week 5 chemo and radiation Flashcards
1
Q
with ___ treatments, you want to cure, control and do palliation
A
cancer
2
Q
when cancer is diagnosed, you need to as a ___, active listen to concerns
A
nurse
3
Q
when cancer is diagnosed, you need to as a ___, manage your own discomfort
A
nurse
4
Q
when cancer is diagnosed, you need to as a ___, give clear explanations and repeat if needed
A
nurse
5
Q
when cancer is diagnosed, you need to as a ___, give written info about reinforcement
A
nurse
6
Q
when cancer is diagnosed, you need to as a ___, refer to oncology when possible
A
nurse
7
Q
when cancer is diagnosed, you need to as a ___, you manage your own discomfort and avoid hindering explaining feelings and avoid technical lang
A
nurse
8
Q
when cancer is diagnosed, you need to as a ___, you manage discomfort by listening when impt and encourage the pt to share their feelings
A
nurse
9
Q
when cancer is diagnosed, you need to as a ___ ask caring questions
A
nurse
10
Q
when curing cancer you see it end in the usual __ span
A
life
11
Q
when controlling cancer, you see the usual or reduced __ span
A
life
12
Q
when doing palliation, you end in ____ care
A
hospice
13
Q
CELL TYPE and LOCATION AND SIZE OF TUMOR help determine what __ is used
A
therapy
14
Q
disease extent and status help determine what ___is used
A
therapy
15
Q
expressed needs and desires help determine what type of therapy is ___
A
used
16
Q
surgery alone or periods of adjunctive systemic therapy is ___ therapy
A
curative
17
Q
time frame to “cure” may differ according to tumor and characteristics
A
curative therapy(hopefully the greatest disease eradication)
18
Q
initial course and maintenance therapy is __ treatment
A
control
19
Q
relief and control of symptoms and maintain QOL are palliation. torf?
A
true
20
Q
may include surgery, chemo and radiation, biologic, and targeted therapy
A
curative therapy
21
Q
testicular cancer can be cured with ___, chemo and radiation
A
surgery
22
Q
with control, you cant cure it but can ___
A
maintain
23
Q
multiple myeloma and chronic lymphocytic leukemia are control treatments. torf?
A
true
24
Q
surgery is the __ form of cancer treatment and meets a variety of goals
A
oldest
25
we are trying to go toward less radical surgeries. torf?
true
26
with surgery you can: prevent, cure and control and do palliation and ____
support
27
chemo is the __ of chemicals and the mainstay for most solid tumors and cancers
use
28
chemo can offer: cure, control or palliative care. torf?
true
29
want to cure with chemo: brkitts lymphoma and testicular cancer. torf?
tru
30
want to cure with chemo: hodgkins lymphoma and acute lymphocytic leukemia. torf?
true
31
want to cure with chemo: neuroblastoma and wilms tumor. torf?
tru
32
want to control with chemo: breast cancer and nonhodgkins lymphoma.torf?
tru
33
want to control with chemo: small cell lung cancer. torf?
tru
34
want to do palliation with chemo: to relieve pain, relieve obstruction and improve well __
being
35
Effective against dividing cells, so cancer cells escape death by staying in G0 phase (resting phase) is done with chemo. torf?
true
36
the ___ of chemo are Presence of drug-resistant resting and noncycling cells
problem
37
with chemo, As tumors get bigger, more cells become inactive and convert to go. torf?
true
38
when handling chemo ___, there is an occupational hazard
agents
39
when handling chemo ___, the drugs can be absorbed thru skin and inhalation
agents
40
when handling chemo ___, be trained to do it
agents
41
chemo can be given by: oral, IM, or IV(most ___)
common
42
IV chemo is given at the CVAD bc __ vessels and frequent administration.
large
43
IV chemo can be given in____ bc continuous and intermittent administration and give other fluids(blood and electrolytes)
CVAD
44
with regional chemo, the drug goes directly to tumor site and has a ___ concentration of drug with less systemic toxicity
hgih
45
regional chemo is: intraarterial and inteaperitoneal . torf?
true
46
regional chemo is: intrathecal or intravetricular. torf?
tru
47
regional chemo is: intravesical bladder. torf?
true
48
intraarterial is thry arteries that supply __
tumor
49
intraperitoneal delivers drug to peritoneal __ for treating peritoneal metastases
cavity
50
intraarterial is used for osteogenic sarcoma and liver cancers. torf?
true
51
inraarterial is used for: neck and head and bladder cancers. torf?
true
52
intraarterial is used for: cervix cancer and melanoma. torf?
tru
53
intraperitoneal is when you give 1-2 L to peritoneum for 4 hours then drain the fluid that was dwelling. torf?
