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med surg


neo new
plasia growth
plasm substance
trophy size
oma tumor
statis location
A none
Ana lack
Hyper excessive
meta change
dys bad,damaged
stomatitis inflammation or ulcers in the mouth
Alopecia loss of hair
neutropenia an abormally low level of neutrophils in the blood
Leukopenia reduction of the number of leukocytes in the blood, less than 5,000
palliative relieving pain or alleviating a problem without dealing with the underlying cause
neoplasm a new abnormal growth of tissue in some part of the body, esp. as a characteristic of cancer
Thrombocytopenia an abnormal hematologic condition in which the number of platelets is reduced to fewer than 100,000 mm^3 (increased risk of bleeding d/t inability to coagulate)
Carcinogen substance known to increase the risk for development of cancer
Hemopoietic system the bodily system of organs and tissues, primarily the bone marrow, spleen, tonsils, and lymph nodes, involved in the production of blood
What are the 7 signs of cancer? 1)changes in bowel or bladder habits 2)a sore that doesn't heal 3)unusual bleeding or discharge 4)thickening or lump in breast or elsewhere 5)indigestion or difficulty in swallowing 6)obvious change in warts or moles 7)nagging cough or hoarseness
what is cancer? uncontrolled division of abnormal cells in a part of the body
oncology branch of medicine concerning the study of tumors
what is the deadliest cancer? lung cancer
top cancer in men prostate
top cancer in women breast
How does cancer develop? some cells that should die, do not die and new cells form when the body doesn't need them. the extra cells may grow and multiply in a disorderly and unrestricted manner which forms a mass of tissue called a tumor.
environmental risk factor for developing cancer sunshine,radiation,hormones,viruses,bacteria, chemicals in the air, water, food or workplace, smoking cigarettes, excessive alcohol consumption,unhealthy diet,lack of exercise, or sexual behavior that increases ones exposure.
what can lead to melanoma and other forms of skin cancer? ultraviolet radiation from natural sunlight, sunlamps, or tanning beds.
sources of ionizing radiation cosmic rays, radon, fallout from atomic bombs, above ground nuclear testing, screening or diagnostic X-rays
what cancers are related to smoking? over a dozen including lung, mouth, bladder, colon and kidney cancers
what is oral cancer related to? chewing tobacco
Asbestos is linked to what? lung cancer and mesothelioma
Vinyl Chloride used in plastics is associated with what? lung cancer and angiosarcomas of the liver and brain
angiosarcoma blood vessel tumors
alcohol consumption may lead to what? cancers of mouth,throat,liver, larynx and esophagus ***increases risk of breast cancer
obesity is linked to which cancers? colon, endometrial, kidney, esophageal, and breast (in older women)
what foods increase risk for stomach and colorectal cancers? large quantities of red meats, preserved meats, salt-preserved meats, and salt
foods that prevent cancer veggies from cabbage family(broccoli,cabbage,brussel sprouts, cauliflower and kale),veggies high in carotene(carrots,peaches,squash,apricots, broccoli),and rich sources of vitamin c (grapefruit,oranges,peppers,broccoli, tomatoes,cantaloupe and strawberry
what virus causes cervical cancer? Human Papillomavirus, HPV
What is one of the major causes of liver cancer worldwide? Hepatitis B and C transmitted through blood transfusions, injectible drug use and unprotected sex
Karposi's Sarcoma a cancer that develops from the cells that line the lymph or blood vessels **usually have tumors on the skin or on mucosal membranes
One major symptom of Karposi's Sarcoma Blotchy lesions that are purple, red or brown most often on legs or face
Two cancers associated with HIV Hodgkin's Lymphoma and Karposi's Sarcoma
This causes mononucleosis and is associated with nasopharyngeal and gastric cancers Epstein-Barr Virus aka Herpers 4
Is cancer genetic? no more than 5% of new cancer cases are inherited
Tests for breast cancer gene BRCA1 and BRCA2 are the most common
Tests to diagnose breast cancer hormone receptor tests, mammogram, lymph node biopsy, and HER2 test
At what age should you get a baseline mammogram done? Age 40
When should you check your breasts for lumps? 7-10 days after menses every month, even following menopause and hysterectomy
How are breast biopsies performed? Fine-needle aspiration, needle biopsy, excisional biopsy, and incisional biopsy
What two drugs can alter pap smears? Tetracycline and digoxin (make sure client tells physician if on either of these)
PAP (Papanicolaou Smear) Study of cells that the body has shed during the normal growth and replacement. Done to detect cervical cancer. Best if done 2 weeks after first day of the last menstrual period. No douching several days before.
