Brainscape's Knowledge GenomeTM

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


See full index

NUR2229 > Wk 2: Oncology Nursing #2 > Flashcards

Wk 2: Oncology Nursing #2 Flashcards

1
Q

Define chemotherapy

A

= a group of drugs that destroy cancer cells.
- can use one or multiple

Action:
- shrink tumor
- destroy cells after surgical removal
- improve symptoms
prolong life where possible

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

What is the typical chemo routine and why?

A
  • it is usually given in cycles to with multiples treatments making up a cycle then repeating cycles for as long as it takes to reach desired outcome.

Cycles allow for bodily cells to recover inbetween nect administration.

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

What are some types of chemo?

A
  • oral : tablet or liquid
  • IV
  • Centeral line
  • IM injection
  • IA intra arterial
  • Intraperotineal
  • intrathecal
  • subcut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Explain the action of chemotherapy

A

Kills any rapidly dividing cells of the body.
- normal bodily cells can repair from the trauma where as cancer cells can not.

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

Side effects of chemo

A
  • fatigue
  • nausea
  • hair loss
  • low libido
  • sore throat and mouth
  • loss of apetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some long term effects of chemo?

A
  • organ damage such as heart, liver, kidneys, lung or brain.
  • infertility
  • increased risk of other cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain radiation

A

= destroy and deactivate cancer cells.

A parallel goal is to preserve the integrity of normal tissues with the treatment field.

  • damaging the nuclease of cells which in turn damages DNA synthesis which causes their ability to reproduce.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some of the key uses of radiation?

A
  • shrink a tumor before removal to make removal easier
  • after surgery to destroy any remaining cancer cells
  • as a main treatment if surgery
  • in a combo with surgery, chemo or stem cell transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the strategy of radiation administration?

A

The total dose is divided into smaller doses or fractions and given daily until that total is reached.

Usually given 5x per week with 2 day rest and continues for several weeks. Each exposure if only a few minutes.

High dose can be directly aimed at the tumor depending on the location and shape.
- however this does limit the amount of radiation that reaches healthy areas of the body.

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

What are the two types of radiation?

A
  • external
  • internal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is involved in external radiation

A

= Beams radiation onto the tumour
- The area receiving radiation is very precise
- Minimises the radiation to surrounding healthy tissue.

  • Treatment is painless however you must sit very still during the procedure which can be very uncomfortable.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is another term for internal radiation?

A

brachytherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What in involved in brachytherapy?

A

= giving radiation through a needle, catheter or another specialised device. The device stays in place for a few minutes to a few days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Top 5 cancers in Aus?

A
  1. prostate
  2. breast
  3. melanoma
  4. colorectal
  5. Lung
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a key practice pain of radiation?

A
  • you may give off small amounts of radiation for a short time after internal radiation therapy.
  • May need to stay in seperate room to prevents others from being exposed.
  • Certain people (e.g. pregnant women, children, adolescents) should not get too close to you until the radiation weakens.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some side effects of radiation therapy?

A
  • for some it causes few to none
  • skin issues at the site of radiation: dryness, itchiness, peeling and blistering
  • fatigue
  • head and neck: dry mouth, jaw stiffness, mouth problems like swallowing and dental problems
  • chest: stiffness and some lung inflammation
  • Stomach: N+V and diarrhoea
  • Pelvis: urination problems, reproductive problems, fertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some examples of complementary therapies to couple with cancer therapy?

A
  • mind and body e.g. counselling, yoga, art therapy, music therapy
  • Body based: accupunture, massage
  • Energy therapies: healing touch
  • Therapies using hers or plants: bush remidies, chinese herbal medicines, medicinal cannabis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why may someone utilise a complementary therapy?

A
  • symptoms management of primary treatment
  • mental/emotional support
  • less side effects
  • more options
  • cultural/spiritual influences
19
Q

What are some factors that should be taken into account when working with hazardous medicines such as cytotoxics?