-true
54
intrathecal or intraventricular ass with lumbar puncture and injecting into subarachnoid space. torf?
true
55
intravesicular bladder is the agent is added to the bladder by cath and retained for 1-3 hours. torf?
true
56
chemo ___ dont distinguish between normal and healthy tissue
agents
57
chemo ___ are normal cells are destroyed
side effects
58
the classes of ADR of chemo are: acute, delayed, and chronic. you see neutropenia. torf?
true
59
chemo drugs given in combo are calc by Body SA and involve drugs with different MOA. torf?
true
60
when the cancer cells mutate, there is ___ to chemo
resistence
61
___is the oldest nonsurgical cancer treatments
radiation
62
50% OF PTS GET RADIAITON.TORF?
TRUE
63
emission of energy from a source and travels through space or some material
radiation
64
low and high beams involved in radiation. torf?
true
65
expand energy quickly, for skin lesions, and penetrate a short distance
low energy beams
66
GREATER depth of penetration and good for ___ dosing of internal targets while sparing skin is high energy beam
optimal
67
with radiation, the nonmencalture is Gv(grey) or cGV(centigray) and 1 cGv=__
1 rad
68
100 cGv=1 __
G(grey)
69
total doses of __ are divided into fractions
radiation
70
Typically delivered once a day for 5 days a week for 2 to 8 weeks is standard ___ with radiation
fractionation
71
certain tumors are __ suspectible to radiation than others
more
72
immobilization device is the one where you trap the head. torf?
true
73
radiation is used to treat a __ of the body
area
74
radiation is __ a primary treatment for systemic disease
not
75
radiation can be used by itself or with chemo or with ___ to treat primary tumors & for palliation of metastatic lesions
surgery
76
teletherapy is also called ____ radiation
external
77
the most common radiation treatment is teletherapy. torf?
true
78
the pt is exposed to radiation from a megavolt machine in teletherapy. torf?
true
79
gamma knife tech is using ___
cobalt
80
cyclotron is using neurons and protons. torf?
true
81
linear accelerator is using ionizing radiation. torf?
true
82
internal radiation is also called bradytherapy and uses the ___ or insertion of radioactive materials into or close to tumor
implantation
83
minimal exposure to healthy tissue and commonly used with external radiation is ___ radiation
internal
84
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
85
chemo and radiation side ___ are bone marrow suppression and fatigue
effects
86
chemo and radiation side ___ are GI disturbances and skin/mucosal reactions
effects
87
chemo and radiation side ___ are pulm and repro effects
effects
88
with bone marrow suppression you can see myelosuppresion(___ common side effects of chemo)
most
89
with bone marrow suppression you can see treatment induced reductions in RBC/WBC results in: infection, hemmorhage, or ___ fatigue
overwhelming
90
with bone marrow suppression you can see there are __ with neutropenic conditions
precautions
91
with radiation, the bone marrow within treatment field is effected but with ___ the whole body is effected
chemo
92
if receiving chemo, the ___ common effect is neutropenia
most
93
for bone marrow suppresion, it occurs in RBC after 3 ___
weeks
94
for bone marrow suppresion, it happens in WBC within 1-2 ___
weeks
95
for bone marrow suppresion, it happens in PLTs withing 2-3 ___
weeks
96
skin reactions occur in the radiation treatment field. torf?
true
97
skin reactions can be acute or chronic. torf?
true
98
skin reactions can develop 1-24 hours after treatment or progressive as treatment dose ______
accumulates
99
with skin reactions, you want to __ infections
prevent
100
with skin reactions, you want to __ wound healing
faciliate
101
with skin reactions, you want to __irritated skin temp extremes
protect
102
with skin reactions, you want to __ pts deal with hair loss
help
103
with skin reactions, you see __and wet desquamation
dry
104
a __ skin reaction must be kept clean and protected
wet
105
a wet desquamation is If the rate of cell sloughing is ___ than the ability of the new epidermal cells to replace dead cells
