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NURS 2514 > Week 1 - Cancer Seminar > Flashcards

Week 1 - Cancer Seminar Flashcards

1
Q

why is early detection and prompt treatment important with cancer

A

= increased survival rates among patients with cancer

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2
Q

what is the difference between screening and diagnostics?

A
  • screening = for someone who is asymptomatic but at high risk
  • diagnostic = for someone who has symptoms
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3
Q

what are the 2 screening tests for breast cancer?

A
  • mammogram

- breast self exam

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4
Q

what is the screening test for cervical cancer?

A
  • pap smear
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5
Q

what are the 2 screening tests for colorectal cancer?

A
  • colonoscopy

- stool tests

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6
Q

what is the screening test for prostate cancer?

A
  • digital rectal exam
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7
Q

what is the screening test for testicular cancer?

A
  • testicular self exam
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8
Q

what is the screening test for lung cancer

A
  • low dose CT scan for high risk
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9
Q

what is a screening test for skin cancer

A
  • skin cancer self exam
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10
Q

what is a general screening test for various cancers?

A
  • blood tests
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11
Q

the nursing process begins with….

A
  • assessment
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12
Q

what are the 3 things involved in assessment

A
  1. health history/interview
  2. physical exam
  3. diagnostic studies
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13
Q

what acronym is used when gathering information for history of the current illness?

A

OPQRSTU

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14
Q

list 10 risk factors for cancer we should ask about/ identify during the interview

A
  1. age
  2. smoking/tobacco
  3. alcohol intake
  4. sun exposure
  5. infectious agents
  6. genetic risk
  7. radiation
  8. carcinogens
  9. nutrition
  10. physical activity (
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15
Q

what are 3 things we should ask the patient about during the interview?

A
  1. past medical history
  2. family history
  3. lifestyle
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16
Q

what are the 7 cancer warning signs

A
  1. change in bowel or bladder habits
  2. sore that doesnt heal
  3. unusual bleeding or discharge
  4. thickening or a lump anywhere
  5. indigestion or difficulty swallowing
  6. obvious change in wart or mole
  7. nagging cough or hoarseness
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17
Q

what are the 4 aspects of a physical exam

A
  • inspection
  • palpation
  • auscultation
  • percussion
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18
Q

what should we look for during inspection

A

any abnormalities in the skin

  • color (pallor, jaundice)
  • bruising
  • bleeding
  • visible lesions or lumps
  • asymmetry
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19
Q

what should we feel for during palpation

A
  • feel for palpable masses in each body system
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20
Q

what specific places are good to palpate when assessing for cancer?

A
  • breasts (breast cancer)
  • lymph nodes (lymphomas)
  • chest (lung cancer)
  • abdomen
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21
Q

what are the 5 local signs of cancer

A
  • visible lesions
  • physical asymmetry
  • palpable masses
  • abnormal sounds
  • pain
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22
Q

what are the 5 systemic signs of cancer

A
  • cachexia
  • bleeding
  • anemia
  • infections
  • fever
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23
Q

list the 7 diagnostic categories

A
  • cytology
  • lab tests
  • endoscopy
  • radiological studies
  • radioisotope scanning
  • bone marrow aspiration
  • biopsies
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24
Q

what is cytology? what is an example?

A
  • examination of cells from the body under a microscope

ex. pap smear

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25
Q

what are 2 types of labratory tests used as diagnostic studies?

A
  • CBC

- electrolytes

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26
Q

what type of markers can be found and used in lab tests?

A
  • tumour markers
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27
Q

describe the use of tumour markers

A
  • helpful, not definitive

- need another diagnostic test to confirm

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28
Q

what is an endoscopy?

A
  • procedure which uses a camera to gather biopsies, take pictures, etc.
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29
Q

what is an example of an endoscopy?

A
  • upper endoscopy through the mouth to see the upper GI tract
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30
Q

what are 2 examples of radiological studies?

A
  1. MRI

2. CT

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31
Q

what is the main difference between MRIs and CT scans?

A
  • MRI = no radiation

- CT = uses radiation

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32
Q

what is a MRI

A
  • imaging technique that uses magnets

- can be used to see size of tumour and mets

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33
Q

who would a MRI be good for? not good for?

A
  • good for pregnant women

- not good for patients with pacemakers or any sort of metal

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34
Q

what is a CT

A
  • imaging technique that uses xray imaging to create a 3D image
  • can see tumour size & mets
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35
Q

what is an example of radioisotope scanning

A
  • PET scan
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36
Q

how does a PET scan work

A
  • an imaging technique that uses radiotracers
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37
Q

what is a PET scan specifically good for?

A
  • determining how well a treatment is working

- shows how active a cancer is

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38
Q

what is bone marrow aspiration? what is a con to this procedure?

A
  • procedure that takes a sample of your bone marrow for examination
  • very painful
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39
Q

which diagnostic test is the most definitive means of diagnosing cancer?

A
  • biopsy –> piece of tissue is surgically removed for histological examination
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40
Q

what are the 3 different types of a biopsy?