Pap smear results grade I Normal
Pap smear results grade II Abnormal or possible infection
Pap smear results grade III suspiciously malignant
Pap smear results grade IV probably malignant
Pap smear results grade V malignant
What is done when a pap smear comes back malignant? a punch biopsy is done, followed by a Cold Cone Procedure
what position is used for a pelvic exam? lithotomy
what does a patient need to do before a pelvic exam? empty bladder
how to help a patient through a pelvic exam encourage deep breathing and relaxation.
when should a testicular self-exam be done? once a month on the same day each month and after a warm bath or shower
when should a prostate exam be done? Annually for men over 50 years of age, or annually for men over 40 years of age that are African American or have a family hx of prostate cancer
if elevated this blood test could indicate prostate cancer PSA (Prostate Specific Antigen)
Non-invasive procedures to detect cancer blood tests, radiologic studies, mammograms and ultrasonography
what types of cancer is ultrasonography most applicable in detecting tumors? pelvic, retroperitoneal, and peritoneal
Non-invasive technique that uses sound waves directed into specific tissues Ultrasonography
non-invasive technique that allows visualization of internal structures radiologic studies
Invasive procedures to detect cancer endoscopy, exploratory surgery, frozen section and biopsy exam
What elevated blood tests could indicate cancer? PSA (prostate), CA-125(ovarian), Alkaline Phosphate (bone mets), Calcium (bone), Ferritin (when fighting cancer), and CEA (carcinoembyronic antigen)
What do you need to do if a patient s receiving a CT scan? check allergy to shellfish and no metformin the day of the test if with contrast
What is the most important thing to remember if a patient is receiving an MRI? Remove all metal ***take a careful hx
MRI contraindicated in what patients? pacemaker, any metallic implant, heart valve prosthesis, metal IV intracatheter, gold fillings in ttteeeth, and metal workers(metal fragments in body)
How should you prepare your patient for an MRI? Explain about being enclosed in the machine, the clicking noise, will not be left alone, and more comfortable with eyes closed d/t brightness of machine interior
types of biopsies incisional, excisional, and needle aspiration
incisional biopsy piece of tissue is removed from the lesion and studied under a microscope
excisional biopsy remove the complete lesion
needle aspiration fluid or tissue from the lesion is removed
HOw to prep a pt for a biopsy must have informed consent and explain the procedure to patient very carefully. Need a biopsy tray and anesthetic (sterile technique)
Nursing care after a biopsy the client may or may not be in pain administer pain meds as needed, bed rest for a few hours, monitor vital signs for any signs of shock d/t bleeding (decrease BP, increased Pulse) emotional support until results are back, monitor dressing for bleeding
Benign neoplasm harmless, the tumor is encapsulated, grow slowly, remain localized, usually do not reoccur if removed, good prognosis, can obstruct pathways and interfere with organ function
encapsulated definition it is covered with a fibrous capsule that prevents the release of cells and prevent spreading to other body parts
Malignant tumor made of abnormal cells, do not resemble normal cells in structure, grow and multiply rapidly in disorganized fashion, uncontrolled, not encapsulated, cells move easily thru the body, prognosis poor, metastasize to different organs and tissues
Metastasis how cancer spreads; the ability of cancer cells to penetrate into lymphatic and blood vessels, circulate through the bloodstream, and then invade and grow in normal tissues elsewhere.