faster
106
___desquamation occurs with exposure of the dermis and weeping of serous fluid.
wet
107
Wet desquamation of tissues generally produces __, drainage, and increased risk of infection
pain
108
skin __ for radiation is to clean and protect with soap, rinsing and pat dry
care
109
skin __ for radiation is to use lotion
care
110
skin __ for radiation is to avoid meds, deoderant, perfume, tape and shaving the area
care
111
skin __ for radiation is to avoid tight or harsh clothes
care
112
skin __ for radiation is to use gentle detergent
care
113
skin __ for radiation is to expose to air
care
114
skin __ for radiation is to use astringent compress and absorbant dressings
care
115
skin __ for radiation is to observe daily for infection
care
116
fatigue effects ___ cancer pts
all
117
anemia is a __ of fatigue
cause
118
accumulation of toxins in body after cells killed are ___ of fatigue
causes
119
extra energy needed to heal and no sleep are causes of ___
fatigue
120
exercise and activity are ways to __ fatigue
manage
121
fatigue can persist long after ___ has ended
treatment
122
a cancer pt who is full of fatigue the nurse should __before activity
rest
123
a cancer pt who is full of fatigue the nurse should __assistance with activity
get
124
a cancer pt who is full of fatigue the nurse should __active in periods of time pts feel better
remain
125
a cancer pt who is full of fatigue the nurse should __nutrition and hydration
maintain
126
a cancer pt who is full of fatigue the nurse should __for reversible causes of fatigue
assess
127
with the GI effects, you want to ___giving antiemetics
prevent
128
with the GI effects, you want to ___for s/s of alkalosis, dehydration and I/O
assess
129
with the GI effects, you want to ___a high cal, low fiber, high protein and nonirritating food
eat
130
with the GI effects, you see ___(mouth ulcers)
mucositis
131
the ___ mucosa is the most sensitive to treatment
intestinal
132
___ effects are N/V & diarrhea
GI
133
mucositis, and anorexia are ___ effects
GI
134
if on chemo, you can get anticipatory or __ N/V
delayed
135
V occurs within 1 __ of chemo or few hours post radiation to chest or ab(can be 24 hours later)
hour
136
a __ informs the pt of the sex SE
nurse
137
a ____ tells to use appropriate shielding
nurse
138
a ____ refers to counseling if needed
nurse
139
a ___ encourages discussion of issues RT to sexualty
nurse
140
pulm effects may be ___ and irreversible
progressive
141
cough and dyspnea are __ effects
pulm
142
pneumonitis and pulm edema are ___ effects
pulm
143
treat __ probs with bronchodialters and O2
pulm
144
treat __ probs with bed rest and cough suppressants
pulm
145
Pneumonitis&pulmonary fibrosisare due to ____ reaction of endothelium
inflammation
146
pulmonary edema& hypersensitivity pneumonitis are due to ____ reaction of endothelium
inflammation
147
interstitial fibrosis and pneumonitis are due to ____ reaction of endothelium
inflammation
148
CAD preexisting are more ___ to CV effects
vulnerable
149
do ECG for CV effects of ___
treatment
150
doxorubicin is a ___ to treat cancer but can lead to worse probs.
antibiotic
151
treatment can __ irreversible and progressive CV toxicities
produce
152
pericardial effusion is a CV ___
effect
153
-icin's can ___ECG abnormalities, L ventricular dysfunction, and HF
cause
154
you can have ___ brain and mental cloudiness or fog
chemo
155
chemo brain can be severe and can last for short term or long ___
term
156
chemo __ can cause mem or thinking probs
brain
157
most at __ pts are treated with alkylating agents and high dose radiation
risk
158
secondary cancers that __ happen are leukemia
can
159
secondary cancers that __ happen are angiosarcoma
can
160
secondary cancers that __ happen are skin cancer
can
161
multiagent use of chemo can be additive effects ___ lateeffects
increasing
162
___ effects of radiation are liver and kidney probs
late
163
___ effects of radiation are lung and heart probs
late
164
___ effects of radiation are muscle and bone and CT probs
late
165
___ effects of radiation are skin telangiestasias to strictures
late
166
___ effects of radiation are fistulas and necrosis
late
167
___ effects of radiation are lymphedema
late
168
___ effects of chemo are toxicity and cataracts
late
169
___ effects of chemo are OP and endocrine probs
late
170
___ effects of chemo are renal insuffiencient and hepatitis
late
171
___ effects of chemo are neurocog dysfunction
late
172
___ of cancer are continuous growth of cancer into normal tissue
complications
173
___ of cancer are SE of treatments
compliations
174
___ of cancer are malnutrition and altered taste senstation
complications
175
there is fat and __ depletion
muscle
176
do nutritional ____ when 5% weight lost and protein or cal malnutrition
counseling
177
cancer pts should __foods they dont like and use spices
avoid
178
cancer pt may have dehydration and impaired __ healing
wound
179
avoid temp extremes and tobacco and ETOH with cancer __
pts
180
hard to ___ nutritional status when 10lb weight gain
maintain
181
with cancer __ you may need to do enteral or parenteral nutrition
pts
182
cancer cachexia is also called __ syndrome
wasting
183
wasting __ is anorexia and weight/appetite
syndrome
184
tissue wasting and muscle atrophy are ___ syndrome
wasting
185
immune dysfunction and metabolic abnormalities are ___ syndrome
wasting
186
the weight loss with cancer cachexia cant be ___ nutritionally
reversed
187
cancer complications are the __ cause of death
primary
188
lungs, GI,and GU are common ___ sites
infection
189
mouth and rectum are common ___ sites
infection
190
peritoneal cavity and blood are common ___ sites
infection
191
complications of ___ infection are due to ulceration
cancer
192
complications of ___ infection are due to compression of vital organs by tumor
cancer
193
complications of ___ infection are due to neutropenia bc of disease and treatment
cancer
194
if you have neutropenia, call abt a fever above 38/100.4__
degrees
195
with neutropenia and a depressed immune system, the infection__ are subtle
s/s
196
the complications of cancer oncologic emergencies are life threatening. torf?
