when there is a radiation implant ? Can you have a pillow ? Are you allowed to go to the restroom ?

A
  • Lying flat
  • No pillow
  • No restroom, it may dislodge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What should the nurse do when a radiation rod is displaced ? Think nursing safety

A
  • Call radiation team
  • Use gloves
  • Use forceps
  • Place rod in a lead container
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is bone marrow transplantation and peripheral blood stem cell transplantation most commonly used for ?

A
  • Treatment for leukemia and lymphoma (cancer of lymph system)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What can BMT and PBSCT also be used to treat ?

A
  • Neuroblastoma ( cancer of immature nerve cells from adrenal gland, ganglia, neck)
  • Multiple myeloma (malignant plasma cells found in bone marrow)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the goal of treatment of BMT and PBSCT ?

A
  • Get rid of all leukemic or malignant cells through high doses of chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where is transplantation administered through ?

A
  • Central line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does the Pt remain without during post transplantation period ? * Think of what high does of chemotherapy will cause the Pt. to lack of*

A
  • The Pt remains without any natural immunity until donor stem cells begin to spread and grow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are major concerns post transplantation ? think with a lack of natural immunity you are prone to get sick

A
  • Neutropenia

- Severe thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How to care for a patient with a radiation implant ?

A
  • Lying supine (prevents dislodgement)
  • No bearing down
  • No bladder distension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What kind of diet are radiation implant Pt’s put on ?

A

Low fiber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Can a client undergoing radiation have sex ? Can it spread to the partner ?

A

Yes, Partner is not exposed with radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is important if child bearing age when undergoing radiation ?

A

Where a condom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Can you have sex after chemotherapy ?

A
  • Depends on WBC numbers

- Area being treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Where is chemotherapy excreted and for how many hours ?

A
  • Can be excreted through vaginal secretions

- Excreted for 48-72 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Explain bone marrow aspiration procedure

A
  • Pt under anesthesia
  • Needle inserted in rear hipbone ( iliac crest ), this is where a large amount of bone marrow is located
  • Extracted via needle and syringe
  • Several skin and bone punctures to each hip is required in aspiration of bone marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Any surgical incisions or stitches after a bone marrow aspiration ?

A

None needed, only skin punctures where needle was inserted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

At what age can person become a bone marrow donor ? What is important of the donor to be considered?

A

< 40
Must be the same ethnicity
Genetics should be the same

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is bone marrow harvest ?

A

Amount of bone marrow harvested depends on the size of the Pt and concentration of blood marrow cells in donor’s blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How much bone marrow is usually harvested

A

1 or 2 quarts of marrow and blood are harvested this is only 2% of a person’s bone marrow, body will replace in 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What may the Pt feel after anesthesia wears off ? (from BMT)

A
  • Discomfort at harvest site

- Pain is similar to feeling of falling on hard ice can be controlled by Tylenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Donors who are not also the BMT patient are usually discharged when ?

A
  • After an overnight stay and can fully resume activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What medication is not allowed to be taking in Pt receiving BMT

A

Motrin , due to risk of bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are 4 common types of leukemia * think ALL, CLL.

AML, CML*

A
  • Acute lymphocytic leukemia
  • Chronic Lymphocytic leukemia
  • Acute Myeloid Leukemia
  • Chronic Myeloid Leukemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Which type of leukemia is common in children ? at what age usually ?

A
  • Acute lymphocytic

- Age is < 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are signs and symptoms of leukemia which diagnostic blood tests are they low in ?

A
  • Fever and chills
  • Fatigue and weakness (ongoing)
  • Frequent infections
  • Losing weight without trying
  • Swollen lymph nodes
  • Enlarged liver or spleen
  • Bleeds easily (ecchymosis and petechiae, bleeding under the skin), red tiny spots
  • Overt bleeding ( Hematuria, nose bleeds, bleeding gums, increased menstrual flow, occult blood)
  • Excessive sweating especially at night
  • Bone pain and tenderness

Diagnostic Blood Tests:

  • Low WBCs
  • Low RBCs
  • Low Platelets
  • Decreased hemoglobin and hematocrit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the major cause in death in leukemia *Think what are you low in if you are prone to getting infections *

A
  • Immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

List some things that important in protecting a leukemia Pt * think about what are things to prevent them from further getting sick and what to avoid*

A
  • Protective isolations
  • Frequent handwashing
  • No visitors who are infectious
  • Aseptic technique
  • Keep all supplies separate from other Pts supplies
  • No raw fruits and veggies ( on low bacteria diet)
  • No fresh flowers or plants
  • Do not leave water standing in room for more than 15 min
  • Daily bathing using antimicrobial soap
  • Avoid any invasive procedures ( injections, rectal thermometer, enemas, catheters)
  • Change would dressings daily
  • Monitor for cloudiness in urine
  • Monitor skin and oral mucous membranes for signs of infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What kind of medications would be prescribed in leukemia Pts ?

