week 5 chemo and radiation Flashcards
with ___ treatments, you want to cure, control and do palliation
cancer
when cancer is diagnosed, you need to as a ___, active listen to concerns
nurse
when cancer is diagnosed, you need to as a ___, manage your own discomfort
nurse
when cancer is diagnosed, you need to as a ___, give clear explanations and repeat if needed
nurse
when cancer is diagnosed, you need to as a ___, give written info about reinforcement
nurse
when cancer is diagnosed, you need to as a ___, refer to oncology when possible
nurse
when cancer is diagnosed, you need to as a ___, you manage your own discomfort and avoid hindering explaining feelings and avoid technical lang
nurse
when cancer is diagnosed, you need to as a ___, you manage discomfort by listening when impt and encourage the pt to share their feelings
nurse
when cancer is diagnosed, you need to as a ___ ask caring questions
nurse
when curing cancer you see it end in the usual __ span
life
when controlling cancer, you see the usual or reduced __ span
life
when doing palliation, you end in ____ care
hospice
CELL TYPE and LOCATION AND SIZE OF TUMOR help determine what __ is used
therapy
disease extent and status help determine what ___is used
therapy
expressed needs and desires help determine what type of therapy is ___
used
surgery alone or periods of adjunctive systemic therapy is ___ therapy
curative
time frame to “cure” may differ according to tumor and characteristics
curative therapy(hopefully the greatest disease eradication)
initial course and maintenance therapy is __ treatment
control
relief and control of symptoms and maintain QOL are palliation. torf?
true
may include surgery, chemo and radiation, biologic, and targeted therapy
curative therapy
testicular cancer can be cured with ___, chemo and radiation
surgery
with control, you cant cure it but can ___
maintain
multiple myeloma and chronic lymphocytic leukemia are control treatments. torf?
true
surgery is the __ form of cancer treatment and meets a variety of goals
oldest
we are trying to go toward less radical surgeries. torf?
true
with surgery you can: prevent, cure and control and do palliation and ____
support
chemo is the __ of chemicals and the mainstay for most solid tumors and cancers
use
chemo can offer: cure, control or palliative care. torf?
true
want to cure with chemo: brkitts lymphoma and testicular cancer. torf?
tru
want to cure with chemo: hodgkins lymphoma and acute lymphocytic leukemia. torf?
true
want to cure with chemo: neuroblastoma and wilms tumor. torf?
tru
want to control with chemo: breast cancer and nonhodgkins lymphoma.torf?
tru
want to control with chemo: small cell lung cancer. torf?
tru
want to do palliation with chemo: to relieve pain, relieve obstruction and improve well __
being
Effective against dividing cells, so cancer cells escape death by staying in G0 phase (resting phase) is done with chemo. torf?
true
the ___ of chemo are Presence of drug-resistant resting and noncycling cells
problem
with chemo, As tumors get bigger, more cells become inactive and convert to go. torf?
true
when handling chemo ___, there is an occupational hazard
agents
when handling chemo ___, the drugs can be absorbed thru skin and inhalation
agents
when handling chemo ___, be trained to do it
agents
chemo can be given by: oral, IM, or IV(most ___)
common
IV chemo is given at the CVAD bc __ vessels and frequent administration.
large
IV chemo can be given in____ bc continuous and intermittent administration and give other fluids(blood and electrolytes)
CVAD
with regional chemo, the drug goes directly to tumor site and has a ___ concentration of drug with less systemic toxicity
hgih
regional chemo is: intraarterial and inteaperitoneal . torf?
true
regional chemo is: intrathecal or intravetricular. torf?
tru
regional chemo is: intravesical bladder. torf?
true
intraarterial is thry arteries that supply __
tumor
intraperitoneal delivers drug to peritoneal __ for treating peritoneal metastases
cavity
intraarterial is used for osteogenic sarcoma and liver cancers. torf?
true
inraarterial is used for: neck and head and bladder cancers. torf?
true
intraarterial is used for: cervix cancer and melanoma. torf?
tru
intraperitoneal is when you give 1-2 L to peritoneum for 4 hours then drain the fluid that was dwelling. torf?
