Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

nurse 251 > week 2 (cancer) > Flashcards

week 2 (cancer) Flashcards

You may prefer our related Brainscape-certified flashcards:
NCLEX-PN® flashcards NCLEX-RN® flashcards
1
Q

what is cancer characterized by?

A

characterized by the uncontrolled and unregulated growth of cells
-as the population ages, the incidence of cancer rises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

statistics of cancer?

A
  • aprox 43% of Canadians with develop cancer during their lifetimes
  • cancer is the leading cause of death in every Canadian province accounting for 30% of deaths
  • lung cancer remains the leading cause of premature death from cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some modifiable risk factors for cancer?

A
  • tobacco use
  • excessive body weight
  • lack of physical activity
  • unhealthy eating habits
  • excessive exposure to the sun
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what difference in cells exist in a healthy person vs someone with cancer?

A
  • normally, equilibrium is consistently maintained (cellular proliferation equals cellular degeneration)
  • normal cells “respect: the boundaries and territory of the cells surrounding them
  • cancer cells have no regard for cellular boundaries and will grow on top of one another and also on top of or between normal cells
  • cell division in cancer is dysregulated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what the three options of a cell once it has mutated?

A

1) the cell can die, either from damage resulting from the mutation of from apoptosis
2) the cell can recognize the damage and repair itself
3) the mutated cell can survive and pass along the damage to its daughter cells (if this continues, causes cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what potential do mutated cells have?

A

they could become malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the two classifications of tumors?

A

benign or malignant

  • benign neoplasms are well differentiated (normal cellular maturation)
  • Malignant neoplasms range from well differentiated to undifferentiated
  • malignant tumor cells have the ability to invade and metastasize unlike benign neoplasms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the stages of cancer?

A

initiation, promotion, progression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the initiation stage of cancer?

A

a mutation in the cells genetic structure resulting from an inherited mutation, an error that occurs during DNA replication or after exposure to a carcinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the promotion stage of cancer?

A
  • characterized by the reversible proliferation of the altered cells
  • a single alteration of the genetic structure of the cell is not sufficient to result in cancer
  • the odds of cancer development are increased with the presence of promoting agents
  • promoting agents include: smoking is a promoting agent in bronchogenic carcinoma and in conjunction with alcohol intake, promotes esophageal and bladder cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the progression stage of cancer?

A
  • the final stage in the natural history of cancer
  • characterized by increased growth rates of the tumor, as well as by increased invasiveness and spread of the cancer to a distant site (metastasis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a carcinogen?

A
  • may be a chemical, radioactive or viral in nature
  • many carginogens are detoxified by protective enzymes and harmlessly excreted
  • if this protective mechanism fails, the carcinogen can enter a cells nucleus and alter DNA
  • certain drugs like immunosuppressents are identified as carcinogens (potential to cause neoplasms in humans)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the signifiance of radiation with cancer?

A
  • the incidence of childhood cancer is higher amough children exposed to radiation during fetal life
  • UV radiation has long been assocaited with melanoma, squamous cell carcinoma, and basal cell carcinoma of the skin
  • safe threshold of exposure to radiatoin is unknown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what us worse, a CT can or an X ray?

A

CT scan - emits a lot of radiation ( bit gives a more clear image)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an example of a viral or bacterial carcinogen?

A
  • Certain DNA or RNA viruses can transform cells they infect and induce malignant transformation
  • ppl with AIDS have higher incidence of Kaposis’s sacrocoma
  • Human papillomavirus is assosiated with squamous cell carcinomas like cervial cancer and helicactor pylori is implicated in the development of gastric and duodenal ulcers as well as some gastic cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what can untreated H pylori result in?

A

doudenal and gastric ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is important to remember about the pt when they await a diagnosis of cancer?

A
  • creates trememndous anxeity for the individual and family
  • nurses should be available to actively listen to pts concerns
  • Ability to listne, ask questions sensitively, and avoid false reassurance are essential elemets of the nurse-pt theraputic relationship
  • during this time of high anxiety, pt needs repetition and reinforcement of info, opportunity to ask questions, and clarification of disgnositc workup
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a biopsy?

A

a procedure is the definitive means of diagnosing cancer, and the results guide treatment decisons
-a piece of tissue is surgically removed from teh suspect area for histological examination by pathologist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is a needle biopsy?

A

cells and tissue fragments are obtained through a large-bore needle guided into the tissue of investigation (eg, bone marrow, prostate gland, breast, liver, or kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is an incisional biopsy?

