Unit VI Flashcards
Network of cells, tissues, organs that work together to defend body aganst attacks by foreign invaders
immune system
altered adverse reactoin to foreign substance that doesnt normally cause reaction
allergy
genetic trait predisposing for localized anaphylaxis
atopy
substance that induces formation of antibodies when introduced into body
antigen
most antigens are composed of
protein
what are the four ways antigens can enter the body
ingestion, inhalation, injection, absorption
substance synthesized by B lymphocytes in response to presence of specfic antigen
antibody
antibodies are a class of proteins known as
immunogloblins
where are lymphocytes produced
bone marrow
B lymphocytes are found in the
bone marrow & produce antibodies
t lymphocytes move from where
bone marrow to thymus
Humoral immunity
is extracellular body fluid
primary immune response is noted when
4-8 days after initial exposure to antigen
can cross the placenta, provides newborn with passive immunity for at least 3 months
IgG
first type of antibody formed, primary immune response (can kill bacteria)
IgM
protects against infection in intestines & respiratory tract, lines mucus membranes
IgA
assist in differentiation of B lymphocytes
IgD
causes symptoms of allergic reations
IgE
loss of hair
alopecia
an abnormal or allergiv reaction to an antigen antibody formation
hypersensitivity reaction
the body fails to recoginze self-proteins and reacts against its own proteins
autoimmune disease
loss of appetite
anorexia
a medicine that prevents or controls vomiting or nausea
antiemetic
a drug that kills or blocks the growth and or spread of cancer cells
antineoplastic (chemo)
an abnormal growth of tissue which does not spread from one body part to another
benign tumor
the cutting out of a small piece of tissue for microscopic examination
biopsy
what is the only way to diagnois cancer
biopsy
a disease in which abnormal or malignant cells grow out of conrtol and usually spread to other parts of the body
cancer
a small cancer that has not spread and is located on the surgace of a tissue
cancer in situ
a substance or agent which causes cancer
carcinogen
a kind of cancer which originates in the skin or membranes lining the interior of hollow organs, such as the lungs & intestines etc
carcinoma
chemo used in conjuction with surgery, radiation or both to destroy cancer cells
adjuvant chemotherapy
simultaneous use of several drugs
combination chemotherapy
a science which studies cells under the microscope
cytology
an accumulation of fluid or semisolid material within a sac in the body
cyst
a chemical test to detect blood in the stool
guaiac test
tissue examined under the microscope
histology
artificial stimulation of the body’s immune mechanism to treat or combat disease
immunotherapy
the use of x-rays for treating disease
irradiation
an abnormal change in body tissue or organ due to a disease or injury
lesion
a tumor made up of cancer cells
malignant tumor
cancer of pigment forming cells usualy of the skin
melanoma
to spread from the original site
metastasize
a new and abnormal growth of tissue or cells, a tumor
neoplasm
a type of neoplasm which does not invade or destory nearby tissues
non-invasive
th study of cancerand treatment of malignant disease
oncology
a benign tumor of bone
osteoma
treatment that relieves pain and symptoms of disease but which does not cure the disease
palliative treatment
an overgrowth of tissue projecting into a body cavity
polyp
the use of radiation for treatment of disease
radiotherapy
complete or partial disappearance of a disease
remission
a malignant tumor of muscles and or connective tissues
sarcoma
an abnormal swelling or enlargement of cells or tissues
tumor
what is the goal of treatment of cancer
cure, control & palliation
surgery where a biopsy, used to confirm or rule out the diagnosis of cancer
diagnostic surgery
what surgery is the goal to remove the entire tumor with minimal functional and structural destruction. Tumor and lymph nodes are removed
radiacal surgery
a surgery that is preventitive, where lisions are removed early while they are non malignant or cause harm
prophylactic surgery
surgery for the relief of pain, obstruction, hemmorrhage and comfort measures
palliative surgery
surgery for insertion of therapeutic devices
supportive surgery
surgery used to assist with body image, improving function, anatomical defect or cosmetic apperance
reconstructive surgery
uses high energy ionizing radiation to kill/destroy cancer cells (break one or both strands of DNA)
radiation therapy
debulk
take away excess
radioactive isotops that are used for tempoary or permenant implants
internal radiation (brachytherapy)
what is importnat to remember with internal implants
priciples of time(minimize exposure), distance (maximize distance from source) & shielding (decrease exposure, lead shield)
Side effects of radiation
fatigue, skin changes, anorezia and other site specific side effects
desquamation
peeling of the skin
how long will it take after the last radiation treatment will it take for a pt to feel better bc of cummalitive effect
4-6 weeks
nurtrionally what does someone with radiation need to do
increase calories & proteins and have small frequent meals
