Scc Nursing Med Surg Ii - Adult Cancer

Front 1

Regional Invasion regarding cancer

Back 1

Invasion of surrounding tissues and organs

Front 2

Define Metastasis and describe three kinds

Back 2

spread to distant body parts

– Vascular spread - via blood stream
– Lymphatic spread - via lymph system
– Implantation - spread to a body cavity

Front 3

Define TNM classification

Back 3

T - anatomic size of the primary tumor
N - the extent of lymph node involvement
M - the presence or absence of metastasis

Front 4

Factors that contribute to the development of cancer(further descriptions on pg 513)

Back 4

1. Age
2. Genetic heritage
3. Hormonal factors
4. Immunologic factors
5. Drugs and chemicals
6. Radiation

Front 5

Cancer Related Health Risk Practices

Back 5

Smoking
-#1 preventable cancer

Nutrition
-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

Front 6

Diagnostic Tests for Cancer

Back 6

–Cytology studies

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

– PSA
- 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

Front 7

Seven Warning Signs of Cancer

Back 7

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

Front 8

Goals for Cancer

Back 8

- Cure
- Control
- Pain Control (Palliative)

Front 9

What is are the negative effects of Radiation Therapy?

Back 9

Radiation Therapy does not differentiate between cancerous cells, such as hair cells, gastrointestinal cells, epithelial cells, and reproductive cells

Front 10

What general precautions should be taken when treating a cancer patient under radiation therapy

Back 10

- 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

Front 11

What access device is convinient for chemotherapy if peripheral access devices are not available

Back 11

Vascular Acess Devices

Front 12

Nursing actions for IV chemotherapy infiltration

Back 12

Before IV infiltration occurs, a nurse should always check IV and assess its patency.
But if infiltration does occur:

1. STOP INFUSION FIRST
2. Apply Ice
3. Administer Antidote

Front 13

Name three side effects of chemotherapy

Back 13

1. Neutropenia
2. Anemia
3. Thrombocytopenia

Front 14

Neutropenia

Back 14

- Decrease in white blood cell count

- Normal white blood cell count is 5,000-10,000

Front 15

Anemia

Back 15

- Decrease in red blood cell count

- Normal red blood cell count is 4.0-6.0

Front 16

Thrombocytopenia

Back 16

- Decrease in platelet count

- Normal platelet count is 150,000-300,000

Front 17

What three ways can health car workers consider to protect themselves from a pt receiving radiation?

Back 17

time- limit time spent with pt
distance- increase distance from radiation
shielding- use lead barriers

Front 18

What things would you want to teach your client regarding skin care while receiving radiation?

Back 18

- 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

Front 19

What is the Nadir effect?

Back 19

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

Front 20

What nursing care would you think about when caring for an immunosuppressed pt?

Back 20

good handwashing, prevent exposure to people w/ known infections, aseptic technique, observe for infection,reverse isolation is possible, neutropenic precautions ( no fresh fruit/flowers)

Front 21

Your client has anemia. What s/s would you expect to see?

Back 21

fatigue, hypoxia, hypotension, tachycardia, anxiety

Front 22

What nursing care would you want to provide for a client with anemia?

Back 22

-plan rest periods
-assist pt w/ activities
-admin Oxygen
-admin blood transfusions
-promote good hygiene

Front 23

what signs and symptoms would you expect to see in a pt with thrombocytopenia?

Back 23

signs are related to bleeding.
- petechiae, bruising, bleeding gums, hematuria
signs of bleeding in the brain- H/A, change in LOC, restlessness

Front 24

Nursing care for clients w/ thrombocytopenia

Back 24

-admin platelet transfusion
-use soft toothbrush, avoid razors, stools softeners, no aspirin

Front 25

Your client has stomatitis r/t chemo, what is some nursing care you will implement?

Back 25

-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

Front 26

A client is experiencing anorexia r/t chemo, WHY?

Back 26

-effect of chemo on hunger center
- N/V
-stomatitis

Front 27

How can you help your client get adequate nutrition during chemo?

Back 27

-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

Front 28

Tell me about alopecia r/t chemo

Back 28

-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

Front 29

What drugs are toxic to the kidneys?

Back 29

cytoxan or methotrexate

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

Front 30

What drug causes pulmonary toxicity?

Back 30

BLEOMYCIN

-observe for pneumonia, CHF, SOB, coughing

Front 31

What drug causes cardiovascular toxicity?

Back 31

ADRIAMYCIN!!

-observe for signs of CHF
-obtain EKG

Front 32

What drug causes birth defects?

Back 32

methotrexate

-sperm banking, birth control

Front 33

how long should you be looking for signs of toxicity after the pt has finished taking adriamycin or bleomycin?

Back 33

Effects continue for 6 months

Front 34

Why does my patient have constipation??

Back 34

narcotics!
decreased fluids!
lack of activity!

Front 35

What do I do about my patient's constipation??

Back 35

-increase roughage in diet
-adequate fluids
-laxatives,stool softeners
-enemas
-prevention

Front 36

Superior Vena Cava Syndrome,

What is that?

Back 36

venous congestion caused by obstructed venous drainage in upper thorax by a tumor

signs: SOB, H/A, visual disturbances, facial edema

Front 37

What is the most lethal and common side effect of chemo?

Back 37

BONE MARROW SUPPRESSION (oh it's not good)