nursing care of patients with cancer

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1

cancer with the highest incidence among women? and men?

  • breast cancer (29%)
  • prostate cancer
2

define dynamic equilibrium?

cell death = cell growth. cells are dying as equal as they are growing

3

contact inhibition is defined as

"personal space" cells don't invade territories.

4

cell differentiation

cells start out as any type of cell and become organ specific with specific functions

5

what is it called when cancer cells does not respect the boundary and grows anywhere

loss of contact inhibition

6

explain the pyramid effect

cancer cells are not dying as fast as it's growing

7

defect in cellular proliferation can turn protooncogens, the normal cells into what?

oncogenes which are tumor inducing genes

8

what is tumor suppressor genes? what happen when it is inactivated?

the tumor suppressor genes suppress cells growth. when it is switched off, the tumors have a chance to grow

9

what happens in the initiation stage of cancer development

  • mutation of cell's genetic structure due to inherited mutation and exposure to carcinogens
10

what are some examples of carcinogens

  • chemical: alcohol, asbestos, smoking
  • radiation: radiation
  • viral: HPV, hepatitis, H-pylori, Epstein barr virus
11

T/F once a cell becomes mutated, it is cancerous.

False, cancerous cell don't necessarily become cancerous, they either die, repair, or survive

12

what are some cancer promoting activities? are they reversible?

  • tobaccos use
  • unhealthy diet
  • physical inactivity
  • obesity
  • all reversible
13

growth and invasiveness

cancer metastasizing

14

explain tumor angiogenesis

blood vessels grow into tumor feeding it, which makes it get nutrients and grow

15

what are the routes for metastasis

through blood, lymph and sometimes through walls of organs

16

most common site of metastasis

brain, bone, liver, lung, adrenal gland

17

name at least 3 difference between benign and malignant tumors

  • benign tumors are well defferentiated
  • benign tumors don't metastasize
  • benign tumors have a rare recurrence
18

cancer in situ (stage 0)

confined to site where it started

19

stage 1 cancer

tumor limited to tissue of origin; localized tumor growth. a few cells outside where it's supposed to be

20

stage 2 cancer

limited local spread. it has not spread that much in the organ it is in. Eg. if it's in the lungs, it's in the lower lobe

21

stage 3 cancer

extensive local and regional spread. it's still at one place but it has spread to the entire organ

22

stage 4 cancer

metastasis. the cancer has spread to other organs apart from the affected one

23

TNM

card image
24

what are some nursing teaching you can give a patient about prevention and early detection of cancer

  • avoid or reduce exposure to known suspected carcinogens
  • eat a balanced diet
  • exercise regularly
  • maintain a healthy weight
  • adequate rest
25

cancer warning signs

CAUTION

  • Changes in bowel or bladder
  • A sore that does not heal
  • Unusual bleeding or discharge from any orifice
  • Thickening or lump
  • Indigestion or difficulty swallowing
  • Obvious change in wart or mole
  • Nagging cough or hoarseness
26

what is the definitive test for dx of cancer? what else can be done?

  • biopsy
  • radiologic studies
  • colonoscopy
  • sigmoidoscopy
  • lab tests
27

what is the purpose of surgical therapy

card image
28

chemotherapy may be absorbed through

  • skin
  • inhalation during prep, transportation and administration
29

T/F anyone can give chemo

False, you have to be chemo certified because it is a potential occupation hazard

30

what are some nursing considerations after someone receives chemotherapy for the first 48hrs?

  • be cautious with body fluids
  • a chemo person will have their own room
  • double gloves, flush twice, men should sit down to pee
  • clothes and dish wares should not be sent along with others, it should be taken down separately
31

methods of chemo administration

  • intrathecal: injection into spinal cord
  • intraarterial: put in artery that is feeding the tumor
  • topical: for skin cancer
32

chemotherapy can be given via_____

  • oral, IM, IV
  • intracavitary
  • continuous infusion
  • subcutaneous
33

what can occur with IV administration of chemo drugs

  • irritants can cause damage to vein
  • vesicants
34

what is vesicants? what are some nursing considerations?

  • tissue breakdown or necrosis of IV site due to damage to vein
  • do good assessment of IV site. watch out for pain, coolness, swelling, pale
35

why is a port a better option? what are central lines good for? how do you know it is in the right place?

  • because it can be used for multiple purposes. give chemo, fluids
  • central lines are good for IV antibiotics it feed into the vena cava. verify placement with X-ray
36

what are the effects of chemotherapy on normal tissue

  • acute toxicity
  • delayed effects
  • chronic toxicities
37

are chemotherapy good at detecting cancerous cells from normal cells?

no. they can't tell the difference. it targets rapidly dividing cells

38

what are some places where cells grow rapidly

hair, mouth, and GI

39

acute toxicity can happen when? what are some S/S

  • occurs during and immediately after drug administration
  • N/V
  • allergic reaction
  • dysrhythmias
  • extravasation
40

what are some delayed effects of chemotherapy

  • mucositis
  • alopecia
  • bone marrow suppression
  • skin rashes
  • altered bowel function
  • cumulative neurotoxicities
41

what is cumulative neurotoxicity?

  • "chemo brain" some of brain cells are damaged during chemo.
  • impaired sensation, weakness or loss of coordination
42

what are some organs that can be damaged by chemotherapy

  • heart
  • kidney
  • liver
  • lungs
43

when is radiation therapy given? what does it depend on

delivered once a day for 5 days a week for 2-8 weeks. it depends on patient, where the cancer is located and type

44

external radiation or teletherapy

is the most common. it is coming from a machine targeting the area. tumor markers are put on patients so they know where the beam goes. the machines target one area. teach patients to leave markers alone and to shield every other place depending on where it is locadted

45

internal radiation or brachytherapy

radiation is put inside the patient, it is surgically inserted. protect yourself because the patient will be omitting radiation. limit time with patient, keep your distance. have tracers with you if with patient, it will show how much radiation you're exposed to

46

SE of radiation

is going too be specific to area you're targeting.

47

integumentary effects of chemo and radiation therapy

alopecia, desquamation

48

hemorrhagic cystitis effects of chemo and radiation

cell lining gets destroyed

49

effects of chemo and radiation on body and food intake

  • taste alteration
  • anorexia
  • stomatitis, esophagitis, mucositis
50

GI effects of chemo and radiation

  • N/V
  • diarrhea or constipation
51

common effects of chemo and radiation

  • bone marrow suppression
  • fatigue
52

pulmonary, cardiovascular, and reproductive effects of chemo and radiation

  • pneumonia
  • pericarditis
  • infertility
53

dry vs. wet desquamation

due to radiation therapy. used nonirritating lotion for dry and a wet dressing, usually a Vaseline gauze for wet

54

late effects of radiation and chemo includew

  • increased risk for leukemia, angiosarcoma, skin cancer
  • strictures, fistulas, radiation necrosis, arthralgia, renal insufficiency, osteoporosis
55

allergenic transplant

stem cell transplant coming from a donor

56

syngeneic transplant

stem cell from an identical twin

57

autologous transplant

stem cell from self. take out stem cell, clean it and put it back in

58

umbilical stem cell tansplant

come from mother, beneficial if younger

59

sources of cells

  • bone marrow transplant
  • peripheral stem cell transplantation: from someone's blood to another person
60

what are some complications that can occur with stem cell transplatation

  • bacterial
  • viral
  • fungal infections
  • graft vs. host disease
61

graft vs. host disease

T lymphocytes attack stem cells. attacks skin, liver, and GI tract