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66 Cards in this Set
- Front
- Back
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What are the characteristics of cancer cells?
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Larger than normal cells
Bigger Nucleus Little resemblance to normal cells Varying size and shape (not uniform) Grow rapidly Respect no rules for growth or division No purpose or function Exist only as parasites Require nutrition May be liquid or solid |
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What are the difference in grading of cancer cells?
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Grade 1: cells resemble normal cells (best prognosis)
Grade 4: cells look nothing like the host tissue (malignancy) |
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What is Carcinoma?
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cancers which arise from epithelial tissues (skin, mucous membranes, glands)
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What is Sarcoma?
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Cancers which arise from blood vessels, lymph nodes, nerves, connective tissues, muscle or bone
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How do you stage cancer?
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T: characteristics and the size of the Tumor
N: involvement of lymph Nodes M: metastasis (spread to the distant organs) |
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What are the cancer diagnostic tests?
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Imaging (X-ray, CT scan, MRI)
Biopsy (closed with needle) Blood Tests (CA-125 ovarian, PSA) Physical Exam PET scans |
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What are the objectives of cancer treatment?
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Cure
Control Palliation Adjuvant therapy (combining therapy - yoga, herbs, chemo) |
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What are the types of surgical treatment of cancer?
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Biopsy
Tumor and Lymph node removal De-bulking Hormone Ablation Surgical Palliation Staging Laparotomy Reconstruction |
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How is hormone ablation helpful in breast cancer?
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Younger females with breast cancer have a more difficult illness because they have more estrogen to feed it - hormone ablation helps that
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How does external radiation work?
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its a condensed beam of radiation that is pointed towards the tumor, but doesn't make the pt radio active
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How does radiation work?
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it stops cell division and breaks bonds
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What is the nursing care for patients receiving internal radiation?
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Limit time in the room
Maintain distance from pt Shield yourself from radiation Wear dosimeter never handle implant Handle secretions/excretions with gloves dispose of dishes and silverware Give lots of eye contact and conversations from doorway administer laxatives before treatment begins observe the skin for breakdown provide divisional activities |
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What are precautions for family members when they visit?
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Stay 30mins and 6 ft away
Must not be pregnant Must have paper shoe covers, gowns and gloves Encourage family members to make frequent telephone calls |
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How does chemotherapy work?
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combination of drugs promotes cell death by disrupting the cell life cycle so they can't reproduce
targets fast growing cells |
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What are some fast growing cells?
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Hair
GI WBC chemo attacks these because they have more cycles to attack |
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What are some nursing implications for administering chemotherapy?
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Must be certified
Protective gloves and aprons must be worn (even 48hrs after chemo has stopped) Special disposal of tubing, bags, etc Special procedure for cleaning spills |
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Why are chemo pts more susceptible to infection?
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because WBC grow fast and are destroyed
Occurs at the nadir (7-10 days after initiation) Absolute Granulocyte Count Decreases (<1000 BAD) |
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What are the neutropenic precautions?
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Handwashing **
No crowds or small children Avoid sunburn (heals slowly) No dental work or invasive procedure No tampons, foleys, or rectal temperatures Take T frequently (>100.4 bad) No plants, standing water, or fresh or uncooked foods Wear mask ambulating in halls Neupogen injections to stimulate WBC growths (WBC <500) ? Cantelope? |
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What can you do if a cancer patient has a fever?
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Sponge bath
Ice packs cooling blanket Tylenol No ASA or ibprofen |
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What are the Thrombocytopenia precautions?
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<50,000 platelets
Use soft toothbrushes No IM injections Give stool softeners or laxitives Apply pressure for 5 mins to injury Hemoccult test Progesterone used to stop periods Give platelet transfusions (<20,000) Assess for petechiae, bleeding from nose, urine, or in mouth Administer Neumega (promotes RBC growth) |
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What are some education points for pts with anemia getting chemo?
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Plan rest periods
Avoid sudden position changes Increase iron intake Transfuse when pt is symptomatic <11 Report CP, dyspnea, SOB, dizziness, inc HR |
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What are some GI S/E of chemo and radiation?
