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45 Cards in this Set
- Front
- Back
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Nadir
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the lowest absolute neutrophil count after chemo or radiation therapy
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Common bleeding sites
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skin, mucous membranes, intestinal, urinary, and respiratory tracts, and the brain
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Clinical and lab tools used to assess nutrition
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albumin levels, , electrolytes, lymph count, H&H, creatinine, and serum iron levels
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The most common side effect reported by chemo and radiation patients
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Fatigue
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Nutritional considerations
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small, frequent meals
avoid fluids while eating using meds like corticosteroids and progestational agents to stimulate appetite |
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Methotrexate
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Antimetabolite
side fx - hepatoxic, renal toxic, GI, myelosuppression |
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Allopurinol (Zyloprim)
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Antimetabolite
side fx - GI used in CA pt's to decrease uric acid levels |
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Vincristine (Onocovin)
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Mitotic Inhibitor - works on the acoustic nerve (VIII)
side fx - nuero toxic, pulm toxic, derm, CV, GI, oto, GI |
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Antitumor Agents
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Bleomycin (Blenoxane)
side fx ;ulm toxic Doxorubicin (Adriamycin) side fx - cardiac toxic |
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drug given in BRCA
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Megestrol acetate (Megace)
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Most common tumor in children located outside the cranium
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Neuroblastoma
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Typical symptoms of nueroblastoma
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wt loss, abd fullness, irritability, fatigue, fever
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DX testing of nueroblastoma
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Ct scan (skull, neck, chest abd, & bone)
Bone marrow Urine testing - detect breakdown of adrenal products |
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Nadir
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when blood counts hit rock bottom. usually 10-14 days after starting chemo
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precautions during Nadir
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avoid live attenuation shots
avoid people with infections no raw food or undercooked meats |
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Leukemia
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cancer of the blood-forming tissues, a proliferation of immature, abnormal white blood cells
Most common malignancy of childhood |
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Leukemia classifications
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ALL - acute lymphocytic
AML - acute myelogenous CLL - chronic lymphocytic CML - chronic myelogenous |
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Leukemia with 1 year survival rate
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AML - most common type in adults & affects the erythrocytes, thrombocytes, granulocytes, and monocytes
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Leukemia that affects the T and B lympsh
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ALL
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Definitive test for Leukemia
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Bone marrow aspiration
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Neutropenic precautions
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keep from injury
frequent rest, avoid fatigue adequate nutrition monitor for platelet deficiency avoid mouthwash w/alcohol avoid rectal temps |
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3 phases of chemo
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Induction - achieve remission
Intensification (consolidation) - maintain remission Maintenance - chemo is cont'd for 2-3 years |
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Infratentorial brain tumors
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below the tentorium & posterior
changes in gait & balance |
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Supratentorial brain tumor
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above the tentorial notch - anterior & mainly in cerebellum
changes in personality, memory, & thinking |
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SIADH
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syndrome of inappropriate anti-diuretic hormone
Excess fluid volume seizure precautions should be implemented |
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Nephroblastome
(Wilms' Tumor) |
Intrarenal tumor - common during childhood & assc'd w/congenital anomalies, hypospadia, & ambiguous genitalia
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Nephroblastomia s&s
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Pain, hemoturia, wt loss, fever, swelling over flank area, firm, non-tender; anemia
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Ct education after nephrectomy
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avoid palpation of abd, protect fx of other kidney, monitor for UTI's, & avoid contact sports
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Osteogenic Sarcoma
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tumor that arises from a bone cell, probably osteoblast
most common bone cancer in children & affects the metaphysis usually in boys and can metastasize to lungs |
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Bone cancer surgery
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radical resection or amputation
Thoracotomy if lung metastasis is present |
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Ewing's Sarcoma
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malignant, small tumor that arises in marrow spaces of bone
Usually no amputation Bone fx is 1st symptom Occurs between 5-25 years |
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Rhabomyosarcoma
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Cancer most common in abd, head, neck, GU tract
Occurs in kids<5years |
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Retinoblastoma
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congenital tumor arising from retina
may be ass'd w/Down's syndrome Prognosis - 5 yr survival for 85-90% |
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Clinical manifestation of Retinoblastoma
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cat's eye-whitish glow
absent red reflex strabismus |
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Hodgkin's vs. Non Hodgkin's
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Main difference is Reed-Sternberg cells (lg distinct dark nuclei in tissue)
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Hodgkin's disease
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solid tumor of lymphoreticular system that usually starts in supraclavicular lymph nodes & metastasizes to spleen, liver, lungs, mediastinum, & bone marrow
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Clinical manifestations of Hodgkin's disease
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painless enlargement of lymph nodes firm, non tender, persistent, nonproductive cough, low grade fever,night sweats, anorexia, nausea
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Non Hodgkin's lymphoma
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malignant lymphoma of internal framework of lymph system
greater incidence in men Metastasizes to bone marrow or CNS |
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Multiple Myeloma
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malignant disease of the most mature form of B lymphocyte, the plasma cell
No cure |
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Classic presenting symptom of multiple myeloma
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Bone pain, usually in back or ribs
There is no cure |
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BRCA risk factors
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high fat diet
early menarche late menopause early exposure to radiation obesity high alcohol intake nulliparity & late maternal age for 1st child personal hx Hormone replacement |
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Nutrition plans for chemo pt's
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avoid offensive foods
experiment w/seasonings & food combo's food at room temp minimize odors |
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Dysphagia nutrition plan
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modify food consistency
avoid highly seasoned, spiced, or acidic foods adjust food temp to tolerance |
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Stomatitis/Mucositis nutriton plan
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avoid salty, acidic, spicy foods
avoid acidic/alcohol mouthwash good oral hygeine |
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Cancer nutrition plan
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low residue foods during acute phase
^ fluid consumption ^ K+ intake avoid gas-forming foods & carbonated beverages adjust lactose intake to level of tolerance |
