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Medsurg exam 3 > Oncology > Flashcards

Oncology Flashcards

1
Q

Cancer definition (5 categories)

A
  1. rapid cell production
  2. uncontrolled cell growth
  3. involves any body tissue
  4. does not go through apoptosis
  5. ability to metastasize
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2
Q

Metastasis is

A

invasive, increased tumor growth

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3
Q

What are the 3 stages of cancer development

A
  1. Initiation
  2. Promotion
  3. Progression
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4
Q

What is the initiation phase?

A

The phase in which the cancer is stimulated.

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5
Q

What are the causes of cancer (6)

A
  1. Viruses
  2. Hormones
  3. Radiation
  4. Chemicals
  5. Genetics factors
  6. Unk factors
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6
Q

What is the promotion phase of cancer?

A

Cells abnormally dividing

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7
Q

What is the progression phase of cancer?

A

Evidence of metastasis

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8
Q

Tumors are classified by the

A
  1. site
  2. grade
  3. stage
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9
Q

Clinical staging classifications 0-4

A

0: Cancer in site; tumor has not gone anywhere and is less than 3mm
1: tumor still tiny and barely grown
2: Limited local spread; mild growth
3: Extensive local and regional spread; ex- started in tonsil and is now in esophagus
4: Another organ is involved

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10
Q

Cancer is diagnosed by

A
  1. symptoms
  2. Dx tests
  3. Pathology
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11
Q

Hormonal receptor cancer

A

hormones drive the cancer; meds are usually given to stop the hormone growth

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12
Q

Dx test; carcinoembryonic antigen (CEA)

A

blood test; helps evaluate if cancer is improving or worsening

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13
Q

Alph-fetoprotein test assesses

A

malignant liver cells

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14
Q

genetic testing assesses

A

if the patient has a known genetic mutation

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15
Q

Cancer prevention (5)

A
  1. Avoid/reduce exposure
  2. Eat a balanced diet
  3. Exercise regularly
  4. Rest
  5. regular exams
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16
Q

7 warning signs of cancer

A 
C: change in bowel/bladder habits
A: a sore throat that doesnt heal 
U: unusual bleeding/discharge from any orifice
T: thickening of skin or a lump
I: indigestion or difficulty swallowing
O: obvious change in a wart or mole
N: nagging cough/hoarseness
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17
Q

Treatment goals

A
  1. cure
  2. control rate
  3. pain
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18
Q

Cancer Tx methods (5)

A
  • surgery
  • radiation
  • chemo
  • hormonal therapy
  • bio therapies (only targets cancer specific cells)
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19
Q

chemotherapy is a ____ therapy

A

systemic

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20
Q

Chemo can be administered

A

IV, PO, IM, SQ, topical

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21
Q

chemo is most effective in tumors with

A

long cell cycles

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22
Q

chemotherapy can slow

A

cancer

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23
Q

chemo is most effective in _____ _____ tumors

A

slow growing

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24
Q

chemotherapy complication- vesicant due to extravasation

A

IV chemo does not go into vein but around the vein and kills/blister surrounding tissues

