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165 Cards in this Set
- Front
- Back
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2nd most common cause of death-
an uncontrolled unregulated growth of cells, serving no purpose or host |
cancer
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cancer is a group of over how many diseases
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200
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#1 cause of death by cancer
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LUNG cancer
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how many percent of people over 55 get cancer
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76%
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cells in body determined by DNA, cell becomes specialized in function
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defect in CELL DIFFERENTIATION
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uniform in size and have nuclei that are characteristics of the tissue to which the cell belongs
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Normal Mature Cells
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Normal Cells have what
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nucleus-chormosomes with DNA
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cells too close to replicate, growth is maintained
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contact inhibition
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cells that supress growth
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tumor supressor genes
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cells reproduce and balance out (normal cellular proliferation)
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equilibrium
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In a NORMAL cell proliferation, what happens to the CELL
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CELL REPLICATES DNA
AND SPLITS (MITOSIS) MATURE CELLS BECOME SPECIALIZED. CELLS REPRODUCE AND BALANCE OUT (e) |
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Genetic material on genes to keep cell in mature state during replication. cell can express less mature function without this "LOCK"
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Prontoncogenes (LOCK)
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loss of DNA control, change in size, shape, less mature cells
(Not easily reversed, DNA loses control) |
dysplasia
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totally immature cells, NO dna control, IRREVERSIBLE
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anaplasia
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change in number or density of normal cells (abnormal proliferation) REVERSIBLE
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hyperplasia
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cells change to normal cell type - but in the wrong place.
(protective mechanism, but not a good change) REVERSIBLE if taken away |
Metaplasia
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Not easily reversed
DNA LOSES CONTROL occurs where? |
Dysplasia
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Orderly process that progresses from a state of immaturity to a state of maturity is called
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Normal Cellular Differentiation
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what perform a specific function
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mature cells
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Name the 4 potentially unproductive alterations
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Hyperplasia
Metaplasia Dysplasia Anaplasia |
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what cancer developement directly alter DNA
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genotoxic
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what cause other effects in cell not directed in DNA
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Promoters
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cellular mutation - an orderly process, takes longer than 10 years
PERMANANT DAMAGE in the cellular DNA IRREVERSIBLE |
Initiation
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REVERSIBLE proliferation of altered cells, increases the risk of cancer.
withdrawl factors reduce risk of cancer |
Promotion (supportive)
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a PROMOTER without _________ will not get cancer
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Initiation (smoker. ie)
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clinically evident disease
Increased growth rate of tumor, increased invasiveness, spread of cancer |
Progression
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what cm is big enough to palpate a tumor
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1 cm
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reversible, proliferation of altered cells
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promotion
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permanant damage in the cellular DNA , irreversible occurs during
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Initiation
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incrased growth rate of tumor, spreading of cancer
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progression
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causes change in cell, cause other problems than DNA problems, takes a long time to become cancer
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promoter
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examples of PROMOTERS are
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chemical agents
radiation viruses drugs hormones |
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an example of a genotoxic promoter is
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chemotherapy
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promoters damage what system
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immune system
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damage DNA of cells, genotoxic
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viruses (hpv)
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kept in check by tumor supressant genes, genetic material.
contribute to abnormal proliferation leading to cancer |
oncongenes
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antigents on cell develop - lessens immune system ability
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tumor associated antigens (TAA)
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the role of immune system is
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surveillance
tumor associated antigens |
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tumor =
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neoplasm
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TAA is an antigen known as
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tumor associated antigens
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a mass of new tissue, grow at rate uncoordinated with needs of body
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neoplasms
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neoplasms share some of properties of ___________ and do not benefit the host.
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parent cells
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localized, solid mass, well defined borders, frequently encapsulated, respond to bodys homeostatic controls, NOT TOTAL ANARCHISTS
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benign neoplasms (Tumor)
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grow aggressively, do not respond to honmeostatic controls, not coheisive, IRREGULAR SHAPE
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malignant neoplasms
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3 LOSSES of MALIGNANT CELLS
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LOSS of mitosis rate regulation
LOSS of specilaization/differentiation LOSS of contact inhibition |
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malignant cells are IRREVERSIBLE?
