Oncology Part 2

Question 1

this interferes with cancer cells rapid division

damages DNA

Answer 1

chemotherapy

Question 2

how is chemo typically given

Answer 2

multiple types of chemo (poly)

targets cells at different stages of cell cycle

Question 3

when does chemo work best

Answer 3

when used on rapidly dividing cells

when given on a regular basis/schedule (important to maximize cancer death)

Question 4

how is chemo typically given

Answer 4

intravenous access

PORT-implanted venous access site

Question 5

describe a PORT

Answer 5

leave in indefinitely
functions similar to PIC line
implanted under skin, line to heart

Question 6

chemo is rarely given ____

Answer 6

IV due to extravasation and infiltration

Question 7

what does chemo kill

Answer 7

rapidly dividing cells

skin, hair, GI tract, bone marrow

Question 8

what are the side effects of chemo

Answer 8

alopecia, NV, mucositis, change in cognitive function, peripheral neuropathy, bone marrow suppression

Question 9

describe alopecia as chemo SE

Answer 9

hair loss

ALL hair loss (eyelash, eyebrows etc)

Question 10

describe NV as chemo SE

Answer 10

very common, delayed response to chemo

can take an antiemetic prior to chemo

Question 11

what can be given to help with NV of chemo

Answer 11

Zofran (serotonin antagonist)
Decadron (corticosteroid)
Reglan (Prokinetic)
Ativan (Benzo)

Question 12

describe mucositis as chemo SE

Answer 12

painful sores form mouth to GI tract

use mouthwash, soft toothbrush, systemic pain meds

Question 13

describe change in cognitive function as chemo SE

Answer 13

aka chemo brain
concentration and memory loss
common in women with breast cancer

Question 14

describe peripheral neuropathy as chemo SE

Answer 14

chemo induced
dose dependent
affect hands, feet, erectile, constipation
** may be PERMANENT

Question 15

priority nursing intervention for peripheral neuropathy

Answer 15

prevent injury (Ie/ falls)

Question 16

chemotherapy nursing care

Answer 16

if given IV, PREVENT extravasation
will destroy healthy tissue (doesnt distinguish)
must be chemo certified (special protection)
precautions with drug disposal and tubing
do NOT get onto your skin

Question 17

if chemo drug leaks…

Answer 17

stop immediately and apply cold depending on drug (some antidotes may be used)

Question 18

when does hair return after completion of chemo

Answer 18

about 1 month after

usually returns thicker and darker than before

Question 19

describe bone marrow suppression as chemo SE

Answer 19

worry about this the most
anemia-low RBC causes fatigue and pallor
thrombocytopenia
neutropenia

Question 20

what is thrombocytopenia

Answer 20

decreased platelet

bleeding precautions

Question 21

platelet count for prolonged versus uncontrolled bleeding

Answer 21

<50,00 = prolonged
<20,000= uncontrolled

Question 22

why is neutropenia bad

Answer 22

at risk for infection due to fewer neutrophils

fungal, bacterial, viral

Question 23

neutropenic precautions

Answer 23

limit exposure to others
wear mask outside
hand washing
watch vitals (esp temperature)

Question 24

other therapies besides radiation and chemo

Answer 24

hormone manipulation (breast and GYN cancer, turns off certain hormones by supressing them)
biologic response modifiers (treatment for supportive)

Question 25

best management for sepsis and DIC is…

Answer 25

PREVENTION

ie/aseptic technique and assessment

Question 26

oncologic emergencies

Answer 26

sepsis
DIC
SIADH
spinal cord compression
hypercalcemia
superior vena cava syndrome
tumor lysis syndrome

Question 27

what is sepsis

Answer 27

bacteria enters bloodstream

high mortality rate

Question 28

what is DIC

Answer 28

disseminated intracellular coagulation
defect in clotting process
**at risk for hemorrhage
widespread clotting

Question 29

what is treatment of DIC

Answer 29

heparin-prevents formation of new clots

Question 30

what is SIADH

Answer 30

syndrome of inappropriate ADH
increase in ADH (anti-diuretic)
RETAIN fluid
treat condition and cause

Question 31

what is spinal cord compression

Answer 31

treatment is palliative
radiation to reduce size of tumor
steroids also decrease size of tumor

Question 32

what is hypercalcemia

Answer 32

increase in Ca
occurs in pts with bone metastasis (releases Ca)
lung, head, kidney cancers also release Ca

Question 33

priority for hypercalcemia pt

Answer 33

REHYDRATE pt

Question 34

what is superior vena cave syndrome

Answer 34

SVC compressed by tumor
edema, dyspnea, epistaxis
hemorrhage and death are possible
palliative

Question 35

what is tumor lysis syndrome

Answer 35

tumor quickly killed by treatment
body doesnt respond to it (liver and kidney cant adapt to cells)
INCREASE in K

Question 36

treatment for tumor lysis syndrome

Answer 36

hydration and dialysis

sometimes given allopurinol-helps with renal excretion