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Med Surg. 1 > oncology unit 1 > Flashcards

oncology unit 1 Flashcards

1
Q

oncology …

A

is the study, detection, diagnosis, and management of cancer.
OCN-oncology nurse
ONS-oncology nursing society (research)
ACS-amercian cancer society

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2
Q

carcinogenesis

A

process of transforming normal cells into malignant cells . (Genesis) the process by which normal cells are transformed into cancer cells.
A carcinogen is anything that causes cancer (chemical,physical) or a substance known to increase the risk of cancer.

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3
Q

Angiogenesis

A

Growth of new blood vessels that allows cancer cells to grow.

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4
Q

Benign

A

Not cancerous, unable to spread to other areas.

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5
Q

Biopsy

A

Remove a small sample of tissue to be examined microscopically to detect malignant cells

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6
Q

Extravasation

A

Leakage of medication from the vein into the subcutaneous tissue

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7
Q

Vesicant

A

Substance that causes tissue necrosis and damage

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8
Q

What are the side effects of chemotherapy?

A

Chemo destroys all cells! Including cancerous cells and good cells. By interfering with cellular functions and reproduction.

Side effects: neutropenia- abnormal neutrophil count (low platelet). Thrombocytopenia- decrease in the number of circulating platelets associated with potential bleeding. Mucositis- inflammation of GI. Stomatitis- inflammation of the oral tissue (head & neck). Myelosuppression- caused a decrease in blood cell producing in the bone marrow.

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9
Q

What are the 2 type of chemotherapy?

A

Radiation therapy- (specific area) ionizing radiation to interrupt the growth of the malignant cells.
Brachytherapy- delivery of radiation therapy through internal implants.

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10
Q

Characteristics of malignant cells?

A

Malignant cancer cells are uncontrollable growth in cancer cells. They contain a protein tumor specific antigen CEA- tumor marker doesn’t mean you have cancer (blood work). PSA- prostate specific antigen.
And the nuclei are large and irregular.

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11
Q

Metastasis

A

The spread of cancer cells from original cancer site to distant organs.
Invasive

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12
Q

Hyperplasia

A

A rapid increase of cells in tissue.

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13
Q

Metaplasia

A

Conversion of mature cells into another.

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14
Q

Dysplasia

A

Cells that are different in size.

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15
Q

Anaplasia

A

Cells that differ in characteristics, shape and organization.

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16
Q

Neoplasia

A

Uncontrolled cell growth that is cancerous.

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17
Q

Malignant transformation

A

Initiation: carcinogen alter DNA of the cell which will either cause the cell to be repaired or die.
Promotion: is the result of repeated exposure to carcinogen.
Progression: irreversible period when the cells undergo neoplastic transformation then malignancy.

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18
Q

Dietary substances that increases the risk of cancer?

A

Fats, alcohol, salt-cured or smoked meat, nitrite and red or processed meats.

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19
Q

Risk factors of developing cancer are?

A

Exposure to radiation (ultraviolet rays-skin cancer).
Exposure to environmental carcinogens (fumes from rubber or dust)
Smokeless tobacco - increases the risk of cancer in the mouth, larynx, pharynx and esophagus.
Frequent and heavy consumption of alcohol- increase the risk of cancer of the mouth, pharynx, larynx, esophagus, liver, colon, rectum and breast.
Occupation
Infectious agents

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20
Q

Genetic factors of developing cancer are?

A

5-10% display the pattern of cancer (predisposition)

Breast cancer, lung cancer, leukemia is greater in identical twins and neuroblastoma increase in siblings.

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21
Q

Cancer risk assessment and cancer genetic counseling.

A

1st- family history assessment
2nd- obtain information about both maternal and paternal side of the family.
3rd- patient assessment …physical findings that may be a predisposition are colon polyps etc.

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22
Q

What is cancer?

A

A group of diseases characterized by uncontrollable growth and spread of abnormal cells. If the spread is not controlled it will result in death. Also they are unable to recognize their own natural boundaries due to faulty gene mutation in the cancer cells.

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23
Q

Neoplasm

A

Means tumor which literally means new growth

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24
Q

Terms referring to abnormal cell growth which are NOT cancer include?

A

Hyperplasia
Metaplasia
Dysplasia

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25
Q

Cancer screening (tests)

A

Occult blood, CXR, DRE-both male and female
Female SBE, Mammography and Pap smear
Male DRE, Prostate and testicular self exam.

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26
Q

Primary prevention

A

Refers to the complete prevention of disease, often through the methods that inhibit exposure to risk factors. 4 most important are nonsmoking, exercise regime, sunscreen and a balanced diet.

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27
Q

Secondary prevention

A

Activities that detect disease early (self breast and testicular exams) can be dramatically improved through early detection followed by appropriate treatment.

28
Q

Tertiary prevention

A

Involves preventing further disability and restoring a higher level of functioning in someone with a disease. Also provides treatment and rehabilitation.

29
Q

Cancer warning signs are?

