Test 1- cancer Flashcards
1
Q
Our bodies ability to reproduce cells, to grow cells, and to stop when appropriate
A
Cellular regulation
2
Q
Continued growth vs set growth (cellular regulation)
A
Continued -Hair, nose, skin, lining of organs and mucus membranes, bone marrow, constant damage and wear and tear
Set- Heart, lungs, skeletal muscle, neurons, etc, will stop growing when it’s time
3
Q
Cells look and act like the cells from which they came from - will stay that way until apoptosis (death)
A
Normal cell growth
4
Q
When normal cells are damaged
A
Scar tissue replaces normal cell growth when damaged
5
Q
How our body keeps things in check, when to create new cells, how big to grow and when to stop growing
A
Cellular regulation
6
Q
Each cell is divided into identical original cells- until death apoptosis
A
Mitosis
7
Q
Normal Cell growth specific role in morphology ?
A
Divide to look like themselves,
act like themselves,
highly differentiated,
do not migrate,
growth is orderly
well regulated
8
Q
How do cells know when to stop growing ?
A
Oncogene (start growth)
and suppressor genes, contact inhibition (stops growing when it touches something else),
Apoptosis (programmed cell death,)
Euploidy (set number of chromosomes)
9
Q
Look normal but grow at wrong rate, time, location
Examples moles, uterine fibroids, skin tags, endometriosis
A
Benign cell growth
10
Q
Characteristics of benign tumor cells
A
Retain specific morphology
Can retain function
Right adherence to each other
Tend to be encapsulated -right clump
Does not invade into surrounding tissues
Usually Grow locally and organized manor- easy to remove (example- endometriosis)
Grows orderly : even though the growth isn’t needed or is in the wrong place, the rate of growth is normal
11
Q
Abnormal growth serves no purpose, harmful to other body tissues
A
Malignant cell growth
12
Q
Characteristics of malignant tumor cells *
A
Aneuploidy (abnormal chromosomes)
Anaplasia (loss of appearance)
Uncontrolled division
Loss of specific function
Migration and loss of differentiation (no clear borders and can spread to other areas of body)
Lose ability to regulate themselves (It lost ability to recognize when it touches another cell stop growing) lost contact inhibition
Lost cell shape and function
Metastasize through tissue or blood stream
13
Q
Poor cell differentiation, lose their characteristics and what makes them them.
Lose orientation to other cells and loses contact inhibition (unable to act as normal)
A
Anaplastic
14
Q
defined as group of diseases characterized by abnormal growth and spread of cells
Cell regulation is out of control
A
Cancer
15
Q
Most common cancers
A
Breast Lung Colon Prostate Melanoma
16
Q
Pathophysiology of cancer
A
Initiation
Promotion
Progression
Metastasis
17
Q
Stage of cancer where normal cells lose cellular regulation
Exposure to carcinogens (chemicals, physical agents, viruses) -these initiate
Latent period
Irreversible and CAN lead to cancer (not all cells will lead to cancer but it has the potential)
A
Initiation
18
Q
Stage of cancer where enhances growth of initiated cell occurs
Example: Insulin and estrogen, stress in body
A
Promotion
19
Q
Stage of cancer where continues to change , more malignant over time, primary tumor (where ever the tumor started)- can cause death if located in vital organ and interfering with performance
If in non-vital organ such as breast it can grow very large without causing death
A
Progression
20
Q
Stage of cancer where cells move from primary location
Primary tumors but in a new location example- breast cancer with liver _________
Occurs in local, surrounding tissues , and or blood/lymph borne
Spread into primary organ? - can cause death
A
Secondary or metastatic tumors
21
Q
Table 21-5
describes the size of a tumour and how far it has spread from where it originated.
Extent of tumor or extent of spread
TNM
The lower this is the greater the chance of survival
A
Staging
Tumor node metastasis
22
Q
The degree of malignancy
describes the appearance of the cancerous cells.
Helps with determining prognosis and appropriate therapy
How different have the cells become?
