Ams-Test 1- Adult Cancer

Front 1

What is cellular mitosis?

Back 1

All cellular activities including reproduction follow an orderly series of events under control of DNA

Front 2

When do normal cells divide? When do cancer cells divide?

Back 2

Only to meet the needs of the body and only in enough numbers to replace dying cells.
Cancer cells are dividing and reproducing out of control

Front 3

What is hypertrophy

Back 3

Tissue that increases in size by increasing the size of each cell (Heart)

Front 4

What is hyperplasia?

Back 4

Tissue that increases in size by increasing the number of cells (Skin flap)

Front 5

What is neoplasia?

Back 5

Cell growth that continues over and above what is needed for replacement. Wh

Front 6

What is cell to cycle time?

Back 6

The time from mitosis of a cell to its mitosis into a daughter cell.

Front 7

How long is the human cell cycle time?

Back 7

Varies from 1-5 days

Front 8

What 3 things have very quick cell cycle time? Why is this improrntant?

Back 8

-Bone marrow tissue
-Hair folicles
-Epithelial lining of the GI
Because these cells under normal conditions are rapidly dividing, so since chemo effects rapidly dividing cells it cant see the difference between cancer cells and these cells.

Front 9

Do cancer cells require a large ammt of energy? What are the effects of this on a person?

Back 9

Yes, This is why people with cancer look emaciated, sick, green.

Front 10

What is Cachexic?

Back 10

Malnourished

Front 11

Describe the spread of cancer

Back 11

-Extension into surrounding tissue
-Blood vessel penetration
-Relaase of tumor cells

Front 12

What are tumors classified by?

Back 12

-Tissue of origin
-Anatomic site
-Biologic behavior
-Degree of differntiation

Front 13

When determining the degree of malignancy (grading) The ________ The grade, the ______ the prognosis

Back 13

Higher, poorer

Front 14

When determining the extent (staging), The ______the number, the _______ the prognosis.

Back 14

Lower, better

Front 15

What is metastasis?

Back 15

the transference of disease-producing organisms or of malignant or cancerous cells to other parts of the body by way of the blood or lymphatic vessels or membranous surfaces.

Front 16

What is TNM classification used to describe?

Back 16

The anatomic extent of cancers

Front 17

What does TNM stand for?

Back 17

T-Anatomic size of tumor
N-Extent of lymph node involvment
M- The presence or absence of metastasis

Front 18

What are some of the advantages of TNM?

Back 18

-improves communication for HC workers
-Assists in developing treatment
-Used to evaluate treatment plan
-Helps to determine prognosis
-ued for research and statistics

Front 19

What factors contribute to the development of cancer?

Back 19

-Age (More exposure, Immunocompromised)
-Genetic (10%)
-Hormonal factors (Imbalances)
- Drugs and chemicals
-Radiation
-Viruses

Front 20

What is the definitive way to diagnosis cancer?

Back 20

Biopsy

Front 21

What are some of the diagnostic tests for cancer?

Back 21

-Cytology studies
-CBC
-PSA, CEA

Front 22

What is CEA used to determine?

Back 22

helps to track cancer and to tell us if its returning

Front 23

What are the warning signs of canceR?

Back 23

C-Change in bowel bladder habbits
A- A sore throat that wont heal
U- Unusual bleeding or discharge
T- Thickening or lump in breast or elswhere
I- Indigestion or difficulty swallowing
O- Obvious change in wart or mole
N- Nagging cough or hoarsness

Front 24

What are the goals for cancer treatment?

Back 24

-Prophalaxis
Diagnosis
Cure
Control
Pallative
Determination of effectivness
Reconstruction

Front 25

What is Radiation?

Back 25

The movement of energy through a space or medium. Therapy is based on the concept that rapidly reproducing malignant cells are more sensitive to radiation than normal cells.

Front 26

What are the 3 imporntant things for HC workers to remember?