T/F |
True
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what kind of neoplasm can be fatal if pressed on organs
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benign neoplasm
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what kind of neoplasm can cause bleeding and death of tissue
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malignant neoplasm
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malignant neoplasms =
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canfcer
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malignant cells are able to promote their own survival
t/f |
true
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malingant cells are able to create own blood supply - this is called
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angiogenesis (malignant cells)
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replication gets more and more different, imoortal and IRREVERSIBLE, they can produce on their own hormones for growth
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malignant cells
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KNOW BENIGN AND MALIGNANT CHART ON PP
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KNOW BENIGN AND MALIGNANT CHART ON PP
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Decreased Fiber in diet can lead to
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colon cancer
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WHAT IS THE SINGLE GREATEST RISK FACTOR FOR DEVELOPING ANY TYPE OF CANCER?
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ADVANCING AGE!
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primary tumors are also known as
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original tumors
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secondary tumors are also knon as
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metastasis (sites = brain, lung, liver, adrenals, bone)
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tumor must be how big before becoming clinically evident cancer
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1 cm (detect through palpation.feeling)
1cm = 1 BILLION CANCER CELLS |
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MRI is able to detech how small tumors?
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1/2 cm
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what tools locate abnormal tissue to diagnose primary tumors?
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XRAY
CAT SCAN ULTRASOUND MRI PET |
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How are you able to tell hat type of cell it is (malignant,benign)
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look at cell under microscope
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needle in space, suck out is what type of biopsy
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needle/aspiration
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cut , remove sample of tumor is called
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incisional biopsy
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cut out completely, less than 2cm, iswhat type of biopsy
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excisional
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Alkaline Phosphate Enzyme
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? look in text?
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what does a BIOPSY tell you?
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definitive/confirms diagnosis of
histologic or cellular exams. 1) tells if cell is malignant or benign 2) tissue from which tumor arises and degree of cellular differentiation. 3) helps grading/staging/treatment decisions |
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how is a tumor Identifed by?
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a tumor is ID'd by TISSUE OF ORIGIN.
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Cancer Classification is by
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ANATOMIC SITE
GRADING STAGING (Size and extent of disease) |
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ecto and endo derm is classified as
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carcinomas (pg 280-16:4)
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mesoderm is classified as
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sarcomas
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skin and glands of cells is
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ectoderm
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muscle and fat cells is
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mesoderm
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more differentiated means it looks more like what?
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the parent cell
MORE DIFFERENTIATED= GOOD! |
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Mild dysplasia, is what grade
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grade 1 (mild dysplasia)
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moderate dysplasia is what grade
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grade 2 (moderate dysplasia)
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severe dysplasia is what grade
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grade 3 (severe dysplasia)
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anaplasia - UNDIFFERENTIATED, THE WORST.... is what grade
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grade 4 (anaplasia = bad!)
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what grades do the cells look undifferentiated and nothing like the parent cell
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grades 3 - grades 4
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what stage is cancer in SITU (no invasion)
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stage 0
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what stage is localized tumor growth
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stage 1
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what stage is metastasis
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stage 4
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what stage is limited local spread
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stage 2
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what stage is extensive local and regional spread
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stage 3
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indirect effect of cancer, endocrine effect, cancer sets up outside of tumor and SECRETES INCREASING HORMONES
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Paraneoplastic syndrome
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what causes an increase fatigue and ecrease in appetite and weight?
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widespread Metabolism
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TNM =
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PRIMARY TUMOR
REGIONAL LYMPH NODES DISTANT METASTISIS |
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Signs of Cancer Detection
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unexplained weight loss
fever, fatigue, pain change in bowel habits sores that do not heal white patch in mouth unusual bldeeding thickening or lump in breast trouble swallowing change in skin nagging cough or hoarseness |
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SCREENINGS are an example of what kind of prevention?
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SECONDARY prevention = screening
checkups breast exam colon and rectal exam cervical exam prostate |
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every 3 years over 20 a woman should have
every year over 40 a woman should have . |
breast exam
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3 normal _____ exams and you are okay...after age 21
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cervical
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cells that grow in orderly way - perform specific function, duplicate DNA exactly, specific shape and structure are called
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Normal CeLLS
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Cell groth not right
perform specific function cells do not wander |
Benign Cells
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rapid, chaotic, continuous cell groth.
UNDIFFERENTIATED function cells wander and metastisize and invade other areas |
Malignant Cells - bad.
