Neoplastic part C

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Author:
Prittyrick
ID:
311977
Filename:
Neoplastic part C
Updated:
2015-11-23 19:45:26
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cancersux
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Description:
cancer sux
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  1. Lymphoma
    • malignant, begin in bone marrow & lymph system
    • malignant¬† changes in lymphocytes
    • tumors in lymphoid tissue
    • - hodgkins disease
    • - non hodgkins lymphoma
    • metasizes to any organs
  2. hodgkins disease
    • Giant Reed-Sternberg cell- 1+ nuclei
    • - + means you have hodgkins
    • - more than one nucleus
    • - high cure rate 60-90% (most curable)
    • 15-35 yrs old, > 50
    • 10 yr survival 77-88%
    • more common in men
    • exact cause unknown
    • - EBV viral, genetics, decreased immunity, occupational toxins, agent orange
  3. Hodgkins disease
    how it works
    • Initiates from a single node
    • - spreads lymph- chain
    • - does this in a pattern (chemical mediators inflammation)
    • hyperplasia of monocytes & macrophages destroys lymph nodes
    • malignant cells may spread along lymphatics
    • - liver, spleen, lungs (lymph node tissue)
    • rapid proliferation of abnormal lymphocytes- these lymphocytes don't work well
    • incre risk for infection
  4. Hodgkins Disease
    s/s
    • *** Hallmark sign enlarged, moveable, nontender lymph nodes
    • - 80% will present in the neck, cervical chain
    • -¬† superior clavicle (above)
    • - media sternal
    • wt loss, fatigue, weakness, fever, chills, tachycardia, night sweats, severe pruritis (chemical mediators), if a pt has alcohol the nodes become painful (not sure why)
    • B symptoms: fever w/out chills, drenching sweats, weight loss, w/enlarged lymh nodes
    • - advance disease
  5. Hodgkins: advance
    • heptomegaly, splenomegaly, jaundice
    • anemia- dec BM function
    • bone pain- lymphocytes infiltration bone
    • SVC syndrome- tumor
    • abdominal mass- lymph
    • airway obstruction- bc nodes enlarged obstruct airway
  6. hodgkins's disease
    diagnosis
    • ** lymph node biopsy
    • - reed sterberg cells
    • - may take several biopsy's
    • - if the lymph node is affected you will see microcystic, hypochromic (no color, low hgb) anemia
    • changes in WBC (neuts can be alot but still abnormal), dec platelets (if BM or spleen is involved)
    • increase risk for infection
  7. Hodgkins disease
    diagnosis cont
    • ESR
    • test EOD (end organ damage) ie liver, kidney
    • cxr, CT, of chest, abd and pelvic (looking for pulmonary involvment)
  8. Hodgkins disease
    stage
    • Staging I-IV and
    • - A - no symptoms (no sweating, fever)
    • - B- symptoms (advance, wt loss 10%, unexplained fever, night sweats, out of lymphatic system)
    • CXR, CT, PET, Bone marrow biopsy
  9. Hodgkins disease
    no need to memorize
    • stage I
    • - 1 lymph nodes
    • Stage II
    • -¬† 2 or more lymphs on the same side
    • Stage III
    • - several lymph nodes both sides
    • stage IV
    • - disseminated involvment
    • above the diaphram tends to be confined in the lymphatic system
    • below it is out of the lymphatic system- it is disseminated which is also in the liver and spleen
  10. Hodgkin's disease
    tx
    • based on clinical staging
    • chemo
    • radiation
    • can do one or the other or both
    • depending on how many nodes on involved
  11. Hodgkins radiation therapy
    • very effective for stage IA or IIA (no symptoms, one or two nodes involved on the same side)
    • to affected area over 4-6 weeks
    • 95% complete remission
    • 90% survival > 20 years
  12. Hodgkins
    combo chemo
    • classic side effects
    • alopecia, NV, fatigue, BM depression, infection, mucousitis
    • dissemenated
  13. hodgkins
    TX
    • adjuvant therapy: chemo and radiation
    • bone marrow or peripheral stem cell transplantation
    • hematopoeitic growth factors
    • chemo or xrt incres risk of another malignancy (monitor pt)
    • - health promotion
  14. Bone marrow transplantation
    • look at definition
    • autologous or allogenic
    • Iilac crest or sternum
    • frozen
    • remission more likely than cure
    • many risk including death
    • HUGE risk for infection
  15. Stem cell transplanation
    • peripheral- fewer cells than BM
    • may work more quickly, have fewer side effects
    • umbilical cord- may be saved
    • embryonic stem cells- controversial
  16. Hodgkins nursing care
    • as with others recieving chemo/XRT
    • infertility and sperm changes with chemo
    • avoid pregnancy, bank sperm/ova
    • long term effects: fatigue
    • health promotion: decrease risk of ca

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