-true
intrathecal or intraventricular ass with lumbar puncture and injecting into subarachnoid space. torf?
true
intravesicular bladder is the agent is added to the bladder by cath and retained for 1-3 hours. torf?
true
chemo ___ dont distinguish between normal and healthy tissue
agents
chemo ___ are normal cells are destroyed
side effects
the classes of ADR of chemo are: acute, delayed, and chronic. you see neutropenia. torf?
true
chemo drugs given in combo are calc by Body SA and involve drugs with different MOA. torf?
true
when the cancer cells mutate, there is ___ to chemo
resistence
___is the oldest nonsurgical cancer treatments
radiation
50% OF PTS GET RADIAITON.TORF?
TRUE
emission of energy from a source and travels through space or some material
radiation
low and high beams involved in radiation. torf?
true
expand energy quickly, for skin lesions, and penetrate a short distance
low energy beams
GREATER depth of penetration and good for ___ dosing of internal targets while sparing skin is high energy beam
optimal
with radiation, the nonmencalture is Gv(grey) or cGV(centigray) and 1 cGv=__
1 rad
100 cGv=1 __
G(grey)
total doses of __ are divided into fractions
radiation
Typically delivered once a day for 5 days a week for 2 to 8 weeks is standard ___ with radiation
fractionation
certain tumors are __ suspectible to radiation than others
more
immobilization device is the one where you trap the head. torf?
true
radiation is used to treat a __ of the body
area
radiation is __ a primary treatment for systemic disease
not
radiation can be used by itself or with chemo or with ___ to treat primary tumors & for palliation of metastatic lesions
surgery
teletherapy is also called ____ radiation
external
the most common radiation treatment is teletherapy. torf?
true
the pt is exposed to radiation from a megavolt machine in teletherapy. torf?
true
gamma knife tech is using ___
cobalt
cyclotron is using neurons and protons. torf?
true
linear accelerator is using ionizing radiation. torf?
true
internal radiation is also called bradytherapy and uses the ___ or insertion of radioactive materials into or close to tumor
implantation
minimal exposure to healthy tissue and commonly used with external radiation is ___ radiation
internal
the pt is emitting radioactivity and limit the amt of time near pts being treated with internal radiation. you can organize care and use shielding and wear a film badge to mon ___
exposure
chemo and radiation side ___ are bone marrow suppression and fatigue
effects
chemo and radiation side ___ are GI disturbances and skin/mucosal reactions
effects
chemo and radiation side ___ are pulm and repro effects
effects
with bone marrow suppression you can see myelosuppresion(___ common side effects of chemo)
most
with bone marrow suppression you can see treatment induced reductions in RBC/WBC results in: infection, hemmorhage, or ___ fatigue
overwhelming
with bone marrow suppression you can see there are __ with neutropenic conditions
precautions
with radiation, the bone marrow within treatment field is effected but with ___ the whole body is effected
chemo
if receiving chemo, the ___ common effect is neutropenia
most
for bone marrow suppresion, it occurs in RBC after 3 ___
weeks
for bone marrow suppresion, it happens in WBC within 1-2 ___
weeks
for bone marrow suppresion, it happens in PLTs withing 2-3 ___
weeks
skin reactions occur in the radiation treatment field. torf?
true
skin reactions can be acute or chronic. torf?
true
skin reactions can develop 1-24 hours after treatment or progressive as treatment dose ______
accumulates
with skin reactions, you want to __ infections
prevent
with skin reactions, you want to __ wound healing
faciliate
with skin reactions, you want to __irritated skin temp extremes
protect
with skin reactions, you want to __ pts deal with hair loss
help
with skin reactions, you see __and wet desquamation
dry
a __ skin reaction must be kept clean and protected
wet
a wet desquamation is If the rate of cell sloughing is ___ than the ability of the new epidermal cells to replace dead cells
