Nurs Exam III Cancer

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JChristie20
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Nurs Exam III Cancer
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2011-03-28 15:42:55
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Nurs Exam III Cancer
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  1. most human tissues contain predetermined, undifferentiated
    stem cells
  2. cancer cells are characterized by loss of contact inhibition which means?
    cells grow into other organs, which normal cells do not
  3. regulate normal cellular processes such as promoting growth
    protooncogenes
  4. this type of gene is used to regulate growth, and mutations render them inactive
    tumor suppressor genes
  5. well differentiated-easily identified, usually encapsuled and expansive, metastasis doesn't occur
    benign neoplasm
  6. may range from well differentiated to undifferentiated; able to metastasize; infiltrative and expansive growth; rarely encapsulated; own blood supply
    malignant neoplams
  7. a mutated cell has the potential to develop into _____ and ______ cells
    • clone
    • neoplastic
  8. mutated cells only become tumors when they establish ability to ______ and ______
    • self-replicate
    • grow
  9. carcinogens can be _____ and _____ _____
    • detoxified
    • harmlessly excreted
  10. cells damaged by carcinogens may replicate into daughter cells with same genetic alteration, _____ and _____
    • self repair
    • die
  11. long latency period makes identification of carcinogens difficult
    chemical carcinogens
  12. about half of cancer related deaths in the US are related to what 4 causes
    • tobacco use
    • unhealthy diet
    • physical inactivity
    • obesity
  13. the latent period of cancer may range from ___ to ___ years
    1-40
  14. progression of cancer is characterized by these three factors
    • 1. increased growth rate of tumor
    • 2. invasiveness
    • 3. metastasis
  15. most frequent sites of metastasis are
    • lungs
    • brain
    • bone
    • liver
    • adrenal glands
  16. the immune response is to ____ or _____ cancer cells
    • reject
    • destroy
  17. these continually check cell surface antigens and detect and destroy abnormal cells
    lymphocytes
  18. B cells produce antibodies directed to
    tumor surface antigens
  19. mechanism by which cancer cells evade immune system
    immunologic escape
  20. weak surface antigens allow cancer cells to "____ ____" survelliance
    sneak through
  21. this is the induction of suppressor T cells; blocking antibodies bind TAAs preventing recognition
    immunologic escape
  22. found on tumor cell surfaces, inside tumor cells and fetal cells; may result as cell regains its embryonic capability to differentiate into many cells types
    oncofetal antigens
  23. on cancer cells of GI tract; normal cells of fetal gut, liver and pancreas
    carcinoembryonic antigen (CEA)
  24. malignant liver cells and fetal liver cells
    a-Fetoprotein (AFP)
  25. this test is done often in men over the age of 50 years old
    Prostate specific antigen (PSA)
  26. these originate from embryonal ectoderm(skin, glands) and endoderm (mucous membrane of respiratory tract, GI and GU tract)
    carcinomas
  27. these originate from embryonal mesoderm (connective tissue, muscle, bone and fat)
    sarcomas
  28. lymphomas and leukemia's originate from
    hematopoietic system
  29. in this grade of cancer cells differ slightly
    grade 1
  30. in this grade of cancer cells are more abnormal and moderately differentiated
    grade 2
  31. in this grade of caner cells are very abnormal and poorly differentiated
    grade 3
  32. in this grade of cancer cells are undifferentiated and cells are immature
    grade 4
  33. this cancer classification is considered "cancer in situ"
    0
  34. in this cancer classification the tumor is limited to tissue origin and has localized tumor growth
    1
  35. in this cancer classification the cancer is limited to local spread
    2
  36. in this cancer classification there is extensive local and regional spread
    3
  37. in this cancer classification there is metastasis
    4
  38. in the TNM classification system anatomic extent of disease is based on 3 parameters and that is
    • tumor size and invasiveness (T)
    • spread to lymph nodes (N)
    • metastasis (M)
  39. this involves histologic examination by a pathologist of a piece of tissue to determine cancer
    biopsy
  40. this method of tx focuses on removing only as much tissue as necessary and spare the normal tissue
    cure and control
  41. good prognostic indicators for cancer include what?
    • small tumor size
    • clean tissue margins
    • absence of lymph node involvement
    • abnormal tissue markers
  42. this is used to relieve spinal cord compression
    laminectomy
  43. this Tx effects cells at a cellular level and is effective against dividing cells so cancer cells escape death by staying in G0 phase(resting)
    chemotherapy
  44. the bodies response to products of cellular destruction(chemo)
    • fatigue
    • anorexia
    • taste alterations
  45. acute chemotherapy toxicity occurs during or immed. after drug administration and causes what S/S
    • N/V
    • allergic reactions
    • dysrhythmias
    • extravasation (flare reaction)
  46. the delayed effects of chemotherapy are numerous and include
    • mucositis
    • alopecia
    • bone marrow suppression
    • delated N/V
    • skin rashes
  47. chronic toxicity's of chemotherapy include involve damage to what major organs
    • heart
    • kidney
    • liver
    • lungs
  48. dosages of chemo drugs are calculated according to what
    body surface area
  49. produces ionization of atomic particles when absorbed in tissue; generates free radicals that break bonds in DNA, causing loss of proliferative capacity
    radiation therapy
  50. cellular damage may be lethal or sublethal; normal tissues are usually able to recover; cancer cells permanently damaged
    radiation therapy
  51. these radiation beam expend energy quickly, penetrate a short distance, and useful for skin lesions
    low energy beams
  52. these radiation beams have greater depth of penetration; suitable for optimal dosing of internal targets while sparing skin
    high-energy beams
  53. this form of radiation therapy focuses on siza and orientation of radiation beams, permits max Tx of tumor, uses immobilization devices to help pt be stable
    simulation
  54. in this type of radiation Tx the pt is exposed to radiation from a megavolt machine
    • external radiation
    • (teletherapy)
  55. this form of radiation therapy involved minimal exposure to healthy tissue; used in combination with teletherapy
    • internal radiation
    • (brachytherapy)
  56. the common side effects of chemotherapy and radiation include
    • bone marrow suppression
    • fatigue
    • GI disturbances
    • integumentary and mucosal reactions
    • pulmonary effects
    • reproductive effects
  57. most common side effect of chemotherapy
    myelosuppression
  58. a patient should be on a diet that is nonirritating,
    • low-fiber
    • high calorie and high protein
  59. dry skin should be lubricated with nonirritating lotion or solution that contains no....
