Ch.16 Oncology/Cancer

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  1. anaplasia
    dedifferentation: malignant
  2. Dysplasia
    Different size, shape than their other normal cells.
  3. hyperplasia
    growth increase in cells
  4. metaplasia
    mature cells replaced with another type of mature cell.

    mature cell conversion.
  5. neoplasia
    new cell growth w/o the physiologic demand.
  6. Is the exact cause of cancer known?
    • No. Could be:
    • Viruses
    • genes
    • agents
    • diet
    • genetics
  7. What organs are most affected from chemical agents?

    Brain or lungs, liver and kidneys?
    Lungs, liver, kidneys.
  8. C - A – U – T – I – O - N

    assessment in cancer. 
    –Change in bowel or bladder habits

    –A sore that doesn’t heal

    –Unusual bleeding or discharge

    –Thickening or lump in the breast or elsewhere

    –Indigestion or difficulty swallowing

    –Obvious change in warts and moles

    –Nagging cough or hoarseness
  9. What is the cell cycle?
    G1, S, G2, Mitosis.
    • G1 – RNA and protein
    • synthesis

    • S
    • phase – DNA synthesis

    • G2
    • – premitotic phase; DNA synthesis
    • is complete, mitotic spindle forms

    • Mitosis – cell division
    • occurs
  10. How do cancer metastasize? What hwy do they use?
  11. What kinda cancer is CARCINOMA?

    • Cervical
    • brain
    • breast
    • skin
  12. What kinda cancer is SARCOMA?

    • cartilidge
    • bone
    • muscle
  13. What kinda cancer is LYMPHOMA?
    • lymphs
    • spleen
  14. What kinda cancer is LEUKEMIA?
    over production of WBC
  15. What does cells of cancers looks like comapred to normals ones?
    • Tumor specific antigens
    • shape
    • structure
    • metabolism
  16. Carcinogenesis stages.

    • Initiations:
    • initiators (chemicals, physicals factors, biological agents)

    • Promotion:
    • cellular protooncogenes "turn on" growth
    • cancer suppresor genes "turn off" - they mutate, are broken, aren't doing their job = cells keep growing.

    • Progression:
    • altered cells chance to metastasize
  17. What consists of primarty, secondary and tertiary prevention of cancer?
    • Primary:
    • reducing cancer risk

    • Secondary:
    • screening, detection, intervention

    • Tertiary:
    • slow progression, Tx after diagnosis
  18. What are the differences between tumor removal?

    •Wide excision

    • Removal of mass, surrounding tissue, lymph
    • nodes

    • Can result in disfigurement and altered
    • functioning

    •Local excision

    • Performed on outpatient basis when mass is
    • small

    •Salvage surgery

    • Additional treatment option that uses an
    • extensive surgical approach to treat the local recurrence of a cancer 
  19. What prophylactic surgery for cancer?
    Removing tissue that are at risk for cancer.

    mastectomy, colonectomy
  20. What do you assess for in pts after cancer surgery?
    • Infection, impaired wound healing, altered
    • pulmonary or renal function, and DVT
  21. What do you say if the family asks, "what is cancer?"
    • If the family is asking for results of
    • surgery, “Was it Cancer?”, the nurses response is guided by the information the
    • physician has previously conveyed to the patient and family
  22. •Which type of surgery is
    being done when lesions that are removed are likely to develop into cancer?




  23. How much pts recieve radiation therapy in their treatment?

    more than half?
    less than half?
    More than half.
  24. Radiation therapy can:

    how can each?
    • Cure: small, easy ones like the neck.
    • Control: when tumor can't be surgically removed and local spread
    • Neo: to make something smaller so it can be removed.
    • palliative: reileve symptoms when it has spread.
    • Prophylactic: prevent spread
  25. What are the SE and outcomes of radiation therapy?
    Skin changes, hair loss, fatigue, pain

    • strategies to elim SE
    • elim or slow disease
    • relief from symptoms
  26. What phase of the cell is it most vulnerable to radiation?
  27. What cells are most likely affected by radiation therapy?
    • Those that proliferate the most. 
    • Bone marrow
    • Lymph
    • Epithelium of GI
    • Hair
    • Gonads
  28. How do muscle, cartililage, connective tissue react to radiation therapy?
    resistant. they don't proliferate as much.
  29. What type of radiation therapy is most commonly used? How does it work?

    Aims at body from something. over course of weeks.
  30. What do you have to teach to someone that has brachytherapy?
    • private room
    • need sign
    • visitors 30m/6ft
    • no preggs
    • no children<16
    • no vistiors for a couple months
    • flush twice
  31. What is alopecia?
    loss of body hair
  32. Does chemo have the ability to kill soft tissue?
  33. What meds are commonly used ot counter-act the SE (nausea) of radation therapy?