Angiogenesis process of forming new blood vessels (tumor growth stops without this)
Two ways cancer can metastasize besides through blood and lymphatic vessels invasion of nearby tissue(extension/seeding) and the cancer cells invade nearby normal tissues and organs or transplantation during surgery
how are tumors classified? by where they originate
lipoma fatty tumor
fibroma tumor composed of fibrous tissue
types of malignant tumors sarcoma, carcinoma, lyphoma, and Leukemia
Sarcoma tumor of connective tissue; muscle, bone, fat, blood vessels and may affect bone,bladder, kidneys, liver, liver, parotids, and spleen
Carcinoma made of epithelial cells, tends to metastasize, originate from skin,glands,mucous membran linings of the respiratory tract,GI tract or genitourinary tract
Lymphoma type of blood cancer that occurs when B or T lymphocytes begin behaving abnormally
Leukemia type of cancer of the blood or bone marrow characterized by an abnormal increase of immature WBC called blasts
4 criteria for classifying tumors -anatomical site -grading (differentiation) -staging (extent of spread) -TNM (tumor size, node involvment, metastasis)
Differentiation degree to which the cancer cells look like the original specialized cells
stage I cancer cancer is limited to tissue or organ of origin
stage II cancer limited local spread
stage III cancer extensive local and regional spread
stage IV cancer cancer has spread to distant parts of the body (metastasized)
3 methods to treat cancer surgery, chemotherapy, and radiation therapy
radiation therapy high energy radiation used to kill cancer cells by damaging their DNA (can't self-repair), may be frrom outside the body or by radioactive material placed into the body, and it may be given alone or in combo with chemo
what diet should a person receiving radiation therapy have? high-calorie, high protein to build new tissue
Prepping a patient for radiation therapy empty bowels and bladder, adequate hydration, rested if possible
skin after radiation therapy avoid lotions ointments and powders, avoid sun exposure to irradiated areas, do not wash off indelible ink markings, area becomes reddened then scarlet the area peels , becomes leathery and goes back to normal after a few weeks
skin care after radiation monitor for desquamation, use warm water and pat dry, water based moisture only, apply antibiotic ointments or steroid cream as prescribed, may apply cool compresses to relieve itching, get an order for Aquaphor
Side effects of radiation alopecia, headache, n+v, diarrhea, anorexia, fatigue, fever, thrombocytopenia(bleeding), dry mouth, loss of taste, esophagitis/cystitis
nursing considerations after radiation therapy monitor vitals, WBC, RBC and platlets for s/s of infection, may use lidocaine mouth rinse for mouth sores, give several small feedings, offer antiemetics and antidiarrheals
brachytherapy internal radiation therapy delivered from radiation sources placed inside or on the body
types if brachytherapy interstitial, intracavitary, and episcleral
interstitial brachytherapy radon source placed within tumor tissue
intracavitary brachytherapy a radon source is placed within a surgiccal cavity or a body cavity near a tumor
episcleral brachytherapy a radon source is attached to the eye to rteat melanoma inside the eye
nursing considerations with Brachytherapy secretions are radioactive(double glove,double flush), use eyewear,gown, no visitors under 18 or pregnant, Never touch dislodged applicator(tongs), avoid complete bed baths when app in place, no more than 10 min within 6ft, private room, sign on door
monitoring a patient with brachytherapy monitor for bleeding, skin erruptions or discharge, watch for implant in bedpan, forceps and led container in room, do not pull threads attached to implant, monitor for dehydration, encourage fluids, maintain patent foley, monitor for paralytic ileus
Bone marrow transplant replaces bone marrow that either is not working properly or has been destroyed by chemotherapy or radiation. used for leukemia, lymphoma and multiple myeloma. Administered through IV line
Ablative (myeloablative) treatment high-dose chemotherapy, radiation or both are given to kil any cancer cells. Also kills healthy bone marrow that remains, and allows new stem cells to grow in bone marrow
Reducred intensity (nonmyeloblative) treatment aka a mini transplant patients recieve lower doses of chemotherapy and radiation before a transplant.