A
Grading
23
Q
Always referred to by stage at diagnosis, even if it gets worse or spreads
A
TNM
24
Q
- refers to size and extent of main tumor
- Number of lymph nodes affected
- Whether it has metastasized
A
TNM
Example - T1N0M1 (small primary tumor, no lymph, Mets can’t be measured
25
Primary Tumor (T)
Tx
To
T is
T1, T2, T3, T4
Tx- primary tumor can not be assessed
T o- no evidence of primary tumor
Tis- carcinoma in site
T1, t2, t3 t4- increasing size and or local extent of the primary tumor. T1 is small tumor and t4 is large
26
Regional lymph nodes (n)
Nx-
No-
N1, N2 , N3-
Nx- Regional lymph nodes cannot be assessed
No- No regional lymph node metastasis
N1, N2 , N3-Increasing involvement of regional lymph nodes, how many nodes affected
27
Distant metastasis (m)
Mx -
Mo
M1
Mx- presence of distant metastasis cannot be assessed (none)
Mo-No distant metastasis (where it started)
M1- distant metastasis(liver cancer spread to Brian)
28
How to define the progressive spread of intestinal cancer and it’s invasion into surrounding tissues
Staging
29
Carcinoma in situ (means cancer in place)
The cancer cells have not yet invaded into surrounding tissues, without envision the tumor can’t spread in the cure rate is 100%
What stage?
Stage 0
30
Stage?
The primary tumor is small but invasive into surrounding tissues and has not spread
Stage 1
31
Stage?
The primary tumor is larger, but there is still no clinical evidence of spread
Stage 2
32
Stage?
The tumor has spread to lymph nodes plans (also called lymph nodes) In that region of the body
Stage 3
33
Stage?
The Cancer has spread beyond the region where it has initiated to a distant tissue or organ
Stage 4
34
Five stages of grading?
1- nearly normal cells
2- Some abnormal cells loosely packed
3-Many abnormal cells
4- very few abnormal cells left
5- completely abnormal cells
35
Etiology or cause of cancer
External factors Are responsible for 80% of cancers
Environment - uv exposure , chemical exposure
Lifestyle- tobacco, alcohol, viral exposure, sexually acquired HPV
Dietary factors - red meat , low fiber, animal fats
Personal factors- immunity, age, genetics
**education - risks - prevention(healthy diet, sunscreen etc)
36
Primary prevention of cancer
Avoidance of known or potential carcinogens
Use of vaccines, hep b, HPV
Health screening and counseling to determine risks
Lifestyle changes - tobacco and alcohol cessation
Removal of at risk tissues - moles , colon and polyps, breasts
37
Secondary prevention for cancer
* SCREENING FOR SPECIFIC CANCERS
* DOESN’T REDUCE INCIDENCE BUT CAN REDUCE DEATH RATE
•WWW.CANCER.ORG
* EARLY RECOGNITION OF CANCER
* KNOW THE WARNING SIGNS OF CANCER*
38
**CAUTION
Warning signs of cancer ?
Change in bowel or bladder habits
A sore throat that does not heal
Unusual bleeding or discharge
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
39
ACS Recommendations for screening for cancer’s
Breast -
Colorectal
Uterine
Prostate
Testicular
•BREAST: AGE 20 BSE; AGE 30 PROVIDER EXAMS Q3Years, AGE 40+ ANNUAL MAMMOGRAM & EXAM
•
COLORECTAL: AGE 50+ FECAL OCCULT BLOOD; COLONOSCOPY Q10 years
•
UTERINE: AGE 18 PAP; MENOPAUSE: ENDOMETRIAL BX
•
PROSTATE: AGE 50 PSA ANNUALLY, DIGITAL rectal exam
Testicular-age 20 TSE, age 30 provider exams q 3 years
-If genetic risk then get screening earlier
40
PREVENTION type?
* MINIMIZING SIDE EFFECTS
* REDUCING DISABILITY
* INCREASING MAINTENANCE FUNCTION
* PREVENT REOCCURRENCE
* STRATEGIES
* HEALTH COUNSELING
* CHEMOPREVENTION
(Prevent It from making life worse)
Tertiary
41
Impact of cancer on the body
CANCER IS A CHRONIC ILLNESS
•CARE IS COMPLEX, MULTIFACETED
•REQUIRES INTERDISCIPLINARY TEAM
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•IMPAIRED IMMUNITY
•IMPAIRED CLOTTING
•ALTERED GI FUNCTION
•ALTERED PERIPHERAL NERVE FUNCTION
•MOTOR AND SENSORY DEFICITS
•PAIN
Altered respiratory and heart function
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42
Cancer diagnosis how/tests?
Definitive test?
Nurses role?
