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Test 4 > Respiratory Malignancies > Flashcards

Respiratory Malignancies Flashcards

1
Q

Risk Factors for Head and Neck Cancer

List 11

A
  • Smoking
  • Alcohol
  • HPV
  • Gender: Men 2-3x more common
  • Age
  • Poor oral Hygiene
  • Occupational hazards
  • Marijuana use
  • GERD
  • Poor nutrition: weakens immune system
  • Weakened immune system
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2
Q

In young adult population, main risk factor is

A

HPV

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3
Q

A patient with a history of heavy alcohol use and newly diagnosed with head and neck cancer is admitted for surgery, what should the nurse monitor for?

A

Alcohol withdrawal

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4
Q

8 S/S of Head and Neck Cancer

A
  • Ear pain (otalgia)
  • Nose bleeds (epistaxis)
  • Coughing up blood (hemoptysis)
  • Difficulty swallowing (dysphagia)
  • Difficulty breathing (dyspnea)
  • White, patchy lesions (Leukoplakia)precancerous (does not heel after 2 weeks)
  • Red, patchy lesions (Erythroplakia)
  • Weight loss
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5
Q

Difinitive Dx study for Head & Neck Cancer

A

Biopsy

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6
Q

If patient has an ENDOSCOPY for dx studies, what should be monitored after procedure before allowing the patient to eat or drink.

A

Gag reflex- to prevent aspiration

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7
Q

System used by healthcare providers to determine cancer stage

A

TNM staging system

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8
Q

TNM stands for

A
  • Tumor: size of tumor
  • Node: Number and location of involved lymph nodes
  • Metastasis: Extent of metastasis (has it spread)
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9
Q

3 main treatments for Head and Neck Cancer

A
  • Chemotherapy & Targeted Therapy
  • Radiation
  • Surgery
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10
Q

Preferred treatments for Head and Neck cancer

A

Radiation + Chemo

(chemo on its own does not cure)

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11
Q

Review:

larynx is essential for

A

normal breathing
protecting the airway
producing sound (speech)

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12
Q

Surgical Treatment:

HIGHEST risk with Partial Laryngectomy

A

risk of aspiration

  • important parts of the throat that prevent food and liquids from entering the airway are removed. Since the airway is still connected to the mouth, there’s a higher risk of aspiration.
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13
Q

Which of the following surgical procedures results in no risk for aspiration?

A) Partial laryngectomy
B) Total laryngectomy
C) Tracheostomy
D) Esophagectomy

A

B) Total laryngectomy

-Since a total laryngectomy removes the entire larynx, separating the airway from the digestive tract, there is no risk for aspiration. (Separates esophagus and trachea)

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14
Q

Surgical Treatment:

What senses are LOST with a TOTAL Laryngectomy?

List 3

A
  • Normal speech ability is lost
  • Sense of smell: air no longer passes thru the nose when breathing, disrupting ability to smell
  • Sense of taste
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15
Q

After a total laryngectomy, what type of airway management will a patient require?

A

permanent tracheostomy

  • creates a NEW airway for breathing, as the removal of the larynx eliminates the normal route for air passage through the mouth and nose.
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16
Q

Surgical removal of lymph nodes and surrounding tissues in the neck to eliminate cancerous cells.

A

Radical Neck Dissection

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17
Q

What are the potential complications of a radical neck dissection that can affect a patient’s physical abilities and appearance?

A

Complications may include:
* difficulty lifting and turning the head
* shoulder drop on the affected side
* significant physical deformity

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18
Q

Radiation Therapy:

Involves delivering high-energy radiation beams from OUTSIDE the body directly to the tumor.

A

External beam

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19
Q

Radiation Therapy:

Involves placing radioactive sources directly INSIDE or very close to the tumor.

A

Internal implants (brachytherapy)

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20
Q

2 types of Internal Implants (brachytherapy)

A
  • temporary
  • permanent
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21
Q

Which type of the 2 types of Radiation Therapy is the patient radioctive

A

Internal implants (brachytherapy)

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22
Q

Review from N2:

2 types of brachytherapy based on the form of the radioactive material

A
  • sealed (or solid) brachytherapy
    -seeds, applicators
  • unsealed (or liquid) brachytherapy
    -injected,oral: systemically
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23
Q

Type of Brachytherapy where patient emits radiation but NONE in EXCRETIONS (waste products)

A

Sealed

24
Q

Type of Brachytherapy where Patient AND Exretion are radioactive

A

Unsealed

25
Q

Nursing Responsibilities for Patients receiving Brachytherapy tx.

List 5

A
  • Private Room for Pt
  • Limit visits 10-30 mins
  • Visitors sit 6 ft away from pt
  • No small children or pregnant women
  • Assess fistulas or necrosis of adjacent tissue
  • Monitor for S/S: burning, excessive perspiration, cills/fever, N/V, diarrhea
26
Q

Chemo and Radiation (both) are used for which stages of cancers (all cancers)?

