week 4: cancer Flashcards
what are hemopoietic growth factors and how do they help with cancer treatment
they stimulate the bone marrow to make good cells
what is nadir
lowest point of white blood count and shows us how immunocompromised the patient is
what is ANC
absolute neutrophil count (basically the nadir)
what is thrombocytopenia
impaired clotting with no platelets
how does cancer affect GI tract
increases metabolic rate, decreases appetite and affects taste
how does cancer affect the nerves
it is rare but they can affect peripheral sensory nerve perception.
this may be due to a tumour in the spine or neurotoxic chemo.
how can cancer affect central motor and sensory function
cancer invades bone or brain, which causes hypercalcemia
what is pleural effusion
collection of fluid between lining and wall of lungs
what is the dosing of pain medication you should be giving to a cancer patient
regular dosing is key. every 4-6 hours should be good
how can we prevent extravasation from chemo
use a central line
whats a port-a-cath
its a line that’s under the skin, with a pouch that is relatively shallow. you can puncture it very easily to draw blood or give medications
what drug go we give to help with diarrhoea in cancer patients
Imodium
whats the #1 antiemetic for cancer treatment
ondansetron
what is brachytherapy
internal radiation (using seeds, ribbons, capsules)
what is radiation dermatitis
radiation can lead to an open wound
what is xerostoma
severe tooth decay and dry mouth
what lab values determine bone marrow suppression
decreased platelets, Hgb, wbc
what are some things we can do to help with skin care for patients going through radiation
avoid skin irritation by using light clothes, no tight belts/bands/cuffs, moisturise with a water based moisturiser, avoid alcohol based anything and retinol. avoid sun expusoreu and heat.
describe internal radiation
- its safer because it reduces exposure to ionising radiation. they put seeds (radioactive isotopes) into the body, patients needs their own bathroom and cant interact with anyone pregnant.
which temperature of a cancer patient should we flag
anything above 37.5
what are the 2 types of breast cancer
non-invasive: remains in mammary duct
invasive: most common: spreads around to surrounding lymph nodes
what is a lumpectomy
breast conserving, cuts out only the part with cancer.
what is a partial mastectomy
a little more of breast is removed
what is a simple mastectomy
remove breast
what is a modified radical mastectomy
remove breast and glands
what is a breast cancer surgery with “clear margins”
basically they took out the cancer, and there’s no cancer in surrounding tissues
what is an ALND (auxiliary lymph node dissection)
remove pretty much all the lymph nodes
really old school we don’t do this much anymore
what is a SNLD (sentinal lymph node dissection)
lymph node closest to the tumour is removed and sent to pathology to see of cancer cells have spread
why wouldn’t we want to remove too many lymph nodes
because the less you remove, the less of a risk for lymphedema (like long, extreme swelling)
what is an autologous DIEP flap
basically a BBL but takes fat from the stomach and uses it to create new breasts
what is som post op considerations for a mastectomy
- they will have a drain attached to them so make teach family how t empty the drain
- increase hight of bed and raise affected arm
- sleep on non-dependent side
- teach about signs of lymphedema
what are signs of lymphedema
limb may feel heavy, achy, num, tingly, swelling.
what is the main goal post mastectomy in relation to mobility
to prevent frozen shoulder
what are some ways to prevent frozen shoulder
- pain meds before exercise,
- warmth to relax muscles
- elevate arm post-op
avoid sun and trauma
no BP on that arm
what is ALL
acute lymphoma leukemia
- most common
- starts in bone marrow and spreads to other parts of the body
what is AML
acute myeloid leukaemia
- starts in myeloid and spreads
what is CLL
chronic lymphotic leukemia
- slow growing
starts in WBC
what is CML
chronic myeloid leukemia
- starts in myeloid
- slow progression
what are some potential side effects of leukemia
splenomegaly, hepatomegaly, lymphadenopathy, bone pain, meningeal irritation.
what us a vibe narrow aspirate
determines sybtype of leukemia and treatment protocol
what are the three phases of leukemia treatment protocol
induction phase: literally kill all leukaemia cells.
consolidation: continue to kill cells
maintenance: treat with lower doses every 3-4 weeks for prolonged time.
what should nurses focus o n in the induction phase of leukemia protocol
managing v low WBC (including neutropenia, thrombocytopenia and anemia)
preventing infection
and support systems such as O2, IV fluid, protecting kidney function, etc.
how does septic shock present in cancer patients
Low grade fever of 38 may be the only sign.
what are the nursing interventions for septic shock
follow protocol: culture, CXR, swabs, start antibiotics ASAP
what is DIC
decimated intravascular coagulation
- often caused by sepsis
- basically body starts to form mini clots all over
- v bad sign
- patient usually dies within the next few hours
how does cancer cause SIADH
cancer cells make, release, and store ADH.
what are symptoms of SIADH
nausea, vomiting, seizure, obtundation, brain swelling.