A
  • Antibiotics
  • Antiviral
  • Antifungal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are concerns about bleeding in leukemia Pts ? Think blood tests

A
  • Risk for bleeding, if platelet count is less than 50,000 cells/mm
  • If platelet count falls below 20,000 cell/mm Pt may need a platelet transfusion
  • For anemia and fatigue packed red blood cells may need to be prescribed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Fatigue and nutrition for leukemia Pt. * What diet and how care for*

A
  • Small frequent meals that are high in (Calories, protein, and carbohydrates), require little chewing to reduce using up energy
  • Assist in self- care and mobility activities
  • ## Rest periods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Multiple Myeloma

A
  • Increased plasma cells and tumors within the bone
  • These cells invade the bone marrow and soft tissues and develop into tumors that will destroy the bone (osteopenia to pathological fractures)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Lab tests for Multiple Myeloma

A 
- Increase protein but decrease in:
Hemoglobin 
Hematocrit 
White cells 
Low platelets
61
Q

Early signs of MM ?

A

Bone pain and anemia

62
Q

Clinical manifestations of Pt with multiple myeloma Think how is blood, bones, and organs effected

A
  • Bone pain (mainly back)
  • Anemia, decrease in WBC, decrease platelets (thrombocytopenia), hypercalcemia (renal failure), elevated protein
  • Thinning of the bones, kidney and renal failure, high levels or uric acid
  • painful cervical lymph nodes
63
Q

What are diagnostic tests that should be taken for Pt. who has Multiple myeloma ?

A
  • Radiographic films
  • CBC and serum protein
  • Bence Jones test ( 24 urine collection) - for protein, a gram of protein is very serious
  • Bone marrow aspiration
64
Q

What is treatment given to a Pt with multiple myeloma ?

A

Chemo and radiation or a combination of both

65
Q

Nursing management in Pt with multiple myeloma Pt care ( what will you give and help to avoid for the Pt)

A
  • Increase fluids to prevent calcium crystallization in the kidneys
  • Blood transfusion for anemia
  • Analgesics (bone pain), Drug of choice is usually morphine
  • Protect from falls and no lifting more the 10lbs
  • Thalidomide ( used to treat MM) DO NOT take if pregnant or getting pregnant, will cause congenital disorders
66
Q

Hodgkin’s Lymphoma

A
  • Malignancy of lymph nodes that is in a single lymph node of chain of nodes and eventually invades non lymphoid tissue
67
Q

What parts of the body usually involve Hodgkin’s ? What is the hallmark sign ?

A
  • Lymph nodes
  • Spleen
  • Tonsils
  • Bone marrow
    The hallmark sign are Reed- Sternberg cells in the nodes
68
Q

How do you confirm Hodgkin’s ?

A

Biopsy

69
Q

Non Hodgkin’s Lymphoma

A
  • Painless and enlarged cervical and supraclavicular lymph nodes
70
Q

What is the reason for the use of Neupogen (Filgrastim) in Hodgkin’s ?

A
  • Treatment used for severe neutropenia induced chemotherapy
  • Reduces risk of infection in Pts with some tumors **DOES NOT prevent infection only reduces
71
Q

Neupogen is administered via ?

A
  • Sub cut

- IV ( May dilute to 5% dextrose but not saline)

72
Q

How long does a vial or pre-filled syringe have to be left out to be discarded ?

A
  • If greater than 24 hours
73
Q

What are common side effects when taken neupogen ?

A
  • Abd pain
  • Nausea
  • Vomiting
  • Bleeding gums
  • Nose bleeds
  • Hematuria ( blood in urine)
  • Rectal bleeding
  • Prolonged bleeding from cuts
  • Diarrhea
  • Redness and pain to injection site
74
Q

Side effects of chemo ?