A

III & IV (3/4)

27
Q

Used with chemotherapy for patients with late-stage head and neck cancer

A

Targeted Therapy & Immunotherapy

28
Q

Targeted Therapy & Immunotherapy:

These patients are at high risk for

A

infection

29
Q

Fever that is an EMERGENCY situation for chemo patients

A

Fever of 100.4 F

know

30
Q

With Head and Neck Cancers we are more concerned with:

List 4

A
  • Airway
  • Breathing
  • Bleeding
  • Infection
31
Q

Can head and Neck cancers be prevented?

A

Most can!
* stop tobacco and alcohol
* poor oral hygiene
* HPV infection

32
Q

Head & Neck Cancer:

Nursing Management for Acute Care

A
  • Teach about the type of treatment pre-op.
  • Prepare them to deal with the psychological impact of cancer
  • Alteration in physical appearance
  • Possible need for enteral feedings
  • Potential for altered methods of communication
  • Assessment of the support system ( social service)
33
Q

Post-Op Care for Airway Management

A
  • Inflammation may compress the trachea
  • Semi-Fowler’s position to decrease edema
  • Frequent suctioning via tracheostomy for patients with laryngectomy
  • Adequate fluids to keep secretions thin and mucous membranes moist **
34
Q

Post-Op Wound Care:

first dressing change after surgery typically performed by

A

surgeon

35
Q

*Post-Op: Nutrition *

What clinical indicator suggests that a patient may begin enteral or oral feeding after surgery?

A

The return of bowel sounds.

36
Q

What are important considerations for pain control in patients who may not be able to speak?

A
  • Administer analgesic drugs as needed to manage pain effectively.
  • Use visual cues, such as the FACES pain scale, to help assess pain levels
  • Text-to-speech apps
  • Keyboard-based communication
37
Q

High Mortality, Low cure rates
What cancer am I?

A

Lung cancer

38
Q

What is the primary risk factor for developing lung cancer?

A

smoking

39
Q

What are the other 2 causes of Lung Cancer

A
  • Radon: gas emitted from soil
  • Occupational and environmental causes (industrial pollutants, firefighters, coal miners)
40
Q

Why is the prognosis for lung cancer generally poor?

A

due to late diagnosis and the frequent presence of metastasis at the time of detection.

41
Q

Most Common S/S of Lung cancer

A

Chronic cough or Bloody cough

42
Q

Early S/S of Lung Cancer

A
  • Bone pain: due to mestastasis near spine, rib cage, pelvis
  • Wheezing sound
  • raspy, hoarse voice
  • SOB
  • Difficulty Swallowing: metastasis tumors can hit nerves near esophagus
43
Q

2 Late S/S of Lung Cancer

A
  • Unexplained Weight Loss
  • Nail Clubbing
44
Q

DX study that is DEFINITIVE for Lung Cancer

A

Biopsy

45
Q

What is the relationship between lung cancer and superior vena cava syndrome?

A

Lung cancer can cause superior vena cava syndrome (SVCS)
* when a tumor compresses or invades the superior vena cava, leading to obstructed blood flow

46
Q

What symptoms might indicate the presence of superior vena cava syndrome in a lung cancer patient?

A
  • Facial swelling or puffiness.
  • Neck swelling or distention.
  • Shortness of breath or difficulty breathing.
  • Headaches or dizziness.
  • Prominent veins in the neck or chest
47
Q

2 Treatments for Superior Vena Cava syndrome (SVC)

A
  • Radiation therapy with or without chemotherapyis the mainstay of treatment for most patients.
  • Intravascular stents are proven to be safe and effective and allow the most rapid resolution of symptoms
48
Q

What are key components of respiratory status and care for a patient after lung cancer surgery?

List 5

A
  • Assessment of respiratory status.- IMPORTANT
  • Proper positioning to facilitate breathing.
  • Use of an incentive spirometer
  • “turning, coughing, and deep breathing” (TCDB) techniques.
  • Effective chest tube management to ensure proper drainage and lung expansion.
49
Q

How does effective pain control contribute to preventing hypoventilation in patients?

A
  • When a patient has pain, it can be uncomfortable to take deep breaths or cough.
  • If the pain isn’t managed well, the patient might avoid taking deep breaths
  • When they’re not in pain, they’re more likely to take deep breaths and cough when necessary.
50
Q

Repeted:

Lung Cancer- POST OP
No. 1 Emergency Symptom

A

Fever 100.4 F or greater.
* Most reliable indicator for infection!!
* check WBC!!!!

IMPORTANT

51
Q

What role does early ambulation play in post-surgery recovery?

A

Helps prevent DVT and PE, improves circulation, and accelerates recovery.

52
Q

Treament for Lung cancer leads to several common symptoms.

List 5

A
  • Fatigue
  • Nausea/Vomiting
  • Anorexia
  • Cachexia: wasting of body due to severe chronic illness
  • Rashes
  • Alopecia (hair loss)
53
Q

A condition characterized by the collapse or partial collapse of the lung or a section (lobe) of the lung.

A

Atelectasis

54
Q

Early signs of Atelectasis

A
  • Decreased breath sounds
  • Low grade fever
55
Q

Late signs of Atelectasis

A
  • cyanosis
  • intercostal retractions
56
Q

Nutrition needed for Lung Cancer patients

A

high-calorie
high-protein

Test 4 (8 decks)

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