Treatment Of Cancer Flashcards
What is surgery used for?
Diagnosis, prevent, stage and treat
Example of a diagnostic
Biopsy
Example of primary
mastectomy
Prophylactic
Hysterectomy
Palliative
To relieve pain
Like a benign tumor growing and causing pain
Palliative
To relieve pain
Ex benign tumor causing pain
Reconstructive
Going in and having an augmentation after mastectomy
Ex surgeon puts in spacer during a mastectomy
A punch biopsy
Typically closed with sutures
Fine needle
23-30 gauge needle
Aspirate fluid
Pretty superficial, or breast
Least painful
Core needle
12 gauge needle
Liver, kidney go right in and retract specimen
Most painful
Surgery as a primary treatment
Debunking
Radical excision
Salvage surgery
Debunking
Remove as much of the tumor
Radical excision
Can be disfiguring and alter function
Salvage surgery
Extensive surgery to the site at which periodic therapies have failed
Ex modified radical mastectomy or radical neck dissection
Care of a surgical pt
Incision care
Prevent infection
Manage pain
Education on care of drains, s/s of infection
Dietary intake to promote healing ( protein and vitamin c)
Goal of radiation therapy
Elimination of cancerous cells
What cells does radiation and chemotherapy affect?
Rapidly proliferating cells
GI and hair
Radiation therapy
Energy to kill tumors
Shrink tumors
Eliminate cancer cells
Damages cells DNA
Healthy cells can also be damaged
Treatment of choice for localized cancer
Benefits of radiation
Used before surgery to shrink tumors
Given before during or after chemo
Palliative: shrink tumors, reduce pressure pain and other symptoms
Radiation toxicity
1 Fatigue
Anemia
N&V
Thrombocytopenia
What is one of our nursing priority
Breathing and proper nutrition
Internal or brachytherapy
Spares normal tissue
Give off some radiation so pregnant women and children should avoid exposure to pt
Nursing care in the room less than 60 minutes a shift (goes for visitors as well)
Side effects of brachytherapy
Fatigue
Anorexia
Immunosuppression
Not skin breakdown like external or teletherapy would
Client education for temporary brachytherapy
Avoid close contact until treatment is complete
No contact with pregnant women
Bed rest to prevent dislodging radioactive source
Maintain balance diet consider small frequent meals
Maintain fluid in taking 2-3 liters /day
If a brachytherapy needle become dislodged you would
Pick it up with gloved hands and long forceps to put in an lead container
People with external teletherapy markings
Do not wash them off
Side effects of radiation
Fatigue
Skin changes
Alopecia
Immunosuppresion
Radiation pneumonia
Ulceration of oral mucous membranes
GI N&v diarrhea
Symptoms increase as treatment progresses
How long do you protect the skin for after radiation?
Up to a year
Chemotherapy
\the use of anti cancer drugs to eliminate cancer but it eliminates healthy cells as well
What is the number 1 cause of death for pt getting chemo therapy
Sepsis
Who can administer medication the a chemo pt?
A chemo certified nurse
Who give the chemo pt chemo
A chemo certified nurse
What is important to monitor on someone receiving chemo
Labs
Protocol for chemo therapy
Two chemo certified nurses checks drug with pt with the orders
Check potency of line of the port
Set the pump together with another chemo certified nurse to make sure it is correct
ALWAYS CHECK LABS
What is important to check if a chemo pt is given steriods?
Check glucose. Don’t give chemo if liver enzymes are out of whack
(Steriods are given to help inflammation and irritability with an organ )
What else can we prevent by checking the patency (blood return) to make sure that the needle is in the port
Extravasation
Pt teaching guidelines
Teach family members and visitors.. handwashing!!
What happens when you get a mastectomy and have to go chemo after?
You have to wait 6 weeks before you start chemo because it delays healing
48-72 hours following chemo
Flush toilet twice
Rinse toilets with bleach once a day
Caregiver should wear gloves if in contact with any body fluids contaminated laundry
Avoid sexually activity
***use two forms of birth control
When handling chemo drugs, body fluids of pt within 48 hours of chemo
Always wear ppe just in case of accidental spills
Where do you throw empty bags
Chemo hazard container
Immunotherapy
Boost immune system which creates an enviroment that is conductive for cancer cells to grow
Causes flu like symptoms not as bad as chemo
Immuno therapy
Triggers your own body to fight the cancer
Flu symptoms but not as toxic as chemo
Targeted therapy
Interferes with cancer growth targets specific receptors important in tumor development
Flu like symptom bone marrow suppression
1 side effect with chemo therapy is
N&V
More side effects of chemo
N&V
Alopecia
Stomatitis
Pain
Enteritis
Pain
Diarrhea
Anemia
Fatigue
Myelosuppression
Pancytopenia
Leukopenia
Neutropenia
Thrombocytopenia
Pancytopenia
Decrease in all of you cells
Stomatitis
Do a good mouth assessment
Why is the mouth effected in chemo?
Rapidly proliferation cells
Acute N&v
Vomiting 24 hours after treatment
Delayed N&v
You feel great until you get chemo 4-4 days later you get nauseated
Anticipatory n&V
Pt tasting the chemo and getting sick while nurse is getting it ready
If a pt has anticipatory N&v what should you do as a nurse
Believe them and think of different ways you can try to help them
When do you start a pt on Ondansetron
30 min before chemo starts and then doses every 6 hours for 72 hours
Anorexia Cachexia syndrome
Loss of skeletal muscle and fat - not starvation
Combination of not wanting to eat and cancer eating everything
End result of cancer
Immunosuppression
Kills more pt than cancer itself
They are given prophylactic antifungal , antivirals and antibacterial
Nadir
Lowest point a blood cell count will get
What is the first sign that a person is going sepsis
RESPIRATIONS ARE GOING UP
B/p go down
Hr goes up
If someone comes in with an infection what do you do
Check respirations
Neutropenic precautions
Wash hands frequently
Low bacteria diet
No fresh flowers pants pets fruits or vegetables
Avoid crowds
No visitors with infections
No immunizations, no live vaccine like flu and pneumonia
Patient education for thrombocytopenia
Monitor bleeding in stool or bladder
Electric razor
If you have trauma put ice of it immediately
Use a soft bristle tooth brush
Nursing management for thrombocytopenia
Monitor platelet count
Monitor stools and urine for occult blood
Assess skin for ecchymosis, petechia and trauma at least every shift
Educative client about bleeding and safety precautions
Avoid IM injections ad limit venipuncters
Pain managment
Pain scale
Assess pain at every encounter
Administer analgesics
Teach pain relief measures
Distraction imagery
Relaxation
Teach therapy
Nursing managements for chemo brain
Calendar or day planner
Write everything down
Excercise the brain
Physical activity
Ask for support
If it persist- Alzheimer drugs
Ascites
Late sign of cancer =, usually a poor prognosis
Watch b/p
What diets can promote healing
Vitamin c and protein
Debunking
Remove as much of tumor as possible
Salvage surgery
Chemo didnt work so now they try surgery
Mastectomy
Simple
Modified radical
Radical
Radical surgery
Eevevvvvvveerrryyythaaaannnggg
Modified
Leave the lymph nodes
What is key to help with radiation?
Keep the pt hydrated to flush out radiation
At lease 2-3 liters a day