A
  • Alopecia
  • GI disturbances
  • Bone marrow depression
75
Q

Pancytopenia

A
  • Decreased in platelets
  • Decreased in WBCs
  • Decreased in RBCs
76
Q

Side effects of radiation therapy

A
  • Fatigue
  • Hair loss on treated body part
  • Nausea/Vomiting/Diarrhea If Abd is treated
  • Mouth sores/Dry mouth/ if head/neck is treated
77
Q

How often should TSE’s be performed ?

A

Monthly, on same day each month

78
Q

What are common signs of testicular cancer ?

A
  • Painless testicular swelling
  • “Dragging” or “Pulling” feeling in the scrotum
  • Palpable masses
79
Q

What are late signs of testicular cancer ?

A
  • Back pain

- Respiratory symptoms

80
Q

What organs can metastasis occur in in testicular cancer ?

A
  • Liver
  • Lung
  • Bone
  • Adrenal glands via blood
  • Lymphatic channels
81
Q

Nursing interventions for Testicular cancer

A
  • Chemo may be prescribed
  • Radiation may be prescribed
  • Prepare for orchiectomy if prescribed
  • Retroperitoneal lymph node dissection if prescribed (This reduces tumor volume and chemo and radiation will be more effective)
  • Reproduction, sexuality, fertility info and options will be discussed
82
Q

Post-op interventions for testicular cancer what are you monitoring for what kind of medications will be prescribed

A
  • Monitor for bleeding
  • Infections
  • Antibiotics may be prescribed
  • Explain and provide pain management methods to reduce swelling ( icepack may be prescribed, make sure it is wrapped in cloth)
  • Sutures removed in 7-10 days
83
Q

When do you notify the RN for post op in testicular cancer ?

A
  • Fever
  • Chills
  • Increasing pain
  • Tenderness at incision site
  • Drainage at incision site
84
Q

Cervical Cancer

A
  • Cancer in the cervix and other pelvic structures

- Spread of cancer usually confined to pelvis but can spread to lymph

85
Q

What are risk factors in Cervical cancer ? * such as common infections how you can get it*

A
  • HPV ( Human Papilloma Virus ) , is an infection
  • Cigarette smoking
  • Early intercourse (before age of 17)
  • Multiple partners
86
Q

Signs of Cervical cancer

A
  • Painless vaginal bleeding ( post menstruation and after sex)
  • Foul smelling or serosanguineous vaginal discharge
  • Pelvic, lower back, leg, or groin pain
  • Anorexia and weight loss
  • Leakage of urine and feces from vagina
  • Dysuria ( painful urination)
  • Hematuria
  • Pap Smear ( not normal result)
87
Q

Endometrial (uterine cancer)

A
  • Slow growing tumor arising from endometrial mucosa of uterus ( mostly common in menopause )
88
Q

Risk factors of endometrial cancer

A
  • Use of estrogen replacement therapy
  • Nulliparity ( Never gave birth
  • Increased age
  • Menopause
  • Family history or heredity
  • Obesity
  • Hypertension
  • Diabetes mellitus
89
Q

What are risk factors of endometrial cancer ?

A
  • Abnormal bleeding especially in post menopausal women
  • Vaginal discharge
  • Low back
  • Pelvic or abdominal pain (this happens late in disease)
  • Enlarged uterus
90
Q

Breast Cancer, How can you diagnose it ?

A

Diagnosed by biopsy through a needle aspiration or surgical removal of the tumor

91
Q

What are risk factors of breast cancer ?

A
  • Age
  • Family history
  • Early menstruation
  • Previous cancer of the breast, uterus, or ovaries
  • Late in age for first birth
  • Obesity
  • High dose radiation exposure of the chest
  • Race and ethnicity (Caucasians and African American women)
  • Dense breast tissue (less fatty tissue)
92
Q

Data collection ( how to detect signs of breast cancer)

A
  • Mass felt during a BSE
  • Lesion is present during mammogram
  • Asymmetry ( affected breast is higher than the other )
  • Nipple retraction or elevation
  • Bloody or clear discharge
  • Skin dimpling
  • Skin edema (lymphatic involvement)
  • Axillary lymphadenopathy ( appears swollen)
  • Lymphedema of affected arm (swelling)
93
Q

What is a late stage symptom in breast cancer ?

A

metastasis to bone and lung

94
Q

Breast Self Examination (BSE) when to do it

A
  • Should be done 3-4 days after period (for younger women)
  • Every first day or end of month ( for irregular periods)
  • Should be done same day each month ( post menopausal)
95
Q

How to perform BSE

A
  • Use 3 middle fingers in dime size circles from periphery (outer) going towards the center of the breast in circular motion
  • This can be done standing
96
Q

Mammography

A
  • Age 35 is typically when to start
  • At risk age 30
  • Age 40 up Annually
  • Age 50 to 74 every 2 years
  • May have before 50 if history of breast cancer
97
Q

Ultrasound for breast cancer, what does it detect ?