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Anorexia (give nutrient rich food)
Stomatitis (magic mouth wash) N/V (avoid smelly foods) Diarrhea (fluid, BRAT diet, full bladder during radiation) Constipation (esp with Vinca-Alkaloid Rx) |
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How do you treat stomatitis?
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Magic Mouth wash - avoid citrus foods
Niastatin, Karafate, Lidocane sometimes yeast will grow from Tx |
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How do you treat N/V?
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prevention
Give Zofran, Decadron, and Benadryl |
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What are other S/E of Chemo and Radiation?
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Alopecia
Renal Dysfx (hydrate to prevent) Fatigue, depression, hopelessness Gout (Rx alpurinol) Don't use steroids - delays healing |
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To prevent renal dysfunction in chemo and radiation, when would you hold chemo?
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if BUN and Cr are increased or WBC are decreased
use lasix and mannitol to tx |
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What happens if the cancer is in the brain, and the pt needs chemo?
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because it can't cross the BBB, you can put it in the spinal fluid
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What are the Oncologic Emergencies?
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Superior Vena Cava Syndrome
Spinal cord compression Hypercalcemia Pericardial Effusion Extravasation |
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What are the S/S and Tx for Superior Vena Cava Syndrome?
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S/S: tumor causing Venous blood backing up - SOB, facial edema, JVD
Tx: notify the Dr., elevate HOB, O2 |
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What are the S/S and Tx for Spinal Cord Compression?
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S/S: sudden loss of bowels and bladder control, can't feel legs
Tx: pain management, avoid valsalva, surgery |
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What are the S/S and Tx for Hypercalcemia?
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S/S: >12 Ca, ECG changes, N/V
Tx: Hydration and lasix |
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What is important to know about prostate cancer?
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Risk factors: none except age
S/S: difficulty urinating Diagnostic Tests: PSA Treatment: surgery, radiation and chemo Nursing: edu about catheters |
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What is important to know about Laryngeal cancer?
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Risks: Tobacco and ETOH
S/S: hoarseness w/o bad cold Diagnosis: laryngoscope, Xray, biopsy Treatment: internal or external radiation and/or surgery to remove larynx Nursing: airway management, trach education (pt sit up, more sputum, expect bloody drainage, can't speak) |
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What is lymphoma?
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a group of malignant diseases having thier origin in the lymphatic system and can spread to the other lymphatic tissue
Hodgkins and non Hodgkins |
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What age frequently gets Hodgkins and Non Hodgkins?
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Hodgkins: 15-35 and over 50
Non-Hodgkins: children age 5 or >35 |
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What is thought to be the cause of Hodgkin's Lymphoma?
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immunodeficiencies or viral agents
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What are the S/S of Hodgkin's Lymphoma?
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Begins in lymph close to large vessels occurring OVER NIGHT
Painless lump swelling first sign Night Sweats, itching, and low grade fever Lymphocyte function makes pt susceptible to infection Lumps might compress internal organs |
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What are the S/S of Non-Hodgkins Lymphoma?
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Abnormal malignant lymphocytes proliferate in the lymph nodes and spread (HIV susceptible)
Lymph is LARGE throughout the body |
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How is Hodgkin's Treated?
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Stage 1&2: high dose radiation (above diaphragm)
Stage 3&4: Chemo and radiation (below diaphragm) good prognosis 90% survival |
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How is Hodgkins diagnosed?
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Presence of Reed-Sternberg Cells
Staged according to the spread of the disease (1 is single location) |
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What is Multiple Myeloma?
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Cancer of the bone marrow where abnormal plasma cells proliferate
these cells destroy bone marrow dec RBC WBC and platelets |
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What are the S/S of Multiple Myeloma?
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Bone pain from pressure
Because Ca is pushed out of the cells - fractures Hypercalcemia (Tx with hydration) Kidney Failure |
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What is the treatment for Multiple Myeloma?
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No Cure, but can be controlled
Bone Marrow transplant |
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What is a risk factor for Pancreatic cancer?
