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NCLEX > Oncology Part 1 > Flashcards

Oncology Part 1 Flashcards

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1
Q

Sarcoma vs Carcinoma vs hematologic malignancy

A

Sarcoma originate in the connective tissue (bones, muscle, fat, tendon)

Carcinomas originate in the epithelial tissue (organ linings including skin)

HM originate in the blood or lymphatic cells

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2
Q

What’s the most common type of cancer?

A

Carcinoma - includes all type of skin cancer

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3
Q

What are the ways metastasis can occur?

A

Direct invasion, through blood, through lymphatic system

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4
Q

Worst co-carcingenic pair

A

Alcohol and tobacco

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5
Q

Low fiber is bad why

A

Fiber causes less motility and causes us to retain the carcinogens for longer (processed foods, preservatives, red meat and animal fat)

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6
Q

In what age is cancer most prevalent? What race?

A

> 60 d/t a more poor immune system, the longer you’ve been exposed to toxins such as tobacco, asbestos, diesel, exhaust)
(immunosuppressed also at high risk)

African Americans, then caucasian

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7
Q

Breast cancer familial gene

A

BRCA 1

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8
Q

Does getting chemo for another cancer increase the risk for another type of cancer?

A

YES

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9
Q

When is the best time to do a breast exam? What about after menopause?

A

Day 7-12 after the period is just about over
NEVER do prior because there is swelling then

If post menopausal - Pick a day of every month

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10
Q

How often should women get a breast exam?

A

Yearly if >40 years old

Every 3 years if age 20-39

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11
Q

At what age should women get a yearly mammogram

A

Starting at age 40

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12
Q

What do you tell a women prior to getting a mammogram? Why?

A

No lotion, powder, deodorant because it can be picked up as a Ca deposit, which usually indicates cancer

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13
Q

How often should women get a pap smear?

A

Every 3 years starting at age 21 if there are no problems

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14
Q

When should people get a colonoscopy?

A

Starting at age 50, and every 10 years if there haven’t been any problems

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15
Q

When should fecal occult blood be tested?

A

Start at age 50 and be done yearly, unless there have been problems or a family history of problems

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16
Q

How often should men have testicular exams? Are testicular tumors dangerous? Why?

A

Every year

Yes, because they grow very fast

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17
Q

How often should testicular self exams be done? What is the major age group for testicular CA?

A

Monthly

Age 15-36 - need to teach TSE early

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18
Q

When should men get a prostate exam?

A

> 50, yearly

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19
Q

CAUTION acronym for cancer

A 
Change in bowel/bladder habits
A sore that doesn't heal
Unusual bleeding/discharge
Thickening/lump
Indigestion or difficulty swallowing
Obvious change in wart/mole
Nagging cough or hoarseness
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20
Q

Differences between
Anemia
Leukopenia
Thrombocytopenia

A

Anemia: Low RBC
Leukopenia: Low WBC
Thrombocytopenia: Low Platelets

All because cancer invades the bone marrow

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21
Q

Differences in risks
Anemia
Leukopenia
Thrombocytopenia

A

Anemia: Risk for hypoxia
Leukopenia: Risk for infection
Thrombocytopenia: Risk for bleeding (shaving, IM)

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22
Q

What does cachexia mean?

A

Extreme wasting and malnutrition, usually indicates close to death

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23
Q

What is the most common complaint of impending cancer?

A

FATIGUE especially if the cancer has spread and is d/t either anemia or growth of cancer

Exhaustion that doesn’t go away with sleep

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24
Q

Fever is a common sign in what kind of cancer?

A

Leukemia and lymphoma

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25
Q

Common sites for pain with CA

A

HA - brain cancer

Back - colon, ovaries, rectum

26
Q

3 most common blood tests used to diagnose cancer

A
  1. Abnormal CBC & differential (# of different types of WBC - neutrophils are most concerning)
  2. Elevated liver enzymes - AST and ALT
  3. Tumor markers (biomarkers) - increased, substance or process that is indicative on cancer
27
Q

Positive diagnostic studies

A

CXR, CT, MRI
PET scan
Imaging studies (such as bronchoscopy, endoscopy)
Biopsies

28
Q

What do we need to thinking about with a patient having a bronchoscopy in terms of eating? What are we going to watch for afterwards?

A

NPO during and until gag reflex returns

Watch for RR depression, hoarseness, dysphagia, or SQ emphysema

29
Q

What is SC emphysema

A

Crackles when touching skin indicating air trapped and airway perforation and air leaking into the tissue

30
Q

Is RR depression normal after bronchoscopy?