A
  • Ultrasound can detect weather a mass is solid or fluid filled cyst
98
Q

Pt Teaching ( When not to have a mammogram and what not to wear when you do have the test)

A
  • During or 1 week before your period (due to tenderness of breasts)
  • On day of test Pt is not to wear deodorant, perfume, powder ( They show up as white spots on the x-ray
  • No dresses ( You will need to be undressed waist up)
99
Q

3 Types of surgical breast procedures (explain each)

A
  • Lumpectomy ( removal of lump and surroundings, and breast tissues with biopsy to lymph nodes)

Simple Mastectomy ( Removal of breast including nipple with only biopsy to lymph nodes

  • Radical mastectomy ( Removal of the breast to breast muscle layer of the chest including axillary lymph nodes)
100
Q

What to remember post surgical breast procedure

A

Arm is raised to prevent lymphedema

101
Q

Post mastectomy axillary exercises

A
  • Arm swing
  • Hand climbing
  • Pulley motion
  • Hand squeezing
  • Bra Fastening
  • Toweling
  • Hair brushing
    These are stress related to mastectomy, may last a year or more
102
Q

What to avoid post mastectomy

A
  • Using razors to shave under arms
  • Avoid venipunctures
  • Taking blood pressure on the affected arm
  • Taking blood on affected arm
  • Insect bites ( Use protective clothing and use repellent)
  • Heavy lifting for at least 6 weeks or until MD approves
103
Q

Gastric Cancer

A

Malignant growth of mucosal cells in inner lining of stomach ( invades muscle and beyond in advanced disease )

104
Q

Helicobacter Pylori

A

May be linked to gastric cancer

105
Q

What are complications of gastric cancer ? What is the goal of treatment

A
  • GI Hemorrhage
  • Obstruction
  • Metastasis
  • Dumping syndrome
  • Goal of treatment is to remove tumor and provide nutritional program
106
Q

Early signs of gastric cancer Think when you feel bloated the food did not _____ well, and how do you feel where is the pain

A
  • Indigestion
  • Abd discomfort
  • Full feeling
  • Epigastric back or retrosternal pain
107
Q

Late signs of gastric cancer

A
  • Weakness and fatigue
  • Anorexia and weight loss
  • Nausea/vomiting
  • Pressure in stomach
  • Dysphagia and obstructive symptoms
  • Iron deficiency anemia
  • Ascites
  • Epigastric mass felt
108
Q

Nursing interventions

A
  • Vitals
  • HgB and Hematocrit
  • Administer pain meds
  • Prepare for chemo and radiation
  • Prepared for surgical resection of the tumor(s)
109
Q

What are surgical procedures for gastric cancer ?

A

Subtotal Gastrectomy
Gastroduodenostomy (Billroth 1)
Partial gastrectomy, remaining is anastomosed to the duodenum

 Gastrojenostomy (Billroth 2)     Partial gastrectomy remaining is anastomosed to the jejunum 
Total Gastrectomy (esophagojejunostomy) 
- Removal of the stomach with the attachment of the esophagus to the jejunum or the duodenum
110
Q

What is important to monitor in for Post op in Gastric cancer

A
  • Place in fowler’s position
  • Analgesics/antiemetics
  • I/O , electrolyte replacement
  • Maintain NPO for 1-3 days until peristalsis
  • NG tube
  • Complications such as
    Hemorrhage
    Dumping syndrome
    Diarrhea
    Hypoglycemia
    Vit B12 deficiency
111
Q

Pancreatic Cancer (data collection)

A
  • Nausea/vomiting
  • Jaundice ( obstruction in bile duct and will retain in body without it leaving from bile duct skin turns yellow)
  • Clay colored stools
  • Glucose intolerance
  • Abd pain
112
Q

What is pancreatic cancer associated with ?