A
  • dose form of medication
  • route of exposure
  • frequency and duration of the task
  • workplace practice
  • presence or absence of any exposure controls such as engineering controls, administrative controls or personal protective equipment (PPE).
20
Q

What is a hazardous medicine?

A

Those that exhibit one or more of the following six characteristics in humans or animal studies:
1. Carcinogenicity
2. teratogenicity or other developmental toxicity
3. reproductive toxicity
organ toxicity at low doses
4. Genotoxicity
5. and/or structure and toxicity profiles of new medicines that mimic existing medicines determined hazardous by the above criteria

21
Q

What are the 7 types of cancer treatment?

A
  • surgery
  • radiation
  • chemotherapy
  • targeted therapy
  • immunotherapy
  • hormone therapy
  • Transplant
22
Q

Explain targeted cancer therapy

A

any known treatment that is specific the a cancer because of its location or development.

e.g. Herceptin: reduces her2 gene over-expression that often occurs in breast cancer/

23
Q

Explain immunotherapy as a cancer treatment

A

= uses own body immune system to fight cancer
- challenge is no way to find specific cancer cells and not have an immune reaction to the rest of the body. Need a way to put markers on cancer cells.

  • minimal side effects
  • great effect on cancer

One side effect:
- can cause immune system to go into hyperdrive but we cant turn it off and thus wear out the bodys immune system.

24
Q

Explain hormone therapy as a cancer treatment

A

= uses synthetic hormones to block the effect of the body’s natural hormones. The aim is to lower the amount of hormones the tumour receives.
- can help reduce the size and slow down the spread of the cancer.

PO or injected

25
Q

Explain stem cell transplant therapy as a cancer treatment. And what are the different types?

A

= takes stem cells and grows them then give them back to the person on chemo whos effected cells are in theory killed by the chemo.

Syngenic transplant: from an identical twin

Allogenic transplant: from someone else

Can be taken from the placenta.

26
Q

Define neo-adjuvant treatment

A

= all treatments that are administered before primary cancer treatment.
e.g. radiation before surgery or chemo before surgery

27
Q

Define adjuvant treatment

A

= therapy that us administered after the primary treatment.
e.g. chemo after radiation when radiation is parimary treatment or radiation after surgery.

28
Q

What is the cell kill theory?

A

states that a chemotherapy concentration given for a defined period of time, kills a constant fraction of the cells in the population, independent of the number of cells.
- hence why repeat doses need to be administered.

29
Q

What are the two types of chemo?

A

1) cell cycle specific
2) cell cycle non-specific

30
Q

Explain cell cycle specific chemo

A

= some chemos can only work on certain points of the cell cycle.
- excellent cell kill however only at certain times.
- this is why we use more than on chemo/treatment strategy

31
Q

Explain cell cycle non-specific chemo

A
  • can effect a cell in any stage of the cycle even resting.
  • effective again slow growing and rapidly dividing tumors.
32
Q

Given an example of a way to utalise cell specific and cell non specific

A

E.g. give 2 cell cycle specific and 1 cell cycle non specific.

Aim: knock off as many cells at that time.
- Gives maximum killing off.
- This is why we combine agents
- This is not an option for some cancers which don’t respond to many types of cancer.

33
Q

What are some reasons why the chemo cycles are far apart?

A
  • we need to split them up as giving the whole amount would kill he human.
  • Giving the whole amount that suppresses bone marrow function so no RBC, WBC or platelets so would come down in serious infections, inflamation, N + V.
  • we usually do 2 more cycles than needed.
34
Q

What is the impact of chemo on bone marrow?

A
  • it can suppress it

Anaemia: low red blood cells

Leucopenia: low white blood cells

Thrombocytopenia: low platelets

35
Q

What is the neutrophil nadir?

A

the lowest point of WBC hit at about 10 days post chemo.
- this is when bacterial infections are most common.

36
Q

What is the intent of scalp cooling?

A

Causes vasoconstriction of blood vessels that supply hair and thus reduce the amount of he chemo drug that reaches the hair cells.

