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NUR 112
Cancer therapies
| Question | Answer |
|---|---|
| what is a neoplasm? | another word for tumor -- mass of tissues/ cells that have grown at an irregular rate |
| what are the 2 types of neoplasms? | benign and malignant |
| characteristics of benign neoplasms | solid mass well-defined borders encapsulated; respond to body’s homeostatic controls typically doesn't endanger life |
| when do benign neoplasms stop growing | typically stop growing when reaching boundaries of another tissue’s borders |
| when might there be complications related to benign neoplasms? | due to secondary effects on surrounding tissues and obstructing function of organs (ex tumor presses on abdomen and pt cannot eat anything due to this) |
| how do malignant neoplasms grow | -Grow aggressively – do not respond to body’s homeostatic controls -“cut through” surrounding tissues (invasion) causing bleeding, inflammation, and tissue death (necrosis) |
| what is metastasis | spreading of malignant neoplasms to other areas of the body; Will have a primary tumor (tissue of origin) that will identify type of cancer |
| can malignant neoplasms return after surgical removal | yes |
| 3 characteristics a malignant neoplasm has to meet to be metastasis | 1.Intravasation of malignant cells through blood or lymphatic vessels walls into circulation 2. Survival of malignant cells in blood (escape immune surveillance) 3. Extravasation from circulation and implantation in new tissue |
| Chemotaxis | movement of cells in response to chemical stimulus |
| characteristics of invasion and metastasis | Ability to cause pressure atrophy Ability to disrupt the basement membrane of normal cells Motility |
| causative agents of cancer | carcinogens – 2 categories -Genotoxic – directly alter DNA and cause mutations -Promoter substances – cause adverse biological effects (cytotoxicity, hormone imbalances, altered immunity, chronic tissue damage, etc.) |
| modifiable risk factors for cancer | Poverty Stress Diet Tobacco use Alcohol use Recreational drug use Obesity Sun exposure Occupation Infection |
| non-modifiable risk factors for cancer | Genetics Age Sex poverty occupation infection |
| Anorexia-cachexia syndrome | Loss of appetite; involuntary weight loss; muscle wasting; emaciated appearance; fatigue |
| Disruption of function manifestations | Bowel obstruction; urinary retention; varies on location |
| Hematologic alterations manifestations | Secondary anemia; clotting disorders; vitamin B12 and iron malabsorption |
| Hemorrhage manifestations | Bruising; petechiae; hemoptysis; hematemesis; hematochezia; dependent on location |
| Infection manifestations | Fever; malaise; fatigue; septicemia |
| pain manifestations | acute or chronic; type and severity vary; depends on location |
| Paraneoplastic syndromes | Depends on location – increased hormone production from ectopic tumor site will look similar to hypersecretion of hormone |
| Psychological stress | Guilt;, fear; anxiety; hopelessness; panic; depression; anger |
| cancer preventions | Avoid smoking Eating balanced diet Limit alcohol consumption Vaccination Good physical health; regular exercise Wearing sunscreen and sunglasses that protect from UV rays Using PPE if workplace involves environmental hazards |
| gold standard for cancer diagnosis | BIOPSY! - examination of tissue reveals the type of cell and its structural difference from parent tissue |
| treatment options for cancer | Surgical procedures Chemotherapy Radiation Hormone Therapy Immunotherapy Supportive treatment |
| goals of radiation therapy | Shrink tumor pre-operatively Prevention of postoperative tumor recurrence Eradication of cancer cells in other parts of the body Sometimes palliative only |
| what is brachytherapy | implantation of radioactive “seeds” to deliver radiation in a specific area of the body |
| nursing interventions for internal radiation therapy | Careful handling of body fluid Positioning based on radiation source Radiation precautions DISPOSAL IN LEAD LINED CONTAINERS |
| nursing interventions for external radiation therapy | Skin/mucous membrane assessment -->Clean with mild soap using hands Monitor for fatigue and injury to radiated area |
| difference between internal and external therapy | internal is more specific; external will affect cancerous cells and surrounding tissues |
| is a person undergoing brachytherapy considered radioactive? | considered radioactive for 48 hours after implantation |
| precautions for radiation therapies | Patient with implanted radiation should be in lead-lined room Nurse wears protective barrier such as lead apron Limit time/exposure as much as possible No pregnant health care workers assigned to patient |
| what is chemotherapy | Cytotoxic medications that damage cellular DNA or destroy rapidly dividing cells |
| what are the side effects of chemo related to? | Adverse effects related to unintentional harm to normal cells because it also kills other rapidly regenerating cells (ex hair) |
| when undergoing chemo, how long are body fluids hazardous | treated as hazardous for at least 48 hours from last chemotherapy dose |
| common ending for chemo drugs | -mab and -nib |
| chemotherapy complications | Immunosuppression (neutropenia) N/V Anorexia*/Malnutrition Mucositis Stomatitis Anemia Thrombocytopenia Peripheral neuropathy Cognition change |
| what is mucositis? | inflammation of the mucosa that line your mouth and your entire gastrointestinal tract |
| 3 types of rapidly regenerating cells that can be disrupted by chemotherapy | hair, mouth, and stomach lining cells |
| neutropenia; absolute neutrophil count (ANP) | < 2.0 10^9/L |
| role of neutrophils in the body | 1st responder to infections |
| Neutropenic precautions | Monitor WBCs, ANC, and VS (No of fever does not rule out infection) Private room/ wear masks No fresh fruit/ flowers Visitors restricted/limit germ exposure Meticulous hand hygiene Avoid children Assess oral mucosa for oral candidiasis |
| how to treat oral candidiasis (thrush) | tx with antifungal mouthwash (Nystatin) |
| times of higher risk for hazardous drugs | Needle sticks Contaminated food/beverage Any step of the medication preparation or administration process Caring for body fluids of a patient receiving hazardous drugs |
| Hazardous Drug Precautions exposure risk to HCPs | Can cause chromosomal damage if not using proper PPE Teratogenic |
| symptoms of exposure to hazardous drugs (chemo) | hair loss, abdominal pain, fatigue, nausea, allergic reactions, contact dermatitis, skin/eye/nasal injury |
| PPE for chemo admin | Gloves (double glove & wash with soap and water after taking off) Gowns Face protection/ splash guard Respiratory protection |
| is PPE necessary for oral chemo pills | NO |
Created by:
ginnyfoscue
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