true
197
the complications of cancer oncologic emergencies are bc of disease or treatment. torf?
true
198
the complications of cancer oncologic emergencies can be: obstructive, infiltrative, and metabolic. torf?
true
199
SVC syndrome and SC compression sydrome are ___ emergencies
obstructive
200
third space syndrome and intestinal obstruction are ___ emergenices
obstructive
201
metabolic ___ are caused by ectopic horomones from the tumor or treatment
emergencies
202
___ hormones arise from tissues that don't normally produce these hormones
ectopic
203
in a ___ emergency, the Cancer cells return to a more embryonic form, thus allowing the cells' stored potential to become evident.`
metabolic
204
SIADH and hypercalcemia are metabolic ___
emergencies
205
tumor lysis syn. and septic shock are metabolic ___
emergencies
206
DIC are metabolic ___
emergencies
207
malignant tumor infiltrate the organs or secondary to therapy are ___ emergencies
infiltratitive
208
cardiac tamponade and coronary artery rupture are infiltrative ____
emergencies
209
with cancer pain, the pts report should be ____
believed
210
with cancer pain, use drugs to __ pain
control
211
with untreated cancer pain, it ____suffering, low QOL and increased burden on cargiver
causes
212
with cancer pain, the biggest barrier to good __ management
pain
213
50% of cancer pts have mod to severe pain if the ___ is active
treatment
214
80-90% of advanced cancer pts have mod to severe pain. torf?
true
215
non pharm ways to manage pain are relaxation and imagery. torf?
true
216
drug therapy for cancer __ is: NSAIDS, opioids and adjuvant pain meds
pain
217
when managing cancer __ tell pt to keep a diary
pain
218
you can use antiseizure/depressants for neuropathic __
pain
219
with cancer pain management, addiction and tolerance are __ probs
not
220
religion, social, coping skills and demographics are ways to cope with ___
cancer
221
____ pops are at risk for late stage disease at time of diagnosis
underservered
222
to be culturally competent for cancer, ___ culture differences, care barriers, and adapting to specific care needs
assess
223
more blacks with cancer then in ___
whites
224
when coping with cancer, the __ should use persuasive anxiety and fear
nurse
225
when coping with cancer, the __ should be available and be caring
nurse
226
when coping with cancer, the __ should listen and do symptom relief
nurse
227
when coping with cancer, the __ should give accurate info
nurse
228
when coping with cancer, the __ should build trust and use touch
nurse
229
when coping with cancer, the __ should set realistic goals and support lifestyle patters
nurse
230
when coping with cancer, the __ should maintain hope and give support
nurse
231
when coping with ___, offer support from survivors and have phone contact info between visits
cancer
232
when coping with ___, assist in planning for nutrition and transportation
cancer
233
when coping with ___, do edu and support
cancer
234
when coping with ___, do a psychosocial intervention and give info
cancer
235
old cancer concerns are: CM may look like aging and they are more ___ to complications
vulnerable
236
old cancer concerns are: Will the treatment provide more benefits than harm? torf
true
237
old cancer concerns are:Is there need to optimize other co-morbidities or nutritional or functional status before starting treatment? torf
true
238
old cancer concerns are:What are the patient’s preferences and wishes? torf
true
239
old cancer concerns are: Will they be able to tolerate the treatment safely? torf
true
240
aging and growth help the survivor rate. and improvement in early detection and ___
treatment
241
secondary cancer and cog changes are long __effects of cancer
term
242
CV/sexual dysfunction and psychosocial effects are long term __of cancer
effects
243
with cancer, the __ should tell pt what to expect to decrease anxiety
nurse
244
with cancer, the __ should encourage discussion of fears
nurse
245
with cancer, the __ should reassure the pt that situation is temporarily
nurse
246
with cancer, the __ should inform the pt of support care
nurse
