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NRSG 326 > Week 1: Oncology > Flashcards

Week 1: Oncology Flashcards

1
Q

What are the 3 most commonly diagnosed cancer in men/women?

A

Breast
Lung
Colorectal

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2
Q

What are the 3 most common cancers to result in death?

A

Lung
Prostate
Colorectal

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3
Q

How does the rate of cancer among Indigenous peoples compare to the general population? Why do you think this might be?

A

Tobacco use rates 3x higher in Indigenous populations, and cancer rates are disproportionate to the rest of the population, as well as worst outcomes due to the generational trauma and impact colonization has had

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4
Q

Encapsulated tumour?

A

usually benign and rarely malignant

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5
Q

Differentiated tumour?

A

normally benign and undifferentiated if malignant

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6
Q

Tumour metastasizes?

A

Absent if benign and frequently present for malignant

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7
Q

Tumour reoccurs?

A

rare if benign and possible for malignant

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8
Q

How a tumour grows for benign/malignant?

A

Expansive if benign and infiltrative and expansive if malignant

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9
Q

Characteristics of benign tumour cell?

A

fairly normal similar to parent cells

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10
Q

Characteristics of malignant tumour cells?

A

little resemblance to parent cells

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11
Q

4 carcinogenic factors that can initiate cancer

A

Chemical carcinogens
radiation
viral/bacterial carcinogens
genetic susceptibility

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12
Q

4 promoting factors that can cause the proliferation of cellular mutation?

A

dietary fat
obesity
cigar smoke
alcohol consumption

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13
Q

What makes tobacco a complete carcinogen?

A

It is capable of both initiating and promoting the development of cancer

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14
Q

What is grading?

A

Grading is the appearance of the cells and comparing the difference

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15
Q

What is staging?

A

Staging is classifying the extent and spread of the disease

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16
Q

What does stage 0 mean

A

cancer in situ

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17
Q

What does stage 1 mean

A

Tumor limited to tissue of origin, localized

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18
Q

What does stage 2 mean

A

limited local spread

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19
Q

What does stage 3 mean

A

extensive local and regional spread

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20
Q

What does stage 4 mean

A

metastasis

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21
Q

what are the 8 recommendations to prevent cancer?

A
  1. reduce or eliminate exposure to carcinogens anf cancer promoters
  2. eat a balanced diet
  3. participate regularly
  4. maintain healthy weight
  5. limit alcohol use to 1-2/day
  6. get to know your body
  7. follow cancer screening guidelines
  8. know the seven warning signs of cancer
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22
Q

What are the warning signs of cancer?

A

CAUTION
1. Change in bowel of bladder habits
2. A sore that does not heal
3. Unusual bleeding or discharge from any body site
4. Thickening or a lump in the breast or elsewhere
5. Indigestion or difficulty in swallowing
6. Obvious change in a wart or mole
7. Nagging cough or hoarseness

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23
Q

What is a needle biopsy?

A

Cells and tissue fragments are obtained through a large bore needle and guided into the tissue of investigation

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24
Q

What is an incisional biopsy?

A

performed with a scalpel or dermal punch and obtains a tissue sample

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25
Q

What is an excisional biopsy?

A

Involves the removal of the entire tumour

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26
Q

What are the goals of cure, control, and palliation

A

Cure: to eradicate the disease
Control: To have it respond to therapies but not cure
Palliation: to provide relief for long term care, no goal of curing or controlling

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27
Q

6 principles when surgery is used to cure or control cancer

A
  1. Cancer that arises from a tissue with a slow rate of cellular proliferation or replication is the most amenable to surgical treatment
  2. A margin of normal tissue surrounding the tumour should be resected along with the tumour
  3. Only as much tissue as needed removed
  4. adjunctive therapy is used when appropriate to eliminate residual micrometatasis
  5. Preventative measures are used to reduce the surgical seeding of cancer cells
  6. The usual sites of regional spread may be surgically removed for diagnostic or therapeutic purposes
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28
Q

6 ways surgery may be used to cure or control cancer?

A

Diagnosis, palliation of symptoms, rehabilitation, supportive care,cure or control of cancer, determine diagnostic and treatment plan

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29
Q

What is a debulking procedure?

A

removing as much of the tumour as possible and then the patient is given chemotherapy or radiation therapy

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30
Q
  1. Why might surgery be used for cancer patients receiving palliative care?
A

to help with the body changes that occur - for example a breast reconstruction

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31
Q

What is the goal of chemotherapy?