A

Change in bowel habits sign of colorectal cancer a sore that does not heal on the skin or in the mouth could be malignant.
Unusual bleeding or discharge from rectum, bladder or vagina could be colorectal, prostate, bladder or cervical cancer.
Thickening of breast tissue or a new lump in breast indigestion or trouble swallowing cancer of the mouth, throat, esophagus or stomach.
Obvious changes to moles or warts could be skin cancer.
Nagging cough or hoarseness that persists for 4-6weeks could be cancer of lung or throat cancer.

30
Q

Diagnosis of cancer.

A

Cancer Dx is based on assessment of physiologic and functional changes.
Determine the extent of cancer.
Identify possible spread
Evaluate the function of involved and uninvolved body system
Obtain tissue and cell for analysis.

31
Q

Tumor spreading

A

Lymph nodes are the most common place for cancer to spread.

32
Q

Description, grading, and staging of tumors.

A

Description: carcinoma-malignant tumors composed of epithelial cells.
Sarcoma- malignant tumor of connective tissues such as bone or muscle.
Grading: grade1-4 (1-least malignant 4-most malignant)
Staging: stage 0-cancer in situ. Stage 1-tumor limited to the tissue of origin. Stage 2-limited local spread. Stage 3-extensive local and regional spread. Stage 4-metastasis

33
Q

Diagnosis of cancer

A 
Biopsy: the most definitive cancer test result. (Incisional,excisional,needle aspirations) 
Other tests but are not 100% accurate to diagnose. 
Endoscopy 
Diagnostic imaging 
Bone scanning 
Tumor markers 
Computed tomography (CT) 
Radioisotope studies 
Ultrasound testing 
Magnetic resonance imaging
34
Q

3 most common types of biopsy.

A

Excisional: the removal of the normal tissue beyond the tumor and tumor area. This 1 provides an entire tissue for staging and grading. Example (skin,breast,upper and lower GI and respiratory tract)
Incisional: is done if the tumor mass is to large to be removed. A piece of tumor is sent to analyze.
Both are done by endoscopy
Needle biopsy: sample of suspicious masses. It’s done out patient basis less painful of all and is minimal risk for infection.

35
Q

nursing action post biopsy

A

assess the site for any bleeding
use ASEPTIC tech. (prevents infection)
*educate pat. & family on any procedures and the time it takes to get results back.
how to care for the biopsy site and the signs of infection.

36
Q

what are the blood test for diagnosing cancer?

A

serum alkaline phosphatase: bone metastasis
serum calcitonin
carcinoembryonic antigen (CEA): colon CA
PSA and CA-125 : prostate
stool examination for blood
CBC with differential

37
Q

tumor markers for PROSTATE cancer

A

PSA is used in screening for prostate cancer, and monitors cancer progression.
digital rectal scan

38
Q

tumor markers for BLADDER cancer

A

tumor marker is still under study but bladder tumor antigen BTA and nuclear matrix protein 22 (NMP22) are used.
false positives are common in certain populations

39
Q

tumor markers for COLERECTAL cancer

A

40% of patients diagnosed will develop incurable recurrence of the disease
CEA tumor marker has become and integral element of surveillance following resection
CEA is ineffective as a screening tool due to low sensitivity and specificity

40
Q

tumor markers for PANCREATIC cancer

A

early symptoms are vague and nonspecific

CA 19-9 is used because of high sensitivity and

41
Q

tumor markers for BREAST cancer

A

most commonly used tumor markers are estrogen receptors (ER), progesterone receptors (PR), HER2/neu, CA 15.3, CA 27.29
ER & PR are used prognostic information
HRE2/neu are used as a predictive tumor marker and CA 27.29 used to defect metastatic

42
Q

tumor markers for OVARIAN cancer

A

CA 125 is the best and most widely used tumor marker

CA 125 is also valid and effective tool for monitoring treatment response.

43
Q

tumor markers for LUNG cancer

A

the use of tumor markers for these patients are controversial because of the poor prognosis associated with lung cancer.
the tumor markers in lung cancer are not very specific

44
Q

The tumor-node-metastasis TNM system used to stage cancer

A

T-TUMOR
TX-unable to evaluate the primary tumor
T0-no evidence of primary tumor
Tis-tumor in situ
T1,T2,T3,T4- size and extent of tumor
N-NODE
NX-unable to evaluate regional lymph nodes
N0-no evidence of regional node involvement
N1,N2,N3-# of nodes that are involved or extent of spread
M-METASTASIS
MX-unable to evaluate distant metastasis
M0-no evidence of distant metastasis
M1-presence of distant metastasis

45
Q

C-A-U-T-I-O-N 7 warning signs of cancer

A 
C-change in bowel or bladder habits 
A-a sore that doesn't heal 
U-unusual bleeding or discharge 
T-thickening or lump in the breast or elsewhere 
I-indigestion or difficulty swallowing 
O-obvisous changes in warts or moles 
N- nagging cough or hoarsness
46
Q

nursing actions for after biopsy

A
  • signed consent form
  • assemble supplies and use aseptic technique
  • prevent bleeding (withhold anticoagulants) monitor findings
  • monitor for bleeding (visible staining of dressing, hypotension, tachycardia)
  • provide safe environment (bed rest, withhold oral intake)
  • ensure adequate oxygenation
  • if pat. had liver biopsy lay pat. on the right side
47
Q

diagnostic aids to detect cancer

A

mammography- xray images of the breast
MRI-magnetic fields and radio frequency signals that make sectional images of different body parts (brain,breast,pelvic, and thoracic spine)
endoscopy- direct visualization of body cavity (GI tract and bronchial)
nuclear medicine imaging- iv or po ingesting radioisotope substance for (bone, liver, spleen and thyroid cancer)
PET scan- tracts the progression of cancer/ treatment out patient proc. and you have to get BG on pat. if they are diabetic.

48
Q

types of surgery

A

*diagnosing, staging and treatment
Prophylaxis- the removal of a risk tissue or organ (breast)
Debulking- is the process of reducing the size of a tumor
Reconstruction-e.i breast implant after a mastectomy
Pallative- is to improve quality of life

49
Q

radiation therapy

A

external- is when a large machine rotates around a pat. and sends beams of radiation in many directions.
internal- a form of internal radiation therapy is called brachytherapy, the radiation source is solid in the form of seeds, ribbons or capsules,which are place in the pat. body near the cancer.

50
Q

radiation therapy side effects include

A

SE-mild erythemia to 2nd degree burn,fatigue,nausea,anorexia.
site-specific-mucosisis,caries,esophagitis,dysphasia,tenses,cystitis,urethritis,alopecia, bone marrow suppression.

51
Q

nursing interventions for the pat. undergoing radiation therapy

A
  • keep skin dry, don’t wash skin until dr. rx
  • wash with mild soap,rinse, pat dry with warm or cool water never hot.
  • dont remove line or marks on skin, no tape
  • avoid powders,lotions,creams,and alcohol deodorants.
  • wear loosing fitting shoes
  • use an electric shaver
  • protect skin from sun and chlorinated pools
52
Q

radiation safety for the caregiver 3 key points

A
  1. distance- the greater the distance from the radiation source, the less exposer
  2. time-limited to 30min of direct care per 8 hrs
  3. shielding- the dose of rays is reduced as the thickness of lead shield is increased
    * dosimeter badges required
53
Q

internal radiation safety measures

A

limit time spent in the room down to mins, asses the pat. 1 time briefly per shift
communicate with the pat by telephone
no visitors!

54
Q

oral stomatitis

A

rapid divided cells in the pat. mouth post chemo and radiation can cause pain for months.

  • candida albicans (yeast present on the pat. mouth)
  • have pat suck on ice or popsicles
  • mouth rinses
55
Q

Leukopenia

A

chemo and radiation therapy tend to decrease WBC which can lead to leukopenia.

56
Q

Anemia

A

a decrease in red blood cells results in low hemoglobin and hematocrit.
normal hemoglobin for woman 12-16g/100ml
pussy niggas 13-18g/100ml
if your pat has abnormal lab results then tell the dr. asap b/c your pat. needs a blood transfusion.

57
Q

why are patients placed on neutropenic precautions?

A

to prevent infection because of the decrease in neutrophils anything less than

58
Q

Thrombocytopenia

A

normal platelet count is 150,000-400,000

  • is when platelet count fall below 100,000
  • these patients are at risk for bleeding when the count falls below 20,000
  • RN must notify dr. anything less then 50,000 count
59
Q

Pancytopenia

A

abnormal decrease in WBCs, RBCs, and platelets.

60
Q

Polycythemia

A

Excess RBC’s

61
Q

Granulocytopenia

A

Greatest risk factor in the development of sepsis in the cancer patient
-malignancy related immunosuppression (pat. Older than 65)
Loss of skin and mucosal injury.

62
Q

Patients at risk for sepsis

A
  • Indwelling devices, foley, feeding tube or Trach tube.
  • central venous access devises CVA
  • organ related diseases.
63
Q

SIRS-Systemic inflammatory response syndrome (sepsis)

A

Indicated by the presence of 2 or more S&S

  • fever greater than 100.4
  • pulse greater than 90 beats/min
  • respiratory rate greater than 20
  • WBC greater than 12,000
64
Q

Pathophysiology of sepsis

A

-sepsis occurs
Decrease blood flow due to continuation of coagulation cascade
Decreased tissue perfusion
Organ dysfunction

65
Q

Pathophysiology (septic shock)

A

Septic shock occurs
Persistent systemic hypotension
Profound organ hypo perfusion
Abnormal shunting of blood flow

66
Q

Clinical manifestation of septic shock

A

Vital signs

Oral temp >100.4 or

67
Q

Clinical manifestation of septic shock

A 
CNS 
Significant confusion 
Disorientation 
Cyanosis 
Dysrhythmias
Metabolic acidosis 
Transient Oliguria 
Increase BUN &screaming

Med Surg. 1 (2 decks)

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