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75 Cards in this Set
- Front
- Back
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What age group and sex is most effected by cancer?
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> 65 years old and Men
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What is the most common cancer among both men and women?
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Lung
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Cancer is the ____ leading cause of death in the United States.
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2nd
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How are cancer cells described?
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As malignant neoplasms
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What is the definition of metastasis?
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Ca cells infiltrate lymph and blood vessels which carry the mutant cells to other parts of the body
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What are the 3 ways cancers spreads?
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1. Metastasis: lymph and blood
2. Invasion 3. Seed |
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What are the 4 general etiologies of cancer?
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1. Environmental
2. Genetical/Familial 3. Hormonal Agents 4. Age |
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What are the possible environmental agents that can lead to cancer?
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1. Biological: viruses and bacteria
2. Physical agents: sunshine, xray, radon 3. Chemical agents: tobaccos, pesticides, arsenic, tar asbestos 4. Dietary: fats, alcohol, nitrates, high calorie diet |
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What % of all cancers are linked to cigarette smoke/tobacco?
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30%
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What foods are thought to be protective against cancer?
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-High fiber
-green veggies -fruit |
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What are the 8 steps for cancer prevention?
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1. Eat More Fresh Vegetables
2. Increase Fiber intake 3. Reduce intake of fat 4. Stop smoking 5. Moderate alcohol 6. Avoid sun 7. Be active 8. Weight control |
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What addition to a man's diet has been found to reduce the risk of prostate cancer by 50%?
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Omega 3 fatty acids
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Folic acid can reduce the risk of what cancer by 25% if incorporated into the diet?
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Colorectal cancer
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If a patient has an extensive family history of cancer, how much earlier will screening begin?
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10years earlier
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What are the generalized cancer symptoms?
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1. Unexplained weight loss: usually of 10lbs or > without dieting
2. Unexplained fever 3. Fatigue 4. Pain 5. Skin clues |
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According to the American Cancer Society, what are 7 common symptoms of cancer?
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1. Change in bowel or bladder function
2. Sores that do not heal 3. Unusual bleeding or discharge 4. Thickening or a lump 5. Indigestion or difficulty swallowing 6. Recent change in a wart or mole 7. A nagging cough or hoarseness |
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What is a tumor marker test?
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Test for cancer that involves blood work. It is suggestive and not definitive
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What are some examples of Tumor markers?
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-PSA
-Ca 125, Ca 15-3, Ca 19-9 -AFP |
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What are the common Xrays used to Test for Cancer?
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-Standard Xrays
-MRIs -Computed tomography (CT) |
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Which test for cancer involved radioactive isotope injection which will concentrate in tissue and show up as an image on the screen?
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Nuclear Medicine Imaging
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What does a PET scan show?
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Biological activity
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What is cytology?
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Taking samples of shedding cells ie pap smear
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What is the most reliable form of test to diagnose cancer?
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Biopsy
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How is staging classified?
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T: primary tumor
N: lymph node involvement M: metastasis is present |
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What is grading?
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a classification that predict the prognosis.
1-4 4: aggressive and less responsive to Tx |
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What is treatment option #1 for cancer
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Surgery
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When you use surgery as the primary tx for cancer, what are the surgeons looking to TAKE?
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a wider/bigger piece of the area around the tumor. Want clean edges! Means that the the whole tumor is excised.
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What are the surgical options for cancer?
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1. Surgery as primary treatment
2. Prophylactic surgery 3. Palliative surgery 4. Reconstructive surgery |
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What are the local rxns that can occur with radiation?
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1. altered skin integritiy
2. can develop stomatitis of the epithelial lining of the GI Tract (dry mouth, N/V/D anorexia) 3. Bone Marrow suppression |
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What is the term with RBCs, WBCs and platelets all decrease?
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Pancytopenia
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What in intraop radiation?
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Bring radiation of the tumor while open in surgery.
Use less, have a precise target, less exposure to overlying skin and tissue. |
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What are the nursing interventions associated with External radiation?
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1. Assess skin & oral mucosa
2. Gentle oral hygiene 3. Good skin care 4. No ointments, lotions, powders and avoid sunlight 5. Give antiemetics for abd radiation 6. expect dry mouth for upper body radiation 7. Assist w/ADLs |
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What should be done to prevent dislodgment of an internal radiation device.
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-Complete bed rest
-log roll the pt -foley catheter -low residue diet and antidiarrheal meds |
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What is the number one rule if an internal radiation device falls out?
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Do not touch it!
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What is the rule for visitors of a pt with an internal radiation device?
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They can only visit for < 30 mins at a distance of 6 feet
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What must the nursing staff where when treating a pt with an internal radiation device?
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Dosometer and a shield
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What is the name for internal radiation?
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Brachytherapy
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How long is an internal radiation device left in?
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24-72 hours
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What are the nursing interventions for internal radiation?