    • metal
    • alcohol
    • perfume
    • additives
  60. pulmonary effects of cancer may be _____ and ____
    • progressive
    • irreversible
  61. the 7 warning signs of cancer are:
    C
    A
    U
    T
    I
    O
    N
    • Change in bowl habits
    • A sore that doesn't heal
    • Unusual bleeding or discharge
    • Thickening or lump
    • Indigestion or difficulty swallowing
    • Obvious change in wart or mole
    • Nagging Cough or hoarseness
  62. increase in number of density of normal cells. hyperplastic cells are under normal DNA control. Can become malignant
    hyperplasia
  63. dividing cells differentiate into cell types not normally found in that location of the body. Cells under normal control and are reversible when the disruptive condition ceases. EX Smoking
    metaplasia
  64. represents a loss of DNA control over differentiation occurring in response to adverse conditions. can become cancerous under certain conditions.
    dysplasia
  65. regression of a cell to an immature or undifferentiated cell type. division is no longer under DNA control. not reversible and usually malignant
    anaplasia
  66. any new or continued cell growth not needed for normal development or replacement of dead or damaged tissues; always abnormal even if it causes no harm
    neoplasia
  67. therapy with biological response modifiers which are natural substances produced in small amounts by the bodys immune system
    immunotherapy/biotherapy
  68. these have been reported several years after radiation therapy
    fibrosarcomas
  69. induce biologic activities that activate immune system and alternate function in cancer cells
    -stimulates proliferation of T and B cells
    -activates natural killer cells
    interleukins
  70. major toxicity results in changes in permeability and vascular tone; shift from intravascular to extravascular results in fluid depletion
    -leads to hypotension
    -bone marrow suppression
    capillary leak syndrome
  71. capable of binding to specific target cells to ultimately destroy them; administered by infusion
    monoclonal antibodies
  72. major side effects of monoclonal antibodies are
    cardiotoxicity, heptaotoxicity, rarely anaphylaxis
  73. inhibits tyrosine kinase, the enzyme regulating cell proliferation and survival
    -side effects(rash, dry skin, fatigue, fever, interstitial lung disease)
    tyrosine kinase inhibitors
  74. inhibits activity which regulates cell growth
    side effects(bone marrow suppression, peripheral neuropathy, fatigue, diarrhea, N/V)
    proteasome inhibitior
  75. binds vascular endothelial growth factor
    -side effects(HTN, colon bleeding, inpaired wound healing, thromboembolism, hemorrhage)
    angiogenesis inhibitor
  76. glycoproteins that stimulate production, maturation, regulation and activation of cells in hematologic system; may hasten recovery from bone marrow depression
    hematopoietic growth factors
  77. CSF responsible for stimulating erythroid precursor cells to produce mature RBCs
    -produced in Kidneys
    • Erythropoietin
    • -Epogen, Procrit
  78. platelet growth factor; indicated for prevention of severe thrombocytopenia and reduction of need for platelet transfusion
    -adverse effects(edema, dyspnea, tachycardia, nausea, mouth sores)
    Interleukin-11(Neumega)
  79. what is given to control severe chills
    IV meperidine
  80. in this prodecure tumor cells eradicated and bone marrow is rescued by infusing healthy cells
    hematopoietic stem cell transplant
  81. in this procedure stem cells are acquired from donor who matched human leukocyte antigens (HLA); large doses of systemic therapy are administered to kill all tumor cells
    Allogeneic stem cell transplantation
  82. in this procedure stem cells are obtained from one identical twin and infused into other twin bc they have identical HLA
    syngeneic
  83. in this procedure patients receive their own stem cells following myeloblative chemotherapy; stem cells are harvested, treated, scored and infused; usually takes 4-6 weeks
    Autologus
  84. harvesting stem cells from bone marrow is a procedure performed in the OR under what anestheria
    general or spinal
  85. in this procedure cell separation equipment sort stem cells out and other cells are returned to donor; takes 2-4 hrs; multiple collections may be needed
    peripheral stem cell transplant
  86. with this T lymphocytes from donor stem cells recognize recipient as foreign and attacks organs such as skin, liver and GI
    graft-versus-host disease
  87. transfer of exogenous genes into cells of patients in an effort to correct defective gene; target healthy cells to enhance their immune function; target cancer cells to destroy them
    -used to prevent angiogenesis
    gene therapy
  88. S/S of superior vena cava syndrome are
    • facial edema
    • head, neck and chest vein distention
    • seizures
    • headache
  89. S/S of spinal cord compression are
    • intense, localized, persistent back pain
    • motor weakness
    • change in bowl
    • sensory paresthesia and loss
  90. S/S of third space syndrome which is shifting of fluid from vascular space to interstitial space
    • hypovolemia
    • Hypotension
    • tachycardia
    • decrease urine output
  91. fluid accumulates in pericardial sac or tumor
    S/S heavy chest, SOB, dyspnea
    cardiac tamponade

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