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EXAM #1 - FAMILY
Cancers
| Question | Answer |
|---|---|
| Ovarian Cancer Patho & Risk Factors | Neoplastic growth of the ovary. Mainly in women 63 or older. More common in white women. Cause is unknown, and it can originate from different cell types, although it is believed to originate in the ovarian epithelium. Two Genes (BRCA1 & BRCA2) are the genetic link of breast and ovarian cancers. |
| Ovarian Cancer Early Symptoms | abdominal bloating, early satiety, fatigue, vague abdominal pain, urinary frequency, diarrhea or constipation, malaise, and unexplained weight loss or gain. |
| Ovarian Cancer Late Symptoms | anorexia, dyspepsia, ascites, a palpable abdominal mass, pelvic pain, and back pain. |
| Ovarian Cancer Assessments | include early period onset (before 12), late menopause (after 55), increasing age after menopause, high-fat diet, obesity, persistent ovulation over time, family history, perineal talcum powder or hygiene sprays, older than 30 years at first pregnancy, positive BRCA1 or BRCA2 mutations, personal history of breast, bladder, or colon cancer, hormone replacement therapy for more than 10 years, infertility. |
| Diagnosis of Ovarian Cancer | Laparoscopy (abdominal exploration with an endoscope) |
| Stage I of Ovarian Cancer | limited to ovaries |
| Stage II of Ovarian Cancer | Growth to both ovaries, with pelvic extension |
| Stage III of Ovarian Cancer | Cancer spread to lymph nodes and other organs or structures inside abdominal cavity |
| Stage IV of Ovarian Cancer | Cancer has metastasized to distant sites |
| Surgical Intervention of Ovarian Cancer | remains the mainstay of management of ovarian cancer. Typically includes hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, omentectomy (excision of all or part of the omentum, which is a sheet of fat covered by the peritoneum that protects abdominal structures, and pelvic para-aortic lymph node sampling to evaluate cancer extension |
| Endometrial Cancer Patho & Risk Factors | Also known as uterine cancer. It is a malignant neoplastic growth of the uterine lining. Hormone exposure and obesity are believed to be in its development. Increased estrogen levels, obesity, diabetes, and hypertension are all high risk factors. The pattern of spreading partially depends on the degree of cellular differentiation. Adenocarcinoma of the endometrium is typically preceded by hyperplasia. Carcinoma is found only on the endometrial surface. |
| Endometrial Symptoms | Dyspareunia, low back pain, purulent genital discharge, dysuria, pelvic pain, weight loss, and change in bladder and bowel habits |
| Stage I of Endometrial Cancer | Confined to the corpus uteri |
| Stage II of Endometrial Cancer | Spread to the cervix, but not outside the uterus |
| Stage III of Endometrial Cancer | Spread locally and regionally |
| Stage IV of Endometrial Cancer | Invaded the bladder mucosa, bowel with distant metastases to the lungs, liver, and bone |
| Cervical Cancer Patho & Risk Factors | Malignancy located in the uterine cervix. Majority is caused by Human Papilloma Virus (HPX). Starts with abnormal changes in the cellular lining or the surface of the cervix. Typically occurs in the squamous-columnar junction of the cervix. Then cylindrical secretory epithelial cells (columnar) meet the protective flat epithelial cells (squamous) from the outer cervix and vagina in what is termed the transformation zone. |
| Cervical Cancer Treatment | Cryotherapy, Conization, LEEP, LLETZ, Cold Knife Cone Biopsy, Hysterectomy, Radiation, and Chemo |
| Cryotherapy | destroying abnormal cervical tissue by freezing with liquid nitrogen, freon, or nitrous oxide. |
| Cone Biposy (Conization) | removes cone-shaped section of cervical tissue. The base of the cone is formed by the ectocervix (outer part of the cervix) and the apex of the cone is from the endocervical canal. Done by LEEP or LLETZ |
| Loop Electrosurgical Excision Procedure (LEEP) or Large Loop Excision of the Transformation Zone (LLETZ) | the abnormal cervical tissue is removed with a wire that is heated by an electrical current. |
| Cold Knife Cone Biopsy | Surgical Scalpel or a laser is used instead of a heated wire to remove tissue. |
| Laser Therapy | Destroys diseased cervical tissue by using a focused beam of high energy light to vaporize it (burn it off) |
| Hysterectomy | Removes the uterus and cervix surgically |
| Radiation Therapy | delivered by internal radium applications to the cervix or external radiation therapy that includes lymphatics of the pelvis |
| Chemoradiation Therapy | weekly cisplatin therapy concurrent with radiation. Investigation of this therapy is ongoing. |
| Nurses Role in Cervical Cancer | primary prevention by educating women about risk factors and ways to prevent cervical dysplasia. Ensure pap smears, and providing emotional support. |
| Vaginal Cancer Patho & Risk Factors | Most causes are from adjacent or distant organs that the cancer originated. However, squamous cell carcinomas that begin in the epithelial lining of the vagina account for about 85% of vaginal cancers. Commonly begin in the upper third of the vagina and spread early by directly invading the bladder and rectal walls. They also spread through blood and lymphatics. |
| Vaginal Cancer Symptoms | Most are asymptomatic. But symptoms such as painless vaginal bleeding (often after intercourse), abnormal vaginal discharge, dyspareunia, dysuria, constipation, a mass in the vaginal wall that can be palpated, and pelvic pain. |
