meg surg

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meg surg
2013-05-20 01:59:20
chapter 11

pt w/cancer
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  1. nucleus
    • control center of a cell.
    • a cell surrounded by double layer nuclear membrane with pores.
    • inside are nucleoli and DNA of a cell.
  2. nucleolus
    • a small sphere made of DNA.
    • inside nucleus.
  3. gene
    • a code of one protein.
    • controls everything.
    • no gene no activity.
  4. how many chromosomes?
  5. cell membrane
    made of collagen.
  6. mitochondrion
    power house
  7. role of hospice providing care pt with cancer?
    • palliative care (comfort & quality of life).
    • life expectancy 6months or less.
  8. cancer mortality rates/death rates
    2nd to heart disease.
  9. neoplasms
    • tumor
    • cells that reproduce abnormally.
    • cells that have gene protein that mutate.
    • not all neoplasms contain cancer cells.
    • neoplastic growth is hard to detect.
  10. benign tumor
    • cluster of cells that aren't normal to the body but is noncancerous.
    • tumor that take over function of organs are cancer.
    • slow growth.
    • effects tissue.
    • don't spread.
  11. cancer
    group of cells growing of of control, taking over organ function.
  12. malignant
    • describes cancer, tumor resists treatment tends to worsen and threaten life.
    • rapid growth.
    • alters cell membrane.
    • spreads tumor other parts of body.
  13. cancer type
    • 100 different types.
    • caused by mutated cellular genes.
    • not just one disease, many, with different causes, manifestation,treatments and prognoses.
  14. cancer cells lack
    • contact inhibition.
    • property of a normal cell which contact with another cell/tissue signals them to stop dividing.
    • cancer cells don't posess contact inhibition,they contuie to divide and invade surrounding tissue.
  15. carcinoma
    • most common cancer.
    • includes cells of the skin,GI system, lungs.
  16. leukemia
    abnormal growth of white blood cells.
  17. sarcomas
    cancer effects connective tissue, fat the sheath that contains nerves, cartilage, muscles,& bone.
  18. lymphomas
    cancer cells of lymphatic system, lymph nodes, & spleen{garbage can}.
  19. lung cancer
    • male 15%
    • female 14%
    • both die from.
  20. biopsy
    accurate identification of cancer.
  21. incisional biopsy
    1# surgical removal of a small amount of tissue.
  22. excisional biopsy
    2# removal of entire tissue mass.
  23. needle aspiration biopsy
    3# insertion of a needle into the tissue for fluid or tissue aspiration.
  24. transcutaneous aspiration
    4# insertion of a fine needle into the tissue such as breast prostate, salivary gland, & is used for diagnosing metastatic cancer.
  25. frozen section biopsy
    • 5# provides immediate evaluation of a tissue sample during a surgical procedure.
    • helps direct the remainder of the surgical procedure.
  26. stereotactic biopsy
    6# safe & efficient procedure for evaluating lesions in the brain & breast.
  27. malignant/benign
    note: stage 4 no help.
  28. bone marrow aspiration
    • 7# done to learn the number, size, shape of rbc,wbc, platelets.
    • used to diagnose leukemia.
  29. tumor-node-metastasis(TNM) cancer staging
    • T1-T4
    • size/or extent of the primary tumor
  30. curative surgery
    surgery can be curative when it is possible to remove the entire tumor.
  31. prophylactic surgery
    • used to remove moles or lesions that have the potential to become malignant.
    • moles=cancer
  32. palliation surgery
    • done for palliation( symptom control,vomiting stool).
    • surgical removal of tissue to reduce the size of the tumor mass is helpful, especially if the tumor is compressing nerves or blocking the passage of body fluid.
  33. reconstructive surgery
    used for cosmetic enhancement or for reurn of function of the body parts.
  34. radiation
    • used commonly in cancer control & palliation.
    • can be curative if the disease is localized.
    • use of radiation is based on cancer site and size.
    • destroys cancer cells.
    • can be used to shrink tumor before surgery, more effective less dangerous.
  35. anorexia
    • n/v
    • small food carbs high protein.
