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45 Cards in this Set

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