treatment of cancer with chemicals
chemotherapy
cytoxic
kills cells
what cells does chemo affect
all cells cancer and normal cells
routes of chemo
oral, im, iv, intracavity, sub q, topical, intraarterial etc
work together and are more effective against CA cells
synergistic effect
in conjunction with surgery or radiation or both with the ultimate goal to kill cancer
adjuvant
a chemotherapeutic agent capable of causing or forming a blister &/or tissue destruction
vesicant
a chemotherapeutic agent capable of producing venous pain at the IV site & along the vein with or without an inflammaroty reaction
irritant
who can give chemo
only a specially trained RN
infiltration (leakage) of a drug into surrounding tissue, vesicants cause pain & tissue necrosis
extravasation
Inflammation of mouth
stomatitis
what is the most serious side effect of chemotherapy
bone marrow depression
low platelets, WBC & RBC count
what nursing measures should you do with chemo
increase fluids, I & O, oral care, decrease odors in room, aseptic techniques, food lukewarm, assess labs (CBC, H&H, WBC, RBC)
in chemo trials how many ppl are tested in phase 1, 2, 3
20-80
100-300
1000-3000
attempt to stimulate a persons own immune system to fight cancer cells
immunotherapy
natural substances produced in small amts by the body’s immune system
BRM, biological response modifiers
interferes with viral replication, increases natural killer cell activity
interferon
what regulates the production, maturation & function of blood cells (hematopoiesis)
colony stimulating factors (CSF)
when your WBC counts are at its lowest 10-17 days after chemo has been given
nadir
activiates antitumor cells which attack the tumor
IL 2
are 2nd malignancies usually resistant to therapy?
yes
uncontrolled growth and spread of abnormal cells
cancer
incidence
new cases
morbidity
illness rate
mortality
death rate
what is highest cancer overall
lung
what is the highest % of cancer in men
prostate
what is the highest % of cancer in women
breast
what carcinogens can effect cancer
chemicals, diet, radiation, drugs
resting phase of the cell cycle
G0
RNA & protein synthesis phase of the cell cycle
G1
DNA synthesis phase of the cell cycle
S
additional RNA & DNA synthesisphase of the cell cycle
G2
mitosis-cell division phase of the cell cycle
M
what phase do cancer cells not go in
G0
cells with recognizable specialized structures and functions
differentiated
cells which have lost their capactiy for specialized functions
undifferenctiated
causes a cell to mutate
carcinogen
malignant, irreversible change of cells which regress to more primitive level (fetal)
anaplasia
benign change of cells resulting from chromic irritation -may reverse or progress to cancer
dysplasia
reversible, benign change of adults cells from one type to another
metaplasia
abnormal increase in # of cells, increased tissue mass
hyperplasia
process by which neoplasms are produced, new growths
oncogenesis
in the development of cancer, when something happens to the cell to make it change, usually when exposed to a carcinagen
initiation
in the development of cancer, increase progression of cell growth, immune system doesnt know its there
promotion
in the development of cancer, increase of cell growth to allow cell mass to continue, usually where tumors are detected
progression
what is the role of the immone system
to reject or destroy cancer cells if perceived as nonself
cancer cells evade immune system
escape mechanisms
does not invade, localized
benign
will matastasize, immature cells, dont go into resting phase
malignant
oma
tumor malignant
Grade I cancer
well differentiated, no change in apperance
Grade II cancer
moderately differentiaed, moderate change
Grade III cancer
poorly differentiated, very abnormal
Grade IV cancer
undifferentiated, lost all normal cellular charcteristics
describes the extent of the disease, not looking at cell apperance
Staging of cancer Stage 0( cancer in situ) -Stage IV (mesastasis)
TNM classification
T-tumor size
N-lymph nodes involved
M-metastasis
calignant cells detach from parent tissue & migrate; spread of cancer cells
metastasis
when cancer grows into surrounding tissue (local spread)
direct extension
break off from original tumor and seed to grow in other organs
seeding
spread from blood system
hematogenous spread
seven warnings of cancer
C-change in bowel or bladder habits A-a sore that doesnt heal U-unusal bleeding or discharge T-thickening or lump I-indigestion or difficulty swallowing O-obvious change in wart or mole N-Nagging cough or hoarseness
primary prevention
general wellness promotion
secondary prevention
screening (early diagnosis & treatment)
tertiary prevention
assist to highest level of wellness
rehab
characterized by fat, muscle depletion
malnutrition
infection throughout bloodstream
sepsis
obstruction of vena cava by tumor
superior vena cava syndrome
shifting of fluid from vascular space to interstital space
third space syndrom
when is tumor lysis syndrome seen
1 week after chemo, results from rapid destruction of tumor cells leads to acute renal failure
fluid accumulation in the pericardial sac
cardiac tamponade
what is the goal of the psychological aspects of cancer