faster
___desquamation occurs with exposure of the dermis and weeping of serous fluid.
wet
Wet desquamation of tissues generally produces __, drainage, and increased risk of infection
pain
skin __ for radiation is to clean and protect with soap, rinsing and pat dry
care
skin __ for radiation is to use lotion
care
skin __ for radiation is to avoid meds, deoderant, perfume, tape and shaving the area
care
skin __ for radiation is to avoid tight or harsh clothes
care
skin __ for radiation is to use gentle detergent
care
skin __ for radiation is to expose to air
care
skin __ for radiation is to use astringent compress and absorbant dressings
care
skin __ for radiation is to observe daily for infection
care
fatigue effects ___ cancer pts
all
anemia is a __ of fatigue
cause
accumulation of toxins in body after cells killed are ___ of fatigue
causes
extra energy needed to heal and no sleep are causes of ___
fatigue
exercise and activity are ways to __ fatigue
manage
fatigue can persist long after ___ has ended
treatment
a cancer pt who is full of fatigue the nurse should __before activity
rest
a cancer pt who is full of fatigue the nurse should __assistance with activity
get
a cancer pt who is full of fatigue the nurse should __active in periods of time pts feel better
remain
a cancer pt who is full of fatigue the nurse should __nutrition and hydration
maintain
a cancer pt who is full of fatigue the nurse should __for reversible causes of fatigue
assess
with the GI effects, you want to ___giving antiemetics
prevent
with the GI effects, you want to ___for s/s of alkalosis, dehydration and I/O
assess
with the GI effects, you want to ___a high cal, low fiber, high protein and nonirritating food
eat
with the GI effects, you see ___(mouth ulcers)
mucositis
the ___ mucosa is the most sensitive to treatment
intestinal
___ effects are N/V & diarrhea
GI
mucositis, and anorexia are ___ effects
GI
if on chemo, you can get anticipatory or __ N/V
delayed
V occurs within 1 __ of chemo or few hours post radiation to chest or ab(can be 24 hours later)
hour
a __ informs the pt of the sex SE
nurse
a ____ tells to use appropriate shielding
nurse
a ____ refers to counseling if needed
nurse
a ___ encourages discussion of issues RT to sexualty
nurse
pulm effects may be ___ and irreversible
progressive
cough and dyspnea are __ effects
pulm
pneumonitis and pulm edema are ___ effects
pulm
treat __ probs with bronchodialters and O2
pulm
treat __ probs with bed rest and cough suppressants
pulm
Pneumonitis&pulmonary fibrosisare due to ____ reaction of endothelium
inflammation
pulmonary edema& hypersensitivity pneumonitis are due to ____ reaction of endothelium
inflammation
interstitial fibrosis and pneumonitis are due to ____ reaction of endothelium
inflammation
CAD preexisting are more ___ to CV effects
vulnerable
do ECG for CV effects of ___
treatment
doxorubicin is a ___ to treat cancer but can lead to worse probs.
antibiotic
treatment can __ irreversible and progressive CV toxicities
produce
pericardial effusion is a CV ___
effect
-icin’s can ___ECG abnormalities, L ventricular dysfunction, and HF
cause
you can have ___ brain and mental cloudiness or fog
chemo
chemo brain can be severe and can last for short term or long ___
term
chemo __ can cause mem or thinking probs
brain
most at __ pts are treated with alkylating agents and high dose radiation
risk
secondary cancers that __ happen are leukemia
can
secondary cancers that __ happen are angiosarcoma
can
secondary cancers that __ happen are skin cancer
can
multiagent use of chemo can be additive effects ___ lateeffects
increasing
___ effects of radiation are liver and kidney probs
late
___ effects of radiation are lung and heart probs
late
___ effects of radiation are muscle and bone and CT probs
late
___ effects of radiation are skin telangiestasias to strictures
late
___ effects of radiation are fistulas and necrosis
late
___ effects of radiation are lymphedema
late
___ effects of chemo are toxicity and cataracts
late
___ effects of chemo are OP and endocrine probs
late
___ effects of chemo are renal insuffiencient and hepatitis
late
___ effects of chemo are neurocog dysfunction
late
___ of cancer are continuous growth of cancer into normal tissue
complications
___ of cancer are SE of treatments
compliations
___ of cancer are malnutrition and altered taste senstation
complications
there is fat and __ depletion
muscle
do nutritional ____ when 5% weight lost and protein or cal malnutrition
counseling
cancer pts should __foods they dont like and use spices
avoid
cancer pt may have dehydration and impaired __ healing
wound
avoid temp extremes and tobacco and ETOH with cancer __
pts
hard to ___ nutritional status when 10lb weight gain
maintain
with cancer __ you may need to do enteral or parenteral nutrition
pts
cancer cachexia is also called __ syndrome
wasting
wasting __ is anorexia and weight/appetite
syndrome
tissue wasting and muscle atrophy are ___ syndrome
wasting
immune dysfunction and metabolic abnormalities are ___ syndrome
wasting
the weight loss with cancer cachexia cant be ___ nutritionally
reversed
cancer complications are the __ cause of death
primary
lungs, GI,and GU are common ___ sites
infection
mouth and rectum are common ___ sites
infection
peritoneal cavity and blood are common ___ sites
infection
complications of ___ infection are due to ulceration
cancer
complications of ___ infection are due to compression of vital organs by tumor
cancer
complications of ___ infection are due to neutropenia bc of disease and treatment
cancer
if you have neutropenia, call abt a fever above 38/100.4__
degrees
with neutropenia and a depressed immune system, the infection__ are subtle
s/s
the complications of cancer oncologic emergencies are life threatening. torf?
