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37 Cards in this Set
- Front
- Back
Regional Invasion regarding cancer
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Invasion of surrounding tissues and organs
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Define Metastasis and describe three kinds
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spread to distant body parts
– Vascular spread - via blood stream – Lymphatic spread - via lymph system – Implantation - spread to a body cavity |
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Define TNM classification
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T - anatomic size of the primary tumor
N - the extent of lymph node involvement M - the presence or absence of metastasis |
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Factors that contribute to the development of cancer(further descriptions on pg 513)
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1. Age
2. Genetic heritage 3. Hormonal factors 4. Immunologic factors 5. Drugs and chemicals 6. Radiation |
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Cancer Related Health Risk Practices
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Smoking
-#1 preventable cancer Nutrition -Proper amount fiber = less cancer risk Alcohol intake -At risk for oral cancer (mouth, esophageal) Sexual practices -Sex at early age is a risk for cervical cancers Other factors –Viruses (Human Papilloma Virus) HPV –Psychosocial factors |
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Diagnostic Tests for Cancer
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–Cytology studies
CBC (Complete blood count) - Tells whether or not if there is bone marrow suppression, not a real diagnostic tool for cancer – PSA - Prostate Specific Antigen - For men - CEA (Carcinogenic Embryonic Antigens) - Both are not definitive tests for cancers, but they can indicate if previous cancers are coming back |
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Seven Warning Signs of Cancer
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Change in Bowel/bladder habits
A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast or elsewhere Indigestion or difficulty swallowing Obvious change in a wart or mole Nagging cough or hoarseness |
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Goals for Cancer
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- Cure
- Control - Pain Control (Palliative) |
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What is are the negative effects of Radiation Therapy?
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Radiation Therapy does not differentiate between cancerous cells, such as hair cells, gastrointestinal cells, epithelial cells, and reproductive cells
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What general precautions should be taken when treating a cancer patient under radiation therapy
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- Give them a private room
- Wear a film badge - Have a sign on the door - Encourage self care - Limit visitors- No pregos! - Precautions if implant is dislodged |
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What access device is convinient for chemotherapy if peripheral access devices are not available
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Vascular Acess Devices
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Nursing actions for IV chemotherapy infiltration
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Before IV infiltration occurs, a nurse should always check IV and assess its patency.
But if infiltration does occur: 1. STOP INFUSION FIRST 2. Apply Ice 3. Administer Antidote |
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Name three side effects of chemotherapy
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1. Neutropenia
2. Anemia 3. Thrombocytopenia |
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Neutropenia
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- Decrease in white blood cell count
- Normal white blood cell count is 5,000-10,000 |
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Anemia
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- Decrease in red blood cell count
- Normal red blood cell count is 4.0-6.0 |
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Thrombocytopenia
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- Decrease in platelet count
- Normal platelet count is 150,000-300,000 |
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What three ways can health car workers consider to protect themselves from a pt receiving radiation?
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time- limit time spent with pt
distance- increase distance from radiation shielding- use lead barriers |
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What things would you want to teach your client regarding skin care while receiving radiation?
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- aviod sun, trauma to skin, adhesive tape
- use caution w/ soaps - no bath salts, perfumes, ointments or lotions - no heat lamps, heating pads, ice packs - wear soft, cotton light weight clothing - may have medicated ointment prescribed |
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What is the Nadir effect?
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Cells have different life spans- this causes lab values to reach lowest point at different times.
-WBC lowest at 7-10 days after treatment - RBC lowest 7-10 days after - Platelets- 10 days after |
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What nursing care would you think about when caring for an immunosuppressed pt?
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good handwashing, prevent exposure to people w/ known infections, aseptic technique, observe for infection,reverse isolation is possible, neutropenic precautions ( no fresh fruit/flowers)
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Your client has anemia. What s/s would you expect to see?
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fatigue, hypoxia, hypotension, tachycardia, anxiety
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What nursing care would you want to provide for a client with anemia?
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-plan rest periods
-assist pt w/ activities -admin Oxygen -admin blood transfusions -promote good hygiene |
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what signs and symptoms would you expect to see in a pt with thrombocytopenia?
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signs are related to bleeding.
- petechiae, bruising, bleeding gums, hematuria signs of bleeding in the brain- H/A, change in LOC, restlessness |
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Nursing care for clients w/ thrombocytopenia
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-admin platelet transfusion
-use soft toothbrush, avoid razors, stools softeners, no aspirin |
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Your client has stomatitis r/t chemo, what is some nursing care you will implement?
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-frequently assess oral cavity
-mouth care w/ baking soda, magic mouthwash (don't you dare give them listerine!), nystatin swish and swallow, viscous lidocaine, soft toothbursh, NO FLOSS!, lip lubricant, avoid hot & spicy food, good fluid intake |
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A client is experiencing anorexia r/t chemo, WHY?
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-effect of chemo on hunger center
- N/V -stomatitis |
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How can you help your client get adequate nutrition during chemo?
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-May need enteral feedings or TPN
-small, frequent, high caloric feedings -minimize food odors -ask pt "what do you like?" -antiemetics liberally- 30-60 min before eating |
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Tell me about alopecia r/t chemo
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-visible sign of dz
-hair falls out in clumps/breaks off -have wig made before hair falls out - don't brush or wash hair too often -no color,dye, or perms at this time please |
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What drugs are toxic to the kidneys?
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cytoxan or methotrexate
- monitor BUN/creatinine - increase oral intake to maintain hydration -observe for signs of bleeding bladder (hemorrhagic cystitis)- dysuria, hematuria |
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What drug causes pulmonary toxicity?
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BLEOMYCIN
-observe for pneumonia, CHF, SOB, coughing |
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What drug causes cardiovascular toxicity?
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ADRIAMYCIN!!
-observe for signs of CHF -obtain EKG |
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What drug causes birth defects?
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methotrexate
-sperm banking, birth control |
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how long should you be looking for signs of toxicity after the pt has finished taking adriamycin or bleomycin?
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Effects continue for 6 months
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Why does my patient have constipation??
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narcotics!
decreased fluids! lack of activity! |
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What do I do about my patient's constipation??
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-increase roughage in diet
-adequate fluids -laxatives,stool softeners -enemas -prevention |
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Superior Vena Cava Syndrome,
What is that? |
venous congestion caused by obstructed venous drainage in upper thorax by a tumor
signs: SOB, H/A, visual disturbances, facial edema |
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What is the most lethal and common side effect of chemo?
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BONE MARROW SUPPRESSION (oh it's not good)
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