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37 Cards in this Set

  • Front
  • Back
Regional Invasion regarding cancer
Invasion of surrounding tissues and organs
Define Metastasis and describe three kinds
spread to distant body parts

– Vascular spread - via blood stream
– Lymphatic spread - via lymph system
– Implantation - spread to a body cavity
Define TNM classification
T - anatomic size of the primary tumor
N - the extent of lymph node involvement
M - the presence or absence of metastasis
Factors that contribute to the development of cancer(further descriptions on pg 513)
1. Age
2. Genetic heritage
3. Hormonal factors
4. Immunologic factors
5. Drugs and chemicals
6. Radiation
Cancer Related Health Risk Practices
-#1 preventable cancer

-Proper amount fiber = less cancer risk

Alcohol intake
-At risk for oral cancer (mouth, esophageal)

Sexual practices
-Sex at early age is a risk for cervical cancers

Other factors
–Viruses (Human Papilloma Virus) HPV
–Psychosocial factors
Diagnostic Tests for Cancer
–Cytology studies

CBC (Complete blood count)
- Tells whether or not if there is bone marrow suppression, not a real diagnostic tool for cancer

- Prostate Specific Antigen
- For men

- CEA (Carcinogenic Embryonic Antigens)

- Both are not definitive tests for cancers, but they can indicate if previous cancers are coming back
Seven Warning Signs of Cancer
Change in Bowel/bladder habits

A sore that does not heal

Unusual bleeding or discharge

Thickening or lump in the breast or elsewhere

Indigestion or difficulty swallowing

Obvious change in a wart or mole

Nagging cough or hoarseness
Goals for Cancer
- Cure
- Control
- Pain Control (Palliative)
What is are the negative effects of Radiation Therapy?
Radiation Therapy does not differentiate between cancerous cells, such as hair cells, gastrointestinal cells, epithelial cells, and reproductive cells
What general precautions should be taken when treating a cancer patient under radiation therapy
- Give them a private room
- Wear a film badge
- Have a sign on the door
- Encourage self care
- Limit visitors- No pregos!
- Precautions if implant is dislodged
What access device is convinient for chemotherapy if peripheral access devices are not available
Vascular Acess Devices
Nursing actions for IV chemotherapy infiltration
Before IV infiltration occurs, a nurse should always check IV and assess its patency.
But if infiltration does occur:

2. Apply Ice
3. Administer Antidote
Name three side effects of chemotherapy
1. Neutropenia
2. Anemia
3. Thrombocytopenia
- Decrease in white blood cell count

- Normal white blood cell count is 5,000-10,000
- Decrease in red blood cell count

- Normal red blood cell count is 4.0-6.0
- Decrease in platelet count

- Normal platelet count is 150,000-300,000
What three ways can health car workers consider to protect themselves from a pt receiving radiation?
time- limit time spent with pt
distance- increase distance from radiation
shielding- use lead barriers
What things would you want to teach your client regarding skin care while receiving radiation?
- aviod sun, trauma to skin, adhesive tape
- use caution w/ soaps
- no bath salts, perfumes, ointments or lotions
- no heat lamps, heating pads, ice packs
- wear soft, cotton light weight clothing
- may have medicated ointment prescribed
What is the Nadir effect?
Cells have different life spans- this causes lab values to reach lowest point at different times.
-WBC lowest at 7-10 days after treatment
- RBC lowest 7-10 days after
- Platelets- 10 days after
What nursing care would you think about when caring for an immunosuppressed pt?
good handwashing, prevent exposure to people w/ known infections, aseptic technique, observe for infection,reverse isolation is possible, neutropenic precautions ( no fresh fruit/flowers)
Your client has anemia. What s/s would you expect to see?
fatigue, hypoxia, hypotension, tachycardia, anxiety
What nursing care would you want to provide for a client with anemia?
-plan rest periods
-assist pt w/ activities
-admin Oxygen
-admin blood transfusions
-promote good hygiene
what signs and symptoms would you expect to see in a pt with thrombocytopenia?
signs are related to bleeding.
- petechiae, bruising, bleeding gums, hematuria
signs of bleeding in the brain- H/A, change in LOC, restlessness
Nursing care for clients w/ thrombocytopenia
-admin platelet transfusion
-use soft toothbrush, avoid razors, stools softeners, no aspirin
Your client has stomatitis r/t chemo, what is some nursing care you will implement?
-frequently assess oral cavity
-mouth care w/ baking soda, magic mouthwash (don't you dare give them listerine!), nystatin swish and swallow, viscous lidocaine, soft toothbursh, NO FLOSS!, lip lubricant, avoid hot & spicy food, good fluid intake
A client is experiencing anorexia r/t chemo, WHY?
-effect of chemo on hunger center
- N/V
How can you help your client get adequate nutrition during chemo?
-May need enteral feedings or TPN
-small, frequent, high caloric feedings
-minimize food odors
-ask pt "what do you like?"
-antiemetics liberally- 30-60 min before eating
Tell me about alopecia r/t chemo
-visible sign of dz
-hair falls out in clumps/breaks off
-have wig made before hair falls out
- don't brush or wash hair too often
-no color,dye, or perms at this time please
What drugs are toxic to the kidneys?
cytoxan or methotrexate

- monitor BUN/creatinine
- increase oral intake to maintain hydration
-observe for signs of bleeding bladder (hemorrhagic cystitis)- dysuria, hematuria
What drug causes pulmonary toxicity?

-observe for pneumonia, CHF, SOB, coughing
What drug causes cardiovascular toxicity?

-observe for signs of CHF
-obtain EKG
What drug causes birth defects?

-sperm banking, birth control
how long should you be looking for signs of toxicity after the pt has finished taking adriamycin or bleomycin?
Effects continue for 6 months
Why does my patient have constipation??
decreased fluids!
lack of activity!
What do I do about my patient's constipation??
-increase roughage in diet
-adequate fluids
-laxatives,stool softeners
Superior Vena Cava Syndrome,

What is that?
venous congestion caused by obstructed venous drainage in upper thorax by a tumor

signs: SOB, H/A, visual disturbances, facial edema
What is the most lethal and common side effect of chemo?
BONE MARROW SUPPRESSION (oh it's not good)