Back 26

Time- Limit ammt of time in close proximity to pt. (30 mins/8 hr shift)
Distance-increase the distance from the radiation source. (6 ft away)
Shield- use lead barriers

Front 27

What are the factors that influence side effects of cancer?

Back 27

-Body site
-Dose of radiation
-Extent of body treated
-Method of radiation

Front 28

Describe first degree reaction

Back 28

-Destroys hair roots

Front 29

Describe second degree reaction

Back 29

Sweat glands are destroyed, hair loss may be permanent, skin is bright red

Front 30

Describe third degree reaction

Back 30

Skin has dark purple areas, may have blisters and scabs. Hair loss and sweat gland damage is permanent, may need to stop treatment for healing

Front 31

Describe fourth degree reaction

Back 31

Rare

Front 32

What are some ways to minimize skin damage?

Back 32

Avoid sun exposure, avoid adhesive tape, use mild soaps, no bath salts, perfumes, lotions, heat lamps, heating pads, ice packs, wear soft cotton lightweight clothing, may have medicated ointment perscribed

Front 33

What are some other side effects of radiation?

Back 33

-Scalp and hair loss
-Head and neck
-Chest and lungs
-Abdomen
-Pelvis
-Bone marrow

Front 34

What is internal radiation?

Back 34

The use of high energy radioactive sources placed into or directly on the body to treat disease.

Front 35

What are some precautions for internal radiation?

Back 35

-Private room
-Sign on door
-Wear film badge (To see how much radiation they are being exposed to)
-Encourage self care
-Rotate care givers
-Limit visitors
-Precautions if implant is dislodged

Front 36

What kind of cells does chemotherapy affect?

Back 36

Rapidly dividing cells (Malignant)

Front 37

What are cell cycle specific drugs

Back 37

Drugs that are effective during a particular point in the cell cycle

Front 38

What are cell cycle nonspecific drugs

Back 38

Drugs that are effective during the entire cell cycle

Front 39

Can chemotherapy agents be given many different ways?

Back 39

yupp

Front 40

When are vasculaar access devices used?

Back 40

-If perhipheral access is not avaliable
-For long term therapy
-When vascular system needs to be accessed often
-Patients preference

Front 41

What are some nursing actions for IV infiltration?

Back 41

-Stop infusion
-Apply Ice
-Give antidote if it gets into tissue

Front 42

What is bone marrow depression

Back 42

A decrease in the number of blood cells (WBC, RBC, Platlets)

Front 43

When a pt is recieving chemo, what should be monitored closely?

Back 43

Bone marrow suppression

Front 44

What is neutropenia

Back 44

Decrease in the number of WBC

Front 45

What is anemia

Back 45

Decrease in the number of RBC's

Front 46

What is thrombocytopenia

Back 46

Decrease in the number of platlets.

Front 47

What is the Nadir effect?

Back 47

Because cells have different life spans lab values will reach their lowest point at different times.

Front 48

What are some nursing concderations for the immunocompromised (low WBC)

Back 48

-Handwashing
-Prevent exposure to infection
-Meticulous aseptic technique
-Careful observation for infection
-Possibly reverse isolation
-Neutropenic precautions- no flowers, fresh fruits

Front 49

What is the nursing care for patients with anemia?

Back 49

Observe S&S of anemia (Fatigue, hypoxia, hypotension, tachycardia, anxiety)
Plan rest periods
Admin Oxygen
Assist with activities
Administer Blood transfusions
Promote good hygene

Front 50

What is the nursing care for a patient with thrombocytopenia?

Back 50

Observe for S&S of bleeding-Petechia, brusing, bleeding gums, hematuria
Observe for bleeding in brain-Headache, change in LOC, restlesness
Admin platlet transfusion
Encourage soft toothbrush, avoid razors, stool softners, no asprin

Front 51

What is hematuria?

Back 51

Blood in urine

Front 52

What is stomatitis?

Back 52

Inflammation of the mouth

Front 53

What is the treatment for Chemo-stomatitis?