* LAB TESTS: TUMOR MARKERS
* RADIOGRAPHY
* BIOPSY: ONLY WAY TO GET DEFINITIVE DIAGNOSIS
* BONE MARROW ASPIRATION**
* NURSES ROLE
* EXPLAIN TO PATIENT
* PREPARE FOR PROCEDURE
* PREPARE FOR COMPLICATIONS
43
Tx options for cancer
TREATMENT OPTIONS
* SURGERY
* RADIATION
* CHEMOTHERAPY
* HORMONE REPLACEMENT
* STEM CELL TRANSPLANTS
* CAM
44
Tx goals for cancer
* CURE THE CANCER
* CONTROL THE SPREAD
* PALLIATIVE
45
Reasons for surgery with cancer
•USED FOR
* PROPHYLAXIS
* DIAGNOSING (BIOPSY, STAGING)
* REMOVE (CURATIVE)
* CYTOREDUCTIVE (DEBULKING)
* PAIN MANAGEMENT
* RECONSTRUCTIVE
* PLACE DEVICES (IV LINES, DRUG DELIVERY DEVICES, ETC)
46
Cancer Radiation therapy types ?
Side effects ?
* EXTERNAL THERAPY
* LOCALIZED
* CAN BE TOTAL BODY
* SIDE EFFECTS (TABLE 22-2) **
* RAPIDLY DIVIDING CELLS
* ENTERITIS
* FATIGUE
* SKIN IRRITATION
47
* RADIATION DELIVERED INTERNALLY (treats the cancer internally)
* RADIATION IS discharged FROM PATIENT
Patient is considered radioactive
BRACHYTHERAPY
48
Radiation precautions
RADIATION PRECAUTIONS*
* PRIVATE ROOM/BATH
* CAUTION SIGN ON DOOR
* POSSIBLY USE LEAD SHIELDS
* KEEP DOOR CLOSED
* STAFF WEARS DOSIMETER
* LEAD APRONS
* NO PREGNANT OR TRYING TO CONCEIVE STAFF
* VISITORS LIMITED TO 30 MIN
* VISITOR STAY AT LEAST 6 FT AWAY
* NEVER TOUCH SOURCE WITH BARE HANDS-use forceps to pick up
* ALL DRESSINGS AND LINENS IN ROOM UNTIL source is removed
Urination/excretions is radioactive- flush at least two times. No one else should use toilet
Sign on room, closed door, dosimeter on visitors
49
THE CLIENT HAS UTERINE CANCER AND IS BEING TREATED WITH INTRACAVITY RADIATION. THE CNA REPORTS THAT THE CLIENT INSISTED ON AMBULATING TO THE BATHROOM AND NOW “SOMETHING FEELS LIKE IT IS COMING OUT”. WHAT IS THE PRIORITY ACTION?
B.ASSESS FOR DISLODGEMENT, USE FORCEPS TO RETRIEVE AND A LEAD CONTAINER TO STORE
Then inform doctor
50
* CYTOTOXIC SYSTEMIC THERAPY
* ANTINEOPLASTIC AGENTS GIVEN TO INTERRUPT THE CELL CYCLE
* DAMAGES DNA AND INTERFERES WITH CELL DIVISION* even healthy cells
CHEMOTHERAPY
51
Safety concerns with chemotherapy
•VESICANT: WATCH FOR EXTRAVASATION
Body fluids hazardous for 48 hours
(Very hard on veins) many people get porticaps placed to protect them
Peripheral IV- watch vein if given this way
Yellow bag for linens
52
GENERAL INTERVENTIONS:
| SAFE & EFFECTIVE CARE ENVIRONMENT for chemotherapy
* PREPARE DRUGS IN A BIOHAZARD CABINET-in pharmacy
* WEAR GLOVES, GOWN, EYE PROTECTIONS AND MASK WHEN HANDLING (AVOID IF PREGNANT) *know which meds can’t if pregnant) with any form
* DISCARD USED EQUIPMENT IN BIOHAZARD CONTAINERS
* GIVE EXACTLY AS PRESCRIBED
* MONITOR FOR PHLEBITIS AND EXTRAVASATION
* MONITOR CBC** (HGB, WBC, PLTS)
* MONITOR FOR BLEEDING AND INITIATE BLEEDING PRECAUTIONS* (THROMBOCYTOPENIA)
* AVOID IM INJECTIONS AND VENIPUNCTURE, electric razor, fall prevention
* MONITOR FOR SIGNS OF infection *
High calorie diet
(Low appetite)
Antiemetics- #1 se of chemo
Fluid intake of 2000 ml per day-IV
53
Side effects of chemotherapy
Managing ?