A
  • Aging
  • Eating foods high in fat
  • Diabetes
  • Alcohol use
  • Smoking
  • Exposure to environmental chemicals
113
Q

Nursing interventions for pancreatic cancer

A
  • Radiation
  • Chemo
  • Whipple procedure
114
Q

What is a Whipple procedure

A
  • Removal of:
  • Head of the pancreas
  • First part of small intestine (duodenum)
  • Gallbladder
  • Bile duct
    remaining organs are reattached to allow for digestion of food
115
Q

Post op Whipple surgery (what to monitor)

A
  • Blood glucose

- Hyper/Hypoglycemia from surgical manipulation

116
Q

Lung Cancer

A

Malignant tumor of the bronchi and peripheral lung tissue

117
Q

Causes of lung cancer

A
  • Smoking

- Exposure to environmental and occupational pollutants

118
Q

How can you diagnose lung cancer Think diagnostic tests

A
  • Chest x-ray
  • Ct scan
  • MRI
  • Sputum studies
119
Q

Data collection

A
  • Cough
  • Wheezing/Dyspnea
  • Hoarseness
  • Hemoptysis ( Blood-tinged or purulent sputum)
  • Chest pain
  • Anorexia/weight loss
  • Weakness
  • Diminished or absent breath sounds
  • Respiratory changes
120
Q

Interventions (What to monitor) positioning

A
  • Vitals
  • Breathing patterns
  • Breath sounds
  • Hemoptysis
  • Fowler’s position
  • O2 and humidification to moisten secretions
  • Pulse Ox
  • Provide activity as tolerated (active and passive ROM)
121
Q

What kind of medications are prescribed for lung cancer ?

A
  • Bronchodilators

- Corticosteroids ( decreases inflammation, bronchospasm, edema)

122
Q

Surgical procedures for Pt. with lung cancer

A
  • Laser Therapy: Relieve endobronchial obstruction
  • Ablation Therapy: Destroy tumor
  • Thoracentesis and pleurodesis: remove pleural fluid and relieve hypoxia
  • Thoracotomy ( opening into the thoracic cavity ) with pneumonectomy ( surgical removal of the lung )
123
Q

Post-op lung cancer interventions

A
  • Monitor VS
  • Monitor for cardiac and respiratory statuses
  • Monitor lung sounds
  • Chest tube drainage system (will drain air or blood that accumulates in the pleural space
  • Monitor for excess bleeding
  • Monitor for chest tube insertion site for crepitus (subcutaneous air) and drainage
  • Administer 02
  • Complete lateral turning must be avoided
  • Pulse Ox
  • Activity as tolerated
  • active ROM on operative shoulder, as prescribed
124
Q

Prostate Cancer

A
  • Slow growing malignancy of the prostate gland
  • Risk in men 50 and over
  • Can spread to surrounding tissues or by metastasis through bloodstream and lymph to bony pelvis and spine
125
Q

What is a concern in bone metastasis in Prostate cancer ?

A
  • Metastasis in bone can spread to the liver, lungs, and kidneys
126
Q

Data Collection for prostate cancer

A
  • Early stages is asymptomatic
  • Hard, pea-sized nodule (bump) palpated on rectal examination
  • Late symptoms (weight loss, urinary obstruction, pain radiating for the lumbosacral down the leg)
127
Q

How is prostate cancer diagnosed ?

A

Biopsy of the prostate

128
Q

What medications could be prescribed for a Pt with prostate cancer ?

A
  • Pain medications
  • Bisphosphonates
  • Corticosteroids
129
Q

Surgical procedures for Pt. who has prostate cancer

A
  • Orchiectomy ( both testicles are removed )
  • Prostatectomy
  • TURP
130
Q

What is TURP ? (explain procedure and what to monitor )

A
  • Involves insertion of a scope into the urethra to excise (remove) prostatic tissue
  • Monitor for hemorrhage, bleeding is common right after TURP
131
Q

What else may be prescribed for prostate cancer? think what kind of catheter

A
  • Continuous bladder irrigation (prevents catheter obstruction
132
Q

Explain what a continuous bladder irrigation

A
  • 3- way lumen irrigation used to decrease bleeding and to keep bladder free from clots or obstruction
  • One lumen is for inflating the balloon (30 mL)
  • One lumen is for instillation (inflow)
  • One lumen is for outflow
133
Q

Nursing interventions for continuous bladder irrigation

A
  • Maintain traction on the catheter if applied to prevent bleeding by pulling the catheter and taping to the abdomen or thigh
  • Keep leg straight if traction is applied to catheter and it is taped to the thigh
  • Cath traction is not released without MD prescription
  • Cath is usually released after bright red drainage is gone
  • Use only bladder irrigation solution
  • Run solution at a rate that will keep the urine PINK
  • Run solution rapidly if there is bright red drainage or clots
134
Q

What will the nurse do if the urinary catheter becomes obstructed ?

