Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
140 Cards in this Set
- Front
- Back
|
3RD most common form of cancer for both men and women
SECOND LEADING CAUSE OF CANCER DEATH |
colorectal cancer
|
|
|
COLORECTAL refers to the _________ and ________
|
Colon and Rectum
|
|
|
The Colon and Rectum make up the
|
LARGE intestine
|
|
|
symptoms of colorectal are asymptomatic until advanced
t/f |
true
|
|
|
85 % arise from
|
adenomatous polyps
|
|
|
what is the most common type of colorectal cancer
|
adenocarcinoma
|
|
|
Cancer usually starts where?
|
the innermost colon
|
|
|
where does Colorectal cancer spread?
|
Lymph Nodes
Liver Lungs Peritoneum |
|
|
what is the only test that shows you the entire colon
|
coloscopy
|
|
|
colorectal cancer is slighlly more common in men - its death rate is highest among
|
african american men and women
|
|
|
75 percent of colon cancer is from
|
Unknown cause
|
|
|
non-cancerous tumor that can eventually become malignant
|
polyp
|
|
|
the most common types of polyps are
|
hyperplastic and adenomatous
|
|
|
originate from epithelium, rarely grow larger than 5mm
|
hyperplastic
|
|
|
the risk of cancer in the polyp increases with
|
polyp size and VILLOUS structure
|
|
|
disorder characterized by MULTIPLE polyps that at times in teh housands and that are located in the large intestine and sometimes in GI tract.
|
FAMILIAR ADENOMATOUS POLYPOSIS (fap)
|
|
|
FAP has a risk of developting colorectal cancer of approximately
|
80 PERCENT
|
|
|
FAP develop cancer at an earlier age (40 years)
|
TRUE
|
|
|
children of parents with FAP must have what
|
screenings at puberty and annually
|
|
|
Risk factors for COLORECTAL cancer are
|
fam history
ibd 10 years or more FAP / HNPCC OBESITY SMOKING ALCOHOL LARGE INTAKE OF RED MEAT |
|
|
Most common symptom of colorectal cancer
|
change in bowel habit
followed by...rectal bleeding |
|
|
what must be tested because tumors may BLEED
|
Fecal occult blood test
|
|
|
good indicator for COLORECTAL CANCER is
|
CEA
|
|
|
It was found that serum from individuals with colorectal carcinoma,[2] gastric carcinoma, pancreatic carcinoma, lung carcinoma and breast carcinoma, as well as individuals with medullary thyroid carcinoma, had higher levels of ______ than healthy individuals.
|
CEA
|
|
|
Elevated CarcinEmbryonic Antigen levels should return to normal after surgical resection, as
elevation of CEA during follow up is an indicator of recurrence of . |
a tumor
|
|
|
what stage of DUKE has tumor into bowel wall but not through
|
stage A
|
|
|
what stage of DUKE incljudes metasteses, the tumor has spread to distant sites
|
stage D
|
|
|
what stage of DUKE has tumor through bowel wall and LYMPH NODES are involved
|
stage C
|
|
|
what stage of DUKE has tumor penetrating through the bowel wall
|
stage B
|
|
|
what tumor means the tumor is through submucosa and into muscle
|
T2
|
|
|
What tumor is beyond mucosa and into submucosa
|
T11
|
|
|
cancer in 4 or more lymph nodes is called
|
N2
|
|
|
removal of part or all of a colon is called
|
laproscopic colectomy
|
|
|
the goal of surgery for colorectal cancer is to
|
complete resection of tumor with adequate margins of HEALTHY tissue
|
|
|
what must the patient take prior to colorectal surgery
|
bowel prep and ORAL ANTIBIOTIC
|
|
|
half or less of colon removed is called
|
hemicolectomy
|
|
|
what treatment ONLY ATTACKS CANCER CELLS
|
biologic/targeted therapy
(monocolonal antibodies) |
|
|
what targest both cancer and good cells
|
radiation
|
|
|
chemotherapy is used when what
|
there is positive lymph nodes at surgery
|
|
|
inform all patients over what age to get screenings
|
50
|
|
|
what is the colon diet?
|
Low alcohol
Low RED MEAT High Fiber |
|
|
diet, excercise, vitamins is known was what kind of prevention
|
primary
|
|
|
screenings, fecol occult testing, colonoscopy, genetic testings are what kind of prevention
|
secondary
|
|
|
a pt diagnosed as having a bowel tumor and several diagnostic tests are ordered. the rRN understands which test will confirm the diagnosis of MALIGNANCY
|
Biopsy!
|
|
|
Further teaching is needed if patient recongized what as a risk factor
|
patients under 50 years old
|
|
|
BREAST CANCER
|
BREAST CANCER
|
|
|
Most common form of cancer among woman 1/8 women
|
Breast Cancer
|
|
|
___ most common death for women
|
2nd
|
|
|
patients with localized breast cancer with no axillary node involvement have a
|
98% 5 year survival rate
|
|
|
There is no single cause to breast cancer.