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smoking
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What are the S/S of Pancreatic Cancer?
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Abdominal Pain
Weight Loss Jaundice DM if tumor is removed from the head of pancreas |
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What is a treatment option for Pancreatic Cancer?
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Whipple Procedure
removal of the head of the pancreas, gallbladder, distal stomach, and duodenum the remaining pancreas and stomach are attached to the jejunum allowing bile to flow and relieve jaundice |
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Why is the Whipple Procedure risky?
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because the suture lines may erode from the pancreatic enzymes
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What information is important about Bladder Cancer?
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Risk: smoking
S/S: painless hematuria, may go through the inside lining of the bladder or cancer may go through the thickness of bladder wall Tx: partial or total cystectomy |
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What are the risk factors for Colon/Rectal Cancer?
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Smoking
Alcohol Obesity Red Meat Low Bulk and Low fiber diets ASA and exercise can dec risk |
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How does Colon/Rectal Cancer spread?
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seeding through the regional lymph nodes and by vascular invasion via portal vein (lungs and liver)
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What are the S/S of Colon/Rectal Cancer?
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Bloody Stool (Hematochezia)
Black tarry stools (Melena) Mucous in Stool Diarrhea Abdominal Pain Weight Loss |
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How is Colon/Cancer Diagnosed and Treated?
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Colonoscopy and Biopsy
Tx: colon resection, radiation, and chemo might have colostomy after surgery |
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What is the treatment for Testicular Cancer?
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Radical Orchiectomy
Chemo and radiation might be done if theres metastasis |
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What are the risk factors for Breast Cancer?
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Family Hx
>30 when having first child Nulliparus >50 but 80% don't have any risk factors |
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How do you detect breast cancer and testicular cancer?
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self examination
mammograms recommended yearly |
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What are the S/S of breast cancer?
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Slow forming tumors
Non-tender Movable Usually in Upper outer quadrant Dimpling (like skin of orange) Asymmetry Nipple retraction Ulceration (late sign) |
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What are the surgical procedures for breast cancer?
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Lumpectomy
Partial Mastectomy Simple Mastectomy (skin and soft tissue remain) Modified Radical Mastectomy (muscles remain) Radical Mastectomy (Everything gone) |
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What is the nursing care after breast cancer surgery?
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Hemovac or Jackson Pratt tubes for drainage
Bulky dressings on surgical site Elevate arm to prevent lymphedema Pain control so pt can cough turn deep breathe |
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What should you educate the pt after breast surgery?
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Wash cuts and scratches promptly
Electric razor only when shaving underarms Do not carry purse on affected side No BP or needle stick on affected arm Wear gloves when gardening Reach for Recovery program Emotional support ROM after 3 days |
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What is leukemia?
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diseases of the blood forming systems, characterized by abnormal proliferation and maturation of certain leukocytes (in bone marrow, spleen, liver, lymph nodes)
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What are the levels of WBC in leukemia?
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Inc WBC but very immature and can't function
the large number of WBC squeeze out and destroy platelet and RBC making the pt anemic, hemorrhage, and susceptible to infection |
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What are the S/S of leukemia?
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Bleeding (nose bleeds common in children)
Bruising Anemia Fatigue Infection Fever (no ASA) Bone Pain fatal within 3 months if aggressive chemo isn't started |
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What is the treatment like for Leukemia?
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Chemo, radiation, and sometimes bone marrow transplant
Introduction Chemo - high dose of chemo intended to kill most of the leukemic cells (hospitilized 4-6weeks) Consolidation Chemo - given 6-8 months after to assure success (out pt) Neutropenic precaution |
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What is important to remember about families with cancer?
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family members all grieve in different ways on different schedules
it is common for the pt to accept diagnosis before family Hope is the most powerful emotion |
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What is hospice?
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at home or in pt care for pts with terminal illnesses (expected life span <6months)
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What are the goals of hospice?
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comfort of the pt
helping family be with the dying one care for the family after pt death Physical, emotional, and spiritual support are given through a combination of professional and volunteer services |