A

now used in the treatment of many solid tumours and is the primary therapy for hematological malignancies

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32
Q
  1. What 5 factors determine the response of cancer cells to chemotherapy?
A

mitotic rate of the tissue from which the tumour arises, size of the tumour, age of the tumour, location of the tumour, presence of resistant tumour cells

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33
Q

What routes/methods can be used to administer chemotherapeutic agents?

A

biopsy
therapeutic device insertion
reconstructive surgery
obstruction removal
hemorrhage cessation

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34
Q

Intra arterial administration

A

medication is delivered into the tumour via the arterial vessel supplying the tumour

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35
Q

Intraperitoneal chemotherapy

A

involves the delivery of chemotherapeutic agents to the peritoneal cavity for treatment of peritoneal messes from primary colorectal and ovarian cancers and malignant ascites

36
Q

Intrathecal or intraventricular chemotherapy

A

involves a lumbar puncture and injection of chemo meds into the subarachnoid space

37
Q

intravesicle bladder chemotherapy

A

instillation of chemotherapeutic agents into the bladder promotes destruction of cancer cells and reduces the incidence of recurrent disease

38
Q

What are the effects of chemotherapy agents on normal tissues?

A

these agents cannot selectively tell the difference between normal cells and cancer cells therefore affects the bodies systems and can produce things such as anorexia, deficiencies etc

39
Q

What is “simulation”?

A

is a part of radiation treatment planning used to determine the optimal treatment method

40
Q

What is external beam radiation

A

the most common form and emits ray

41
Q

What is brachytherapy

A

when radioactive materials are inserted directly into the tumour or close

42
Q

What care and patient teaching is required for a person who has a permanent radioactive implant?

A

radioactive after insertion, nurses must be organized to maintain minimal contact

43
Q

Is radiation therapy used to cure, control, or palliate cancer

A

the goals are to cure control and palliation

44
Q

What factors may increase a cancer patient’s sense of fatigue

A

accumulation of metabolites could be one potential cause, cachexia, anorexia, fever, and infection

45
Q

How should the nurse advise a patient to manage fatigue?

A

maintaining good nutrition and hydration, alternating periods of rest and activity, relying on family support, managing pain and anxiety

46
Q

How should a nurse advise a patient to deal with loss of appetite?

A

small frequent meals of high protein, high calorie foods, and measure weight at least twice weekly

47
Q

How does bone marrow suppression lead to anemia, leukopenia/neutropenia, and thrombocytopenia?

A

bone marrow suppression causes blood cell production to decrease, leading to these conditions

48
Q

Why might people with bone marrow suppression may be susceptible to a brain tumour

A

bone marrow suppression causes blood cell production to decrease, leading to these conditions - the severity of myelosuppression is determined by the extent of bone marrow reserves, the pelvis has 40% active bone marrow while 25% is in thoracic and lumbar vertebrae

49
Q

What potentially life-threatening complications are patient with
neutropenia at risk for

A

serious sepsis and infections

50
Q

What interventions should a nurse implement for a patient who has developed dry desquamation?

A

lather with lotion that contains no metal, alcohol, perfumes or additives

51
Q

What interventions should a nurse implement for a patient who has developed wet desquamation?

A

keep clean and prevent further damage (no tight clothes, dressings, irritants)

52
Q

What part(s) of the body are subject to alopecia (hair loss) caused by chemotherapy?

A

all body hair including eyelashes and eyebrows

53
Q

What should a nurse tell a patient who asks if hair loss is temporary or permanent?

A

may be permanent or temporary depending on the dose administered

54
Q

What is xerostomia, and what causes it?

A

dry mouth caused by radiotherapy GI related changes

55
Q

How should nurses teach patients to deal with xerostomia?

A

constantly check gums and mouth, how to perform oral care

56
Q

Why is tooth brushing and flossing so important in cancer patients? What should patients be taught about brushing and flossing?

A

this reduces the radiation that carries and causes dry mouth. use a saline solution of 1 teaspoon of salt in 1L of water

57
Q

What additional nursing interventions should be implemented to help maintain good nutrition for a cancer patient?

A

antifungal agents, feedings soft high protein/calorie foods, avoid alcohol/tobacco, rely on family for support

58
Q

What type of pulmonary complications can result from chemotherapy and radiation therapy?

