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Ch. 16


what is cancer abnormal cell transformed by genetic mutation of cellular DNA
what is metastsis primary site then travels to other tissues. Lymphatic, hematogenous, angiogenesis spread
what are malignant cancer cells uncontrolled growth that does not follow physiologic demand
what is leading cancer for males? females? Cancer deaths for males/females Prostate 29%, Lung 15% Breast 26%, Lung 15% Lung and bronchus
what are oncogenes tumor inducing genes
what are carcinogens agents that cause cancer - chemical radiation, viral
what is carcinoma ectoderm/endoderm(skin,glands,mucus membranes)
what is sarcoma mesoderm(connective tissue)
what is leukemia, lymphoma hematopoietic tissue
what is difference in benign and malignant tumors benign: differentiated, grows encapaulated malignant: nondefined, nonfx, grows sending out fingers, destruction
what is 3 step process for carcinogenesis initiation, promotion, progression(malignant behavior)
what are some factors that can cause cancer viral/bacteria, physical(sun), chemical(tobacco), genetic, diet(cured meats, nitrates), hormones(DES), immunosuppression(rheumatoid arthritis)
what is primary prevention of cancer? secondary? primary: education(lifestyle, avoid) secondary: screening(mammogram, SBE, pap smear)
what are seven warning signs of cancer C-change in bowel/bladder habits A-a sore that doesn't heal U-unusual bleeding or discharge T-thickening or lump in breast I-indigestion/dysphagia(trouble swallowing) O-obvious change in wart/mole N-nagging cough/hoarseness
what are steps to minimize cancer incr: veg/fruits, fiber, vit C decr: wt, cured meat, sale, high fat, alcohol, sun
Prostate exam should begin at age? rectal? BSE mo? mammography? pap smear yearly prostate/rectal >50 mammography >40 BSE>20 pap smear >18 if sex
what are some diagnostic studies for cancer PSA, 1st descendents, fluoroscopy(contrast), ultrasound, biopsy, CBC, CT, PET, MRI
what is tumor staging determine size of tumor, existence of metastasis
what is tumor grading classification of tumor cells
what is method for staging and grading T: extent of size of tumor N: lymph node involvement M: extent of metastasis Sentinel lymph node
T1,N1,M1 = Tis,N0,Mx = size1, 1node, metastasized ca in situ, no evidence, cannot be determined
What is Stage 0? I,II,III? IV? 0: Ca in situ(early on top layer) I,II,III: more, gr. size, more metastasis IV: Spread to another organ
what is Cancer management possibilities cure, control, palliative
what is most ideal tx of ca? what is debulking surgery, local/wide incisions debulking: remove all tumor and surrounding tissues and nodes.
what is prophylactic, palliative, reconstructive, salvage surgeries prophylactic: colectomy, mastectomy, oophorectomy palliative: relieve complications reconstructive: may follow other surgery Salvage: treat local recurrence(mastectomy after lumpectomy)
what are three types of biopsy incisional(lg tumor too lg to remove), excisional(sm tumor), needle aspiration
What is simulation in radiation therapy process to define and aim radiation beam. Deliver lethal dose(95% of tumor killed)
what is brachytherapy? teletherapy? implant radioactive device inside body cavity external radiation
which kind of tissue is affected most by radiation faster growing tissue: bone marrow, lymph, hair, gonads, gastric, epithelium
what is protocol for workers and brachytherapy time/distance/shielding: 30min visitors, 6ft away Wear film badge(measures dosimeter) no preggies
what should be done to preserve skin integrity for radiation pts avoid soaps/lotions..., rubbing, shaving with straight edge razor, sunlight, tight clothing. Use Vit A & D
what is wet desquamation and how tx blisters Avoid too much washing, use Telfa(waxy) dsg if weepy. Hydrocolloids, hydro gels
what are some GI SE? TX? stomatitis, xerostomia(dry mouth), anorexia, N/V/D Tx: cold meals, bland, small, anti-emetics b4
How are chemo agents classified? cell cycle, chemical group, vesicants
what is a vesicant and what does it cause very strong chemo agent that kills tissue and can cause extravasation. Use central lines, not peripheral s/s: absence of blood return from IV, swelling, pain, redness at site
what are cell cycle non-specific chemo drugs? effect cell during all cycles. Alkylating agents, nitrosureas, antitumor antibiotics, hormone therapy
what are cell cycle specific drugs antimetabolites (S), Mitotic inhibitors(M), Topoisomerase inhibitors: (S), Mitotic spindle poisons(M) S = synthesis, M = cell division
what is important about intrathecal route of chemo Helps attack CNS tumors
what is a tunneled catheter and what are examples central line threaded under skin and brought to suface distal to vessel. Hickman(3-lines)/Groshong
what is nadir lowest level of neutrophil count, so may hold off on chemo til rises
what are some nsg mgmt in chemo fluid lvls, stomatitis, N/V, pain, altered taste Modify risk for inf, bleeding, safe adm of chemo, protect caregivers
how long can you give bone marrow transplant after immunosuppression 48-72hrs
what are types of BMT(bone marrow transplants) allogenic: clost match autogenic: self syngeneic: twins
what r some complications to BMT graft vs host disease, venous occlusive dis
what are some nsg interventions of pt w/ Ca help SE, nutrition, pain(break through pain-eleavil), fatigue, inf, shock, bleeding(avoid NSAIDS, IM, supp, enemas, constipation). Educate
what is alopecia and when will it start/stop? hair loss begins 2-3wks after tx begins and hair growth 8 wks after tx ends.
Neupogen is a hematopoiectic growth factor for what? bone pain SE, boost WBC, Procrit,Epogen,Aranesp- RBCs
what are s/s of shock alterend mental status, temp change, cool clammy skin, decr UO, hypotension, tachy, tachypnea
what are cytokines and examples produced by cells of immune system: interferons, interleukins, coly-stimulating factors, tumor necrosis factors
what temp should pt call dr about >100.4
thrombocytopenia is a platelet count of what? <100,000
what are some oncologic emergencies infection, superior vena cava syndrome(elevate HOB), spinal cord compression, third space syndrome, cardiac tamponade(fluid in percardial sac), pulsus paradoxus, SIADH(most commonly caused by Ca), hypercalcemia, tumor lysis syndrome
Created by: palmerag