MANAGING SIDE EFFECTS OF CHEMOTHERAPY*
•ALOPECIA (chemo affects rapidly dividing
cells) - hair loss is rapidly dividing.
* XEROSTOMIA- dry mouth
* MUCOSITIS-sores in mucus membranes
* STOMATITIS/ESOPHAGITIS- sores in mouth (give ice chips during chemo because it causes vasoconstriction to vessels in the mouth which prevents the amount of chemo that gets into those veins in the mouth which prevents sores in the mouth. Oral hygiene, soft bristled toothbrush, rinse with water or saline
•N&V how to prevent-
Anticipatory- n/v prior to chemo
Acute- occurs with in the first 24 hours, most common, can be delayed.
Breakthrough- happens intermittently/ at irregular times
Zofran, Reglan, compazine, monitor for dehydration, avoid extreme hot or cold food, god oral care
* DIARRHEA
* FATIGUE
COGNITIVE FUNCTION CHANGES
* MYELOSUPPRESSION- decreases bone marrow - why we monitor CBC.
* ANEMIA- fatigue, SOB, tachycardia, diet changes increase iron intake, blood transfusions to replace missing blood cells, procrit help encourage to make more hgb.
•THROMBOCYTOPENIA- less than 100,000 decrease platelets
Avoid meds that interfere with platelets such as nsaids, anticoagulants aspirin.
•NEUTROPENIA- decrease neutrophils- watch for fever and low WBC count - even low fevers are very serious because they don’t have inflammatory process in place to prevent against infection
Strict aseptic technique - sterile technique with catheters, 20 second scrub with hub of IV placements
54
MYELOSUPPRESSION
What to do for anemia
S/s
ANEMIA (HGB < 12 G/DL AND A HCT < 36%
•FATIGUE, SOB, TACHYCARDIA, CHEST PAIN, HA, MENTAL STATUS CHANGES
* TRANSFUSIONS, PROCRIT AND ARANESP
* PT TEACHING: ANEMIA, MANAGEMENT, SELF CARE
55
•NEUTROPENIA* (ABSOLUTE NEUTROPHIL COUNT <2000/MM3)
Interventions
MONITOR TEMP. 38.1; STRICT ASEPTIC TECHNIQUES
•NEUPAGEN, NEULASTA, ANTIBIOTICS
Low infective environment
56
Thrombocytopenia plt below 100000
Interventions
Watch for drugs with anti aggregation properties : ASA, NSAIDS , anticoagulants
57
CHEMO-INDUCED NAUSEA AND VOMITING
•CATEGORIES*
•ANTICIPATORY (BEFORE CHEMO)
•ACUTE ( FIRST 24 HOURS)
MOST COMMON
* DELAYED (AFTER 24 HOURS)
* BREAKTHROUGH (INTERMITTENTLY DURING THERAPY)
* COMBINATION
* PATIENT CARE*:
* ANTIEMETICS
* GIVEN BEFORE IF POSSIBLE
* MONITOR FOR DEHYDRATION/MALNUTRITION
* ORAL CARE
* AVOID EXTREME TEMPERATURES IN WATER/FOOD*
58
NEUROPATHY & COGNITIVE in cancer
Main priority?
NUMBNESS, TINGLING, BURNING HANDS AND FEET
•SAFETY IS THE PRIORITY CONSIDERATION*
Don’t handle anything extreme hot or cold with out pot holder, turn down water heater so they don’t burn self.
* CHEMO BRAIN FOG* (forgetful, cant find words, make feel like having a stroke, keep patient active physically and mentally)
* TEMPORARY INABILITY TO FIND WORD, MEMORY LAPSES, PROLONGED LEARNING TIME
* PHYSICAL EXERCISE HELPS
* TEACH IN SMALL AMOUNTS, REINFORCE
* ENCOURAGE WRITING THOUGHTS/QUESTIONS DOWN in journal so they remember important questions
59
ANOREXIA & CACHEXIA
MUCOSITIS
* NAUSEA AND VOMITING
* LOSS OF APPETITE, MUSCLE WASTING, METABOLIC ABNORMALITIES
* MOUTH CARE, PAIN CONTROL RELAXATION TECHNIQUES
* NURSING INTERVENTIONS* ?