    • avoid fiber foods.
  36. mucositis
    • inflammation of the mucus membrane.
    • mouth & throat.
    • avoid smoking, alcohol,acid food, mouth wash, hot/cold drinks.
  37. xerostomia
    dry mouth.
  38. desquamation
    peeling skin.
  39. skin reaction
    • skin may have makings or tattoos to show treatment area.
    • dont wash off.
  40. bone marrow depression
    low blood cell counts occur with both radiation & chemotherapy, because they attack rapidly all dividing cells, not just cancer cells.
  41. radioisotopes
    • must wk efficiently with pts receiving radioisotopes that are releasing gamma rays.
    • less exposed to radiation at foot of bed.
    • distance is use to protect the nurse, doorway.
    • focus on providing only essential care.(no visitors)
    • never touch radioactive materials¬† without unprotected hands; shielding is important.
  42. chemotherapy
    • a chemical therapy that uses cytotoxic (destructive to cells) drugs to treat cancer.
    • can be used for cure, control, or palliation of cancerous tumors.
  43. cancer chemotherapy meds
    • antitumor antibiotics
    • doxorubincin(adriamycin, doxil)
    • a/r: red urine decrease wbc & platelet count. (all cancer)
    • antimetabolites A/R bone marrow depression
    • monitor: wbc & platelet count
    • teach: signs of infections and bleeding.
    • thrombositopnea: decreased clotting platelets.
  44. chemotherapy/radiation side effects
    fast growing epithelial cells,such as hair, blood, skin, GI tract.
  45. hematologic system
    • chemotherapy is toxic to bone marrow.
    • blood cells(wbc) drop after 7-14 days of chemo.
    • nadir: lowest cell count (most risk complication).
    • leukopenia: decrease WBC.
    • neutropenia: decrease neutrophils.
    • thrombocytopenia: reduced platlets;risk of bruising & bleeding; require platelet transfusion.
    • anemia:decreased RBC; require blood transfusion.
  46. BITES
    • Bleeding suggests low platelet count.
    • Infection suggests low WBC risk for infection.
    • Tiredness suggest anemia.
    • Emesis places the pt risk for altered nutrition & fluid & electrolyte imbalance.
    • Skin changes, evidence of radiation reaction or skin breakdown.
  47. erythropoietin(anemia)
    • stimulates proliferation of stem cells into RBC.
    • S/F hypertension.
    • monitor b/p.
  48. interleukin-11
    stimulates production of platelets.
  49. alopecia
    hair loss
  50. normal platelet level
    • 150,000- 300,000/mm normal
    • potential for bleeding 50,000/mm or less.
    • spountanious bleeding less than 20,000.
    • monitor lab studies.
  51. ineffective protection r/t thrombocytopenia
    • monitor platelet count.
    • 50,000 potential for bleeding.
    • spontaneous less than 20,000
  52. imbalanced nutrition
    • stable weight.
    • weigh pt daily.
    • weight is obj. to determine if intake is adequate to maintain weight.
  53. intervention pt/w cancer
    • good hand washing before interacting with pt.
    • limit visitors to only healthy adults.
    • keep fresh flowers and potted plants out of room.
  54. superior vena cava syndrome
    • pt with lung cancer or cancer of the mediastinum when the tumor or large lymph nodes block circulation in the vena cava.
    • edema in head, neck, arms.
    • S/S shortness of breath,cough chest pain,red face, swollen neck vein.
    • dont take b/p out of arms, raise head of bed.
  55. spinal cord compression
    • occurs when malignant growth presses on spinal cord.
    • painful, motor loss.
  56. hypercalcemia
    • calcium into the blood, from bone deterioration or from ectopic secretion of parathyroid hormone by a tumor.
    • common in pt with metastasis, breast cancer.
    • treated with iv, hydration to lower the calcium levels.
  57. disseminated intravascular coagulation.(DIC)
    • abnormal clot formation.
    • bleeding out.
    • treatment frozen plasma and heparin.
  58. pericardial effusion
    direct invasion of cancer, pericardial sac fills with fluid may lead to life threatening compression of the heart (tamponade).