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37 Cards in this Set
- Front
- Back
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Big Risk Factors for Cancer (CA)?
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Alcohol and Tobacco
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Suspected Dietary Causes of Cancer?
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~low fiber diet
~Increased red meat ~increased animal fat ~nitrates (processed sandwich meat) ~alcohol ~preservative and additives |
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Most important risk factor for Cancer?
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Aging
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What foods can decrease a persons risk for developing cancer?
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~Cruciferous Veggies (broccoli, cauliflower, cabbage)
~Vitamin A (colored veggies) ~Vitamin C |
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Prevention: Female
~Self Breast Exam ~Clinical Breast Exam ~Pelvic Exam ~Pap Smear ~Mammogram ~Colonoscopy |
~Monthly self-breast exam- starts when woman gets her first menstrual, post menopausal-pick one day and stick with it each month
~Yearly clinical breast exam for women >40 yrs old ~Annual pelvic exam ~pap Smear: every 3 years if there's no problem tell pt no douching it alters cervical cells and no sex right before exam ~Mammogram: baseline age 35-40, yearly after 40, before test no lotion powder or deodorant they show up as calcium deposits and it can show up as Cancer ~Colonoscopy: at age 50 then every 10 years unless there's a problem |
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Prevention: Males
~Self Breast Exam ~Testicular Exam ~Rectal Exam ~Colonoscopy |
~Monthly self breast exam
~Monthly testicualr exam (especially age 15-35) ~Yearly digital rectal exam and yearly PSA (prostate specific antigen) for men over 50 ~Colonoscopy at at age 50 an every 10 years after that |
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General S/S:
Think "CAUTION" |
Chanes in bowel/bladder habits
A sore that doesn't heal Unusual bleeding/discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious changes in wart/mole Nagging cough or hoarseness |
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What is cachexia?
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extreme wasting and malnutrition (usually see this close to point of death)
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General Tx:
*Radiation Therapy (Internal Radiation-Brachtherapy) |
The radioactive source is inside the pt, radiation IS being emitted
Types of internal radiation: a. unsealed: pt AND body fluid emit radiation b.sealed or solid: pt emits radiation, body fluids NOT radioactive-implanted close or in the tumor |
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Precautions with internal Radiation
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~Private room
~wear a film badge at all times ~restrict visitors ~limit each visitor to 30 minutes per day ~no visitor under 16yrs old ~visitors must stay atleast 6ft from source ~no pregnant visitors/nurses ~mark the room ~nurses should gather all supplies before entering the room |
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How to prevent dislodgment of the implant?
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~keep pt on Bedrest
~decrease fiber in diet-so pt wont have to go to bathroom alot and too much fiber makes intestines expand and this can push out the implant ~prevent bladder distention-can push out implant ~ |
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Radiation Therapy:
*External Radiation |
think of outpatient patient who gets marks on their body
~usual side effects of external radiation are usually limited to the exposed tissue: erythema, shedding of skin, altered taste, fatigue (BIG!), pancytopenia (all blood and components are decreased) ~have pt protect site for 1 year are completion of therap-even if it looks healed it's still fragile |
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Chemotherapy
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~many are absorbed into the skin & mucous membranes so be careful handling them
~pt WBC count must be at at least 3000 before they will receive their tx normal WBC= 5000-10000 Nadir= o WBC, wiped out |
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Vesicant
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type of chemo drug that if it infiltrates (extravates) will cause tissue necrosis
this is a dangerous drug, nurse should stay with the pt the entire time |
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What a s/s of infiltration/extravasation?
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pain, redness, swelling, no blood return -CHECK FREQUENTLY!
can eat up the tissue and pt will need skin grafts #1 thing to remember with extravasation is prevention, what should nurse do if this happoens: 1. stop the infusion 2. put a cool ice pack on this to help veins to vasoconstrict so the med can't get in 3. Call doctor |
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General ways to prevent infection for patients with Cancer
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~Private Room
~Wash hands ~have own supplies in room (equipment included) ~Limit people ~Change dsg and IV tubing daily ~cough and deep breathe -to prevent PNA ~no fresh flowers or potted plants ~avoid crowds ~do not share toiletries ~bathe warm, moist areas daily ~wash hands after touching pet ~avoid raw veggies and fruits ~drink only fresh water *remember slight increase in temp may mean sepsis for them *Absolute neutrophil count is the most important |
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Cervical Cancer
*List S/S *Dx |
s/s:
invasive cancer classic sx: painless vaginal bleeding, watery blood tinged discharge dx: pap smear |
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Uterine Cancer
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s/s:
\Major Sx: post menopausal bleeding, watery blood tinged discharge dx: CA-125 blood test to r/o ovarian involvement *the most definitive dx test is D7C (dilation & curettage) and endometrial biopsy |
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hysterectomy 2 types:
1. TAH (total abd hysterectomy)-what are they removing? 2. Radical Hysterectomy- What are they removing? What are the major complications with both? |