A

performed with a scalpel or dermal punch (kinda like a hole punch) is a common technique for obtaining a tissue sample from a skin lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is an exceisonal biopsy?

A

involves removal of the entire tumor. it is usually used for small tumors, skin lesions, intestial polyps, and breast masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the classifciation of tumors?

A

tumors can be classified according to anatomical site, histological analysis (grading) and extent of disease (staging)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is histological grading?

A

-The appearance of cells and the degree of differentiation are evaluated
Grade 1: cells differ slightly from normal cells (mild dysplasia) and are well differentiated
Grade 2: cells are more abnormal (moderate dyslasia) and moderatley differentiated
Grade 3: cells are very abnormal (severe dysplasia) poorly differentiated
Grade 4: cells are immature and primative (anaplasia) and undifferentiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is clinical staging of cancer based on?

A

the description of the extent of the disease rather on cell apperance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the clinical staging of cancer?

A

stage 0: cancer in situ
stage 1: tumor limited to the tissue origin, localized tumor growth
stage 2: limited local spread
stage 3: extensive local and regional spread
stage 4: metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what does early detection of cancer increase rates of?

A

survical rates increase

27
Q

what is some public education a nurse can teach for prevention and detection of cancer?

A

1) reduction or elimination of exposure to carginogens (ie, cig smoke, sun exposure)
2) eat a balanced diet
3) learn and practice self examination ie, breats and testiculat self exam
4) follow cancer screening guidelines

28
Q

what are the three goals for cancer treatment?

A

cure, control, and palliation

1) when the goal is to CURE, tx that has the greatest likelyhood of eradicting the disease is offered
2) CONTROL is the goal of tx for many cancers that cannot be completey eradicated but are responsive to cancer therapies
3) PALLIATION, relief or control of symptoms and the optimaization of quality of life are primary objective, rather than cure or control of the disease process

29
Q

when is surgical therapy effective for pts with a tumor?

A

removal of tumor and margin of the surrounding normal tissue may cure localized cancer, but it is ineffective if the cancer has metastasized to other locations

30
Q

what is chemotherapy

A

is used in the tx of many solid tumors and is the primary therapy for hemtological malignancies, including leukemia and lymphoma
-nurses have to be specifically trained to administer chemotherapy

31
Q

what routes of administration are common for chemotherapy?

A

oral and intravenous routes

32
Q

what is extravastion

A

the major concern associated with the intravenous adminitration of chemotherapy are the potential for irritation or damage to the vessels including infection and extravasation

  • many chemotherapeutic drugs are vesicants that cause severe local tissue breakdown and necrosis when accidently infilterated into the skin
  • pain, swelling, redness and the presense of vesicles on the skin are symptoms of extravasation
33
Q

what can minimize the risks of administration of chemotherapy and avoid physical discomfort?

A

chemotherapeutic agents may be administered by means by means of a central venous accesss devices

34
Q

what are some advantages of venous accesss deveices?

A
  • They provide for rapid dilution of chemotherapeutic agents
  • decreased incidence of extravasation
  • reduce need for venipuncture
  • adminitration of additional fluids such as blood products
  • parenteral nutrition
  • can be short term or long term
35
Q

what are infusion pumps used for?

A

used primarily for intraaterial adminitration of chemotheraputic agents
-enables continous infusion of chemotherapeutic agents directly to the area of the tumor while sparing the pt the systemic effects of the drug

36
Q

what is the most common use to infusion pumps for chemotheraputic administration?

A

hepatic artery infusion in the tx of liver metastasis, usually primary colon cancer

37
Q

why is it difficult to treat cancers that metastasis to the CNS?

A

cancers such as breat, lung,GI, leukemia, and lymphoma (all metastasize to the CNS) are difficult to treat because the blood brain barrier often prevents distribution of chemotherapeutic agents to this area

38
Q

what can be used to treat metastasis of the CNS ?

A

intrathecal chemotherapy

39
Q

what is a Ommaya reservior? what does it ensure?

A

is a silastic, dome- shaped disc with a extension catheter that is surgically implanted through the cranium into a lateral ventricle (basically digging a hole and injecting chemotherapy)
-ensures a more unifirm distribution of chemotheraputic drugs

40
Q

what is external radiation?

A

the most common form of radiaiton treatment delivery, the pt is exposed to radiation from megavoltage tx machine

41
Q

what is internal radiaiton?

A

another radiaion delivery system is “close” tx. in this method radioactive materials are implanted inserted directly into the tumor or close to the tumor

42
Q

how common is fatigue with cancer pts?