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what determines the extent of disease and unique for each type of cancer
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Staging
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alteriation in cell growth results in cells that differ in size, shape, appearance , different than normal cells.
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dysplasia
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name some external factors of cancer
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chemical carcinogens(absestos)
viral carcinogens (hep B, HPV) physical |
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name some personal factors of cancer
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immune function
age cultural/ethnic genetic risk |
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normal genes, but mutations can cause them to become activated to function as oncogenes (tumor inducting genes) or tumor supressive genes .
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protoconogenes
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what phase does mutations occur in cells genetic structure (DNA) resulting from an inherited mutation or exposure to a carcinogen. it is IRREVERSIBLE, but not all altered cells go on to establish a tumor.
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Inititation stage
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what response occurs when our immune system responds to the tiumor associated antigens - this involves cytoxic t cells , natural killer cells, macrophages - does not help get rid of cancer
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immunologic surveillance
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cancer cells ander and invade from the initial to distal sites in the body - as a tumor increases in size it needs its ON BLOOD SUPPLY and nutrients - cancer can spread from local seeding, blood and lymph and embed along surface of body organs
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metastisis
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RUL cancer - what tests aid diagnosis
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chest xray, mri, cbc, bronchoscopy,cat scan, pfts, sputum.
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RUL lobectomy (removal of a lung) - what is the pre-operation teachings
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prevention of resp complications
chest tube/chest drainage system teachings ivs foley, pain management |
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a chest tube is placed where?
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in pleural cavity
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a chest tube placed in pelural cavity does what
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restores intrapleural negative pressure allowing for rexpansion of the lungs and drain air/fluid from pleural space
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a RESPIRATION RATE OF 36-40 = BLOWING OFF CO2 - WHAT ACID-BASE IMBALANCE IS PREDICTED?
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RESPIRATORY ALKALOSIS
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drain accumukated fluid out of the lungs (pleural effusion) is known as
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thoracentesis
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for oxygenation - what should you do for patient
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positition head of bed, o2 order, continue to monitor
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mucous membranes dry, lips cracked, lethargic, poor skin turgor, increased HR, high sodium is indicative of
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Fluid volume deficit
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pleural effusion vs fvd
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fluid in pleural effusion is 3rd space fluid and useless to body - it cannot help correct F.V.D.
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Lymph node present in right neck area is very significant and concerning why?
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hard, non mobile lymph nodes are painless and characteristic of malignancy - bad!
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listorine for oral mucosa breakdown good or bad>?>
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bad! too dry and may burn, mosition with nasal saline solution.
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what kind of nutritional food is best for mouth ulcers?
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soft, non irritating, HIGH PROTEIN, HIGH CALORIE foods
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what is the most common method of chemo administration
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IV
(port, output center) |
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excess vomiting after chemo puts the patient in risk of what acid base imbalance
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Metabolic Alkalosis
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An anemic patient - what will help
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IRON RICH FOODS such as
LIVER, SPINACH, ETC. iron supplements MEDS = EPOGEN/PROCRIT |
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tumor is identified by what
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tissue of origin
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what originate from ectoderm and endoderm, tissue of origin
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carcinomas
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what originate from mesoderm?
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sarcomas
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lymphomas and leukemia originate from
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hematopoietic system
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skin and glands is part of the
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ectoderm
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mucous membrane linings of respitory, gi and gu tracts are
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endoderm
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connective tissue, muscle, bone and fat are part of the
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mesoderm
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primary feature of the TNM staging system is
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invasion
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what system helps determine the ANATOMICAL extent of disease
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TNM system
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the only definitive means of diagnosing cancer, involving surgical aquisition of tissue from area for histologic examination to determine benign or malignant, tissue of origin and degree of cellular differentiation
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biopsy
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removal of entire tumor to examine smaller than 2cm
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excisional biopsy
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performed w scalpel to obstain a tissue sample for diagnosing cancer
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incisional biopsy
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the goal of what is to reduce or eliminate the number of malignant cells in primary tumor and metastatic tumor sites
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chemotherapy
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by staying in what phase, can cells escape death
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Go (resting stage)
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what damages the intima of vein causing plebitis and sclerosis but not tissue damage
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irritants
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what can cause severe tissue breakdown and necrosis if infiltrated into skin, IMMEDIATELY TURN OFF INFUSION
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Vesicant
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the cardinal symptom of extravasation or infiltrating drugs into tissue site is
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pain
followed by swelling, rednesso f viesciles |
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chemotherapy is administered by what placed in large blood vessels
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CVADS central vascular acess device
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used for short term IV therapy, blood producuts and blood drawing
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PICC peripherally inserted central cathetrs
complication : occlusion or phlebitis |
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redness, edema tenderness along track of cather line, REMOVE catheter.....