37
Q

Give an exaple of how a dose and fraction radiation regimine may work.

A

Dose: 60 greay of radio therapy
Fractions: 30 aka 30 days

38
Q

What is hyperfraction?

A

fractions given multiples times per day.

39
Q

Explain neutropenic sepsis?

A

= Neutrophils (WBC) are vulnerable to standard cytotoxic agents and thus get depleted after chemo and thus the patients are highly susceptible to infection and severity of sepsis.

If an immune compromised patient is exposed to a pathogen, the reduced ability to mount an immune response means that patients can deteriorate quickly into sepsis.

  • most common

Treatment:
- must be treated within the hour or 30 minutes if crashing.
- if deteriorating must do a MET

40
Q

Explain the management of oncologic emergencies neutropenic sepsis

A

Recognise

React
- MET
- broard spectrum antibiotics
- fluid restriction
- investions e.g. blood cultures, CXH

Review- Frequent monitoring of patient to escalate care.
- Fluid replacement and - consider HDU/ICU for septic patients.
- Possible renal filtering and vasopressin support as required.
- Review blood results and culture results.
- Change antibiotics as required.

41
Q

Explain spinal cord compression

A

= occurs when cancer grows near to the spine resulting in swelling and reduced blood supply to the cord and nerves.
- if untreated SCC will cause dysfunction and paralysis

Symptoms
- back pain often described as banding pain as though apressure is felt squeezing their hips, pelvis) worsens when lying down.
- loss of function
reduced power and strength
pins and needles
- changes in bowel habits

Diagnosis
- MRI
- CT
- Bone scan
- Clinical exam

Treatment of SCC
- high dose steroids
- monitor BGL
- Monitor and treatment of urinary retention (such as IDC), constipation or diarrhoea
- potential surgery
- reduce mobilisation as falls risk

*If action isnt taken with in a bout 24hrs the paralysis can be permanent.

42
Q

Explain tumor lysis (TSL)

A

= metabolic disturbance which results from sudden injury and death of cancerous cells usually within 3 days following treatment
= damaged/killed cells release intracellular components/toxins causing sudden and sever electrolyte imbalance.
- risk periods: 5-7 days usually within 24-48 hours.

Symptoms
- Hyperuricaemia
- Hyperkalaemia
- Hyperphosphataemia
- Hypocalcaemia.
= cause cardiac arythmias, acute renal failure, seziures and paralysis.
- Weakness
- Muscle cramps
- Diarrhoea
- Nausea and vomiting

Investigations
- clinical exam
- biochemistry
- ECG

Management
- protect renal system with agressive hydration
- strict FBC
- allopurinol to reduce uric acid crystilation
- 6/24 blood tests
monitor urine pH

43
Q

Explain hypercalcaemia

A

= metabolic function, characterised by a serum calcium above 2.6 mmol.

Those at risk;
- metastatic disease in bones
- patients with breast, prostate and lung cancer, multiple myeloma, lymphoma and leukemia

Symptoms
- confusion
vomiting
- dehydration
- sezuires
- Apathy
- Fatigue
- Muscle weakness
- ECG changes
- Polyuria and noctris
- calcium serum levels >3mmol/L

Management
Immediate:
- reduce serum Ca+ level
- maintain renal function with IV fluids
- hydration

Ongoing: bisphosphonate therapy will inhibit further bone breakdown and promote remodeling and reabsorption. When giving: sit up right for 30mins to reduce irritation to oesphagus

44
Q

Explain superior vena cava obstruction

A

= caused my mechanical obstruction from a tumor via migration or occlusion.

  • Cardiac output is reduced.

Symptoms
- swelling of face, neck, and arms,
- peri orbital oedema (Looks like eyes are coming out of head)
- dyspnoea
- reduced perfusion
- Real facial odema
Distended veins in kneck

Treatment
- Includes reducing the size of the obstruction by radiation therapy or surgery
- The aim of treatment is to restore vascular function as quickly as possible
- Radiotherapy which is ironic as it can cause it!

NUR2229 (6 decks)

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