Section 1: Cancer Care Flashcards
What are the typical cells of the immune system and their functions?
-Red blood cells (erythrocytes): These cells transport oxygen from the lungs to the rest of the body and return carbon dioxide to the lungs for exhalation.
-White blood cells (leukocytes): These cells are part of the immune system and help fight infections. They include neutrophils, basophils, eosinophils, monocytes, and lymphocytes.
-Platelets (thrombocytes): These cell fragments are crucial for blood clotting and wound healing
What is Hemopoiesis, also known as hematopoiesis?
- It is the process to produce blood cells.
- occurs in the bone marrow by differentiation of hematopoietic stem cells
- into RBC, WBC, platelets
What is Myeloid neoplasia?
- A group of cancers that originate from myeloid cells in the bone marrow.
- These cancers affect the production and function of various blood cells.
Explain how disease changes other body structures involved in disease establishment and progression: What are common types of Myeloid neoplasms?
-Acute Myeloid Leukemia (AML): A rapidly progressing cancer that affects myeloid cells, leading to the accumulation of immature white blood cells in the bone marrow and blood
-Chronic Myeloid Leukemia (CML): A slower-progressing cancer that affects the myeloid cells and is characterized by the presence of the Philadelphia chromosome
-Myelodysplastic Syndromes (MDS): A group of disorders caused by poorly formed or dysfunctional blood cells, often leading to anemia, infections, and bleeding
-Myeloproliferative Neoplasms (MPN): A group of diseases where the bone marrow makes too many red blood cells, white blood cells, or platelets. Examples include polycythemia vera, essential thrombocythemia, and primary myelofibrosis
What are signs and symptoms that a patient may display in a case of Blood Malignancy such as leukemia?
-Anemia: Fatigue, weakness, shortness of breath, dizziness, pale skin, and chest pain.
-Poor clotting: Easy bruising, frequent nosebleeds, bleeding gums, and tiny red spots on the skin.
-Infections: Frequent infections, fevers, and night sweats.
-Swollen lymph nodes: Lumps in the neck, armpit, or groin.
-Bone pain: Pain in bones or joints
What is a common type of blood malignancy?
Leukemia
How can leukemia be investigated?
-Blood test
-Bone marrow biopsy
-Lymph node biopsy
-Scans
-Genetic tests
-Immunophenotypine
-General health and infection screening
What are treatment plans for leukemia?
-Active monitoring (watch and wait): not having a treatment until you need it
-Targeted Therapies: targets the protein that control the cancer cells that grow, divide, and spread
-Chemotherapy: medicine is used to kill the cancer cells,
-Stem cell transplants: a stem or bone narrow transplant replaces the damaged blood cells with healthy ones
-Growth factors:
Immunotherapy
What are the side effects of chemotherapy?
-Fatigue
-Anaemia
-Infection
-Mucositis
-Hair loss or thinning
-Changes to bowel habits
-Nausea and vomiting
-Tumour lysis syndrome
-Infertility
-Long term health problems with Thyroid, heart or lungs
Pre-treatment medications administered before commencing chemotherapy
-Metoclopramide
- Levomepromazine
- Ondansetron
- Domperidone
- Dexamethasone
- Acetaminophen
- Prednisolone
Examine the difference between malignant and benign tumours
Malignant tumours spread or invade into nearby tissues while benign tumours do not
Characteristics of Malignant Tumours:
Cancerous: Malignant tumours contain cancer cells.
Growth: They tend to grow rapidly and are often irregular in shape.
Spread: Malignant tumours can invade nearby tissues and spread to other parts of the body through the bloodstream or lymphatic system (metastasis).
Appearance: Cells in malignant tumours are often abnormal and differ significantly from normal cells.
Treatment: Treatment may involve surgery, chemotherapy, radiation therapy, or a combination of these, and malignant tumours have a higher chance of recurrence
Characteristics of Benign Tumours:
- Non-cancerous: Benign tumours do not contain cancer cells.
- Growth: They grow slowly and are usually well-defined.
- Spread: Benign tumours do not invade nearby tissues or spread to other parts of the body (metastasize).