A
  1. needle
  2. incisional (only a sample of the lesion is removed)
  3. excisional (entire lesion removed)
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41
Q

why is grading and staging of a cancer so important?

A
  • impacts our treatment
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42
Q

what comes after diagnosis?

A
  • treatment
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43
Q

what are 6 different types of treatment for cancer

A
  • surgery
  • chemo
  • radiation
  • hormonal therapy
  • targeted therapy
  • hematopoietic drugs
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44
Q

what is combination therapy?

A
  • treatment whereas the patient is taking two or more drugs
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45
Q

why do we use combination therapy for cancer?

A
  • so the drugs hit different parts of the cell cycle
  • avoid resistance
  • protect normal cells & allow them time to repair
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46
Q

what is the difference between radiation & chemo?

A
  • radiation = more localized & targeted, damage to cells is permanent (ex. hair wont grow back)
  • chemo = more systemic, hair recovers
47
Q

does damage to other cells still occur with radiaition?

A
  • yes, radiation will damage cells around the tumour
48
Q

what type of cancer do you want to use chemo vs radiation for?

A
  • solid cancer = radiation

- dissemiated cancer = chemo

49
Q

describe pain in relation to cancer treatment

A
  • 50% of cancer patients experience pain while receiving treatment
50
Q

what is a significant barrier to effective pain management?

A
  • inadequate pain assessment
51
Q

describe pain assessment related to cancer treatment

A
  • vital signs & patient behavior do not provide enough data
  • neither does a pain scale in isolation
  • should ask many questions about their pain (OPQRSTU)
52
Q

describe the effects of chemotherapy on the GI system (7)

A
  • anorexia (no appetitie)
  • NV
  • stomatitis
  • mucositis
  • esophagitis
  • diarrhea
  • constipation
53
Q

what is mucositis

A
  • general term for inflammation of the mucus membranes
54
Q

what is stomatitis

A
  • oral form of mucositis

- inflammation of the mouth

55
Q

what do we do to avoid NV with chemo

A
  • anticipate the NV

= give antiemetics to prevent 1hr before treatment

56
Q

describe subjective assessment of the GI system for a patient on chemo

A
  • OPQRSTU
  • diet history
  • LBM & characteristics
  • urine output, color
57
Q

describe objective assessment of the GI system for a patient on chemo

A
  • patient weight
  • hydration status
  • nutritional status
  • inspect mouth & throat
  • blood work
58
Q

what are potential consequences of the side effects occuring in the GI system?

A
  • infection
  • malnutrition
  • weight loss
  • dehydration
59
Q

describe hematological effects of chemotherapy (3)

A
  1. neutropenia
  2. thrombocytopenia
  3. anemia
60
Q

what is neutropenia? what are risks asssociated with it

A
  • condition associated with neutrophil count lower than 1-1.5
  • severe neutropenia = lower than 0.5
  • risk of infection & death from sepsis
61
Q

what is thrombocytopenia? what are risks associated with it?

A
  • condition associated with platelet count less than 10x10^9

- risk of bleeding & spontaneous hemorrhage

62
Q

what is anemia

A
  • deficiency in the number of RBC
63
Q

which are killed from first to last order: RBC, WBC, platelets? how does this effect which conditions are most common regarding hematological effects of chemo?

A
  • WBC then platelets then RBC

= neutropenia, then thrombocytopenia, then anemia

64
Q

what is nadir? how long does it take to reach?

A
  • the lowest WBC we are willing to accept while giving chemo
  • usually 7-14 days to reach nadir
65
Q

describe the assessment for hematological conditions when giving chemo

A
  • frequent lab work (CBC, WBC, Hgb, platelets)
  • look for signs of infection
  • signs of bleeding
  • vitals
66
Q

what specific vitals should we consider when assesing hematological system

A
  • temp (fever, espeically low grade fever = signs of infection)
  • bp & HR (signs of sepsis)
67
Q

what causes the hematological side effects of chemo>

A
  • BMS
68
Q

list the 3 main side effects of cancer treatment on the integumentary system

A
  • alopecia
  • extravasation
  • radiation damage –> desquamation
69
Q

describe alopecia during chemo vs radiation

A
  • chemo = systemic

- radiation = only in treatment area

70
Q

what is extravasation? is this a problem with chemo?

A
  • when the IV is no longer going into the vein & leaking onto the tissue around
  • very very bad with chemo
71
Q

what do you do if someone who is receieving chemo complaing of pain in their hand

A
  • stop the IV!!!
72
Q

what is desquamation? what are the 2 types that occur with radiation

A
  • condition where the radiation will start to cause erythema, scaling, and flaking of the skin
    1. dry
    2. wet
73
Q

how long does it take for radiation damage to occur?

