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48 Cards in this Set
- Front
- Back
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what are the 3 goals of cancer therapy?
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1) Curative - desired outcome for all
2) Control- extension of life & quality of life 3) Palliative- comfort measures; reduce side effects and control pain |
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Name the 5 types of cancer therapy?
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1) Surgical
2) Radiation therapy- ionizing radiation 3) Chemotherapy 4) Biotherapy- modifying pt's immune response to cancer 5) Complimentary & Alternative Medicine (CAM) |
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- the initial and preferred treatment of cancer is _____
- When surgical treatment fails, what is the cause? |
- Surgical
- due to microscopic metastasis; cancer wasn't caught in time |
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adjuvant treatment means?
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additional treatment
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Surgical therapy can ___, ___, & ___ the cancer
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diagnose, stage, treat
staging means to determine the extent of a tumor |
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-ectomy means
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surgical removal of something
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-ostomy means
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to form a new opening
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Describe the 4 types of excisions for curative surgery for breast cancer?
1) Local excision 2) Wide local excision 3) Wide excision 4) Extended radical excision |
1) ex: lumpectomy
2) remove surrounding tissue also 3) remove tumor, surrounding tissue and lymph nodes 4) same as 3 but more |
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- Excise means
- Resect means - Section means |
- to remove completely
- to remove tissue from the body by surgery - act of cutting tissue |
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orchidectomy?
Hypophysectomy? |
removal or 1 or both testicles
pituitary gland removal |
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For cancer surgery, what is
- preop care? - post op care? |
- pt education, reduce anxiety
- reduce pain, prevent complications (incentive spirometer, prevent DVTs via compression boots and heparin therapy); psychological support |
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- NSAIDS cause GI upset, so always take with meals
T or F |
T
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How to prevent surgical site infection?
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- wash hands
- aseptic technique - best way: prophylactic Antibiotics; give within 1 hr before cut-time & preferably by anesthesiologist |
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Name 3 Nursing Diagnoses for pts after cancer surgery?
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- Acute pain r/t procedure
- body image disturbance - ex: if breast was removed - risk for impaired gas xchange- from lying in bed being immobile - need incentive spirometer |
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Hold Lovenox or heparin (anticoagulant) 2 hrs before and 2 hrs after epidural since it can cause hematoma and compress lumbar nerves causing paralysis.
T of F |
T
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Decrease Lovenox dose if creatinine is >2.0 since it causes thrombocytopenia
T or F |
T
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Don't take BP, draw blood, or put in IVs in arm on side where radical mastectomy was done (ie, where lymph nodes are removed)
T or F |
T
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- Can't have radiation & chemo at same time T or F
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T
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Describe the 3 types of radiation therapy?
1) Teletherapy 2) Brachy therapy 3) Cyberknife Rx |
1) external source of radiation (beam therapy); pt not radioactive, always place pt in same position so radiation beam can be aimed at marking on body called "tattoo."
2) radiation source inside pt; pt is radioactive; excretum (feces & urine) are radioactive if unsealed and not radioactive if sealed 3) new technology; treats hard to reach tumors; prevents as much damage to surrounding tissue; same dose, many angles |
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Not all cancers are sensitive to radiation therapy. The cancers that are least sensitive to radiation are ___ & _____
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pancreatic cancer and renal cancer
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Use sealed radiation (with brachy therapy) for ____ cancer
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prostate tumor
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Use unsealed isotope to treat ___ cancer
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thyroid cancer
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Should wear thyroid lead shield as well as pelvic shield anytime radiation or flouroscopy is done
T or F |
T
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Care of pt with radioactive implants:
- Private room & bath - Nurse wears Dosimeter badge at all times to measure radiation exposure. Badge should be read & exchanged monthly - pregnant nurses should not care for this pt - limit visitors to under 1/2 hr visit and stay at least 6 feet away from pt - never touch radioactive material with bare hands. use long forceps to put in lead container. |
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Side effects of radiation therapy:
- Varies - Skin and hair loss - Altered taste sensation caused by metabolites released by dead & dying cells Fatigue due to incr energy demands to repair damaged cells - tissue fibrosis & scarring - Esophagitis/hemorrhagic cystitis if chest radiation |
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what tissue types are strongly affected by chemo?
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skin, GI tract, gonads since they contain fast-dividing cells
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chemotherapy is classified 2 ways based on:
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Cell cycle:
- cell cycle specific - cell cycle non-specific Mechanism of action - alkylating agents - non-specific - interfere w DNA synthesis & replication - Antimetabolites- cell cycle specific - fool cancer cells by acting as metabolites - Antitumor antibiotics - cell cycle non-specific interferes w synthesis of RNA & DNA - Antimitotic- cell cycle specific acts on mitotic phase - Hormonal agents - used w breast cancer |
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What are the 5 routes of administration of chemotherapy?