Autologous bone marrow transplant clients own bone marrow is stored, frozen and used at a later date
Allogenic bone marrow transplant compatible donor
Related bone marrow transplant from a family member
Syngenetic bone marrow transplant from an identical twin
engraftment transplanted bone marrow starts making new bone marrow
nursing considerations with bone marrow transplant patient is immunosuppressed for 2-4wks, infection and severe thrombocytopenia are major concerns, major complications include failure to engraft and graft vs host disease
graft vs host disease the donor cells identify recipient cells as foreign and attacks the recipient caused by inadequate immunosuppression of the donor
signs and symptoms of graft vs host disease skin lesions, ulceration, pruritis, hemolytic anemia, yellow discoloration of skin and/or eyes, n+v, diarrhea, abdominal cramping, and increased dryness/irritation of the eyes
curative surgery performed if the cancer is localized to the organ and regional lymph nodes
palliative surgery performed if the risk/benefit ratio is favorable and if it can benefit the client and improve quality of life
what is important to be aware of when a pt has had a mastectomy/lumpectomy? psycholigical effects can be devastating and they can occur same day or be delayed.
preventative surgery performed in certain conditions that may increase the risk of cancer, may be done based on genetic testing for patients at high risk
chemotherapy the treatment of cancer with one or more cytotoxic antineoplastic drugs to destroy the cancer while doing as little damage as possible to normal cells. effective because the drugs effect some phases of the cell life cycle
chemotherapeutic agents act by killing cells that divide rapidly which is one of the main properties of cancer cells (kills cells that divide rapidly under normal circumstances as well)
Chemotherapy side effects myelosuppression, mucositis, and alopecia ***BARFS- bone marrow suppression, alopecia, retching,fear/anxiety,stomatitis can also cause infertility, loss of libido or erectile dysfunction
myelosuppression decreased production of RBC leading to immunosuppression
mucositis inflammation of the lining of the digestive tract, usually the mouth(stomatitis)
s/s of bone marrow suppression anemia, leukocytopenia, thrombocytopenia
s/s anemia fatigue, paleness of skin,lips,nailbeds, increased heart rate, easily tiring with exertion, dizziness, and SOB
s/s of leukocytopenia fever, chills, rash, diarrhea, and s/s of infection
s/s of thrombocytopenia easy brusing, bleeding;nose bleeds, gums, mouth, or tiny red spots on the skin, blood in urine and dark/black bowel movements
Extravasation of chemo can cause what? irritation, blisters, necrosis, sloughing, and ulcers so check IV site frequently
nursing care of a chemo patient antiemetics administered before and after, IV hydration, encourage fluids of 2,000ml/day, frequent oral hygiene, satin pillow cases, soft baby brush, instruct on contraceptives
What do antineoplastic drugs do? kill or inhibit the reproduction of neoplastic cells
types of chemo alkylating agents, antimetabolites, Anthracyclines, Topoisomerase inhibitors, Mitotic inhibitors, and corticosteroids
alkylating agents directly damage DNA, works in all phases of the cell cycle
Antimetabolites interfere with DNA and RNA growth by substituting for the normal building blocks of RNA and DNA (damage is done during S phase)
Anthracyclines anti-tumor antibiotics that interfere with enzymes involved in DNA replication, works in all phases of cell cycle
Topoisomerase inhibitors interfere with enzymes called topoisomerases which help separate the strands of DNA so they canbe copied
mitotic inhibitors often plant alkaloids and other compounds derived from natural products. Can stop mitosis or inhibit enzymes from making proteins needed for cell reproductio. work during M phase of cell cycle but can damage cells in all phases.
corticosteroids natural hormones and hormone-like drugs that are useful in treating some types of cancers as well as other illnesses. When used to kill cancer cells or slow their growth they are considered chemotherapy drugs
Differentiating Agents act on cancer cells to make them mature into normal cells
hormone therapy sex hormones or hormone-like drugs that change the action or production of female or male hormones. used to slow the growth of breast, prostate, and endometrial(uterine) cancers
immunotherapy given to people with cancer to stimulate their natural immune systems to recognize and attack cancer cells. (separate from chemotherapy)
cancer vaccines are in development ex rituximab(rituxan), alemtuzumab (Campath), thalidomide, and lenalidomide (Revlimid)
Tumor lysis syndrome occurs withing 24h to 7d after chemo, the chemo causes destruction of very large number of cancer cells and are released into blood stream causing renal failure
s/s tumor lysis syndrome n/v/d, anorexia, muscle weakness, cramping, hyperkalemia, paresthesia, tenany(low Ca, High phosphorus), high uric acid, death
Created by: Purple butterfly