A

70%- 100% of pts

43
Q

what can alternations in energy production in a pt with cancer result in?

A

may result from cachexia, anorexia, fever and infection

44
Q

what can help reduce fatigue?

A
  • Maintaining good nutrition and adequate hydration
  • alternating periods of rest and activity
  • relying on family members for assistancewith responsiblities, and managing pain
  • managing pain and anxiety
45
Q

what benefits can mild physical activity programs have for cancer pts?

A

it can ameliorate symptoms of fatigue, lesson anxiety and facilitate sleep in pts

46
Q

what are some oral reactions from cancer?

A
  • mucosal lining of the GI tract in sensitive to the effects of radition
  • nutritional status may be compromised by tx
  • salivary flow often decreases leaving pts with dry mouth
  • magic mouth wash can help with this
  • Oral assessment should be done to prevent infection and facilitate nutritionl intake
  • mucous membranes, characteritcs of saliva and ability to swallow must be assessed regularly
47
Q

how can radiation affect the GI system?

A

alters gastric secretions and direct injury to cells

48
Q

secretions of what decrease with further tx?

A

secretions of mucus, hydrocholirc acid and pepsin decrease

49
Q

what symptoms are part of the early response to irradiation of the GI tissue?

A
  • occurs immediately after first tx

- nausea, vomiting, diarrhea

50
Q

what drugs are used to decrease nausea and vomiting caused by chemotherapy?

A

Antiemetric drugs such as metoclopramide, ondansetron and dexamethasone
-administer these before tx decreases pts experiance of nausea and vomiting

51
Q

what should pts be assessed for when they experiance nausea and vomiting?

A

symptoms of dehydration and alkalosis

52
Q

what are some effects of radiation and chemotherapy on the reproductive system?

A
  • determined by dose deliveried and type of chemotherapy used
  • potential infertility
  • testes and ovaries should be shielded whenever possible during radiation
  • cant produce sperm during tx
  • in some cases, permanent failure to produce sperm can occur, but other cases count recovers in 2-5 years
  • ovaries have no avenus to repair
  • sperm and eggs should be harvested before tx
53
Q

what percent of pts have moderate to severe pain while recieving acute tx for cancer?

A

50%
-undertx of cancer pain is common and has serious otucomes on pts quality of life and ability to function and increases the burden on family caregivers

54
Q

what should be adminitered around the clock on a regular schedule with additional doses for needed breakthrough pain for cancer pts?

A
  • analgesic medication
  • always administer these are the right time
  • fear of addiction must be adressed as a part of pt teaching
55
Q

what are usual sites of infection for cancer pts who have a suppressed immune system?

A

lungs, genitourinary system, mouth, rectum, pertineal cavity, and blood (septicemia)

56
Q

what do nurses need to teach cancer pts about the topic of infection?

A

infection risk is associated with neutopenia - chemotherapy kills neutrophils (is an abnormally low level of neutrophils. Neutrophils are a common type of white blood cell important to fighting off infections — particularly those caused by bacteria)

57
Q

a pt with a body temp of _____ or highers should be seen at a hostpital or cancer centre as soon as possible

A

38 degrees celsius

58
Q

what is a bone marrow transplant?

A

an effective, lifesaving procedure for a number of malignant and nonmalignant diseases

59
Q

how is a bone marrow transplant useful for the tx of cancer?

A

BMT allows for the safe used of a very high dose of chemotheraputic agents or radiation to pts whose tumors are resistant ot unresponsive to standard doses of chemotherapeutic agents and radiation

60
Q

what is a requirement of bone marrow before it is given to a pt?

A

it has to be acquired from donar who is matched to the recipient in terms of human leukocyte antigen (HLA) tissue typing
-often a family member, but a unrelated donor may be found through a bone marrow registry

61
Q

what is the goal of a BMT with cancer pts?

A

goal is to adminiter large doses of systemic therapy and then “resue” the pts bone marrow through the donated marrow

62
Q

what is the most common indication for allogeneic transplantaion?

A

leukemia

63
Q

what is an autologous marrow transplant?

A
  • pt receieves thier own bone marrow
  • this enables pt to get intensive chemotherapy or radiation while supporting them with thier own bone marrow
  • pts own bone marrow is removed, treated, stored and reinfused
64
Q

how long does it take for the transplanted marrow to start producing hematopoietic blood cells

A

usually 2-4 weeks is required

-during this time, it is critical for the pt to be in protective isolation

nurse 251 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions