Patients with Cancer Flashcards

1
Q

What is DMSM? What does it consist of?

A
  • distress management screening measure
  • distress rating from 0-10
  • problem checklist (physical, practical, emotional etc.)
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2
Q

What are some symptoms of distress?

A
  • fear about the future
  • sadness about loss of health
  • feeling powerless, angry
  • decreased appetite
  • poor sleep
  • difficulty concentrating
  • thoughts of illness or death
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3
Q

What are some interventions for distress?

A
  • regular exercise
  • educate patient (symptoms to expect)
  • support groups
  • relaxation, meditation
  • medication
  • multidisciplinary approach
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4
Q

Why is identifying distress in cancer patients important?

A
  • distress can affect decision making, decrease quality of life, decrease compliance and treatment outcomes
  • often unrecognized (may be due to time limits in dr. office)
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5
Q

What did patients with advanced cancer find helpful in terms of communication with health care professionals?

A
  • not appearing rushed
  • being caring (empathy, touch, calls to checkup)
  • acknowledge fear, reassure
  • balance hope and honesty when giving information (don’t give false hope, don’t destroy hope)
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6
Q

What were helpful communication strategies during the diagnostic period for patients with cancer?

A
  • professional demeanor (non-judgemental, compassionate, attentive)
  • receptive (to emotions, to questions)
  • sensitive to terminology used
  • attention to time and space (not rushed, given time, space to regain composure before leaving dr. office)
  • emotional way-finding (offer emotional guidance)
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7
Q

What is anticipatory chemotherapy-induced vomiting? When does it occur? What medication might you use to treat?

A
  • occurs in 24 hours before chemo
  • occurs in patients with experience of chemo (not in first time patient)
  • can use benzodiazepines to treat
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8
Q

When does acute chemotherapy-induced vomiting occur? What pathways are triggered? How might you treat?

A
  • occurs in the 24 hours after chemo
  • vomiting centre stimulated via GI tract and chemotherapy trigger zone
  • 5HT3 receptor antagonist (serotonin receptor blockers) work well
  • best to use drug combo to treat
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9
Q

When does delayed chemotherapy-induced vomiting occur? What neurotransmitter might be involved? What treatment works well?

A
  • occurs more than 24 hours after chemo, up to 7 days later
  • substance P might be the neurotransmitter involved
  • neurokinin 1 receptor antagonists work well but are costly
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10
Q

What is primary disease prevention? What would this involve in cancer prevention?

A
  • reducing risk

- avoiding carcinogens, healthy lifestyle (diet, exercise, quit smoking)

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11
Q

What is secondary disease prevention? What would this involve in cancer prevention?

A
  • screening and early detection

- ex. self exams, DRE, PAP tests, mammography

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12
Q

What system is used to stage a tumour? When might another system need to be used?

A
  • TNM system (size 0-4, node involvement 0-3, metastasis 0-1)
  • TNM system only works on solid tumours, doesn’t work for blood cancers
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13
Q

How is cancer graded?

A
  • histologic classification of cancer
  • graded 1-4
  • grade of 1 = well differentiated cells
  • grade of 4 = poorly differentiated cells
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14
Q

What are different goals of cancer treatment?

A
  • cure
  • control
  • palliate (relieve symptoms)
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15
Q

What are goals of surgery in the management of cancer?

A
  • diagnostic (ex. biopsy)
  • curative (excise tumour and some surrounding tissue - lots of surrounding tissue, structures and nodes if severe/aggressive)
  • prophylactic (ex. Angelina Jolie’s mastectomy because she had BRCA1 or 2 gene)
  • palliative (decrease symptoms)
  • reconstructive (to aid with body image)
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16
Q

What is radiation and how does it work to treat cancer?

A
  • a localized treatment
  • works by damaging/altering DNA in cells, especially effective during DNA synthesis and mitosis, so affects tissue undergoing frequent cell division
  • tumours that are well oxygenated are more sensitive
17
Q

What is brachytherapy? Is there a health risk to others for patients receiving this treatment?

A
  • type of internal radiation where radiation seed can be implanted to treat localized area, can use radioisotopes (ex. prostate)
  • patient may be radioactive to certain degree - take appropriate cautions
18
Q

What is chemotherapy? How does it work to treat cancer and how is it different from radiation?

A
  • medication, can be administered in different ways
  • usually used to treat systemic disease vs. localized
  • goal is to shrink tumour to size where patient’s own immune system can destroy it
  • most work through interference with cell division and thus effect cells that are replicating more quickly (cancer and normal cells)
19
Q

What is biologic response modifier therapy? Give a few examples.

A
  • therapy to enhance the patient’s immune response against tumour cells, has the benefit of not damaging healthy cells
  • examples: mononuclear antibodies, cytokines (colony-stimulating factors, interferons, interleukins), cancer vaccines (guardasil for HPV)
20
Q

What are side effects of radiation?

A
  • skin reactions at site
  • stomatitis (inflammation of oral tissues)
  • xerostomia (dry mouth)
  • GI irritation (nausea, vomiting, diarrhea, anorexia)
  • myelosuppression
  • fatigue, malaise
21
Q

What are side effects of chemotherapy?

A
  • GI irritation (nausea, vomiting, diarrhea)
  • myelosuppression
  • changes in reproductive function (sterility)
  • fatigue
  • alopecia (thinning and loss of hair)
  • damage to kidneys
  • some drugs can cause heart, CNS or lung damage that is permanent
22
Q

What are complications of cancer treatment? (radiation and chemo)

A
  • risk infection (from low WBCs)
  • risk bleeding (from low platelets)
  • risk of fluid and lyte imbalances, decreased nutrition from nausea, vomiting etc.
  • for chemo: if given IV it is a vesicant, watch for extravasation
23
Q

What are nursing priorities during cancer treatment?

A
  • maintain skin integrity
  • promote nutrition
  • relieve pain
  • decrease fatigue
  • improve body image
  • assist in grieving
  • monitor for complications