Females over age 50 dramatically increase risk. Mother/sister family history risk. |
Early or late menopause
1st pregnancy over 30 Diet Obesity Ionizing radiation exposure Hormone replacement hterapy |
|
|
For what type of woman is breast cancer the #1 cause of death
|
Hispanic woman
|
|
|
whatis the most common form of breast cancer
|
Infiltrating Ductal Carcinoma
|
|
|
name the 3 types of breast cancer
|
Infiltrating ductal carcinoma *
Infiltrating Lobular carcinoma NONINVASIVE - DUCTAL IN SITU |
|
|
what are the main components of breast cancer
|
lobules (produce milk)
ducts (milk passages) |
|
|
Breast cancer arises from
|
epithelial lining of the ducts or lobules
|
|
|
Prognosis is related to
|
SIZE
AXILARRY NODE INVOLVEMENT TUMOR DIFFERENTIATION HER-2 STATUS ESTROGEN/PROGRESTERONER RECEPTOR STATUS |
|
|
localized in ductal in SITU is known as
|
Noninvasive (DCIS)
|
|
|
where is the most common recurring B.C. place
|
incisional line, same breast
|
|
|
What combined increase risk of B.C.
|
Estrogen and Progesterone
|
|
|
what is the most important thign a patient can do
|
screenings
|
|
|
GROWTH HORMONE human epidermal receptor, when this increases it is BAD
|
HER
|
|
|
B.C. is detected as a lump or what kind of abnormality
|
mammographic
|
|
|
B.C. is most often found where
|
Upper Outer Quadrant
|
|
|
B.C. is found in teh upper outer quadrant because its location is mostly
|
glandular tissue
|
|
|
small percent of B.C. cause
|
nipple discharge
|
|
|
if 4 or more positive lymph nodes, greater risk for spread - this is called
|
axillary lymph node status
|
|
|
Clinical Manifestation of Breast Cancer is what?
|
a hard, irregular, non tender, non mobile lump found in upper outer quadrant
|
|
|
prescence or absence of what can predict metastatic disease
|
estrogen or progresterone receptors
|
|
|
An INCREASED HER-2 marker receptor is
|
positive for breast cancer
|
|
|
less than TWO CM - NO LYMPH NODES, NON PALAPBLE
|
Stage 1
|
|
|
Presence of Metastisis regardless of size is
|
stage 4
|
|
|
removal of entire tumor keeping as much healthy breast is called
|
lumpectomy (partial mastectomy)
|
|
|
family history, past experience brings about what for the patient, you must allow client to ventilate feelings!
|
ANXIETY
|
|
|
surgeon leaves Pectoral Muscle and Nerves sometimes followed by reconstructuve surgery known as
|
Modified Radical Mastectomy
|
|
|
this is done firs....if positive goes to ALND
|
Sentinal Lymoph Node Disease
|
|
|
positive SLND you must do
|
ALND (AXILLARY)
|
|
|
removal of breast, axillary Lymph nodes, fat in adjacent tissues, pectoral muscles
|
masectomy
|
|
|
the pt with a masectomy cannot have
|
BP, Blood drawn
|
|
|
Post Masectomy youmust
|
elevate arm, avoid elbow contracture, emotional support, electric razors.
|
|
|
Paiin in nerve tissue damage, treated with non-steroids post surgery
|
Post Mesectomy Pain Syndrome
|
|
|
Most important for the post-op patient
|
Mobility, Physical THerapy
|
|
|
what helps prevent the recurrence after lumpectomy or masectomy
|
radiation therapy
|
|
|
The MAMMOSITE system is an example of what
|
High Dose BRACHYTHERAPY Radiation
|
|
|
accumulation of lymph in soft tissue as result of excision or radiation of lymph nudes.
axillary nodes cant return lymph fluid to central circulation, fluid accumulates in arm, pressure on venins. |
lymphedema
|
|
|
Post Op care is done to PREVENT
|
LYMPHEDEMA
|
|
|
Chemo is what kind of therapy - It is VERY responsive for breast cancer
|
systemic
|
|
|
checking for estrogen positive receptor tumors is an exmaple of what kind of therapy
|
hormonal
|
|
|
what is given when tumor overexpresses HER-2
|
HERCEPTIN
Biologic and targeted therapy HER-2 |
|
|
antiestrogen drug
|
tamoxifen
|
|
|
estrogen blocking drug
|
evista
|
|
|
interferes with enzyme that make estrogen, reducing estrogen in body
|
arimidex
|
|
|
Early detection is a SECONDARY PREVENTION - baseline screening mammography is required yearly at what age
|
40
|
|
|
What intervention would assist in preventing lymphedema of the affected arm
|
ELEVATING AFFECTED ARM ON A PILLOW ABOVE HEART LEVEL
|
|
|
Internal therapy, seeds into site, 5 days...
|
brachytherapy
|
|
|
AVOID EXPOSURE TO
|
INFECTION!