to meet the daily physical and psychological needs of the cancer pt
patients may exhibit what behaviors when coping with fears & diagnosis
shock, denile, anger, bargaining, depression, helplessness, hopelessness
those who have overcome and been cured of their cancer
suviorship
complex metabolic problem in advanced cancer pts, lassified by anorexia, altered taste & smell, dry mouth
cachexia
hepatomegaly
enlarged liver
what does a cancer pt need in thier diet
high protein & high calories
proteins
rebuilds tissue
calories
energy & maintence of cells
source of protein
animal product (meat, fish, eggs milk, cheese), legumes, nuts, beans
analgesic drug therapy for mild pain
non opiod analgesics, NSAIDS, adjuvant meds
tylenol, ibuprofen
analgesic drug therapy for moderate pain
mild opiod analgesics, adjuvant meds
darvocet, percocet
analgesic drug therapy for severe pain
strong opiod analgesics, adjuvant meds
morphine
what is a contrainication for bone cancer
massage
psychological dependence, opiods used for uuphoria
addiction
occurs when a lager dose of opiod is required to maintain the same level of analgesia for the same level of pain
tolerance
stage 1 in family crisis
living with cancer, family informed of cancer diagnosis
stage 2 in family crisis
restructuring during the living-dying interval
stage 3 in family crisis
bereavement
before, during and after death
stage 4 in family crisis
reestablishment, completes the grieving process
an organized institution designed to provide palliative & supportive care to terminally ill patient and their families
hospice
what is the number one complaint of cancer patients
fatigue
pain where body part has been removed
phantom pain
what are causes of bone marrow suppression
cancer, chemo, radiation, combination
low hemoglobin
anemia, 120 days after chemo
low platelets
thrombocytopenia, 7-10 days after chemo
low white blood cells
leukopenia or neutropenia, 7-10 days after chemo
all blood counts are low
pancytopenia
what turns on bone marrow to produce cells quicker
colony stimulating factors
when is a chemo pt most at risk for infection?
7-10 days after chemo
all cells start as ?
stem cells or hemocytoblasts
signs and symptoms of anemia
cool, clammy pale skin, decrease b/p, high RR, high HR, fatigue, SOB
protect patient with reduced immunity
neutropenic precautions
mucositis
inflammation of mucus membrane
esophagitis
inflammation of esophagus, hard to swallow
cardiomyopathy
enlargement of heart
CHF
fluid back up in to heart
symptoms caused by damage to peripheral nerves
peripheral neuropathy
chemo brain
side effect of chemo, memory lapse, trouble concentrating, clower thinking process
build up of lymoh fluid in tissue causes edema
lymphedema
when does hair loss start after chemo
about 21 days after treatment
regardless of treatment type, cancer ________ affects a persons physical and psychological functioning
ALWAYS
RBC
transport O2, lasts 120 days
WBC
fight infection, lasts from hours to 7 days
platelets
clotting, lasts 7 days
kills immature blood cells forming in bone marrow
chemotherapy (systemic)
kills immature blood cells forming in bone marrow
radiation (localized)
how many people are living with HIV in the US
1.4 million
emphasis on primary health care and support services that enhance access to and retention in care
ryan white HIV
75% of HUV is transmitted by
sex
every _____minutes, someone in the US is infected with HIV
9 & 1/2 minutes
In a PPD test, a pt with HIV will have positive test what size will the wheal be
5 mm
how is HIV transmitted
infected blood and blood products
sexual contact
maternal/child
number of viral (HIV) particles in 15 mLof blood
viral load
who is at highest risk for HIV
women & children
three enzymes in the HIV life cycle
reverse transcriptse
integrase
protease
primary HIV infection
5 weeks
what is the normal range for the CD4 test
500-1450 cells/mm3
signs and symptoms of HIV
shingles, neuropathy, thrush, HPV, herpes
fat redistrubution may be caused by some HIV infections
lipodystrophy
does pregnancy accelerate HUV
NO
do more americans die from hepatitis or HIV
Hepatitis
help with lower income individuals under 65 will have access to federal tax credits to purchase private insurance coverage
the affordable care act
adults and children in the world with HIV
34.2 million people
What are the three functions of the immune system
Defense
Homeostasis
Surveillance
Organs of the immune system
Tonsils Thymus Bone marrow Spleen Lymph nodes
What is the drug of choice for an anaphylactic reaction
Epi (adrenalin)
How much and how often would you give epi
Mild symptoms
1:1000 (0.3-0.5ml) sub q or IM q10-15 min
Severe symptoms
1:10000 (3-5ml) IV q5-10 min
If a person is having an anaphylaxis reaction what do you do?
Epi High flow O2 Recumbent position Keep pt warm Maintain b/p Benadryl
Involves deposited of antigen-antibody complexes in blood vessel walls of skin, joints, in renal glomeruli
Serum sickness
What is the nursing goal of a pt who has advanced cancer
Assist with achievement of a healthy death
Progressing to cachexia contributes to the morbidity & mortality of cancer patients
Malnutrition
What is most affected by chemo/radiation
Rapidly dividing immature cells