A

pulmonary edema, interstitial fibrosis, pneumonitis,

59
Q

Why are the cells of the GI tract particularly susceptible to damage from chemotherapy and radiation therapy?

A

it is highly proliferative, surface cells are replaced every 2-6 days making them highly vulnerable to cancer therapies

60
Q

How does chemotherapy and radiation therapy lead to nausea/vomiting and diarrhea?

A

radiation alters the gastric secretion by direct injury to the cells, which causes N/V/D

61
Q

What interventions might decrease a client’s nausea and vomiting due to cancer therapy? -

A

antiemetic medications or a light meal before treatment

62
Q

What interventions should the nurse implement for a patient with diarrhea due to cancer therapy?

A

nonirritating foods/meals and spasmodic medications, adequate food/hydration

63
Q

How can radiation therapy affect reproductive capability in men and women?

A

sperm is terminated with certain dosages, the ovaries have no chance of being repaired therefore are protected

64
Q

What patient teaching should a nurse provide for a man or woman who will be receiving radiation therapy of a reproductive organ?

A

information to the partner and patient, caring for psychological changes, counselling services, pretreatment harvesting services, sexual information/tools

65
Q

What are some of the late effects of radiation and chemotherapy that may occur months or years after cancer treatment?

A

leukemias, other secondary malignancies, myelomas

66
Q

What are biological therapies?

A

treatment involving the use of biological agents such as interferons, interleukins, monoclonal antibodies, and growth factors to modify the relationship between the host and the tumour

67
Q

What is the purpose of a bone marrow transplant? why is it done?

A

allows for the safe use of very high dose’s of chemotherapeutic agent or radiation in patients whose tumours are resistant or unresponsive

68
Q

What are some of the complications of a bone marrow transplant?

A

some people die, other relapse from the original disease

69
Q

What sorts of foods should be recommended for a patient with cancer?

A

high calorie, high protein foods

70
Q

How should the nurse advise a patient to cope with changes in taste sensation due to cancer?

A

help them to understand the changes and to find foods that taste appealing to them, as well as try different spices that are appealing to them

71
Q

Why are cancer patients at increased risk for infection?

A

from the suppressed immune system cancer patients have

72
Q

Do cancer patients display the typical signs and symptoms of an infection (e.g. fever?)

A

fever (over 38 go to hospital), necrosis or tumour, neutropenia

73
Q

What is superior vena cava syndrome?

A

results from obstruction of the superior vena cava by a tumour

74
Q

S&S of superior vena cava syndrome

A

facial edema, periorbital edema, distention of the veins of the neck and chest, headaches, and seizures

75
Q

What is spinal cord compression?

A

a neurological emergency caused by the presence of malignant tumour in the epidural space of the spinal cord

76
Q

S&S of spinal cord compression?

A

intense back pain (localized and persistent), vertebral weakness/dysfunction, sensory paresthesia, autonomic dysfunction

77
Q

What is third space syndrome

A

involves a shifting of fluid from the vascular space to the interstitial space that results primarily from extensive surgical procedures, biological therapy, or septic shock

78
Q

S&S of third space syndrome

A

hypovolemia signs, hypotension, tachycardia, low central venous pressure, decreased urine output

79
Q

What is an intestinal obstruction?

A

occurs when partial or complete obstruction of the intestine prevents the passage of intestinal contents through the GI tract

80
Q

What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A

results from abnormal or sustained production of antidiuretic hormone

81
Q

What can cancer cause hypercalcemia?

A

when the parathyroid hormone like substance is secreted by cancer cells in the absence of bone metastasis

82
Q

What is tumour lysis syndrome (TLS)?

A

from the rapid destruction of a large number of tumour cells, which can cause fatal biochemical changes

83
Q

S&S of TLS

A

hyperuricemia, hyperphostphatemia, hyperkalemia, hypocalcemia

84
Q

Infiltrative Emergencies

A

occur when malignant tumours infiltrate major organs secondary to cancer therapy

85
Q

How can cancer cause cardiac tamponade?

A

results from fluid build up in the pericardial sac, constriction of the pericardium by tumour, or pericarditis secondary to radiation therapy for the chest

86
Q

How can cancer lead to a carotid artery rupture?

A

a result of invasion of the arterial wall by tumour or erosion after surgery or radiation therapy

87
Q

What strategies should be used to manage cancer pain?

A

anti-inflammatorys, a strong pain assessment, analgesics, relaxation therapy, imaging

NRSG 326 (3 decks)

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