CONTROL N&V
•ORAL CARE
Dietary management including TPN, steroid use
Ice water or ice chips
Metallic taste in mouth- oral care
Manage pain
Tube feeding, TPN
60
PAIN with cancer
* UNPLEASANT SENSORY AND EMOTIONAL EXPERIENCE ARISING FORM POTENTIAL OR ACTUAL TISSUE DAMAGE
* UP TO 40% DO NOT GET ADEQUATE RELIEF
* DO NOT BE WORRIED ABOUT ADDICTION
Give pain meds as needed
61
•GOALS IS TO PREVENT
HORMONES FROM STIMULATING THE GROWTH OF CANCER CELLS
Attempt to manipulate hormones to prevent cancer growth
•ESTROGENS (hot flashes) AND TESTOSTERONES
Men may grow breast tissue - estrogen
Females may grow facial hair with testosterone
* ADDRESS THE ISSUES THAT AFFECT QUALITY OF LIFE
* HOT FLASHES
* GYNECOMASTIA
HORMONE MANIPULATION
62
```
QUESTION?
•FOR THE CLIENT RECEIVING VINCRISTINE (ONCOVIN), WHICH SIDE EFFECT SHOULD BE REPORTED TO THE PHYSICIAN?
•A. FATIGUE
•B. NAUSEA AND VOMITING
•C. PARESTHESIA
•D. ANOREXIA
```
??
C. Paresthesia- to educate pt
63
* SUBSTANCES NATURALLY PRODUCED BY THE IMMUNE SYSTEM
* OFTEN USED IN CONJUNCTION WITH OTHER THERAPIES
* NEUPOGEN, ERYTHROPOIETIN, NEULASTA-examples
* SIDE EFFECTS?
BIOLOGICAL THERAPY*
SIDE EFFECTS?
•FLU-LIKE SYMPTOMS, FATIGUE, CONFUSION, muscle aches
64
Assesment considerations ?
Chart 21-2*
65
Which two cancer patients could potentially be placed together as roommates?
1. a patient with a neutrophil count of 1000/mm3 (at risk for infection)
2. a patient who underwent debulking of a tumor to relieve pressure
3. a patient who just underwent a bone marrow transplantation (high infection risk)
4. a patient who has undergone laminectomy for spinal cord compression
2. a patient who underwent debulking of a tumor to relieve pressure
4. a patient who has undergone laminectomy for spinal cord compression
66
INTERDISCIPLINARY COLLABORATION
•WHO IS PART OF THE TEAM?
•HOW DO THEY WORK TOGETHER?
•PATIENT CENTERED CARE (PCC)
Look on blackboard
Large team , nurses, doctor, pt , OT, social work, religious leaders, mental health Therapy, patient, family
67
Emergency
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INFECTION OF THE BLOODSTREAM
•CAN RESULT IN SEPTIC SHOCK
•LIFE THREATENING CONDITION!
•CANCER PATIENTS MAY NOT HAVE NORMAL WARNING SIGNS
•LOW GRADE FEVERS ARE SERIOUS*
Prevent infection - high mortality
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Sepsis
68
Emergency
Body starts clotting but can’t keep up with clotting so you start to bleed due to not clotting appropriately at the same time.
DISSEMINATED INTRAVASCULAR COAGULATION
•PROBLEM WITH BLOOD
CLOTTING PROCESS
•CAN BE TRIGGERED BY SEPSIS (GRAM NEGATIVE INFECTIONS)
•EXTENSIVE, ABNORMAL CLOTTING OCCURS
LEADING TO DEPLETION OF CLOTTING FACTORS AND PLATELETS
* THEN BLEEDING OCCURS
* CLOTTING AND BLEEDING EXCESSIVELY
* BLEEDING FROM MANY SITES
* OOZE-HEMORRHAGE from IV SITES, CATHETERS, BLOOD DRAWS
DIC
69
•emergency
(Retraining too much water and sodium is very low 115-120)
NORMALLY ADH IS SECRETED WHEN MORE FLUID IS NEEDED TO BE RETAIN
* IN SIADH ADH IS SECRETED UNNECESSARILY LEADING TO FLUID OVERLOAD, LEADS TO HYPONATREMIA (DILUTIONAL)
* SODIUM 115-120 CAN CAUSE WEAKNESS, CRAMPS, NERVOUS SYSTEM CHANGES (SEIZURES), CONFUSION
* COMA AND DEATH OCCUR AT <110
* CANCER IS COMMON CAUSE
SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (SIADH)
70
Treatment of SIADH
```
TREATMENT:
•TREAT THE CAUSE
•RESTORE NORMAL FLUID BALANCE
•FLUID RESTRICTION
•INCREASE SODIUM INTAKE
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71
*emergency
* CALCIUM GREATER THAN 10
* IT IS A METABOLIC EMERGENCY!