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phlebitis
Do not use picc line for blood pressure or drawing |
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emission and distribution of energy through space or a material medium - damages cellular dna
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radiation
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primary difference between x rays and gamma rays are that gamma rays are
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gamma rays are admitted from a radioactive source through constant dcay
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most common radiation form 0 external beams - megavoltage syustem is called
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teletherapy
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radiation affects only bone marrow in the treatment field
CHEMOTHERAPY affects |
systemically, throughout body
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monitoring what is most important for patients recieving radiation/chemo
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CBC - particular NEUTROPHILS!!! PLATELY AND RBC NEXT.
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what is the lowest blood count called, found between 7 and 10 days after initial therapy.
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nadir
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most common universal symtom affecting 70 to 100 poercent of patients with cancer
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fatigue
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cancer / chemo diet =
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small frequent meals of HIGHT PROTEIN HIGH CALORIE
refrain from high fiber/roughage |
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pulmonary effect of chemotherapy is
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pulmonary edema related to fluid retetntion
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bone marrow transplant has a side effect of low RBC, WBC AND PLATELETS called
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pancytopenia
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fluid accumulation in the pericardial sac, constrictuion of pericardium by tumor.
HEAVY FEELING OVER CHEST, SOB, TACHYCARDIA, N/V, SWEATING, ANXIETY |
cardiac tamponade
goal is to reduce fluid around heart |
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vitals and pt behavior do NOT accurately assess pain, pt must keep
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a pain diary - PATIENT REPORTS LOCATION AND INTENSITY OF PAIN - PT REPORT IS ALWAS BELIEVED AND ACCEPTED AS PRIMARY SOURCE OF ASSESSMENT DATA.
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who is the PRIMARY source of pain assessment data?
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THE PATIENT
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Leading cause of death people age 65-74 is
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cancer
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who has a higher death rate from cancer than whites
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african americans
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cancer is a name for a large group of diseases all of which are characterized by
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cell growth that escapes normal control
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a characteristic of the stage of progression in the development of cancer is
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proliferation of cancer cells in spite of host control mechanisms
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the primary protective role of the immune system related to malingnant cells is
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surveillance for cells with TAA
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PRIMARY difference between benign and malignant neoplasms is
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characteristic of tissue invasiveness
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importan RN roles related to prevention and detection of cancer include
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instruct people on ways to increase capacity to cope with stress
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the goal of cancer treatment are based on the principle that
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a combination of treatment is effective for controlling many cancers
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most effective method of administering a chemotherapeutic agent that is a VESICANT (capable of causing tissue necrosis)
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use a CENTRAL VENOUS ACCESS DEVICE CVAD
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RN explains to a patient undergoing brachytherapy of cervice that she
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requires the use of radioactive precaustions during rn care
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sealed source radiotherapy or endocurietherapy, is a form of radiotherapy where a radioactive source is placed inside or next to the area requiring treatment. is commonly used to treat localized prostate cancer[1], cervical cancer [1] and cancers of the head and neck.[2]
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brachytherapy
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stomatitis(inflammation of mucous membranes of mouth) is a common side effect of chemo agents occurs because
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rapidly devidicing cells of the mucous membranes of the mouth are being destroyed
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the RN counsels pt recieving radiation therapy or chemo that
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following successful treatment, a return to the persons previopus funcitonal level can be expected
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an inappropriiate RN intervention for cancer nutrtion is providing
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bland, pureed food ( cancer taste buds are altered, adding spices will help make food taste better, and a HIGH CALORIE HIGH PROTEIN diet)
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SIADH that occurs in cancer is due to
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ectopic hormonal production
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a pt has been recently diagnosed with early stage breast cancer, which is MOST important for RN to focus on
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maintaining patients HOPE.,
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