_________ is defined as a group of diseases characterized by abnormal growth and spread of cells.
Cancer
At least what percentage of cancer cases are caused by environmental factors, including lifestyle choices, which makes health counseling an important nursing role.
66%
What are the three goals of cancer treatment?
cure the cancer
control it's spread and manage it as a chronic illness (chronic meaning multi symptoms)
easy symptoms and maximize quality of life
There are a wide variety of diagnostic tests for cancer, name a few.
laboratory tests (tumor marker tests; such as - CEA & PSA; blood; urine; and other body fluids); no one value or lab test is specific for cancer they can only indicate the presence of cancer; Radiographic tests (X-ray, ultrasound, CT, MRI w/ or w/out contrast, bone scans, nuclear medicine imaging, and PET scans); Biopsies - removal of sample of tissue (determines if the mass is a tumor or a cyst, adhesion, or other structure such as calcification); and bone marrow aspiration (preformed to obtain a small amount of bone marrow for microscopic examination).
What are the different types of biopsies?
Needle (needle aspiration, stereotactic needle aspiration, and core needle procedure), surgical (preformed to procure a larger piece of tumor tissue), and bone marrow aspiration
What are the three most common treatments for cancer?
Surgery, Radiation, and Pharmacotherapy (chemotherapy)
What other therapies should the nurse be aware of in regards to cancer treatment?
hormone therapy (goal is to prevent hormones to from stimulating the growth of cancer cells); biological therapy (using substances naturally produced by the immune system to fight cancer either directly or indirectly or to lessen the side effects that may be caused by some cancer treatments); bone marrow transplantation or peripheral blood stem cell transplantation (these are procedures to restore cells necessary to produce blood cells); and complementary and alternative therapies.
________ _______ _______ is a side effect common to many cancer treatments, making risk of infection a major concern.
Immune system suppression
_________ has emerged as the most distressing and persistent treatment side effect, surpassing nausea and vomiting, which are also major nursing issues.
Fatigue
What are the three main types of myelosuppression a patient is at risk for, resulting from bone marrow suppression.
anemia, neutropenia, and thrombocytopenia
_______ _______ is a loss of the ability to remember certain things, learn new skills, and complete certain tasks.
Cognitive impairment
Throughout the diagnosis and treatment of cancer, the nurse should consider both the ________ and the _______ when offering coping strategies.
patient; caregiver
Research indicates that over ______ % of patients with cancer do not get adequate relief from pain even though therapy exist to relieve almost all cancer pain.
40
While cancer is now managed as a ______ _______, there are multiple oncological emergencies.
chronic illness
Because of the many side effects impacting the nutrition and the effect of poor nutrition on healing outlook, and comfort, the nurse should aggressively monitor what 2 things?
0. Nutritional status & 2. Regular, even daily weights.
A client was recently diagnosed with ductal cell carcinoma of the breast. The oncologist described the cancer as T2, N1, Mx. The client asked the nurse to repeat what "all those letters ad numbers mean." The nurse would reply that T2, N1, Mx means
C) 1 tumor present which is larger than 2.5cm, nodal involvement in one region, and metastasis was unable to be determined
A family member called the clinic to talk with the nurse regarding her sister's diagnosis of breast, bone, and lung cancers. She tells the nurse that she is extremely concerned because she was aware "ran in her family," but she could not recall that any family member had been diagnosed with bone or lung cancer. The nurse's best response would be
C) "I am sorry to hear about your sister's recent diagnosis. Most probably your sister has breast cancer that has metastasized or spread to the bone and lungs."
Rationae: Common sites for metastasis related to breast cancer are the lungs and the bone
During the planning of a community-wide cancer program, the nurse shares that focus is on secondary prevention. Related activities, would include:
C) instruction on testicular self-exam
Rationale: Screening is part of secondary prevention due to early detection
In caring for a client during the time of nadir, the nurse must be sure to assess for which of the following?
C) Low absolute neutrophil count
In providing instruction to a client after external beam radiation therapy for skin cancer, the nurse instructs the client to:
B) limit creams or lotions used on irradiated areas to those that have been approved by the oncology HCP
Rationale: Damage to the skin must be avoided and many OTC creams and lotions contain alcohol which can dry
As the nurse is preparing to administer doxorubicin (Adriamycin) to a client in the outpatient cancer clinic, approximately 30mL of the fluid leaks onto the counter. The most appropriate nursing action is:
B) locate the chemotherapy spill kit on the client unit and follow the instructions for clean up
Rationale: All chemotherapeutic agents are considered vesicants, so special care should be taken
In providing nursing care to a client who has a cesium implant in place for the treatment of cervical cancer, the nurse should be aware that:
D) both the staff and visitors must limit time spent in the client's room
A client is started on the colony-stimulating factor Neupogen after 10 days of chemotherapy. Which of the following lab values would be most indicative of the effectiveness of the neumega (Filgrastim)?
C) Absolute neutrophil 1100/mm3
A client is diagnosed with stage III colon cancer. He underwent external beam radiation prior to abdominal surgery. In considering the treatment approach, the nurse is aware that the client is at increased risk for:
C) dehiscence
A female client, age 54, comes to the clinic and shares that her best friend was recently diagnosed with colon cancer. The client wants to know which cancer screening test she should have based on her age and sex. The nurse informs the client that ACS recommendations include the following:
B) Flexible sigmoidoscopy every 3-5 years after age 50; mammogram and clinical breast exam every year after age 40; pap smear every year after age 18; and an annual physical that checks for a variety of other cancers.
