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med surg
Oncology
| Term | Definition |
|---|---|
| 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 |
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