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Cancer MS2

QuestionAnswer
Genetic/blood tests BRCA1/BRCA2 for breast cancer, PSA for prostate cancer
Mammography x-ray of breast for breast cancer
MRI For pelvic, abdominal, thoracic, breast and brain cancers
CT For neuro, pelvic, abdominal, skeletal, thoracic cancers
Ultrasound For abdominal and pelvic cancers
Endoscopy Requires sedation. Can biopsy, aspirate, excise tissue. For diagnostic or therapeutic purposes
Nuclear imaging IV or ingestion of radioisotope. For bone, liver, kidney, spleen, brain and thyroid cancers
PET scans Assess biologic activity. Can detect response to treatment. For lung, colon, liver, pancreatic, head/neck, lymphoma and melanoma cancers.
Fluoroscopy Continuous x-ray. For GI cancers
External radiation Small doses over several weeks. Adjunct to chemo. Client is not radioactive. Do not wash off marks. Can cure some cancers (thyroid, head/neck, some cervical)
External radiation adverse effects Skin changes, hair loss, stomatitis, BAD fatigue, anorexia, bone marrow suppression, anorexia. Can persist for months or years after treatment
External radiation considerations Monitor CBC (look for low WBC, platelets, RBCs)
Internal radiation Placed within or close to cancer (usually vaginal, abdominal or intravenous), patients may go home. Client’s excretions are radioactive .
Internal radiation considerations Private room, sign on door, personnel wear a dosimeter badge or record radiation exposure, limit visitors to 30 mins and 6 ft away, no pregnant or child visitors. Caregivers wear lead apron, cluster care
Chemotherapy education Just as toxic to nurse as it is the client (wear PPE). DO NOT crush, split, break or chew. If given longer than 1 hour or frequently then use central line (via Huber needle).
Extravasation Leakage of solution into surrounding tissue. Vesicant or Irritant.
Vesicant Inflammation, tissue damage, necrosis of tendons, nerves, muscle, blood vessels. Very painful, extensive damage
Irritant Local inflammatory reaction, no permanent damage
Extravasation indications Absence of blood return, infusion stopped. Burning, pain, swelling, or redness at IV site
Extravasation interventions STOP infusion immediately, antidote (leave catheter in place for antidote), notify provider, apply ice, elevate arm.
Chemotherapy side effects N/V, diarrhea, myelosuppression, alopecia, stomatitis, mucositis. Cyclophosphamide can cause hemorrhagic cystitis.
Chemoproctecant agents Mesna helps prevent hemorrhagic cystitis. Amifostine prevents kidney damage and mucositis.
Nadir Point in time when counts (neutropenia, anemia, thrombocytopenia) are the lowest
Neutropenia management Temp q4 hours, limit Tylenol, cultures done with first fever. Temp should drop 1 degree in 24 hours, and be gone after 48 hours if antibiotic is working.
Neutropenia Decreased number of granulocytes (a white blood cell). ANC = number of granulocytes in blood. Less than 500 ANC = severe infection risk.
Colony stimulating factors Stimulates bone marrow to produce granulocytes. DO NOT administer within 24-hours of starting or finishing chemotherapy
Neutropenic precautions Private room, no fresh fruit/veggies, no live plants, no sick visitors, no small children, Pt wears mask outside of room, avoid invasive procedures
Anti-emetics Odansteron (acute emesis), aprepitant (delayed emesis), dexamethasone (delayed emesis). All three can be used in combo
Management of N/V (chemo induced) Antiemetics before chemo, small meals, avoid fatty, greasy, spicy, sweet foods, avoid favorite foods
Radiation recall Redness in a previously irradiated area (may be months or years ago), may be painful, treat symptomatically
Neurotoxicity Numbness and tingling of fingers and toes, sensitivity to cold, mental status changes. Reversible when Rx is stopped
Created by: Haydenmeh
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