Cancer ATI Med-surg – Flashcards

Neoplastic disease process, involves abnormal cell growth and differentiation.

Consume a healthy diet, limit sugar and salt, maintain healthy body weight and body mass index, avoid smoking and alcohol, avoid recreational drug use, use proper protection when unavoidable, breast-feed infants exclusively for first six months, engage in physical activity or exercise.

Age, race, genetic predisposition, exposure to chemicals/tobacco/alcohol, exposure to certain viruses and bacteria, diet high in fat/red-meat and low in fiber, sun and UV light or radiation exposure, sexual lifestyles, poverty/obesity/chronic a GERD, chronic disease.

Infection with hepatitis B or hepatitis C

Lymphoma and leukemia

Lymphoma and leukemia.

Colorectal, breast, lung, pancreatic, ovarian

Lung, colorectal, prostate, pancreatic, gastric

Testicular cancer

Breast cancer

Increased risk of lymphoma

Cervical cancer

Lymphoma and Kaposi's sarcoma

Stomach cancer and lymphoma of the stomach lining

Used to stage cancer. TNM diagnostic notation of the staging system is NOT used to indicate response of a tumor to medication therapy regimen used for treatment. Example: A nurse is reviewing diagnostic notation on a patient's pathology report who has ovarian cancer: T2-N3-MX. indicates that the tumor is 4 cm in size involving the ovary and adjacent tissue. T2 designation describes the size and extent of the ovarian tumor using the TNM staging system

Low socioeconomic status, lack of access to healthcare, reluctance to seek treatment

Risk for weight loss and anorexia. Lab values will include albumin, ferritin, transferrin. Have client keep a food diary, encouraged toothbrushing before and after meals, and assess laboratory test report of ferritin. Oral hygiene before and after meals promote increased salivation and improves clients taste perception. Ferritin is an indicator of protein intake of a client with malnutrition due to cancer.

T cells in body attack normal cells rather than cancer swans resulting in changes and neurological function (movement, sensation, mental function). Management includes minimizing immune system response via steroids, immune factors, plasmapheresis, irradiation.

Occurs when excessive levels of antidiuretic hormone's are produced. Antidiuretic hormone's help kidneys and body conserve correct amount of water. This syndrome causes the body to retain water resulting in dilution of electrolytes in blood. Commonly associated with lung and brain cancers. Findings include nausea and vomiting early on, hostility, seizures, and coma. Nursing actions include monitoring client for hyponatremia and low serum osmolality, administer furosemide or hypertonic sodium chloride as prescribed, monitor vital signs and serum sodium as Lasix promote sodium excretion in hypertonic sodium chloride can cause fluid overload LOW URINE OUTPUT IS EXPECTED Client reporting headache and/or nausea could indicate cerebral edema- report immediately

Common complication of breast, lung, head, neck cancers; leukemias and lymphomas; multiple myelomas; bony metastases of any cancer. Manifestations include anorexia, nausea, vomiting, shortened QT interval, kidney stones, bone pain, changes in mental status. Nursing actions: administer 0.9% sodium chloride IV, furosemide, pamidronates, and phosphates as prescribed

Results from obstruction (metastasis of breast or lung) of venous return and engorgement vessels from the head and upper body. Manifestations include periorbital and facial edema, erythema of upper body, dyspnea, and Epistaxis. Nursing actions: position client in high Fowlers position initially to facilitate lung expansion. High dose radiation therapy for emergency temporary relief

Complication secondary to leukemia or adenocarcinomas. Nursing actions include observing client for bleeding and applying pressure as needed, and preparing to administer blood clotting factors that have been lost through bleeding and may need to be replaced with plasma transfusions. Heparin may also be used to slow cascade of events that are making the body overuse it's blood clotting factors

Altered body function (fatigue, weakness, Anorexia), change in body structure (weight loss, masses), change in body symmetry or onset of recent clinical findings (pain, nausea, vomiting)

Secondary sites of discomfort, swelling and or tenderness of lymph nodes or areas of the body, presence of masses, altered function of another body system, bone pain

Complete health history and physical assessment including family history of cancer genetic disorder, provide for privacy, inspect for changes in color/symmetry/movement/body function, auscultate for adventitious sounds that may indicate altered body system function, palpate to detect masses or tissue abnormalities, percuss for changes in expected sound over organs

CAUTION Change in bowel/bladder habits A store that does not heal Unusual bleeding or discharge Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious change in warts or moles Nagging cough or hoarseness

Provides definitive diagnosis indicating site of origin, specific cell type and cell characteristics

Sampling of outer skin layers arrays lesions using scalpel razor blade Ex: basal or Squamous cell skin cancer

Find or core Aspiration of tumor close to the skin surface for fluid and tissue sampling Example: bone marrow aspiration is a form of needle biopsy used to diagnose leukemia and lymphoma

cutting through skin to remove part (incisional) of or all of (excisional) a tumor Example: punch biopsy is a form of excisional cell biopsy used to diagnose skin cancer.

Removal of lymph node in proximity to the cancer. Dye is used to create a map of affected nodes If lymph nodes are negative, cancer has not likely spread. If lymph nodes are positive, surgical excision of remaining lymph nodes in area is performed also called a lymph node dissection

Administration of systemic or local cytotoxic medications that damage cellular DNA or destroy rapidly dividing cells. Agents are often selected in relation to effect on various stages of cell division. Can be given oral, parenteral, IV, Intracavitary, or intrathecal Most commonly used for treatment of cancer but also used for auto immune disease is

Immunosuppression due to bone marrow marrow suppression by cytotoxic medication. Monitor temperature and white blood cell count. Fever greater then 37.8°C or 100°F should be reported to provider immediately. Monitor skin and mucous membranes for infection. Cultures obtained prior to antimicrobial therapy. If clients white blood cells drop below 1000, please client in private room and initiate neutropenic precautions

Client must remain in room unless they need to leave for diagnostic procedure or therapy. If patient leaves room they must have a mask. Protect client from possible sources of infection. have a client, Steph, and visitors perform frequent hand hygiene and restrict visitors who are ill. Avoid invasive procedures that could cause break into shoe unless necessary. Keep dedicated equipment in clients room. Administer colony stimulating factors As prescribed, such as filgrastim (Neupogen or Neulasta)

Serotonin blocker, antiemetic. Can be administered before/during/after chemotherapeutic treatments

Increases appetite in chemo patients

7-10 days

Stomatitis; inflammation of tissues in the mouth, such as gums, tongue, roof, and floor of mouth, inside lips and cheeks. Inspect several times a day and document any lesions. Lesion should be cultured and reported to provider.