Oncology: Dx & Tx Flashcards
General S/S
What does CAUTION stand for?
Change in bowel/bladder habits A sore that does not heal Unusual bleeding/discharge Thickening or lump in breast/elsewhere Indigestion/difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness
General S/S
What does C in CAUTION stand for?
Change in bowel/bladder habits
General S/S
What does A in CAUTION stand for?
A sore that does not heal
General S/S
What does U in CAUTION stand for?
Unusual bleeding/discharge
General S/S
What does T in CAUTION stand for?
Thickening or lump in breast or elsewhere
General S/S
What does I in CAUTION stand for?
Indigestion or difficulty swallowing
General S/S
What does O in CAUTION stand for?
Obvious change in wart or mole
General S/S
What does N in CAUTION stand for?
Nagging cough/hoarsenss
General S/S
Cancer can invade bone marrow which leads to ___
Anemia (hypoxia)
Leukopenia (infection risk!)
Thrombocytopenia (bleeding precautions)
General S/S
Unexplained ___
Weight loss
*cachexia
General S/S
Fever is an early sign with ____
Leukemia
Lymphomas
General S/S
What is the #1 symptoms that clients complain of with dx of cancer
Fatigue
General S/S
Pain is an early sign of what cancers?
Bone, brain, testicular
Severe HA–possible brain
Back pain–possible colon, rectum
Blood tests
What is abnormal?
CBC and differential
Blood tests
Most concerned with what lab?
Neutrophils
Blood tests
What is elevated?
Liver enzymes
Blood tests
Other?
AST ALT
Tumor markers
Positive dx studies? (7)
- CXR
- CT
- MRI
- PET
- Bone marrow biopsy
- Tissue biopsy
- Imaging
What is total laryngectomy?
Removal of vocal cords, epiglottis, and thyroid cartilage
Total laryngectomy
This client will have permanent ___
Tracheostomy or laryngectomy (same things but trach is short term and laryngectomy is long term)
Total laryngectomy
Post op HOB?
30-45
Total laryngectomy
Why NG feedings?
To protect suture line (peristalsis can disrupt suture)
Total laryngectomy
Monitor __
Drains
Total laryngectomy
Watch for ____
Carotid artery rupture
Total laryngectomy
Frequent ___ care to decrease bacterial count
Mouth
Total laryngectomy
NPO people are at risk for getting ___
Pneumonia
Total laryngectomy
When the client leaves the hospital, a __ will be used to cover the trach because it acts like a filter
Bib
Total laryngectomy
What environment helps
Humidified
Total laryngectomy
All breathing is done how?
Through stoma
Total laryngectomy
Can client talk?
No unless they are using electrolarynx or Blom-singer device
Total laryngectomy
Can client whistle?
Drink through straw?
Smoke?
Swim?
NO!!
*although some still smoke even though that is NOT recommended!!
Goals of tx?
Cure
Control
Palliation
What is adjuvant therapy?
Two therapy used together (chemo and radiation)
What is neoadjuvant therapy?
Time specific (one before the next)
surgery, then chemo
What is tx plan based on?
- Recommended tx plans for dx
- Grade of cancer
- What client wants!!!!
Why do surgery?
- Prevention (remove benign/pre-malignant tumors)
- Dx (to stage/lymph node mapping)
- Tx
- Reconstruction (breast cancer)
Post op after mastectomy
Bleeding–where to check dressings?
Front and back (blood can pool in the back)
Post op after mastectomy
If reconstruction includes using their own tissue, they will also have ___ surgical site
Abdominal site
*can harvest adipose tissue from other sites but abdomen is most common
Post op after mastectomy
What draining system will they have?
Hemovac or Jackson Pratt
Post op after mastectomy
What if lymph nodes were removed from one side?
Avoid this for LIFETIME of client!!!:
- No BP
- No blouses with elastic
- No watch
- No IV or injections on affected side
*wear gloves when gardening, watch small cuts, no nail biting, no sunburns
Post op after mastectomy
What helps promote circulation?
Brush hair
Squeeze tennis ball
Wall climbing
Flex and extend elbow
What is internal radiation?
Brachytherapy
Brachytherapy (internal) is used to get the radiation ___ to the cancer or target tissue
Close
Brachytherapy (internal) is internal so it is ____ the body
Inside!
Brachytherapy is very CLOSE to target tissue bc radiation is inside body
With all types of brachytherapy (internal) the client emit ____ for a period of time and is a hazard to others
Radiation
Brachytherapy (internal) is either sealed or unsealed.
What is unsealed?
Ex?
Radioactive?
Client and body fluids emit radiation
EX: Radioisotope given IV or PO
*radioactive 24-48 hrs
Brachytherapy (internal) is either sealed or unsealed.
What is sealed/solid?
Radioactive?
Client emits radiation but body fluids are NOT radioactive
*can be temporary or permanent implant that is placed close to or inside tumor
Precautions with brachytherapy (internal) radiation
How often to rotate nursing assignments? Why?
Daily so nurse isn’t continually exposed
*if you have radiation client, that is your ONLY client for that shift!!
Precautions with brachytherapy (internal) radiation
What room?
Private
Precautions with brachytherapy (internal) radiation
Nurse wear what?
Film badge at all times
Precautions with brachytherapy (internal) radiation
Visitors
- Restrict visitors
- Limit each to 30 min per day, must stay 6 feet from source
- No visitors less than 16 years old
- No pregs (visitors or nurses!!)
Precautions with brachytherapy (internal) radiation
How to mark room?
With instructions for specific isotope
Precautions with brachytherapy (internal) radiation
Wear what?
Gloves with risk of exposure to body fluids
Precautions with brachytherapy (internal) radiation
How to prevent dislodgment?
- Keep client on bedrest
- DECREASE fiber
- Prevent bladder distention (put pt on catheter)
Precautions with brachytherapy (internal) radiation
What if implant becomes dislodge. How to get it?
Gloves
Pick up with forceps
Put in lead container
Precautions with brachytherapy (internal) radiation
After radiation? (5)
- Can sleep in bed with spouse/children (1-11 days)
- Dont use public transportation
- Dont return to work immediately
- Dont share utensils/cook for others
- Stay away from people (6 ft away at least!), esp children for 2-3 days at least
Precautions with brachytherapy (internal) radiation
How to flush toilet?
Close lid and flush 2-3x each use
External radiation (teletherapy, beam)
Radioactive?
No
External radiation (teletherapy, beam)
SE?
Limited to exposed tissues
- Erythema
- Shedding of skin
- Altered taste
- FATIGUE
- Pancytopenia
External radiation (teletherapy, beam)
S/S are ___ and ___ related
Location and dose
External radiation (teletherapy, beam)
Can you wash off markings?
No
External radiation (teletherapy, beam)
How long to protect site from sunlight and UV exposure?
1 year after completion of therapy
External radiation (teletherapy, beam)
What is this?
Focused beam or high energy rays deliver by a machine outside of the body