68WM6 Phase 2 test 17 Cancer
Quiz yourself by thinking what should be in
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| group of diseases characterized by uncontrolled growth and spread of abnormal cells that can result in death if not detected and controlled | cancer
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| a malignant growth composed of epithelial cells that tend to spread to other areas of the body | carcinoma
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| any cancer producing substance | carcinogen
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| process by which normal cells are transformed into cancer cells | carcinogenesis
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| not malignant, not recurrent, not spreading, favorable for recovery | benign
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| process by which tumor cells are spread to distant parts of the body, from a primary site to a secondary site | metastasis
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| loss of hair | alopecia
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| something having its origin within an individual, especially a factor present in tissues of fluids | autologous
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| removal of a small piece of tissue from an organ or other part of the body | biopsy
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| most like the parent tissue | differentiated
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| immune system's recognition and destruction of newly developed abnormal cells | immunosurveillance
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| reduction in the number of circulating white blood cells due to depression of the bone marrow | leukopenia
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| uncontrolled or abnormal growth of cells | neoplasm
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| sum of knowledge regarding tumors, study of cancer | oncology
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| therapy designed to relieve or reduce intensity of uncomfortable symptoms, but does not produce a cure | palliative
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| studying cells that the body has shed during the normal sequence of growth and replacement of body tissue, if cancer is present cancer cells also shed - used to detect cancer in women | papanicolaou smear - PAP smear
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| malignant tumor of connective tissues, such as muscle or bone, painless swelling | sarcoma
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| mouth inflammation caused by destruction of normal cells in the oral cavity | stomatits
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| reduction in the number of circulating platelets due to the suppression of the bone marrow | thrombocytopenia
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| oncologic emergency that occurs with rapid lysis of malignant cells | tumor lysis syndrome
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| Cancer is the leading cause of cancer-related death in both men and women | lung cancer - peak 55-65 y/o
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| ___ cancer is the most common cancer in women (excluding skin cancer) | breast cancer
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| ___ cancer is the most common cancer in men (excluding skin cancer) | prostate cancer
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| ___ cancer is the most common cancer in both men and women | skin cancer; Melanoma-most seriou, non-melanoma is most common
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| ___ cancer is the second most common cancer affecting both men and women | Gastrointestinal
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| Risk for developing cancer | Smoking Smokeless tobacco Diet Obesity Sunlight Radiation Heavy alcohol use
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| Cancer-related checkup every three years from age ___ to ___ | 20-40
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| how often should you get a cancer related exam after the age of 40? | Yearly
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| Beginning at age 50 you should start getting 4 tests...what are they? | Yearly fecal occult blood test Sigmoidoscopy every 5 years Double contrast barium enema every 5 years Colonoscopy every 10 years
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| Females should undergo the following screening exams throughout their life to screen for cancers | yearly pelvic/pap smear at 18 y/o; monthly breast exam; yearly mammogram after age 40
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| Males should undergo the following exams throughout their life: | monthly self testes exam after age 18; Prostate specific antigen (PSA) after age 50, or 40 if high risk
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| 7 warning signals of cancer: (CAUTION) | Change in bowel/bladder habits; A sore that does not heal; Unusual bleeding/discharge; Thickening lump in breast; Indigestion / difficulty swallowing; Obvious change in warts; Nagging cough/hoarseness
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| Name a potentially serious change in bladder habits that may indicate cancer? | Frequent, low-volume urination with a less forceful stream may indicate prostate cancer
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| Cancer-related crisis include | Fear of pain Disfigurement Loss of independence Death
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| Coping with the diagnosis of cancer depends on several factors... | Ability to cope with stress & express feelings and concerns, Age at the time of diagnosis Extent of the disease Prognosis Availability of significant others
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| Emotional Aspects of Cancer; symptoms such as... | Fatigue Nausea Pain Past experience with cancer Attitude associated with the cancer
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| Name three emotions associated with learning of a cancer diagnosis | Anger Fear Loss of control Grief Depression Anxiety Loss of body image Helplessness/ hopelessness
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| Curative cancer care | Removing the tumor Shrinking Arresting the growth “Aggressive therapy” Surgery Chemotherapy Radiation therapy
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| Palliative care centers on .... | making the patient comfortable
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| r/t dieting, Patients with advanced cancer usually suffer from ___ and ___ malnutrition | protein and calorie
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| Patients with advanced cancer usually suffer from protein and calorie malnutrition related to.... | Anorexia, Food taste bitter Nausea and vomiting Diarrhea Stomatitis and mucositis
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| Advanced nutrition support strategies | High calorie, high protein nutritional supplements Enteral tube feedings Parenteral (IV) feedings
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| ___ ___ levels should be monitored carefully | Serum albumin (protein)
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| How much weight loss indicates a serious nutritional deficit? | 5% of pre-cancer body weight
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| nursing interventions r/t a cancer patient | be available, be proactive with pain relief, LISTEN, observe for non-verbal cues, be honest, pt should be able to trust you, assist in planning goals, advocate for your pt, foster hope, facilitate spiritual fitness
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| List an example of how the nurse can advocate for a patient with psychosocial needs | Refer them to a chaplain Refer them to social worker Provide a phone number to a local cancer support group Provide educational materials
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| Role of Hospice | enhancing quality of life in the patient’s final weeks Does not strive to prolong life Physical comfort as well as psychosocial needs Bereavement services, maximize patient/family control
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| Hospice is a team approach; who are the team players? | Patient Family Hospice care coordinator Physician Nurses Psychologists Chaplains, Social workers Pharmacists Home health aides Other specialists
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| what types of tx or medications would a hospice nurse give? | Oral and IV drugs, oxygen and other treatments
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| What is hospice? | A way of caring for people with terminal illnesses.
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| Primary prevention of cancer consists of | of changes in lifestyle habits to eliminate or reduce exposure to carcinogens; early recognition, preventive behaviors and screening tests
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| Cancer cells reproduce in a .... | disorderly and unrestricted manner
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| Tumors are named for .... | The parent tissue Location of the growth Cellular makeup Person by whom it was identified
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| refers to malignant tumors of connective tissues such as muscle and bone | sarcoma
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| Tumors are classified grade 1 to 4 by what? | the degree of malignancy; With 4 being a neoplasm Most unlike the parent tissue Most malignant
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| Tumors are staged by... | Size Extent of spread to lymph nodes Extent of metastasis to other organs
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| The only sure way to know if one has a malignancy is with a ___ ___. | tissue biopsy
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| 3 types of tissue biopsy | Incisional biopsy Excisional biopsy Needle aspiration
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| Other diagnostic testing for cancer | Endoscope Bone scans Computerized Tomography (CT) Magnetic resonance imaging (MRI) Radioisotope Nuclear medicine studies Ultrasound
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| Laboratory tests for cancer | Prostate-specific antigen (PSA) Alkaline phosphatase, serum calcitonin and carcinoembryonic antigen (CEA)
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| Nursing interventions for patients undergoing diagnostic testing center on what? | proper patient education and pretest preparation
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| Describe a complication that may follow excisional biopsy | Bleeding, infection
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| examples of pt/family support measures r/t the nurse r/t a cancer pt | Being aware Being present Address concerns and needed Encourage talk Report problems Refer appropriate support groups
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| ____ is usually considered first as the best alternative when tx cancer | surgery; Chemotherapy and radiation may be used in conjunction with surgery
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| ___ ___ may be used when the cancer has spread to the lymph nodes or cannot be removed surgically | Radiation therapy
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| what are some of the things radiation does r/t tx of a cancer pt? | Radiation may be used preoperatively to shrink a tumor Destroy malignant cells Slow tumor growth
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| Sealed Internal Radiation implant therapy | brachytherapy
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| Children under __ years of age and pregnant women should not be allowed to visit implant patients | 18
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| Visitors should stand as far away from the patient as possible and limit visit time to __ minutes | 10
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| Check the position of the implant every __ hours | 4
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| T/F: Fresh flowers and uncooked fresh fruits/vegetables should be avoided with cancer patients | TRUE
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| Chemotherapy drugs are used to ... | reduce or slow the growth of metastatic cancer
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| give examples of types of blood that could be ordered r/t a cancer pt | Erythropoietin (Epogen, Procrit) Packed red blood cell transfusions, Platelets
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| Chemo Side effects | Alopecia Stomatitis Nausea, vomiting, and diarrhea Weight loss
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| Buildup of high levels of potassium, phosphate, and uric acid in the patient's bloodstream; rapid destruction of cancer cells, Low calcium serum levels, occurs 24hrs-7days after anti-neoplastics | Tumor Lysis Syndrome (TLS)
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| Early signs of Tumor Lysis Syndrome | Nausea, vomiting Anorexia and diarrhea Muscle weakness and cramping
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| Later signs Tumor Lysis Syndrome | Tetany, seizures Anuria and cardiac arrest
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| tx for Tumor Lysis Syndrome | Diuretics Hydration Allopurinol and sodium bicarbonate Kayexalate may be used to help bind and excrete potassium Dialysis may be required in extreme cases
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| nursing interventions r/t Tumor Lysis Syndrome | Maintaining hydration Administering medications Monitoring serum levels of potassium, phosphorus, calcium and uric acid, watch those at risk TLS
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| Biotherapy (immunotherapy) treatment of cancer patients with naturally occurring substances called | biological response modifiers (BRMs
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| what are the effects of biological response modifiers (BRMs) | Increase or restore the immune system's ability to fight cancer. May be directly toxic to the tumor May interfere with the tumor's ability to grow ( Interferon)
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| On the cellular level, how does chemotherapy reduce cancer growth? | It interferes with the cancer cell's ability to reproduce
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| Bone marrow transplantation (BMT) is | the process of replacing diseased or damaged bone marrow
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| explain a bone marrow transplant | Restores the body's ability to produce blood cells, immune system is very weak during transplant Harvested by multiple needle aspirations from the iliac crest Given to the patient intravenously through a central venous catheter
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| define peripheral stem cell transplant (PSCT) | Alternative to bone marrow transplantation Process is called leukopheresis It is more effective with less risk and fewer complications
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| Why are bone marrow transplant patients immunosuppressed? | Their bone marrow is diseased or damaged and cannot produce the needed white blood cells the body needs to fight infection
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| ___, ___, and ___ may affect how pain is perceived and reported | Culture, religion and personality traits
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| ___ ___ are the class of drugs most often used to control advanced cancer pain | narcotic opioids
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| examples of narcotic opioids | Morphine Hydromorphone, fentanyl and methadone Opioids may be given IV, SQ, intrathecally and transdermally
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| nursing considerations/side effects of narcotic opioids | Constipation Adverse reactions Nausea/vomiting Respiratory and CNS depression
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| what are some Non-narcotic methods of pain control | Distraction, biofeedback, massage, relaxation, hypnosis and imagery techniques
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| Best pain-relief regimen involves an | indiviualized plan
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| Name three routes for administering narcotic pain medications | Oral, IV, transdermal, SQ, intrathecal
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| name two drugs that are encapsulated in a lipid membrane have less toxicity with greater efficacy | daunorubicin, doxorubicin
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| Antineoplastic dosages depend on what: | Dosages vary greatly, depending on extent of disease, other agents used, and patient's condition
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| give some examples of Anthracyclines | daunorubicin citrate liposome (DaunoXome) daunorubicin hydrochloride (Cerubidine) doxorubicin hydrochloride (Adriamycin PFS, Adriamucin RDF, Rubex) doxorubicin hydrochloride liposome (Doxil). epirubicin (Ellence) idarubicin (Idamycin)
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| give some examples of Antimetabolites | cytarabine (Ara-C, cytosine arabinoside, Cytosar-U, DepoCyt) fluorouracil (Adrucil, Efudex, Fluoroplex, 5-FU) gemcitabine (Gemzar) hydroxyurea (Droxia, Hydrea) methotrexate (amethopterin, Folex, Folex PFS, Rheumatrex, Trexall)
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| give some examples of Antitumor Antibiotics | bleomycin (Blenoxame) mitomycin (Mutamycin) mitoxantrone (Novantrone) plicamycin (Mithramycin, MIthracin)
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| give some examples of Enzyme | asparaginase (Elspar) imatinib (Gleevac) pegaspargaseOncaspar, PEG-L-asparaginase
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| give some examples of Enzyme Inhibitors | irinotecan (Camptosar) topotecan (Hycamtin)
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| give some examples of Antiestrogens: | tamoxifen (Nolvadex, Tamofen) toremifene (Fareston)
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| give some examples of Hormones | bicalutamide (Casodex) flutamide (Eulexin) goserelin (Zoladex) leuprolide (Lupron, VIadur) medroxyprogesterone (Depo-Provera) megestrol (Megace) nilutaminde (Nilandron) triptorelin (Trelstar Depot)
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| give some examples of Aromatase Inhibitors | anastrazole (Arimidex) letrozole (Femara)
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| give some examples of Kinase Inhibitor | imatinib (Gleevac)
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| give some examples of Monoclonal Antibodies | aldesleukin (Proleukin, IL-2, interleukin-2) alemtuzumab (Campath) gemtuzumab ozogamicin (Mylotarg) trastuzumab (Herceptin)
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| give some examples of Podophyllotoxin Derivatives | etoposides (Vepeside, VP-16)
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| give some examples of Taxoids | docetaxel (Taxotere) paclitaxel (Onxol, Taxol
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| give some examples of Vinca Alkaloids | vinblastine (Velban) vincristine (Oncovin, Vincasar PFS) vinorelbine (Navelbine)
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| give some examples of Miscellaneous | aldesleukin (Proleukin, IL-2, interleukin-2) altretamine (Hexalen, hexamehtylmelamine)
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| Precautions r/t antineoplastics (use cautiously in patients with): | Active infections Decreased bone marrow reserve Radiation therapy Other debilitating illnesses Childbearing potential
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| Chemotherapeutic techniques have a range of side effects mainly affecting the fast-dividing cells of the body Important common side effects include | CNS: memory loss EENT: tinnituys, ototoxicity CV: cardiotoxicity GI: nausea, vomiting, diarrhea or constipation, malnutrition, weight loss or gain nephrotoxicity hair loss
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| what are some typical interactions of antineoplastics? | Allopurinol decreases metabolism of mercaptopurine Toxicity from methotrexate may be increased by other nephrotoxic drugs or larger doses of aspirin or NSAIDs Bone marrow depression is additive
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| Normal value for neutrophils | 3000 - 7000/mm3
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| Neutropenia | < 1000/mm3
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| Severe Neutropenia: | : < 500/mm3
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| r/t severe neutropenia; VS q __ hours and notify physician if temperature starts to rise | 4
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| what are some nursing implications r/t neoplastic drugs | Monitor for increased fatigue, dyspnea, and orthostatic hypotension, Monitor intake and output ratios, appetite, and nutritional intake, Leave IV tubing in place and administer the appropriate antidote through the existing IV tube
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| what else will you monitor for r/t antineoplastic medications? | Monitor for symptoms of gout (increased uric acid, joint pain, and edema)
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| what would you teach your patient r/t anti-gout measures? | Encourage patient to drink at least 2 L of fluid each day Allopurinol may be given to decrease uric acid levels. Alkalinization of urine may be ordered to increase excretion of uric acid
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| what are Monoclonal antibodies used for | to minimize reactions - administer methylprednisolone sodium succinate
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| where should you prep antineoplastic medications? | Solutions for injection should be prepared in a biologic cabinet
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| what ppe do you wear when prepping antineoplastics? | Wear gloves, gown, and mask while handling medication
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| Three things to teach your patient r/t antineoplastics r/t after tx | Health care professional should be informed immediately if symptoms of infection occur Instruct patient to report unusual bleeding Advise patient of thrombocytopenia precautions, continue birth control meds, inform Dr ASAP if possible prego
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| what do you teach your patient r/t oral care r/t antineoplastics? | Instruct patient to inspect oral mucosa for erythema and ulceration If ulceration occurs, advise patient to use sponge brush and to rinse mouth with water after eating and drinking
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| T/F: Instruct patient not to receive any vaccinations without advice of health care professional | TRUE
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| The nurse is aware that classifications of chemotherapy agents include: | Antimetabolites and tumor antagonists, Alkylating agents and antibiotics, Miotic inhibitors and hormones, Antihormones and acidifying agents
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| Cancer cells are characterized by changes in structure or appearance of | anaplastic cells
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| is an abnormal growth of the epithelium, which is the layer of tissue that covers the surfaces of organs and other structures of the body | Epithelioma
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| Carcinoma of oral cavity is more prevalent in who? | heavy drinkers, smokers, prolonged exposure to sun/wind
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| Leukoplakia | -white, firmly attached patch on the mouth and tongue mucosa
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| s/s of leukoplakia | Pain, soreness, bleeding Numbness, dysphagia, loss of feeling, Difficulty eating/speaking Earache, face ache, toothache
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| diagnostic procedures for Leukoplakia | indirect laryngoscopy, X-ray, excisional biopsy(most accurate)
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| Medical/surgical management: treatment depends on what r/t Leukoplakia | location, type of tumor, staging of malignant tumor
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| tx r/t Staging of malignant tumors; stage I: | surgery or radiation
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| tx r/t Staging of malignant tumors; stage II: | surgery and radiation
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| tx r/t Staging of malignant tumors; stage III: | usually palliative
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| tx r/t a small tumor: | surgical removal of tongue, entire larynx, portion above vocal cords
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| tx r/t large tumor | neck dissection
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| 90% of Carcinoma of the esophagus involves | squamous cell carcinomas - associated w/ alcohol abuse and smoking
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| diagnostic tests r/t carcinoma of the esophagus | Barium swallow with fluoroscopy and endoscopy
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| medical management r/t carcinoma of the esophagus | Stage and size tumor 1st Palliative measures if not surgical candidate Esophageal dilatation and stent placement
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| types of surgeries r/t carcinoma of the esophagus | Esophagogastrectomy Esophagogastrostomy Gastrostomy Esophagoenterostomy
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| preoperative Nursing interventions for Esophageal surgery patient: | encourage improved nutrition: high protein/calorie foods, TPN, Oral hygiene, thoracic surgery, Give prescribed antibiotics before esophageal resection or bypass
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| Postoperative Nursing interventions for Esophageal surgery patient: | a) Good ventilation b) Chest drainage system c) Gastric drainage system 1) Small amt of blood in tube 6-12 hrs after surgery 2) Don’t disturb nasogastric tube
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| Maintain nutrition in an esophageal surgical pt by: | 1) Start clear liquids when permitted 2) Soft foods gradually 3) Semi-fowlers for 2 hrs after eating
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| s/s of stomach cancer | may be asymptomatic. As the cancer progresses there may be a feeling of fullness, anorexia, weight loss and anemia. PAIN IS A LATE SYMPTOM
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| Stomach cancer often spreads to the | lymph nodes and metastasizes to the spleen, liver, pancreas or colon
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| s/s of stomach cancer | Weight loss Bleeding in the stools Hematemesis Vomiting after taking any intake of food or fluids Anemia
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| diagnostic tests for stomach cancer | Radiographic studies (barium swallow) Endo/gastroscopic examination with biopsy Stool occult blood test Lab studies to include (CEA) levels, CBC, and serum B12 levels
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| The only curative approach/therapeutic management of stomach cancer is | subtotal or total gastrectomy
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| r/t stomach cancer; problems that can occur during wound healing may be: | dehiscence and evisceration
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| Factors that may predispose a wound to dehiscence or evisceration include: | Excessive coughing, straining Malnutrition, obesity, and infection The physician should be notified immediately if any of these problems exist
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| r/t stomach cancer; Instruct the high-risk groups such as individuals who have had ? | vagotomies or those that take medications to reduce gastric secretions, on the early warning signs of cancer
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| Encourage patient to turn, breathe deeply and cough at least every __ hours until patient is ambulating well. | 2
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| A high intake of what type of foods may be a risk factor for stomach cancer? | Food preserved with nitrates or cooked over charcoal as well as diets high in salt.
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| Some cases of liver cancer are associated with: | Hep B or C
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| qualities of liver cancer | CA eventually spreads to lungs Liver enlarges, misshapen hemorrhage, necrosis, tumors Difficult to diagnosis from cirrhosis
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| assessment finding r/t liver cancer: | Hepatomegaly, ascites, portal hypertension WT loss, peripheral edema Dull ABD pain-RUQ Jaundice Anorexia Frequent pulmonary emboli Positive AFP
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| medical management for liver cancer | Treatment is largely palliative Lobectomy for localized tumors Only 30-40% have surgically resectable disease CA too far advanced for surgery Chemotherapy-poor response Death most likely in 4 to 7 months
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| qualities of gallbladder cancer | occurs more often in women than men, similar to those in cholecystitis, difficult to detect early, surger probably not gonna be successful r/t to liver being invaded as well
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| pacreatic cancer has a high death rate because why? | diagnosing the cancer at a curable stage is difficult
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| who is more at risk for pancreatic cancer? | Found in cigarette smokers, those exposed to chemical carcinogens and people with diabetes mellitus, diet high in meat, fat and coffee consumption
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| some s/s for pancreatic cancer | Anorexia, nausea, flatulence, change in stools Fatigue, Steady, dull and aching pain in the epigastrium or referred to the back; usually worse at night Weight loss Jaundice, pruritis Recent onset of diabetes mellitus
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| Subtotal pancreatectomy has complications of what? | postoperative pancreatic fistulas and is not recommended
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| Adjuvant therapy a.k.a | surgical resection, radiation and themotherapy; is believed to be the most effective treatment
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| What is a surgical procedure that is performed on patients with pancreatic cancer? | Whipple procedure
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| colon cancer has the highest incidence in persons over __ years of age | 60
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| Predisposing factors of colon cancer | Ulcerative colitis and diverticulosis increase the risk of colorectal cancer Polyps may undergo malignant changes and become carcinomas
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| characteristics of a person w/colon cancer | Lack of bulk in diet High fat intake High bacterial counts in the colon
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| subjective info gathered during an assessment r/t colon cancer | Patient will complain of change in bowel habits, excessive flatus and rectal bleeding
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| During the later stages of colon cancer the PT will C/O of | abd pain, nausea, and cachexia (weakness and emaciation with general ill health and malnutrition
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| r/t colon cancer the most clinical manifestation are | chronic blood loss and anemia; others include Vomiting Weight loss Abd distention, ascites
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| what remains the most reliable tool for screening for colon cancer? | A fecal occult blood exam followed by a proctosigmoidoscopy
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| __ ___ of the abd and pelvis can localize the lesion and determine its size | CT Scan
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| ___ is a glycoprotien found in a malignant and non malignant growths, also used to determine a pt's response to antineoplastic therapy | carcinoembryonic antigen (CEA)
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| which cancer is often related to carcinoembryonic antigen (CEA)? | colon cancer
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| often used prior to surgery (administered over 4-6 week period) to reduce the size of the tumor and decrease the rate of lymphatic involvement | radiation therapy
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| why is chemotherapy used? | To patients with systemic disease To patients with undetectable metastasis For palliative therapy
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| how is colon cancer treated if there is NO obstruction? | a portion of the bowel on either side of the tumor is removed and an end-to-end anastomosis is done between the divided ends
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| how is colon cancer tx if there IS an obstruction of the bowel present? | the commonly used procedures area a one stage resection with anastomosis or a two stage resection bringing the ends of the bowel to the surface of the abdomen for closure later
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| resection of ascending colon and hepatic fixture. The ileum is anastomosed to the transverse colon | Right hemicolectomy
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| resection of splenic flexure, descending colon and sigmoid colon. The transverse colon is anastomosed to the rectum. | Left hemicolectomy
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| resection of part of the descending colon, the sigmoid colon, and the upper rectum. The descending colon is anastomosed to the remaining rectum | Anterior rectosigmoid resection
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| Complication that can occur from colon cancer surgery | Delayed wound healing Hemorrhage Persistent perineal sinus tracts Infections Urinary dysfunction Sexual dysfunction
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| What are the most reliable tools for screening for colon cancer? | A fecal occult blood exam followed by proctosigmoidoscopy
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| Patient teaching r/t colon cancer r/t post-op | Instructions in turning, coughing and deep breathing Wound splinting Leg exercises
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| what would you tell your pt to expect post-op r/t colon cancer surgery | Inform PT the he/she will have IV infusions, a foley catheter, possibly an NG tube and abdominal dressings following surgery
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| postoperative care for colon cancer includes | Coughing and deep breathing Early ambulation Ensure adequate nutrition Pain control and meticulous wound and stoma care
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| Common stoma complications include | necrosis and abscess; Report signs of necrosis or abscess immediately
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| Patient can be taught two forms of colostomy management: | Emptying and cleansing the pouch as needed Managing colostomy irrigation
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| Why is it important to auscultate bowel sounds post-operatively? | Paralytic ileus is a common complication of abdominal surgery
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| Antidiarrheal, laxative, bulk forming agent; used in the treatment of diarrhea or constipation | Mitrolan
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| Do not give within two hours of other medications | antacids
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| Inhibits gastric acid | Cimentidine (Tagamet), Ranitidine (Zantac), Pepcid, Prilosec (Totally inhibits gastric acid)
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| antidiarrheal | Kaopectate, Imodium
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| what are some pt teaching points r/t medications r/t intestinal d/o? | Should help produce a BM within 12- 72 hours Take meds as ordered. Do not increase dosage if desired results don’t occur initially Do not use with another laxative; Crush tables / chew the tablets well before swallowing full glass of water
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| Used for chronic atonic or spastic constipation and constipation associated with rectal disorders and anorectal surgery | Metamucil (Psyllium)
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| On contact with water this drug produces a bland, lubricating, gelatinous bulk, which promotes peristalsis and natural elimination | Metamucil (Psyllium)
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| Nursing Interventions r/t Metamucil | Laxative effect in 12- 24 hours. Give for 2-3 days to establish regularity, Best results are obtained if each dose is followed by an additional glass of water
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| If the PT complains of retrosternal pain this may be an indication the drug is what? | lodged as a gelatinous mass in the esophagus
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| why could Metamucil be contraindicated for DM and other patients on low Sodium diets? | because of its sugar and sodium content
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| What are measures that everyone should use to prevent bowel elimination problems? | Proper hydration, increased fiber in the diet and regulation of a bowel movement pattern
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| Renal Tumors, Bladder Tumors and Prostate Cancer has been previously covered. | Please refer to Lesson Plan NP02L056 for more information on these topics.
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| Prostate cancer was previously covered. | Please refer to Lesson Plan NP02L056 for more information on this topic
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| Risk Factors Associated with Cancer | Heredity Radiation exposure Chemicals Irritants Diet (high-fat, low-fiber diets) Hormones (long-term use of estrogen) Immune factors
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| ___ is the most conclusive evidence of cancerous growth | a biopsy
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| Develop when a group of blood vessels dilate and form a tumor like mass It appears as a non-elevated stain on the skin An example is a birthmark | angioma
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| A group of venous capillaries that dilate and branch out like spiders; usually associated w/ liver disease | Spider Angiomas
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| Viral lesion that is contagious; rough papillomatous growth Common locations include hands, arms, fingers and feet | Verruca (wart)
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| A congenital, non-vascular skin blemish Usually benign but may become cancerous; one that is raised and black is considered pre-cancerous - should remove it | Nevus (mole)
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| Usually scaly in appearance, pearly papule with a central crater and waxy pearly border, frequent contact with chemicals, over exposure to the sun, radiation treatment | Basal Cell Carcinoma
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| Most commonly found on the face and upper trunk Rarely metastases, but destruction to underlying structures can be extensive Favorable outcome if treated early | Basal Cell Carcinoma
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|
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| Firm, nodular lesion topped with a crust or ulceration and indurated margins Can metastasize quickly via the lymphatic system Most commonly found on head, neck and lower lips | Squamous Cell Carcinoma
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|
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| Occurs in the dermis and epidermis layers, can occur in the subcutaneous tissue also This cancer originates in the melanocytes of the epidermis | Malignant Melanoma
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| Risk factors include family history of skin cancer fair complexion exposure to the sun | Malignant Melanoma
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| ABCD’s of Melanoma | A = Asymmetry (one half unlike the other) B = Border is irregular C = Color is varied from one area to another D = Diameter is generally larger than 6 mm (size of a pencil eraser)
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| Which form of cancer metastasizes quickly via the lymph system? | Squamous Cell Carcinoma
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| Treatment of choice for well-defined tumors without metastasis | surgical incision
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| examples of meds r/t chemotherapy | Cisplatin, Methotrexate, and Dacarbazine
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| Not indicated for primary melanomas because they are radioresistant, but Is indicated for metastatic cancer originating from a melanoma | radiation
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| metastasis from where can lead to bone cancer? | Metastasis from lung, breast, prostate, thyroid and kidney may be one cause of bone carcinoma
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| A fast growing and aggressive tumor that affects the long bones, A primary malignant bone tumor that is seen in young people, can metastasize via blood stream | osteogenic sarcoma
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| Seen primarily between the ages of 10 and 25, can invade lung tissue and other bones | osteogenic sarcoma
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|
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| Most common benign osteogenic tumor,Usually affect the humerus, tibia, and femur, usually seen in ages 10-30, more males | Osteochondroma
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|
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| Spontaneous fractures - these cancer cells cause a decrease in the strength of the bone | Osteochondroma
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|
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| caused by cancer invasion into the long bone which disrupts the production of red blood cells bone marrow | Anemia r/t osteochondroma
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|
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| subjective data r/t osteochondroma | Pain in the affected bone site Pain especially with weight bearing Tenderness at the affected side
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|
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| Diagnostic Tests r/t Osteochondroma | Radiographic studies Bone scan Bone biopsy CBC, platelets Serum protein levels (elevated in multiple myeloma) Serum alkaline phosphatase (elevation may indicate osteogenic sarcoma
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|
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| r/t osteochondroma, ___ ___ tumors require surgical intervention regardless if they are benign or malignant | Large, symptomatic
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|
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| Types of surgery r/t osteochondroma: | Wide excision or resection bone curettage Leg or arm amputation
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|
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| Postoperative Care r/t osteochondroma should include what? | Neurovascular assessments Vital signs Analgesics
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|
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| What are two types of bone tumors? | Osteogenic Sarcoma and Osteochondroma
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|
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| Excessive growth of hair, Can be hereditary or the result of hormone dysfunction and medications | Hypertrichosis (Hirsutism
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|
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| A disorder where the nails get soft or brittle | Paronychia
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|
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| The absence of hair or a decrease in hair growth | Hypotrichosis, Causes include: skin disease endocrine disorders malnutrition
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|
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| an oncologic emergency that occurs with rapid lysis of malignant cells | tumor lysis syndrome
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|
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| tending to become progressively worse, resistant to treatment, tending to spread and result in death | malignant
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|
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| epithelioma | a neoplasm derived from the epithelium; cancer of the lip is usually called an Epithelioma
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|
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| esophagogastrectomy | resection of a lower esophageal section with the proximal portion of the stomach followed b anastomosis
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|
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| anastomosis | surgical joining of the two ducts or blood vessels to allow flow from one to the other
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|
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| resection of a portion of the esophagus with anastomosis to the stomach | esophagogastrostomy
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|
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| resection of the esophagus and anastomosis to a portion of the colon | esophagoenterostomy
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|
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| insertion of a catheter into the stomach and suture to the abdominal wall; done when pt will not be able to eat food orally r/t inoperable cancer of esophagus | gastrostomy
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|
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| hematemesis | vomiting of bright red blood, indicating rapid upper GI bleeding, commonly associated with esophageal varices or peptic ulcer
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|
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| melena | tarlike, fetid-smelling stool containing undigested blood
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|
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| fundus of the stomach is directly anastomosed to the duodenum; used to remove ulcers and cancer located in the antrum of the stomach | gastroduodenoscopy (Billroth I)
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|
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| duodenum is closed | gastrojejunostomy (Billroth II)
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|
||||
| a malignant tumor of connective tissue, such as muscle or bone, presents as painless swelling | Sarcoma
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|
||||
| mouth inflammation caused by destruction of normal cells in the oral cavity | stomatitis
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|
||||
| an increased venous pressure in the portal circulation caused by compression or occlusion in the portal hepativ vascular system that results in splenomegaly, large collateral veins, ascites, HTN, & esophageal varices | portal HTN
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|
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| excision of approx. 1/2 the colon | hemicolectomy
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|
||||
| cancer care that centers on removing the tumor or shrinking or arresting growth of the cancer. "aggressive therapy" | curative - includes surgery, radiation, and chemo
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|
||||
| during your assessment for lung cancer, the pt may complain of | Chronic hoarseness Chronic cough History of smoking or environmental exposure Weight loss
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|
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| in your assessment of a lung cancer pt, your objective findings may include | Hemoptysis Shortness of breath, wheeze Pleural effusion Edema of face or neck Friction rub Clubbing of fingers Pericardial effusion
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|
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| an estimated ____ of pts diagnosed w/lung cancer are inoperable | 1/3
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|
||||
| surgical tx r/t lung cancer | Pneumonectomy Lobectomy Segmental resection Video assisted thorascopic surgery Radiation and chemotherapy SCLC chemotherapy
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|
||||
| qualities of laryngeal cancer | Squamous cell carcinoma Occur in people over age 60 90% occur in men, due to alcohol and tobacco use Chronic laryngitis Vocal abuse Familial history
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|
||||
| Clinical Manifestations of laryngeal cancer | Progressive or persistent hoarseness Metastasis includes pain in larynx radiating to ear Difficulty swallowing Lump in throat Enlarged cervical lymph nodes
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|
||||
| nursing interventions r/t laryngeal cancer | Suction secretions Provide tracheostomy care Offer small frequent meals Turn, cough and deep breathe Auscultate lung sounds Communication, impaired verbal, related to removal of larynx Provide patient with implements for communication
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|
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| Pancreaticoduodenectomy | whipple procedure
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|
||||
| the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum is removed | whipple procedure
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|
||||
| Most common site of cancer in the urinary tract | bladder
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|
||||
| Usually begins as a tumor on the ______ of the prostate | posterior
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|
||||
| s/s of prostate cancer | Hesitancy, frequency, nocturia, dysuria, UTI Back pain or sciatica from metastasis Weight loss, fatigue
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|
||||
| PSA (Prostate-specific antigen) normal limit | Normal 0-4ng/ml
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|
||||
| diagnostic test r/t prostate cancer; Cytological evaluation for definitive diagnosis | needle aspiration
🗑
|
||||
| Which prostatectomy procedure provides access to the pelvic lymph nodes? | Retropubic prostatectomy
🗑
|
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