* CERTAIN CANCERS SECRETE PARATHYROID HORMONE CAUSING BONE TO RELEASE CALCIUM
* METASTASIS CAN CAUSE BONE BREAKDOWN
* EARLY SYMPTOMS:
* MORE SERIOUS SYMPTOMS:
Fluids to give-
Hypercalcemia
Early s/s: •EARLY SYMPTOMS: VAGUE PAIN, KIDNEY STONES, FATIGUE, N/V
•MORE SERIOUS SYMPTOMS:
MUSCLE WEAKNESS, LOSS OF RELFEXES, DEHYDRATION, ECG CHANGES
Tx- increase fluids -Ns 500ml/hr
72
•Emergency
COMPRESSED
* FACIAL AND ARM SWELLING when laying down
* DISTENDED NECK CHEST VEINS
* SOB, COUGH HOARSENESS, STRIDOR
* DECREASED CARDIAC OUTPUT
* HYPOTENSION
•TREATMENT??
SUPERIOR VENA CAVA SYNDROME*
TREATMENT IS RADIATION or surgical removal - only way to fix is to Take away tumor that is putting pressure on vena cava
73
•emergency
ACUTE DESTRUCTION OF CANCER CELLS
•UNTREATED TLS CAN LEAD TO AKI (acute kidney injury) or HYPERKALEMIA: ECG CHANGES/arrythmias
Tx ?
TUMOR LYSIS SYNDROME (killing cancerous cells
Tx - •fluids, DIURETICS TO INCREASE URINE FLOW AND ALLOPURINOL FREQUENTLY GIVEN
•FLUIDS ARE CRITICAL
* DILUTE SERUM POTASSIUM
* INCREASE KIDNEY FLOW RATES
Treat hyperkalemia if severe *
Dialysis is necessary
74
•FOLLOWING CHEMOTHERAPY, THE CLIENT IS BEING CLOSELY MONITORED FOR TUMOR LYSIS SYNDROME. WHICH LABORATORY VALUES REQUIRE PARTICULAR ATTENTION?
a. PLATELET COUNT
b. ELECTROLYTE LEVELS
c. HEMOGLOBIN LEVELS
d. HEMATOCRIT
B. Electrolyte level’s -potassium
75
SUMMARY
•ABNORMAL CELLULAR GROWTH
•AFFECTS ALL BODY SYSTEMS
•GOALS IS TO CURE, CONTROL AND EASE SYMPTOMS
•TREATMENT IS SURGERY, CHEMO, RADIATION, BIOLOGICALS, CAM
•SIDE EFFECTS
Nutritional support
Yes
76
New growth that is not needed for normal development is called what
Neoplasm - benign (wrong rate place and time)
77
Age /Older people-immunity decreases, cells exposed to environmental factors makes them at highest risk for what
Cancer
78
Cancer is concidered a chronic illness
True
79
Cancer pt care
Infection, fever, wounds, hand hygiene, wear mask, protect self in public, no visitors in hospital, no plants, visitors wear mask and hand hygiene, impaired clotting, altered GI function, changes in the way taste, altered nerve function/ can’t feel hot or cold/sensory, movement, pain, respiratory depending on size of tumor
80
Can not remove 100% of advanced metastasis tumor growth but can get a good portion
True
81
Handling oral chemo agents education?
?
82
If patient says they skip a chemo dose? Response?
?
83
Patient says they hate taking pills and finds it easier to chew them. Response?
?
84
How to dispose oral chemo agents such as caoecitabine that are d/c?
?
85
Med- Bone marrow stimulant
It can help the body make white blood cells after receiving cancer medications. It can also improve survival in people who have been exposed to radiation.
given in several injections on a daily basis until your neutrophil counts come back to normal levels.
Neupogen/ filgrastim
86
) is a hormone produced primarily by the kidneys.
It plays a key role in the production of red blood cells (RBCs), which carry oxygen from the lungs to the rest of the body.
Erythropoietin (EPO
87
Bone marrow stimulant
| It can help the body make white blood cells up to 24 hours after receiving cancer medications.
Neulasta