| Vaginal Cancer Nursing Actions | sexuality counseling, referral to local support groups. Expected results and side effects of treatment. Education on pain and symptoms management. |
| Vaginal Cancer Treatment | If the cancer is localized, radiation, laser surgery, or both may be used. If the cancer has spread, radical surgery might be needed such as a hysterectomy, or removal of the upper vagina with dissection of the pelvic nodes in addition to radiation therapy |
| Vulvar Cancer Patho & Risk Factors | Forms slowly over years, and usually preceded by precancerous changes termed intraepithelial neoplasia (VIN). Can be caused by HPV infection or without HPV infection. |
| Vulvar Cancer Symptoms | dyspareunia, long history of pruritus, ulcers on the outside of the genitalia, vulvar swelling, changes in appearance of existing vulvar mole, vulvar bleeding, and urinary problems, most importantly a vulvar lump |
| Vulvar Cancer Treatment | Surgery, radiation, chemotherapy, are the typical treatments. Laser surgery, cryosurgery, or electrosurgical incisions may be used as well. Larger lesions may need extensive surgery and skin grafting. Traditional treatment is a radical vulvectomy, but more conservative techniques are being used to improve psychosexual outcomes and less morbidity without compromising survival. |
| Vulvar Cancer Nursing Actions | education on the disease, treatment options, and prognosis. Healthy lifestyle behaviors, stop smoking. Teach to examine genital area. Avoid tight undergarments, do not use perfumes and dyes in vulvar region. |
| Mastitis | No Nipple Discharge. Unilateral, outer quadrant of breast, wedge-shaped warmth, redness, swelling, crackled nipples, enlarged breasts, tenderness. Treated with antibiotics, warm shower, supportive bra, breastfeeding, increased fluids |
| Breast Cancer | Neoplastic Disease in which normal body cells are transformed into malignant ones. Cancer is the result of changes in DNA or chromosome structures that cause mutations of specific genes. |
| Invasive Ductal Carcinoma | Most common form. Malignant tumor in epithelial tissue, that tends to infiltrate and give rise to metastases. Spreads rapidly to axillary and other lymph nodes, even while small. Can be well differentiated and slow-growing, poorly differentiated and infiltrating, or highly malignant and undifferentiated with numerous metastases. Often starts in the ducts, breaks the duct wall, and invades the fatty breast tissue |
| Invasive Lobular Carcinoma | Invasive or infiltrating that originates in the terminal lobular units of the breast ducts. Peaks in early 60s. Presents as an area of ill-defined thickening rather that palpable masses. Frequently in the upper outer quadrant of the breast. By the time it is discovered the prognosis is usually poor. |
| Stage O Breast Cancer | In situ, early |
| Stage I Breast Cancer | Localized tumor < 1 in in diameter |
| Stage II Breast Cancer | Tumor 1-2 in in diameter, spread to axillary lymph nodes |
| Stage III Breast Cancer | Tumor 2 in or larger, spread to other lymph nodes and tissues |
| Stage IV Breast Cancer | Cancer has metastasized to other body organs |
| Neoadjuvant Chemotherapy or Radiotherapy is needed when | Tumors are large, bigger than 5 cm, OR there is inflammatory breast cancer. It is used to shrink the tumor before surgical removal |
| Lumpectomy | Breast-Conserving Surgery. The least invasive. Used in early-stage, localized tumors, with the removal of the tumor and a 1-cm margin of normal tissue |
| Mastectomy | Removal of all breast tissue, the nipple, and areola. The axillary nodes and pectoral muscles are spared. Used for Large tum,ors or multiple tumors that have not metastasized to adjacent structures or lymph system |
| Modified Radical Mastectomy | Conducive to breast reconstruction and resulting in greater mobility and less lymphedema. Involves removal of breast tissue, and a few positive axillary nodes. |
| Radiotherapy | High-energy rays to destroy cancer cells that may be left behind in the breast, chest wall, or underarm area after the tumor was removed. Usually given 5 days a week to the site for 6-8 weeks. |
| Chemotherapy | Use of drugs that are toxic to all cells and interfere with a cell's ability to reproduce. Particularly effective against malignant cells, but affects all rapidly dividing cells, especially skin, hair, mouth, GI tract and bone marrow. |
| Hormonal Therapy | Blocks or counters the effects of estrogen, as it plays a central role in pathogenesis of cancer, and treatment with estrogen deprivation has proven to be effective. |
| Immunotherapy | Used adjunct to surgery, represents an attempt to stimulate the body's natural defenses to recognize and attack cancer cells. |
| Nursing Assessment in Breast Cancer | Abnormality on mammogram, lump that is nontender, fixed, and hard with irregular borders. Changes in breast appearance and contour, lump/thickening of the breast, persistent nipple irritation, unusual breast swelling or asymmetry, lump or swelling in axilla, changes in skin color/texture, nipple retraction, tenderness, or discharge. |
| Nursing Interventions in Breast Cancer | Offering support, perioperative care, pain management, wound care, mobility care, respiratory care, emotional care and referral, educationhealth promotion, disease prevention, |
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