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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
Q

extravasation management (7)

A
  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
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26
Q

Major side effects of cancer therapy (5)

A
  1. myelosuppression
  2. GI upset; N/V, diarrhea
  3. Alopecia
  4. Fatigue
  5. Organ toxicity
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27
Q

what is myelosuppression?

A

Bone marrow creates WBC, RBS, platelets; these are suppressed causing pancytopenia

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28
Q

If myelosuppression occurs the pt is on _____ precautions.

A

Neutropenic

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29
Q

What are neutropenic precautions?

A
  • no fresh fruits/veggies
  • no fresh flowers
  • no large crowds
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30
Q

What should the nurse treat myelosuppression with?

A
  • Neupogen

- Epoeitin alpha (procrit)

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31
Q

Administer neupogen if normal absolute neutrophil count

A

LESS THAN 1500

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32
Q

What does neupogen do?

A

elevates absolute neutrophil count

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33
Q

neupogen adverse effect

A

Bone pain; normal finding

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34
Q

What does procrit do?

A

Stimulates RBC production

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35
Q

What should the nurse assess before administering procrit?

A

Hgb; if greater than 10 hold!

BP; if diastolic BP is greater than 80 hold!

36
Q

Procrit adverse effect

A

HTN & thrombotic events

37
Q

Cancer tx GI adverse effect

A

N/V **prevention is key

38
Q

How to tx nausea in cancer pts

A
  • small frequent meals
  • antiemetics before meals
  • avoid fatty, spicy, salty foods
  • eat fav foods!
39
Q

Ondansetron (zofran) treats

A

nausea

40
Q

Zofran adverse effects

A
  • headache***
  • diarrhea
  • fever
41
Q

cancer fatigue management

A

manage activities and rest

42
Q

low platelet bleeding precautions

A
  • soft bristle toothbrush
  • no IM injections
  • no rectal temps
  • avoid increases in pressures
43
Q

stomatitis/mucositis

A

cancer tx adverse effect; mouth sores

44
Q

stomatitis/mucositis drug tx

A

sucralfate (carafate); coats GI tract to coat empty stomach

45
Q

Sucralfate (carafate) adverse effects (2)

A
  • dry mouth

- constipation

46
Q

Sucralfate (carafate) pt teaching

A

increase fluids and exercise

47
Q

Radiation adverse effects (6)

A
  1. burns
  2. fatigue
  3. bone marrow suppression
  4. GI upset
  5. mucositis
  6. pneumonitis
48
Q

The nurse should increase ____ in radiation pts

A

hydration (assess K+)

49
Q

pneumonitis

A

scarring of lungs

50
Q

radiation can also affect the following systems

A
  1. pulmonary
  2. cardio
  3. Reproductive
51
Q

What is tumor lysis syndrome?

A

big tumor that is very responsive to tx; causing massive cell break down and substantial release of uric acid.

52
Q

why is the rapid release of uric acid a complication?

A

uric acid causes the kidneys to shut down and go into metabolic acidosis; assess BUN and Creat.

53
Q

tumor lysis syndrome risk factors

A
  • increase tumor burden

- increased LDH

54
Q

tumor lysis syndrome s/s (4)

A
  1. hyperuricemia
  2. elevated phosphorus
  3. elevated K+
  4. decreased Ca+
55
Q

tumor lysis syndrome treatment goals

A
  1. prevent renal failure

2. correct fluid electrolyte imbal.

56
Q

tumor lysis syndrome Tx

A

allopurinol; decrease uric acid

57
Q

Superior vena cava syndrome

A

compression of the superior vena cava due to a large tumor or thrombosis

58
Q

Superior vena cava syndrome s/s (5)

A
  1. facial/periorbital edema
  2. JVD
  3. Headache
  4. HTN
  5. Seizures
59
Q

Superior vena cava syndrome Tx (2) same as SCC

A
  • emergent radiation

- IV steroids; decrease inflammation

60
Q

Spinal cord compression

A

Large tumor on spinal cord compressing the cord and decreasing blood supply

61
Q

Spinal cord compression causes

A

Ischemia to cord, neuro deficits/paralysis

62
Q

Spinal cord compression s/s (4)

A
  1. back pain
  2. bowel/bladder incontinence
  3. weak extremities
  4. urine hesitancy
63
Q

Spinal cord compression Tx (2) same as SVCS

A
  • emergent radiation

- IV steroids; decrease inflammation

64
Q

SIADH

A

think kidneys; fluid vol. overload; MOST COMMON IN LUNG CANCER

65
Q

what is SIADH

A

cancer cells produce excessive ADH, increased ADH causes increased water retention

66
Q

SIADH s/s (13)

A
  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
Q

SIADH Tx (4)

A
  • chemo
  • fluid restrictions
  • diuresis
  • hypertonic fluids
68
Q

Breast cancer rx (5)

A
  • increased radiation before 20 yrs
  • genetics
  • menses before 12 years old
  • no children
  • dense breast tissue
69
Q

Breast cancer s/s

A
  • change in skin appearance
  • discharge
  • lumps
70
Q

Breast cancer dx tests (3)

A
  • mammogram
  • needle aspiration
  • tissue pathology
71
Q

Breast cancer Tx (4)

A
  • symptomatic
  • chemo
  • radiation
  • hormonal therapy
72
Q

Lung cancer is the most ____ cancer and has the highest _____ rate

A

common; mortality

73
Q

Lung cancer rx

A

smoking

74
Q

lung cancer s/s (7)

A
  • hemoptysis
  • dyspnea
  • hoarseness
  • cough
  • chest pain
  • pleuritic pain on inspiration
  • change in endurance
75
Q

Lung cancer Dx (3)

A
  • bronchoscopy
  • sputum collection
  • CT/MRI
76
Q

Lung cancer Tx (3)

A
  • symptomatic
  • chemo
  • radiation
77
Q

Colorectal cancer is

A

cancer of the rectal/colon area

78
Q

Colorectal cancer Rx (4)

A
  1. POLYPS
  2. IBD/IBS
  3. genetics
  4. chronic constipation
79
Q

Colorectal s/s (7)

A
  • rectal bleeding
  • change in bowel habits
  • abd. pain
  • anemia
  • fatigue
  • weight loss
  • abd. fullness
80
Q

Colorectal cancer Dx (3)

A
  • endoscopy
  • occult blood test
  • CT/MRI
81
Q

Ovarian cancer Rx (4)

A
  • obesity
  • genetics
  • hormone therapy
  • elderly
82
Q

Ovarian cancer s/s (6)

A
  1. abd/pelvic pain
  2. N/V
  3. bloating/indigestion
  4. weight loss
  5. abd edema
  6. abd lump
83
Q

Testicular cancer Rx

A
  • genetics

- undecended teste

84
Q

Testicular cancer s/s (4)

A
  • lump
  • low back pain
  • fatigue
  • swollen
85
Q

Testicular cancer Dx (2)

A
  • blood test

- ultrasound

Medsurg exam 3 (3 decks)

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