- Appearance: Cells in benign tumours resemble normal cells and are less likely to be abnormal.
- Treatment: Often, benign tumours can be removed surgically and typically do not recur
Nursing management of chemotherapy patients:
Danger time known as the nadir occurs between 5 – 10 days post chemotherapy for most regimes.
-Blood transfusion
-Platelet transfusion
-Side effects management
-Maintain a strict input and output chart
-Perform mouth and skin care
-Daily weight
Nursing management of chemotherapy patients: Patient education
-Chemotherapy is excreted in all body fluids and can stay in the system for 48 hours.
-Eat small frequent nutritious meal
-Use of gloves when handling body fluids and maintaining hand hygiene
-Wear disposable pads if incontinent
-Utilise the cancer support community
-Patients are advised not to become pregnant or inseminate for one year after completion. Barrier contraception is advised.
-Sperm and egg storage are offered if appropriate
What is neutropenia?
Neutropenia is a condition characterized by an abnormally low level of neutrophils, a type of white blood cell. It increases the risk of infections, particularly bacterial infections.
What is neutropenic sepsis?
Neutropenic sepsis is a potentially life-threatening complication of neutropenia. It is defined as a temperature of greater than 38°C or any symptoms and/or signs of sepsis, in a person with an absolute neutrophil count of 0.5 x 109/L or lower.
Causes of neutropenic sepsis:
-Cytotoxic Chemotherapy – Damages bone marrow, reducing neutrophil production.
-Immunosuppressive Drugs – Medications like corticosteroids or biologics suppress the immune system.
-Stem Cell Transplantation – Temporarily depletes neutrophils as the immune system rebuilds.
-Severe Infections – Viral, bacterial, or fungal infections can overwhelm the immune system and contribute to neutropenia.
-Bone Marrow Disorders – Conditions like leukemia, myelodysplastic syndromes, or aplastic anemia impair neutrophil production.
-Nutritional Deficiencies – Deficiencies in vitamin B12, folate, or copper can hinder neutrophil production.
Nursing assessment for neutropenic sepsis:
-Assess venous access devices for signs of infection (redness, swelling, discharge).
-Take a detailed history, including recent infections, treatments, and medications.
-Conduct a full physiological assessment (vital signs, respiratory status, perfusion) to establish a baseline.
-Perform a head-to-toe skin assessment for rashes, wounds, ulcers, or signs of infection.
-temperature monitoring (as fever is a key indicator of sepsis)
-monitoring for signs of systemic infection like hypotension or tachycardia
Nursing management for neutropenic sepsis
-Escalate care immediately to a senior clinician and follow the sepsis protocol.
-Administer oxygen therapy to maintain SpO₂ > 94% (unless contraindicated, such as in COPD patients).
-Establish IV access and collect blood cultures, full blood count (FBC),
-renal & liver function tests (U&Es, LFTs), lactate, and CRP.
-Obtain microbiology samples (blood, urine, sputum, wound swabs if applicable).
-Start IV broad-spectrum antibiotics within one hour (as per local sepsis guidelines).
-Administer IV fluid bolus (e.g., 500 mL crystalloid over 15 minutes) if signs of hypoperfusion (low BP, high lactate).
-Monitor closely, including:
-Vital signs (BP, HR, RR, SpO₂, Temp)
-Urine output (catheterize if necessary)
-Mental status and signs of deterioration
-Continue supportive care and prepare for possible intensive care escalation if needed
Sepsis: Patient’s education on discharge
-Educate on strategies for infection prevention, such as the importance of good personal and oral hygiene, handwashing, ensuring foods are well-cooked, and wearing protective gloves for cleaning and gardening, for example.
-Provide advice on the nature of sepsis, what to expect during recovery after sepsis, and sources of information and support.
-Provide information on how and when to seek specialist advice on any symptoms or concerns, and when to seek emergency care.
-Advise having access to a thermometer to check temperature accurately at home, and the importance of monitoring for symptoms and body temperature, especially if unwell.
-Educate on the need to adhere to medication plan.