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1. Private room
2. Post notice of radiation 3. Staff wear dosimeter badges, minimize time at bedside 4. Do not touch it if it falls out 5. instruct pt to call if it dislodges 6. No pregnant staff caring for pt 7. No children or preg visitors 8. Visiting < 30 mins at 6 feet |
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What are the types of chemotherapy?
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1. Cell cycle specific drugs
2. phase specific drugs 3. or classified by various chemical groups |
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What is the down side to chemotherapy?
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There is a direct effect to normal cells as well as tumor cells
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What are the common side effects of chemotherapy?
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1. Alopecia
2. stomatitis 3. bone marrow suppression |
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What is chemobrain?
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A side effect of chemotherapy that feels like a fog. head is not clear
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What are examples of dose limiting factors of chemotherapy?
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1. Hepatotoxicity, pnemonitis
2. Hemorrhagic cystitis 3. tubular necrosis (from cell destruction --> purines are released --> uric acid --> renal problems) 4. cardiotoxicity (think CHF pts) pericarditis |
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What are the cumulative effects of chemotherapy?
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Neurotoxicity: numbness and tingling
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What are the rules for administering chemotherapy?
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1. Pregnant nurses should NOT handle it
2. usually double glove 3. wear a plastic lined gown 4. Do Not eat or drink while administration 5. Call environmental services for any spills 6. Dispose of all items used for chemo as per facility |
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What must occur with extravastions of chemotherapy drugs?
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1. Stop the drug immediately
2. Apply ice to the site 3. Physician may aspirate at the site & inject a neutralizing agent. |
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What is an allogenic Tx for cancer?
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Transplant from a selected donor. most often bone arrow
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What is engraftment?
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Bone marrow from teh donor is infused by IV into the recipient
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How long does it take for the transplanted bone marrow to produce RBC, WBC and platelets?
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2-4 weeks
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What is GVHD?
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Graft versus host sidease
- the host bone marrow (T cells) can recognize the host cells as foreign and attach the recipient |
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What is the most critical time follow a bone marrow transplant?
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the first 100 days
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How do you help prevent GVHD?
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immunosuppresants of both donor and recipients cells
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What is an autologous BM transplant?
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Pt's own marrow is harversted, preserved and tx with chemo
- after marrow has been harvetsted pt is tx with chemo and possiblly total body radiation -own marrow then re-infused and must undergo engratment |
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What is the term of BM transplant from identical twins?
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Syngeneic
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What is stem cell transplantation?
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-hematopoietic stem cells are essentially bone marrow
-pt receives chemo and hematopoietic growth factors -the stem cells are collected -pt undergoes the ablative tx with chemo, TBI and stem cells reinfused -engraftment occurs FASTER with this type |
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What is the major nursing care for BM transplant?
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Reverse isolation
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When should a gown be removed following tx of a BMT pt?
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AFTER leaving the room
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What is the leading cause of death for cancer pts?
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Infection
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What neturophil level is an indicator for high risk for infection?
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Less than 1000
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What medication is given to BMT pt to increase neutrophil counts?
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Neutasta
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What are the most common sites of infection for cancer pts?
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-pulmonary
-UTIs -incision sites |
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What drug is given to increase RBC in cancer pts?
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Epogen, may also be for renal failure
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What must the cancer nurse watch for in terms of platelet count?
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Possible bleeding
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What is a major complication of bleeding for cancer pts?
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hypovolemic shock
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What nursing interventions should be incorporated to ensure skin integrity in cancer pts?
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1. handle gently
2. loose clothing 3. moisture and vapor-permeable dressings (hydrocolloids promote healing) 4. topical antibiotics |
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What interventions should be done to prevent stomatitis?
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1. good oral hygeine
2. avoid food too hot, cold or spicy 3. lubricate lips 4. Rinse of pediatric benadryl elixir, Maalox and viscous lidocain in a 1:1:1 solution. S&S 1 hour a.c 4. No flossing |
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What is the marking of cancer?
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alopeica
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When does hair loss usually start for cancer pts?
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about 2-3 weeks after Tx
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When does hair usually begin to grow back for cancer pts?
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6-8 weeks after Tx
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What nursing interventions can be done to help with the nutritional concerns of cancer pts?
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1. food they like
2. bland, nonirritating foods 3. oral hygiene and pain relief 4. antiemetics, antidiarrheal meds 5. vitamin supplements 6. right administration of chemo 7. may need TPN |
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What % of cancer pts have pain?
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about 60%
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What is unique about morphine?
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It has no ceiling/ upper limit. as the body develops tolerance they will need more.
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What are the nursing interventions for fatigue associated with cancer?
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1. ID sources of fatigue
2. Rest 3. regular, light exercise 4. favorite activities 5. help pt reallocate the responsbilities 6. reduce # of hours of work 7. nutrition 8. administer blood products as ordered |
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How long does hospice give bereavement counseling for family after the death of a loved one?
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1 year
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