Care of the client with cancer – Flashcards
Unlock all answers in this set
Unlock answersquestion
What is cancer?
answer
cancer is a disease where the mechanisms that control the growth and development of the cell are taken over and changed by the disease process. the resulting cell becomes nonfunctional for normal body function. Cancer cells are able to reproduce and spread. The malignant cell (primary cancer) are capable of spreading to surrounding tissues and lymph nodes. cancer growth of the primary cancer in other tissues is metastasis.
question
Is age a risk factor for being susceptible to cancer?
answer
yes, as a person ages they become susceptible to developing cancer. about 77% of those developing cancer are older than 55 years old.
question
what play an important part in development of cancer?
answer
lifestyle. 80% of those developing cancer is related to lifestyle habits i.e. smoking, ETOH, and diet and environmental factors.
question
What is related to 90% of all lung cancer?
answer
smoking, in combination with ETOH is responsible for cancers of the mouth larynx, throat, esophagus, and liver.
question
What are environmental contributions to cancer?
answer
exposure to asbestos, benzene and radiation increase risk for developing cancer. UV from the sun increases the risk for skin cancer.
question
Are people predisposed to developing cancer?
answer
yes, some individuals are predisposed to developing cancer d/t their heredity.
question
What are infections that can cause cancer?
answer
human papilloma virus (cervical cancer), Epstein-Barr virus (lymphoma), hepatitis B and C (hepatocellular), and helicobacter pylori (GI cancer)
question
What is a benign tumor?
answer
grow slowly and expansively. they do not metastasis.
question
what are malignant tumors?
answer
they are invasive and poorly differentiated. they spread to other organs and ares of the body.
question
What helps decrease the death rate of cancer?
answer
primary and secondary preventions, they decrease death rate and improve quality of life.
question
when are most people diagnosed with cancer?
answer
when they are reporting symptoms of the disease
question
what is primary prevention aimed at accomplishing?
answer
reducing risk factors before the disease occurs. the client should make lifestyle changes such as stop smoking, drinking ETOH in moderation, eat a healthy diet, obtain proper exercise, avoid sun exposure, wear sun blocks. drug therapy low does ASA may help reduce colon cancer risk, Tamoxifen can reduce the risk of breast cancer by 50% when women are at high risk.
question
What is secondary prevention aimed at accomplishing?
answer
prevention involves screening and early detection. many authorities have differing opinions when screen should occur. screening should be based on the patient's history, family history, age, ethnic group, risk factors, and potential exposure to carcinogens.
question
What common screenings for cancers?
answer
breast cancer, colon/rectal cancer, ovarian cancer, prostate cancer, skin cancer, testicular cancer, uterine cancer, cervical cancer, endometrial cancer.
question
how is cancer diagnosed?
answer
history and physical, biopsy of tumor, lab test: CBC, platelet count, liver function tests, BuN, CR. blood markers such as CA125(ovarian cancer), CT, MRI, x-rays, and nuclear medicine scans.
question
What do patients often die of from cancer?
answer
metastasis is one reason that cancer cannot always be cured with surgery.
question
What is a biospy?
answer
surgical removal of a portion of the suspected area to have the lab identify the type of tissue involved.
question
what is an excisional biospy?
answer
is where the entire mass is removed with a small margin for diagnostic purposes.
question
what is resconstuctive surgery ?
answer
to repair previous area of radical surgery such as breast reconstruction.
question
what is palliative surgery?
answer
will help relieve complications of cancer
question
what is preventative surgery?
answer
is where they will remove an area that could develop into cancer.
question
what is debulking of a tumor?
answer
is the removal of the bulk of the tumor often done prior to chemotherapy.
question
What is chemotherapy?
answer
the use of antineoplastic medication to destroy cancer cells by hindering cell function and reproduction. many different kinds of agents are used. the goals of chemotherapy are to try and cure the client, control the tumor or is palliative in nature.
question
What does chemotherapy affect?
answer
affects the fours phases of the cell growth cycle. there are times that cells are not growing and are refractory to chemotherapy.
question
What are the stages when giving chemotherapy?
answer
given to help decrease the likelihood of the cancer returning. chemotherapy given before a surgical intervention to help reduce the tumor and improve surgical success. giver very high doses of chemotherapy agents to suppress growth such as bone marrow suppression.
question
What is combination chemotherapy?
answer
the giving of multiple agents to destroy as many cancer cells as possible. remember that cancer cells can be resistant or acquire resistance to chemotherapy agents.
question
how are you suppose to handle chemotherapy agents as the provider of care?
answer
these medications are cytotoxic and can cause you, your patient, your co-worker, and family harm! proper handling of chemotherapy agents is a must. you must be certified to give chemotherapy in many venues. Wear: latex gloves for getting rid of body waste and handling soiled linens for 48 hours of patient receiving chemotherapy agents, wear gown, gloves, and goggles.
question
What are side effects of chemotherapy?
answer
alopecia, anorexia, fatigue, nausea and vomiting, mucositis, anemia, neutropenia, thrombocytopenia(increased risk for bleeding)
question
What are nursing interventions for the cancer patient?
answer
assessment of the patient includes assessing for side effects from chemotherapy. helping to decrease infection by patient education and good nursing care. provide a safe environment to decrease bleeding. monitor stools and assess for bleeding. minimize fatigue by monitoring for anemia, providing a restful environment, and maintaining nutritional status, and good patient education. promote nutrition. give antiemetic prior to chemotherapy. help to decrease patient's anxiety by providing proper environment and medication. minimize stomatitis with good oral care, antiinfective therapy, and treating the pain in their mouth. help the client cope with body image. patient and family education is important
question
What is radiation?