    nausea and vomiting meds.
  34. What is a med that is used during chemo to help the patient make WBC?
  35. What med has cumulative toxic effects on lung function?
  36. What SE on GI during chemo?
    nausea and vomiting
  37. What SE on blood during chemo?
    anemia and thrombocytopenia
  38. Do we recommend childbearing-aged women to use birth control during chemo?
  39. What are some nursing actions for the immunosuppression SEs during chemo?
    • WBC<1000 (normal is 4.4-10.8) 
    • no flowers and fruits
    • administer filgrastim (helps make WBC)
    • eash toothbrush daily or use bleach
  40. What med is used to stimulate appetite?
    megestrol (Megace)
  41. In chemo, is the metallic taste common? What can I do to help it?
    Yes. hard candy.
  42. In chemo, what kinda meals do I eat?
    high calorie, high protein, nutrient dense. several small.
  43. When i'm taking chemo, is alopecia normal? Is it permanent?
    Yes. Temporary. 
  44. What do you need to teach the pt about alopecia?
    • cut the hair short
    • protect scalp from sun
    • avoid dmging hair products
  45. What are some nursing actions you can do against stomatitis/mucusitis?
    • assess mouth several times a day
    • avoid glycerin-based and ETOH-based products
    • admin topicals before meals
    • discourage salty, acidic or spicy
    • mouth care
  46. What kinda oral care can I do with my stomatitis?
    1/2 NS 1/2 peroxide BID
  47. What are some nursing actions against anemia?
    Fatigue, pallor, dizzy, SOB
  48. What are some meds to give for anemia?
    Epogen/ Ferrous sulfate
  49. What can happen with thrombocytopenia?
    • –petechiae (purple spots caused by internal bleeding), ecchymosis(a bruise),
    • bleeding, nosebleeds, hematuria, hematochezia,
    • melena, hematemesis

    • Bleeding
    • precautions (don’t stick or shave), no rectal meds or
    • temps, soft toothbrush
  50. When do you use bone marrow transplants? 
    For hematoligic cancers concerning the marrow.
  51. What is allogenic bone marrow transplant?
    Get marrow from donor.
  52. Is allogenic BMT weaker or stronger than autologous?
  53. What is the con of allogenic bmt compared to autologous bmt?
    needs donor. restrictive. also have graft v tumor effect.
  54. If i'm having alloBMT, i'm having ablative chemo. What is that?
    That means high dose.
  55. The process of getting someone ready for a bmt includes fucking up all of the bone marrrow. That means no cells period. What does it put them at risk for?
  56. What are some drugs to combat graft vs tumor effect?


    –tacrolimus (Prograf)

    –orsirolimus (Rapamune). 
  57. GVHD (graft vs host disease) accounts for how many BMT deaths?

  58. After recieving allobmt, how many days until the patient isn't at much risk?
    100 days.
  59. After receiving BMT, how long do you have to monitor?
    3 months.
  60. Cancer pts have pain. What could it be from?
    Tumor pain: pressure or cell invasion. bone, tissue, muscle.

    Pain from the Txs.
  61. Difference between deep/visceral and somatic pain?
    Deep: organs. sharp pain.

    Somatic: bone, connective tissues. dull pain.
  62. What is the most reliable expression of pain?
    Verbal from client.
  63. Drug that affect intrinsic clotting pathway? What is the lab?
    Heparin. PTT
  64. What is the drug that affects the extrinic and what is the lab?
    Coumadin/Warfarin. PT or INR.
  65. Why would you look at the ANC? (absolute neutrophil count)
    Get a picture on the body's "fighting" abilities.
  66. What is tumor lysis syndrome?
    When lysing cancer cells, they spit shit out->electrolyte imbalance. hyperkalemia -> arrythmias
  67. If the pt has hypercalcemia, does he have cancer? Why?
    No. cancer sucks calcium. So if you have so much of it, there isn't cancer there suckin it all out. 
  68. What is DIC? (disseminated intravascular coaglation)
    Where the body uses all of its clotting factors to clot something, leaving nothing left for the rest of the body to use -> bleeding everywhere -> bleed to death.
  69. What are the diff stages of cancer? 0-4
    • 0 cancer in situ
    • 1 tissue of origin
    • 2 local spread
    • 3 local and regional
    • 4 metastasis
  70. In terms of cancer staging, what is TNM?
    • Tumor 0-4 (size)
    • Node 0-3 (size)
    • Metastasis 0(no metast)-1(metast)
  71. What are the ABCDs of malignant melanoma?
    • Asymmetry (uneven)
    • Border (uneven)
    • Color (uneven)
    • Diameter (larger than pencil eraser)
  72. Thrombocytopenia = platelets < _______?
  73. What is SIADH? Where is it commonly found?
    syndrome of inappropriate anti diuretic hormone?
    Water is reabsorbed -> hyponatremia

    small cell carcinoma of the lung
  74. What is superior vena cava syndrome? S/S?
    Tumor is compressing or blocking vena cava.

    • edema of face and arms
    • epitaxi
    • errythema
  75. What happens when a tumor presses on the spinal cord?
    •Can't feel

    •Autonomic dysfunction

    •Change in bowel or bladder function
  76. What kinda drug do you give for spinal cord compression?
    high-dose corticos
  77. What is the first vaccine to be marketed in the USA?
Card Set:
Ch.16 Oncology/Cancer
2012-12-08 06:59:16
Olson ADH

Ch.16 Oncology/Cancer
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