true
the complications of cancer oncologic emergencies are bc of disease or treatment. torf?
true
the complications of cancer oncologic emergencies can be: obstructive, infiltrative, and metabolic. torf?
true
SVC syndrome and SC compression sydrome are ___ emergencies
obstructive
third space syndrome and intestinal obstruction are ___ emergenices
obstructive
metabolic ___ are caused by ectopic horomones from the tumor or treatment
emergencies
___ hormones arise from tissues that don’t normally produce these hormones
ectopic
in a ___ emergency, the Cancer cells return to a more embryonic form, thus allowing the cells’ stored potential to become evident.`
metabolic
SIADH and hypercalcemia are metabolic ___
emergencies
tumor lysis syn. and septic shock are metabolic ___
emergencies
DIC are metabolic ___
emergencies
malignant tumor infiltrate the organs or secondary to therapy are ___ emergencies
infiltratitive
cardiac tamponade and coronary artery rupture are infiltrative ____
emergencies
with cancer pain, the pts report should be ____
believed
with cancer pain, use drugs to __ pain
control
with untreated cancer pain, it ____suffering, low QOL and increased burden on cargiver
causes
with cancer pain, the biggest barrier to good __ management
pain
50% of cancer pts have mod to severe pain if the ___ is active
treatment
80-90% of advanced cancer pts have mod to severe pain. torf?
true
non pharm ways to manage pain are relaxation and imagery. torf?
true
drug therapy for cancer __ is: NSAIDS, opioids and adjuvant pain meds
pain
when managing cancer __ tell pt to keep a diary
pain
you can use antiseizure/depressants for neuropathic __
pain
with cancer pain management, addiction and tolerance are __ probs
not
religion, social, coping skills and demographics are ways to cope with ___
cancer
____ pops are at risk for late stage disease at time of diagnosis
underservered
to be culturally competent for cancer, ___ culture differences, care barriers, and adapting to specific care needs
assess
more blacks with cancer then in ___
whites
when coping with cancer, the __ should use persuasive anxiety and fear
nurse
when coping with cancer, the __ should be available and be caring
nurse
when coping with cancer, the __ should listen and do symptom relief
nurse
when coping with cancer, the __ should give accurate info
nurse
when coping with cancer, the __ should build trust and use touch
nurse
when coping with cancer, the __ should set realistic goals and support lifestyle patters
nurse
when coping with cancer, the __ should maintain hope and give support
nurse
when coping with ___, offer support from survivors and have phone contact info between visits
cancer
when coping with ___, assist in planning for nutrition and transportation
cancer
when coping with ___, do edu and support
cancer
when coping with ___, do a psychosocial intervention and give info
cancer
old cancer concerns are: CM may look like aging and they are more ___ to complications
vulnerable
old cancer concerns are: Will the treatment provide more benefits than harm? torf
true
old cancer concerns are:Is there need to optimize other co-morbidities or nutritional or functional status before starting treatment? torf
true
old cancer concerns are:What are the patient’s preferences and wishes? torf
true
old cancer concerns are: Will they be able to tolerate the treatment safely? torf
true
aging and growth help the survivor rate. and improvement in early detection and ___
treatment
secondary cancer and cog changes are long __effects of cancer
term
CV/sexual dysfunction and psychosocial effects are long term __of cancer
effects
with cancer, the __ should tell pt what to expect to decrease anxiety
nurse
with cancer, the __ should encourage discussion of fears
nurse
with cancer, the __ should reassure the pt that situation is temporarily
nurse
with cancer, the __ should inform the pt of support care
nurse