A
  • Notify RN
  • Turn off irrigation
  • Assist to irrigate 30- 50 mL of normal saline
  • Notify RN again if the obstruction continues
135
Q

Ileal conduit explain what it is *think of as colostomy for ureters think of nikki

A
  • Ureteroileostomy or (Bricker’s Procedure) - Ureters connected to ileum ( which the last portion of the small intestine )
  • Ureters are brought out and through a stoma (opening) in the lower abd
  • Bag placed outside of stoma for urine to fall into
  • Urine comes out by peristalsis (contraction of muscles)
136
Q

What are complications with having an ileal conduit ?

A
  • Obstruction
  • Pyelonephritis ( inflammation in kidneys)
  • Leakage at stoma site
  • Hydronephrosis ( swelling of kidneys do to urine buildup )
  • Calculi (stones)
  • Skin irritations
  • Ulcerations
137
Q

Kock pouch

A
  • Continent internal illeal reservoir ( meaning patients can empty themselves)
  • ileal reservoir is created from a segment of the ileum and the ascending colon
138
Q

Where are the ureters implanted in a kock pouch procedure ?

A
  • Ureters and implanted into the side of the reservoir, nipple valve is to attach the reservoir to the skin
139
Q

What will a patient with a kock pouch have post- op ?

A
  • Indwelling urinary catheter

- Cath irrigated GENTLY with normal saline to prevent obstruction from mucous and clots

140
Q

What is instructed to the Pt. after removal of the catheter

A
  • Pt. how to self catheterize and how to drain reservoir for 4-6 hour intervals
141
Q

Teaching Pt. about how to care for their urinary stoma ?

A
  • Instruct how to change appliance
  • Self care ( use a mirror)
  • May be drained by a bedside bag or leg bag ( especially at night)
  • Empty bag when its 1/3 full ( prevents pulling of appliance and leakage)
  • Check for perspiration around the seal of the bag
  • Pouch to remain in place as long as it is not leaking
  • Encourage to drink fluids ( help in controlling odor )
  • Wash with soap lukewarm water
  • Soak appliance in dilute vinegar for 20-30 min
  • When taking baths level of water should be below the stoma ( avoid oily soaps)
  • For showers direct the flow of water away from the stoma
142
Q

What to teach Pt about bathing with the Urinary stomas ? ( bath tubs and showering what kind of soap to avoid)

A
  • Wash with soap and lukewarm water
  • When taking baths make sure that level of the water is below the stoma
  • avoid oily soaps
  • When taking a shower flow of water must be directed away from stoma
143
Q

What is important to monitor in a Pt. after bladder surgery ?

A
  • Urinary output
  • Assist RN in irrigating the catheter ( if cath is present )
  • ## Irrigate cath slowly to prevent obstruction
144
Q

Preoperative interventions for bladder surgery ( How to what to educate Pt. Pre and Post Op)

A 
- Educate Pt. about what is to be expected in preop and postop surgery like : 
Medications 
NG tube 
IV lines 
PO status 
Pain 
Coughing 
Deep breathing 
Leg exercises 
Post op activities
145
Q

Interventions cont. ( pre/post op bladder cancer, nursing demonstrations on stoma and appliance care )

A
  • Demonstrate about appliance and how to apply it
146
Q

Post op interventions (what to monitor) for urinary stoma

A
  • Vital signs
  • Incision site
  • Check the stoma every hour for the first 24 hours
  • Color of stoma should be red and moist
  • Monitor for edema in stoma ( may be present in immediate post op period)
  • NOTIFY if stoma color is dark and dusky ( INDICATES NECROSIS)
  • Monitor for prolapse or retraction of stoma ( NOTIFY RN )
  • Monitor for return of bowel function (peristalsis), this returns in 3-4 days
  • Maintain NPO status until bowel sounds return
  • Urine flow should be 30-60 mL/ hour (notify if less or none for more than 15 min
147
Q

What are cancer Pt’s most at risk of ?

A
  • Most at risk for infection particularly ( gram negative organisms in the blood stream )
  • Sepsis or septicemia
  • DIC in sepsis
148
Q

What kind technique will you maintain in Pts with sepsis ?

A
  • Strict Aseptic technique
149
Q

What medications may be prescribed to a Pt with Sepsis and DIC

A
  • Antibiotics

- Anticoagulants

NCLEX ( fundamentals/MegSurg) (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions