MedSurge-Cancer
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| Cancer S/S | CAUTION
C change in bowel/bladder
A a sore that won't heal
U unusual bleeding/discharge
T thickening lump
I indigestion/difficulty swallowing
O obvious change wart/mole
N nagging cough/hoarseness
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| Genetic tests (BRCA1, BRCA2) | mutations in genes can dispose woman to high risk of breast cancer
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| Tissue Biopsy | definitive diagnosis of abnormal cells
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| CBC and differential | screening for leukemia's
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| Chest X-ray, CT scan, MRI, PET, SPECT | used to visualize tumors, metastasis, or progression of cancer
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| CEA, CA-125, PSA, beta-hG, AFP | blood tests that screen for cancers of colon, pancreas, liver, prostate, uterus, and ovaries
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| CEA, acronym for? | carcinoembryonic antigen
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| CA-125, acronym for? | cancer antigen 125
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| PSA, acronym for? | prostate-specific antigen
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| beta-hCG, acronym for? | human chronic gonadotropin
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| AFP, acronym for? | alpha fetoprotein
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| Tumors are staged based on? | tumor, node, metastasis
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| Staging Tumor (TX) | unable to evaluate the primary tumor
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| Staging Tumor (T0) | no evidence of primary tumor
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| Staging Tumor (Tis) | tumor in situ
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| Staging Tumor (T1, T2, T3, or T4) | size and extent of tumor
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| Staging Tumor (NX) | unable to evaluate regional lymph nodes
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| Staging Tumor (N0) | no evidence of regional node involvement
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| Staging Tumor (N1, N2, N3, or N4) | number of nodes that are involved and/or extent of spread
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| Staging Tumor (MX) | unable to evaluate distant metastasis
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| Staging Tumor (M0) | no evidence of metastasis
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| Staging Tumor (MI) | presence of distant metastasis
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| SIADH, acronym for? | Syndrome of Inappropriate Diuretic Hormone
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| SIADH, causes? | water retention, dilution of electrolytes (sodium)
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| SIADH, nursing response... | - monitor for hyponatremia
- admin. Furosemide
- admin. HYPERtonic saline
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| define epistaxis | nosebleed
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| Place cancer pt. in private room if WBC count less than? | 1,000/mm3 & initiate neutropenic precautions
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| Neutropenic Precautions... | - mask pt. during transport
- pt. remain in room
- clean room, H2O, no plants
- restrict ill visitors
- avoid invasive procedures/needles
- keep equip. in pt. room
- admin. Colony-stimulating factors
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| Colony-stimulation factor meds? | eg. Neupogen, Neulasta
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| Cancer pt. should wash toothbrush in? | dishwasher or rinse in bleach solution
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| Megesterol (Megace) is administered to? | increase pt. appetite
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| Mouth care should be done (before / after) meals? | before to enhance client's appetite
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| Antiemetics should be administered? (before / after meals)? | before
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| Improvement in metallic taste can be accomplished by? | - using plastic utensils
- sucking hard candy
- avoiding red meats
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| For itchy scalp associated with alopecia, pt. can use | diaper rash ointment
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| ____-based mouth washes should be avoided with mucositis | Glycerin
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| Pt. should rinse mouth with what solution? | 0.9% NaCL and half peroxide, BID w/soft toothbrush
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| Cancer diet considerations? | soft foods, high proteins eg.
mashed potatoes, scrambled eggs, cooked cereals, milk shakes, ice cream, yogurt, bananas
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| Bleeding precautions... | - avoid IV's / injections
- apply pressure @10 min.
- handle pt. gently, avoid trauma
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| S/S Anemia | - fatigue
- pallor
- dizziness
- SOB
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| Anemia med to administer... | Erythropoietin Alfa (Epogen)
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| Antianemic med to administer... | Ferrous sulfate (Feosol)
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| S/S Thrombocytopenia | - petechiae
- ecchymosis
- bleeding gums
- nosebleeds
- blood in stools, urine, vomitus
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| Thrombopoietic med to administer... | Oprelvekin (Interleukin 11, Neumega)
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| Platelets should be administered if count falls below? | 30,000/mm3
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| define Brachytherapy | radiation administered internally with an implant
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| IV radiation drug? | radionuclide iodine
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| Dosimeter film badge is used to? | records the amount of radiation exposure
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| When pt. is receiving brachytherapy, visitors should? | - limit visit to 30 min.
- remain 6ft. from pt.
- should not be pregnant
- should be over 16 yrs.
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| A common side effect of radiation therapy is? | fatigue
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| Effective meds against tumors that require hormone support? | Leuprolide (Eligard, Lupron)
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| Androgenic hormones can suppress cancer in pts. with? | estrogen-dependent cancer
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| Estrogenic hormones can suppress cancer in pts. with? | testosterone-dependent cancer
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| Males receiving Estrogenic hormones may experience? | gynectomastia, hot flashes, bone loss
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| Flutamide (Eulexin) is a? | Androgen antagonist
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| Estrogen antagonists S/E? | N/V, hot flashes, weight gain, vaginal bleeding, inc. risk thrombosis
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| The two primary cytokines used in immunotherapy are? | Interleukins and Interferons
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| Interlulkins... | help coordinate the inflammatory and immune responses of the body (lymphocytes)
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| Interferons... | when stimulated, can exert an anti-tumor effect by activating a variety of responses
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| Cytokines... | work to enhance the immune system
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| Interleukin's, monitor for? | flu-like symptoms, edema
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| Interferon's, monitor for? | peripheral neuropathy (issues w/vision, hearing, balance, gait)
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| Progression is the? | Final stage of cancer
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| Progression is characterized by | - increased growth rate
- increased invasiveness
- spread of the cancer to a distant site
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| Progression occurs due to? | - rapid proliferation
- decreased cell adhesion
- production of metalloproteinase enzymes
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| Tumor-associated antigens | the altered cell surface antigens as a result of malignant transformation
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| 3 Methods of cancer pain management? | surgery / radiation / chemotherapy
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| Opioids in cancer Tx, given for? | moderate to severe pain
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| Antidepressants in cancer Tx, given for? | to reduce associated depression, promote sleep, and increase serotonin levels that may improve feelings of well-being
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| Anticonvulsants in cancer Tx, given for? | to treat neuralgia or neuropathic-type
pain
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| Steroids in cancer Tx, given for? | reduce pain by reducing swelling
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| Adjunctive agents (Sympatholytic agents) in cancer Tx, given for? | Used to treat neuropathic pain
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| Skeletal muscle relaxants in cancer Tx, given for? | May be used along with other pain meds for muscle spasms assoc. with cancer pain
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| Rectal med administration, contraindicated in pts. with? | low WBC or low platelet count
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| Anesthetic used for isolated pain? | bupivacaine and/or a corticosteroid
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| Intercostal nerve blocks used for? | anesthetic for chest or abdominal wall pain, procedure 15 min - 1 hr.
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| S/S Systemic Infusion... | metallic taste, ringing in ears, perioral numbness, seizures
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| Location of epidural space _____ | space outside the dura mater of the spinal cord
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| Location of intrathecal space _____ | the subarachnoid area within the spinal cord sheath that contains cerebrospinal fluid
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| External catheter placed for long-term pain management of which areas? | abdomen, thorax, below umbilicus
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| Neurolytic ablation, involves? | interrupting the nerve pathway or destroying the nerve roots that are causing pain
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| Neurolytic ablation may cause... | loss of sensory, motor, and autonomic function
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| Radiofrequency ablation, involves? | Electrical currency creates heat on a probe guided to tumor or nerves; to destroy cancer cells or ablate nerve endings
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| Cryoanalgesia, involves? | Uses a needle-like probe to deliver extreme cold to interfere with pain conduction via nerve pathways
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| Transcutaneous electrical nerve stimulation, (TENS) involve? | Low-volt electrical impulses transmitted thru electrodes attached to the skin
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| Do not use TENS on pts. with? | pacemakers or infusion pumps
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| metastasis is? | cancer cells may invade surrounding tissues and/or spread to other areas of the body
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| Carcinomas arise from? | epithelial tissue
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| Adenocarcinomas arise from? | glandular organs
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| Sarcomas arise from? | mesenchymal tissue
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| Leukemias are? | malignancies of the blood-forming cells
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| Lymphomas arise from? | lymph tissue
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| Multiple myeloma arises from? | plasma cells and affects the bone
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