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25
extravasation management (7)
1. immediately stop infusion 2. disconnect/empty tubing 3. do not remove needle 4. attempt to aspirate the med out 5. assess site and symptoms 6. Notify MD 7. administer antidotes
26
Major side effects of cancer therapy (5)
1. myelosuppression 2. GI upset; N/V, diarrhea 3. Alopecia 4. Fatigue 5. Organ toxicity
27
what is myelosuppression?
Bone marrow creates WBC, RBS, platelets; these are suppressed causing pancytopenia
28
If myelosuppression occurs the pt is on _____ precautions.
Neutropenic
29
What are neutropenic precautions?
- no fresh fruits/veggies - no fresh flowers - no large crowds
30
What should the nurse treat myelosuppression with?
- Neupogen | - Epoeitin alpha (procrit)
31
Administer neupogen if normal absolute neutrophil count
LESS THAN 1500
32
What does neupogen do?
elevates absolute neutrophil count
33
neupogen adverse effect
Bone pain; normal finding
34
What does procrit do?
Stimulates RBC production
35
What should the nurse assess before administering procrit?
Hgb; if greater than 10 hold! | BP; if diastolic BP is greater than 80 hold!
36
Procrit adverse effect
HTN & thrombotic events
37
Cancer tx GI adverse effect
N/V **prevention is key
38
How to tx nausea in cancer pts
- small frequent meals - antiemetics before meals - avoid fatty, spicy, salty foods - eat fav foods!
39
Ondansetron (zofran) treats
nausea
40
Zofran adverse effects
- headache*** - diarrhea - fever
41
cancer fatigue management
manage activities and rest
42
low platelet bleeding precautions
- soft bristle toothbrush - no IM injections - no rectal temps - avoid increases in pressures
43
stomatitis/mucositis
cancer tx adverse effect; mouth sores
44
stomatitis/mucositis drug tx
sucralfate (carafate); coats GI tract to coat empty stomach
45
Sucralfate (carafate) adverse effects (2)
- dry mouth | - constipation
46
Sucralfate (carafate) pt teaching
increase fluids and exercise
47
Radiation adverse effects (6)
1. burns 2. fatigue 3. bone marrow suppression 4. GI upset 5. mucositis 6. pneumonitis
48
The nurse should increase ____ in radiation pts
hydration (assess K+)
49
pneumonitis
scarring of lungs
50
radiation can also affect the following systems
1. pulmonary 2. cardio 3. Reproductive
51
What is tumor lysis syndrome?
big tumor that is very responsive to tx; causing massive cell break down and substantial release of uric acid.
52
why is the rapid release of uric acid a complication?
uric acid causes the kidneys to shut down and go into metabolic acidosis; assess BUN and Creat.
53
tumor lysis syndrome risk factors
- increase tumor burden | - increased LDH
54
tumor lysis syndrome s/s (4)
1. hyperuricemia 2. elevated phosphorus 3. elevated K+ 4. decreased Ca+
55
tumor lysis syndrome treatment goals
1. prevent renal failure | 2. correct fluid electrolyte imbal.
56
tumor lysis syndrome Tx
allopurinol; decrease uric acid
57
Superior vena cava syndrome
compression of the superior vena cava due to a large tumor or thrombosis
58
Superior vena cava syndrome s/s (5)
1. facial/periorbital edema 2. JVD 3. Headache 4. HTN 5. Seizures
59
Superior vena cava syndrome Tx (2) same as SCC
- emergent radiation | - IV steroids; decrease inflammation
60
Spinal cord compression
Large tumor on spinal cord compressing the cord and decreasing blood supply
61
Spinal cord compression causes
Ischemia to cord, neuro deficits/paralysis
62
Spinal cord compression s/s (4)
1. back pain 2. bowel/bladder incontinence 3. weak extremities 4. urine hesitancy
63
Spinal cord compression Tx (2) same as SVCS
- emergent radiation | - IV steroids; decrease inflammation
64
SIADH
think kidneys; fluid vol. overload; MOST COMMON IN LUNG CANCER
65
what is SIADH
cancer cells produce excessive ADH, increased ADH causes increased water retention
66
SIADH s/s (13)
1. water retention 2. hypervolemia 3. hyponatremia 4. anasarca (edema everywhere) 5. JVD 6. HTN 7. weight gain 8. thirsty 9. anorexia 10. N/V 11. personality chngs 12. seizures 13. COMA
67
SIADH Tx (4)
- chemo - fluid restrictions - diuresis - hypertonic fluids
68
Breast cancer rx (5)
- increased radiation before 20 yrs - genetics - menses before 12 years old - no children - dense breast tissue
69
Breast cancer s/s
- change in skin appearance - discharge - lumps
70
Breast cancer dx tests (3)
- mammogram - needle aspiration - tissue pathology
71
Breast cancer Tx (4)
- symptomatic - chemo - radiation - hormonal therapy
72
Lung cancer is the most ____ cancer and has the highest _____ rate
common; mortality
73
Lung cancer rx
smoking
74
lung cancer s/s (7)
- hemoptysis - dyspnea - hoarseness - cough - chest pain - pleuritic pain on inspiration - change in endurance
75
Lung cancer Dx (3)
- bronchoscopy - sputum collection - CT/MRI
76
Lung cancer Tx (3)
- symptomatic - chemo - radiation
77
Colorectal cancer is
cancer of the rectal/colon area
78
Colorectal cancer Rx (4)
1. POLYPS 2. IBD/IBS 3. genetics 4. chronic constipation
79
Colorectal s/s (7)
- rectal bleeding - change in bowel habits - abd. pain - anemia - fatigue - weight loss - abd. fullness
80
Colorectal cancer Dx (3)
- endoscopy - occult blood test - CT/MRI
81
Ovarian cancer Rx (4)
- obesity - genetics - hormone therapy - elderly
82
Ovarian cancer s/s (6)
1. abd/pelvic pain 2. N/V 3. bloating/indigestion 4. weight loss 5. abd edema 6. abd lump
83
Testicular cancer Rx
- genetics | - undecended teste
84
Testicular cancer s/s (4)
- lump - low back pain - fatigue - swollen
85
Testicular cancer Dx (2)
- blood test | - ultrasound

Medsurg exam 3 (3 decks)

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