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Oral- given for Hodgekins, lung cancer
IV - given for solid tumors, lymphomas Intra-arterial- given for liver cancer Intra-cavitary - given for bladder cancer Intra-thecal - spinal - given for brain tumors, leukemia |
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Chemotherapy dosage is based on ____
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TBSA - Total Body Surface Area- you need height & weight
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Must wear special ___ gloves when handling chemotherapy meds
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Chemo
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Some chemo meds are vesicants which are very irritating and can cause tissue necrosis if extravasated when given IV. What is first nursing action?
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stop IV immediately before anything else.
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Need to be chemo-certified to give chemo meds
- should not have live plants in chemo room due to bacteria T or F |
T
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Cyclophosphamide?
1) aka ____ 2) class? 3) cell cycle specific? 4) side effects 5) mode of action? |
1) Cytoxan
2) Alkylating agent 3) no 4) hemorrhagic cystitis (use Mesnox when giving Cytoxan to prevent); very toxic 5) interferes with DNA synthesis & replication; prevents dble helix of DNA from separating by tightly binding it |
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Methotrexate?
1) class? 2) cell cycle specific? 3) side effects 4) mode of action? |
1) Antimetabolite
2) yes 3) bone marrow suppressor; can cause macrocytic anemia 4) acts as counterfeit metabolite and fools cancer cell; alters cellular function & causes death |
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Vincristine?
1) aka ____ 2) class? 3) cell cycle specific? 4) side effects 5) mode of action? |
1) Oncovin
2) Antimitotic 3) yes; prevents mitosis 4) Peripheral neuritis, parathesia, ptosis (droopy eyelids) 5) prevents mitosis |
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Adriamycin?
1) aka ____ 2) class? 3) cell cycle specific? 4) side effects 5) mode of action? |
1) Doxorubicin
2) Anti-tumor antibiotics 3) no, non specific 4) cardiac toxicity, allergic reaction so monitor 1st dose; photosensitivity; alopecia, pulmonary fibrosis 5) interferes w synthesis of RNA & DNA |
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Tamoxifen?
1) class? 2) side effects 3) Used for? |
1) Hormonal agent
2) bone pain, hypocalcemia 3) used after pt has breast cancer |
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Lupron?
1) class? 2) side effects 3) Used for? 4) cell cycle specific |
1) Hormonal agent
2) decreases libido, impotence 3) given for prostate cancer as it blocks testosterone; slows growth of hormone dependent tumors 4) no |
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SERM ?
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Selective Estrogen Receptor Modifier; effects some estrogen receptors, but not others
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Common side effects of chemotherapy?
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- Bone marrow suppression- need good handwashing; need to monitor ANC (absolute neutrophil count, ie WBCs)-- if less than 1500, prone for infection
- Alopecia- hair loss which almost always grows back - Mucositis - sores in mouth - N &V |
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Zofran aka onansetron?
- Used for? |
prevents N&V; give 1/2 hr before chemo.
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Pamindronate aka Aredia?
used for |
- prevents bone loss
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Amifostine aka ethyol?
used for |
prevents mouth sores
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ANC is a measure of a pt's ____
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immune status; below 500 and person is at high risk for infection and should be isolated
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BRMs?
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Biological Response Modifiers
- made of cytokines which are small protein hormones made by WBCs - cytokines & BRMs stimulate the immune system to rrecognize cancer cells and destroy them - side effects: fever (need to monitor temps), chills & flu-like symptoms; administer Demerol to prevent flu-like symptoms and also increase fluid intake. |
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Name the 4 types of BRMs?
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1) Cytokines
2) Monoclonal antibodies - new research - these are very specific - attach to cancer cell and disables it; also fight rejection and are used w transplants 3) Immune modulators - gene therapy & vaccines 4) Endostatins - angiogenesis inhibitors, ie prevent tumors from establishing blood supply by blocking formation of new blood vessels |
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Name the 4 different kinds of cytokines?
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1) Interferons - protect against viral infection; slows down tumor cell division; stimulates natural killer cells;
- side effects: flu-like symptoms and peripheral neuropathy 2) Interleukins - help immune cells recognize cancer cells so they can be destroyed - side effects: N&V, abnormal liver function, arrythmias 3) Colony Stimulating Factor: example is Procrit - used when pt has low RBCs; it builds them up; abused by athletes & banned in sports 4) Tumor necrosis factor? |
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Purpose of colony stimulating factors?
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type of BRM used for support therapy during cancer treatment
- induce more rapid recovery of bone marrow after suppression by chemotherapy - this reduces risk for infection and anemia |