A
  • within the first 24 h
74
Q

what is the acronym for skin assessment

A

Color
Warmth
Circulation
Movement

75
Q

list 2 side effects of cancer treatment on the genitourinary system

A
  1. nephrotoxicity (from chemo drugs going thru the kidney)

2. cystitis

76
Q

what is cystitis

A
  • inflammation of the bladder
77
Q

describe assessment of the genitourinary system for a a patient receiving cancer treatment

A

assess kidney function:

  • urine output & characteristics
  • vitals (especially BP)
  • signs of fluid overload (similar to signs of CHF)
  • lab (BUN, creatine, potassium)
78
Q

list 2 side effects of cancer treatment on the nervous system

A
  1. peripheral neuropathy (chemotherapy induced)

2. increased intracranial pressure

79
Q

what is peripheral nueropathy

A
  • numbess, tingling, pins & needles feeling in the peripheral system
80
Q

describe the componenets of a neurological assessment

A
  • LOC
  • orientation
  • cranial nerves
  • reflexes
  • sensation
  • motor strength
81
Q

list 2 side effects of cancer treatment on the respiratorty system

A
  1. pneumonitis

2. fibrosis

82
Q

what is pneumonitis

A
  • inflammation of the lung tissue
83
Q

what specific chemo drug causes pneumonitis

A
  • bleomycin
84
Q

how long does it take for pneumonitis to occur

A
  • 2-3 months after treatment
85
Q

what is fibrosis? how long does it take for it occur?

A
  • scarring & hardening of the lung tissue

- 6-12 months after treatment

86
Q

describe respiratory assessment for a patient receving cancer treatment

A
  • OPQRSTU
  • inspect, palpate, and auscultate lungs
  • cap refill
  • skin color
  • WOB
  • vitals (RR, o2)
  • pulmonary function tests
  • ABGs
  • chest x-ray, CT scan
87
Q

how come it takes so much longer for respiratory effects to occur than GI effects for example

A
  • these cells do not replicate as fast = less targeted by chemo = develops later
88
Q

list 5 side effects on the cardio system from cancer treatment

A
  • cardiotoxicity
  • cardiomyopathy
  • HF
  • arrhythmias
  • pericarditis/myocarditis
89
Q

which chemo drug specifically has a impact on the cardio systen

A
  • doxorubicin
90
Q

describe cardio assessment for a patient receiving cancer treatment

A
  • OPQRSTU
  • inspect, palpate, auscultate the heart
  • look at color, edema, cap refill
  • pulses
  • vitals
  • EKG
  • echocardiogram
91
Q

list 2 oncologic emergencies

A
  1. superior vena cava syndrome

2. carotid artery rupture

92
Q

what is superior vena cava syndrome? how can cancer cause this?

A
  • syndrome where the superior vena cava is obstructed

- if a head or neck tumour gets large enough it can block it

93
Q

list what type of symptoms you may see with superior vena cava syndrome

A
  • increased intracranial pressure
  • edema in eyes
  • confusion
  • headaches
  • JVP distension
94
Q

what is carotid artery rupture? what can this cause?

A
  • radiation to the neck area causes erosion of the carotid artery
  • this can cause hemorrhage
95
Q

describe the difference between the characteristics of a normal lymph node, cancerous lymph node, adn infected lymph node

A
  • normal = normal temp, not hard, movable, small, nontender
  • cancerous = hard, fixated, nontender, large
  • infected = warm, tender, enlarged
96
Q

what is a lymphocyte

A
  • type of WBC
97
Q

describe the function of the spleen

A
  • store healthy blood cells

- filters outs damaged blood cells, bacteria, and cell waste

98
Q

what are lymph nodes

A
  • small structures that work as filters for harmful substances
99
Q

what is bone marrow

A
  • this is where new blood cells are made
100
Q

what are the tonsils

A
  • collects of lymph tissue at the back of the throat

- they help make antibodies against germs that are breathed in or swallows

101
Q

lymphoma is a ______ (descriptive word) cancer

A
  • travelling cancer
102
Q

why does weight loss occur with cancer/lymphoma?

A
  • cachexia
  • nutrient trapping
  • decreased appetite
103
Q

why does pallor occur with lymphoma

A
  • anemia (due to BMS & increased destruction & decreased production of RBC)
104
Q

why does bruising occur with cancer/lymphoma ?

A
  • thrombocytopenia
105
Q

why does fatigue occur with cancer/lymphoma

A
  • nutritional deficit

- just the whole cancer process in general

106
Q

why do night sweats occur with cancer (specifically lymphoma)?

A
  • fever

- B symptoms

107
Q

why do achy bones occur with lymphoma

A
  • due to bone marrow infiltration
108
Q

why does splenomegaly occur with lymphoma

A
  • RBC are dying = increased demands on the spleen
109
Q

why do swollen lympho nodes occur with lymphoma

A
  • too many lymphocytes
110
Q

the diagnostic test that involves taking several mult angle x-rays to form a 3D image is a _____

A

CT scan

111
Q

what are the benefits of using a central line to administer chemo vs a regular IV? what are we trying to avoid?

A
  • this will allow us to avoid extravasation
112
Q

it is 7-14 days after treatment, you are most concerned about which 2 blood cells reaching their nadir?

A
  • WBC

- platelets

113
Q

what type of drug can we administer to help stimulate blood cell production

A
  • hematopoietic drugs

NURS 2514 (75 decks)

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