care for incision, nutrititon, excercise, rest/sleep |
|
|
2nd leading cause of death for men, 80 percent of men greater than 65 have this
|
Prostate Cancer
|
|
|
the most common cancer among men in US
|
Prostate
|
|
|
are caused by the excessive production of adrenal or gonadal androgens by adrenal adenomas, carcinomas, or hyperplasia
ex) TESTOSTERONE |
Adrogen-Dependant Adenocarcinoma
|
|
|
majority of tumor occurs where
|
OUTER aspect of prostate gland, very slow growing
|
|
|
Prostate Cancer spreads by
|
direct extension
lymph system bloodstream |
|
|
Where does Prostate Cancer spread to
|
Pelvic lymph nodes
bladder lungs liver bone |
|
|
Males over what age are higher risk
|
50
|
|
|
what is a bad diet for prostate cancer
|
HIGH FAT
|
|
|
What race is more at risk for prostate cancer
|
African Americans
|
|
|
Prostate cancer is what in early stages
|
Asymptomatic
|
|
|
Pt complains of dysuria, hesitancy,dribblignm frequency, urgency, hematuria, nocturia, retention, inability to urinate
|
manifestation of prostate cancer
|
|
|
WHAT IS THE ONLY INDICATOR OF PROSTATE CANCER
|
PSA
|
|
|
Prostate Specific Antigen PSA - what is normal
|
0-4 NG/ML; is normal
|
|
|
DIGITAL RECTAL EXAM -
ABNORMAL prostate feels |
hard, nodular, assymetirical
|
|
|
elevated PSA >4 =
|
BIOPSY
|
|
|
if abnomrla biopsy of prostate tissue, you must do what
|
BONE SCAN
CT SCAN MRI |
|
|
clinically unrecongizable is staged using Whitmore-Jewett as
|
Stage A
|
|
|
clinically INTRA CAPSULAR is staged using Whitmore-Jewett as
|
stage B
|
|
|
clinically EXTRA CAPSULAR is staged using Whitmore-Jewett as
|
Stage C
|
|
|
WHAT TNM grading is most like original cell WELL DIFFERNTIATED
|
Stage 1
|
|
|
what grade is POORLY DIFFERENTIATED
|
stage 5
|
|
|
to assess pt, ask about
|
urinary pattern, frequency, nocturia, bladder neck obstruction
|
|
|
increase in the number of cells resulting in enlargement of prostate glands - symptoms similar to prostate cancer.
grows INWARD causing NARROWING OF URETHRA |
BPH BENIGN PROSTATIC HYPERTROPHY
|
|
|
3 WAY urinary ccather with a 30-45 ml retention ballon through the urethra into the bladder
|
Continuous Bladder Irrigation
|
|
|
traction for continuous bladder irrigation is how?
|
tape to client abdomen or thigh
|
|
|
CBI is used if the patient has a
|
uncomfortable urge to void continously
treat with ANTISPASMODIC MEDS |
|
|
Surgical removal of a portion of the prostate through the urethra, a method of treating the symptoms of an enlarged prostate, whether from BPH or cancer.
Prostate resection - trans urethral - bladder irrigation |
T.U.R.P
MONITOR I/O |
|
|
PT Post Catheterization Care feels burning on urination as well as some urinary frequency, dribbling, leakage......what does the RN do
|
These are NORMAL and will subside, MONITOR FLUID INTAKE
|
|
|
removal of entire prostate
|
prostatectomy
|
|
|
men prefer what over prostatectomy
|
hormone therapy
|
|
|
most common radiation, targeted
|
external beam readiation
|
|
|
Depending on prostate SIZE, what can be used
|
brachtherapy (implanted radiation)
|
|
|
a gonadotropin-releasing hormone agonist for treatment of prostate cancer
|
Lupron
|
|
|
hormone therapy deprives _______
|
androgen
|
|
|
what must be monitored after treatment, a rise means the tumor can be back
|
PSA
|
|
|
2 COMPLICATIONS OF PROSTATE CANCER
|
URINARY INCONTINENCE
ERECTILE DYSFUNCTION |
|
|
radiation treatment : sealed seeds inserted directly into tissue, emits lowe radiation
|
brachytherapy
|
|
|
radiation treatment : most common, targeted radiation
|
external beam radiation
|
|
|
hormony therapy is prescribed as the most of treatment for a patient with rpostate cancer - the nurse understands that the goal of this form of treatmetn is to
|
LIMIT THE AMOUNT OF CIRCULATING ANDROGENS
|
|
|
PSA
DRE are what kind of prevention? |
SECONDARY preventions (Screenings)
|
|
|
After breast cancer surgery, an accumulation of lymph can occur in the soft tissue of the involved extremity. This is known as
|
lymphedema
|
|
|
The two primary screening tools to detect prostate cancer are
|
Digital rectal exam (DRE) and prostate- specific antigen (PSA)
|
|
|
hormome therapy is a possible choice for treating prostate cancer. This therapy will exert a
|
Anti-androgen effect
HORMONE THERAPY LIMITS ANDROGEN! |
|
|
In chronic lymphocytic leukemia, the type of lympocyte that is involved is the
|
B cell
|
|
|
Hodgkins lymphoma, the histologic examination will reveal which of the following
|
Reed - Sternberg cells
|