1. TAH (total abd hysterectomy)= uterus and cervix only!
2. Radical Hysterectomy= may remove all of the pelvic organs Major complication with abd hysteretomy= hemorrhage major complication of vaginal hysterectomy= infection |
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Post Radical Hysterectomy
*What is something you can do to prevent pneumonia, thrombophlebitis and constipation? |
ambulate the pt
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Post Radical Hysterectomy:
*What should you have pt avoid? |
girdles (it traps blood in pelvis), douching (bad infection), exercise including lifting heavy objects will increase pelvic congestion (ex. avoid picking up children)
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Breast Cancer:
*s/s |
change in appearnca of breast (orange peel appearance, dimpling, retraction, discharge from breast), or lump
Tail of spence-located in the outer quadrant- extending into the axilla-make sure assess this on pt |
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Breast Ca:
*treatment (surgery)-Post Op Care |
Post-Op Care:
Bleeding--> check dressings, back (pooling of blood), hemovac, Jackson Pratt Drain-look for a sudden increase in amount & look at changes in the color Elevate arm on the affected side- to decrease swelling Stay away from the affected arm for a lifetime- Nothing on or in that arm light exercises to promote collateral circulation and want to prevent frozen shoulder syndrome |
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Lung Ca:
*s/s |
~hemoptysis-coughing up blood
~dyspnea (may be confused with TB but TB has night sweats too) ~hoarseness ~cough ~change in endurance ~chest pain ~pleuritic pain on inspiration ~displaced trach-may metastasize to bone |
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Lung Ca:
*Dx |
Bronchoscopy:
~NPO pre and post until gag reflex returns ~Post Bronch: watch for resp depression (this is never good!), hoarseness, dysphagia, SQ emphysema (collection of air undle skin think of rice krispies) |
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Lung Ca:
*Tx |
Surgery: The main treatment for stage I and II
1. lobectomy~ part of lung (lobe) removed, chest tube and SURGICAL SIDE UP, trying to get surgical lung to expand 2. Pneumonectomy~removal of entire lung, position pt on AFFECTED side, no chest tube there is no lung there, AVOID severe lateral positioning--> mediastinal shift (trach is sitting on the side of the neck-BAD!) |
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Laryngeal CA:
*s/s |
~There are no early signs, ~hoarseness,
~difficulty swallowing, ~burning, ~sore throat, ~swelling in neck, ~loss of speech, ~mouth sores, ~lump in neck, ~color changes in mouth/tongue, ~dentures do not fit anymore, ~unilateral ear pain (tumor causing pressure to one side) |
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Laryngeal CA:
*Tx (Surgery) |
Surgery:
~Total Laryngectomy (removal of vocal cords, epiglottis, thyroid cartilage) *remember epiglottis helps with preventing aspiration since the entire larynx has been removed this pt will have a permanent trach Position Post-Op: Mid Fowlers (HOB 35-40 degrees) ~Watch for carotid artery rupture- watch for a change in vital signs, bleeding into the tissue, swelling, etc. ~Rupture of innominate artery-MEDICAL EMERGENCY! will see a pulsating trach this is NOT GOOD! Go get help dont try to fix it! |
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Laryngeal Ca:
*Tx (Suctioning) |
~Sterile Technique
~Hyperoxygenate the pt before & after ~You should stop advancing the catheter when you meet resistance or your pt coughs ~Apply intermittent suctioning on the way out ~Suction no longer than 10 seconds ~Watch for arrhythmias because vagus nerve is stimulated and the HR will decrease ~This pt is NOT hypoxic but they need more oxygen ~Eary Signs of hypoxia: restlessness & tachycardia Late Signs of hypoxia: cyanosis & bradycardia |
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Colorectal Ca:
*Risk Factor (one fact) |
Most frequent site of metastasis is the liver so nurse should take bleeding precautions anytime the liver is not working properly think bleeding 1st
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Colorectal Ca:
*s/s |
most common signs are: rectal bleeding, anemia, and changes in bowel habits/stool
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Colorectal Ca:
*tx |
Surgery, radiation and chemo- drug of choice is Fluorouracil (5-FU)
If a pt has an abdominp-perineal resection (removal of anus, rectum, colon~you can't take a rectal temp b/c there is no rectum Also no rectal temps on a pt who is thrombocytopenic or immunosuppressed |
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Bladder Ca:
s/s: |
Major sx: painless intermittent gross/microscopic hematuria- this pt most likely won't go to the dr b/c they don't feel pain
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Prostate Ca:
*s/s |
this pt comes in with s/s of benign hyperplasia (BPH): hesitancy, freqency, frequent infections (because the bladder is not completely emptied), nocturia, urgency, dribbling, but many pt are asymptomatic
The most common sign is painless hematuria |
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Prostate Ca:
*dx (one method) |
Alklaine Phospatase (if increased it means bone metastasis_- prostate Ca likes to go to the spine, sacrum, and pelvis- MANY TIMES THE PT WILL COME IN COMPLAINING OF BACK PAIN!
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Prostate Ca:
*tx |
Watchful Waiting in early stages (for asymptomatic_- slow growing
~Surgery-Radical Prostectomy or Prostectomy (TURP) this is the most common. TURP is not a cure fro prostate Ca, most common complication is bleeding a little is okay but not too much, continuous bladder irrigation helps to maintain patency, flush out clots (clots will lead to renal failure if not flushed out), subtract irrigant from output |
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Stomach Ca:
*S/S |
most common: heart burn and abd discomfort
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