A

NO IT IS ABNORMAL

Slow RR just means decreased, but DEPRESSION indicates less than 12/min

31
Q

The respiratory rate should always be ______ for NCLEX?

A

PERFECT! Or else something is wrong!!

32
Q

When is the best time to get a sputum sample? Why?

Is this a sterile sample?

A

First thing in the morning because they have been accumulating

It is a sterile sample and we are using a sterile technique (aka don’t let their mouth tough the collecting device)

33
Q

What should a patient do first before obtaining a sputum sample? Why?

A

Rinse mouth out with water

This decreases the bacteria count in the mouth because we want the sputum bacteria, not the mouth

34
Q

Should they just go ahead and to a bronchoscopy to get the sputum?

A

NO - LEAST INVASIVE FIRST… and it’s more expensive that way

35
Q

Can you get sputum from a trach?

A

Yes

36
Q

What does a total laryngectomy remove?

A

Vocal cords, epiglottis, and thyroid cartilage - permanent stomal breathing forever

There are 2 tubes for fluid and air

37
Q

What happens if a trach falls out?

A

First of all, never let go of the trach..

BUT if it does and there isn’t a sterile one there, put the dirty one back in because infection is better than death

38
Q

Position of a post-op total laryngectomy

A

35-45 degree HOB elevated - Mid fowlers

NEVER high-fowlers

39
Q

What kind of feedings will total laryngectomy patients have? Why?

A

NG to protect the suture line

40
Q

S/S Carotid artery rupture

Innominate artery

A

Pulsating trach: EMERGENCY because the artery was nicked

41
Q

When do we hyper oxygenate a sanctioned patient? With what technique? How long?

A

Before and after
Sterile
No longer than 10 seconds

42
Q

When do you stop advancing the suction catheter?

A

When you meet resistance or the patient coughs

43
Q

What nerve can the suction hit?

A

Vagus - STOP suction and give 100% oxygen

*they are not hypoxic, just have bradycardia

44
Q

How does a humidified environment help a trach patient?

A

It warms the air and causes less secretions to develop

45
Q

What devices to the total laryngectomy patients use

A

Blom Singer, electrolarynx

  • They can smoke
46
Q

How does TNM staging work?

A

T - size of tumor
N - lymph node involvement
M - Presence of metastasis

T1-4
N0-3
M0-1

47
Q

Cancer grading

A

Compares the cancer cells to the parent cancer cell that they evolved from

1-4 (4 is most aggressive)

48
Q

3 goals of cancer treatment

A

Cure, Control, Palliation

49
Q

What is adjuvant therapy?

A

2 therapies used together (chemo and radiation)

50
Q

What are neoadjuvant therapies?

A

Therapies that are time-specific, or one before the next (Ex: surgery THEN chemo)

51
Q

What 3 things are treatment plans based on?

A

Recommended plans for the diagnosis
Grade of cancer
What the client wants

52
Q

4 reasons for surgery

A
  1. Prevention (benign lesion)
  2. Diagnose (staging)
  3. Treatment (remove tumor)
  4. Reconstruction (Mastectomy - partial or total/radical)
53
Q

Where is the most common site to use for mastectomy reconstruction?

A

Abdomen - will have an incision site there as well

54
Q

What kind of drains will a mastectomy patient have?

A

Jackson Pratt or Hemovac

55
Q

What to do you if a lymph node has been removed during a mastectomy?

A

LIMB ALERT ON THAT SIDE d/t risk of infection!

Wear gloves in the garden, no nail biting, no sunburn, caution with small cuts, NO types of constriction

56
Q

What are good exercises to do when a lymph node is removed? Why?

A

Brush hair, squeeze a ball, wall climbing, flex and extend elbow

All promote new/collateral circulation

57
Q

Where to check for bleeding after mastectomy?

A

Front and BACK! Because here may be pooling of blood in the back

58
Q

Can mastectomy patients use their arm right away?

A

No…. they need the circulation but need to work up to it

59
Q

Can surgery be palliative?

A

Yes to improve QAL

60
Q

What is the #1 question after cancer surgery?

A

Did they get it all?

61
Q

Successful surgery is based on what 3 things?

A
  1. Could it completely be removed?
  2. Did it already spread at the time of surgery?
  3. Could the surgeon get adequate margins? - amount of normal tissue needed to be removed around the tumor
62
Q

Why would someone do chemo or radiation before surgery? What kind of therapy is this?

A

To shrink the size…. this is neoadjuvant therapy

NCLEX (23 decks)

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