Back 53

-frequent assesments of oral cavity
-avoid commertial mouthwash
-Nystatin swish and swallow
-Viscous lidocaine
-Soft toothbrush, no floss,
-Lubricant to lips
-Avoid spicy foods
-Good fluid intake

Front 54

The treatment for Chemo Pharyngitis is the same as for _______

Back 54

Chemo stomatitis

Front 55

What are some of the causes for chemo anorexia?

Back 55

-effect of chemo on hunger cneter in brain
-N&V imporntant to find good anti emetic
-Stomatitis

Front 56

Treatment for chemo anorexia?

Back 56

-May need TPN
-Offer small, frequent, high caloric feedings
-minimize foul odors
-ask pt what they like

Front 57

What is the reason for chemo nausea and vomiting?

Back 57

Occurs due to the effect of the chemo on the emesis center in the thalmus. The drugs are emetogenic (Vomiting inducing)

Front 58

What is the treatment for Chemo N&V?

Back 58

-Small, frequent feedings
-Dietary counseling
-Cold bland foods
-Antiemetic meds

Front 59

When do antiemetic meds work best?

Back 59

30-60 mins before eating

Front 60

What is chemo alopecia?

Back 60

Hair loss, becasue chemo kills rapidly dividing cells, and hair is a rapidly dividing cell, chemo cant differentiate between the two so they both die,

Front 61

What is Peripheral neuropathy?

Back 61

Loss of sensory or motor function of peripheral nerves

Front 62

What 2 agents are nephrotoxic?

Back 62

Cytoxan and methrotrexate

Front 63

What should we monitor when patients are on nephrotoxic drugs?

Back 63

BUN, Creatinine

Front 64

When patients are on nephrotoxic drugs, what should we encourage? What should we observe for?

Back 64

-Increased oral intake
-Hemmorrhagic cystitis- dysuria, hematuria

Front 65

What is dysuria

Back 65

Difficulty or painful urination

Front 66

What is hematuria?

Back 66

Blood in urine

Front 67

(Bleomycin ) When a pt is given a drug that causes pulmonary toxicity what should you observe for? How long after therapy should they be monitored?

Back 67

Pneumonia, CHF, SOB, coughing
6 months

Front 68

(Adriamycin) When a patient is taking a drug that causes cardiovascular toxicity what should you observe for?

Back 68

Signs of CHF, Obtain baseline EKG

Front 69

(Methotrexate) When a patient is taking a drug that causes Reproductive toxicity What should you tell your pt?

Back 69

-Sperm banking
-Birth control

Front 70

What is Superior vena cava syndrome?

Back 70

a disorder of venous congestion caused by obstruction of venous drainage in the upper thorax either by primary tumor or secondary tumor.

Front 71

What are some signs and symptoms of SVCS?

Back 71

-SOB, headache, visual disturbances, facial edema?

Front 72

What is the most imporntant concideration for a patient of chemotherapy?

Back 72

Myelosuppression (suppression of the bone marrow'sproduction of blood cells and platelets )

Front 73

What is spinal cord suppression?

Back 73

A disorder caused by direct pressure on the spinal cord with compromised vascular supply to the area leading to tspinal cord infarction or veretebral collapse

Front 74

What are some signs and symptoms of spinal cord suppression?

Back 74

Localized back pain and weakness in lower ext.

Front 75

What is pericardial effusion/Cardiac tamponade?

Back 75

an increased accumulation of fluid in the cardiac sac due to the tumor invasion or pericardial thickening after radiation.

Front 76

What is the most common oncological emergency?

Back 76

Hypercalcemia

Front 77

Hypercalcemia occurs in ___% of all cancer patients

Back 77

10-20

Front 78

What is tumor lysis syndrome?

Back 78

Causes electrolyte balance in body to be badly upset because the tumor is being destroyed

Front 79

How can tumor lysis syndrome be prevented?

Back 79

Good hydration

Front 80

What are 3 other oncologic emergencies?

Back 80

SIADH, DIC, septic shock