answer
the use of high-energy ionizing beams to treat cancer and some benign disorders. causes cell death. attempts to localize cell death to the tumor. the presence of O2 is important for radiation to function properly. often requires multiple doses. radiation therapy: Teletherapy (proton).
question
What are acute side affects of radiation?
answer
include fatigue, malaise, erythema at the site, nausea and vomiting diarrhea, esophagitis, mucositis, dryness of mouth, dyspnea, cough, and cystitis.
question
what are chronic side effects of radiation?
answer
include changes to the skin such as fibrosis, permanent darkening of the skin and atrophy, GI problems such as adhesions, obstruction, ulceration and strictures, permanent taste alteration, dental caries, pulmonary fibrosis, nephritis, increased risk of leukemia.
question
How should you maintain skin integrity for the client receiving radiation?
answer
educating the client about skin changes, not applying lotions to site, discouraging rubbing of site, wear loose fitting clothing around site, avoiding overexposure to the sun, not applying adhesive tape to the area, avoid shaving the skin, and bathing with a mild soap and lukewarm water. also need to keep markings in place.
question
What kind of diet increases risk for developing cancer?
answer
diet does have an effect on the risk of developing cancer. high fat diets are associated with development of breast cancer. low fiber diets may increase the risk of developing GI cancer. Obesity has been associated with CA of the breast, colon, uterus, and gallbladder.
question
What are recommendations for diets?
answer
limit saturated fat to no more than 10% of diet. total calories from fats should be no more than 30%. cholesterol should not exceed 300mg/day. salt intake should be no more than 6 g/day, 1 teaspoon.
question
What are over all nursing considerations?
answer
proper pain management. oncology emergencies: septic shock, spinal cord compression, hypercalcemia, superior vena cava syndrome.
question
how should you deal with the client with cancer diagnosis?
answer
support the client: dealing with depression and anxiety, sleep disturbances, body changes, and evaluate social support. spiritual care: chaplains, and religious institutions. Death and Dying: making arrangements, discussing end-of-life issues, quality of life, having client express preferences, advances directives, hospice care, and counseling.
question
What are signs that you could have lung cancer?
answer
fatigue. unsteady gate or episodic memory loss. persistent chest, shoulder or back pain unrelated to pain from coughing.
question
What are factors that can lead to lung cancer?
answer
second hand smoke. exposure to radiation. medical and environmental sources. air pollution. tuberculosis.
question
What are common facts about cancer?
answer
lung cancer ranks as the number 1 cause of cancer related death in the US each year. african americans have the highest incidence of lung cancer, hispanics lowest. signs of lung cancer include: fatigue, unsteady gait, episodic memory loss, persistent chest, shoulder or back pain unrelated from coughing.
question
what is the etiology of lung cancer?
answer
cigarette smoking is responsible for 80-90% of all lung cancers. CO2 and nicotine interfere with normla cell development. lower airway irritant. quit smoking 10 years reduces the mortality rate by 30-50%. directly related to the number of cigarettes smoked in a lifetime.
question
What is the pathophysiology of lung cancer?
answer
arise from bronchial epithelial cells. cells grow slowly taking 8-10 years to reach the size of 1 cm (smallest lesion to be detected on x-ray). inflammation, hypersecretion of mucous, desquamtion of cells, reactive hyperplasia of the basal cells.
question
What does TNM stand for?
answer
T=tumor size, N=lymph node involvement, M=presence or absence of metastases.
question
stages of tumor that can be operated on?
answer
stage I, II, IIIA are good surgical candidates. stages IIIB, or IV non operable & poor prognosis.
question
What is leukemia?
answer
a group of malignant disorders of the blood, and blood forming tissues of the bone marrow, lymph system, and spleen. miscommunication between cells causing a loss of regulation in cell division. normal genes transformed into abnormal genes.
question
What are the different types of leukemia?
answer
AML=acute myelogenous leukemia, increases w/ advancement of age peak incidence between 60-70 y/o. ALL=acute lymphocytic leukemia, childhood. CML=chronic myelogenous leukemia, 25-60 y/o. CLL=chronic lymphocytic leukemia, 50-70 y/o
question
What is acute leukemia?
answer
proliferation of immature hematopoietic cells. rapid onset.
question
what is chronic leukemia?
answer
more mature froms of the white blood cells. gradual onset.
question
What are characteristics of acute myelogenous leukemia?
answer
25% of all leukemia's however 85% of the acute leukemia's in adults. hyperplasia of the bone marrow. low RBC, Hgb, Hct, Low platelets, high WBCs. fatigue, weakness, headache, mouth sores, bleeding, fever, infection. 12,810 will be dx in 2009. abrupt onset. NDX infection.
question
What are characteristics of acute lymphocytic leukemia?
answer
general age of onset less than 14 y/o. children under 14 y/o have best prognosis....poor prognosis for adults with ALL. immature lymphocytes proliferate in the bone marrow and are B-cell in origin. acute onset of fever, pallor, bleeding, progressive weakness, fatigue, bone and joint pain. leukemic meninigitis is common d/t arachnoid infiltration.
question
What is the plan of care for the cancer patient?
answer
subjective and objective data. nursing diagnosis r/t anemia, thrombocytopenia, neutropenia. goals that patient will understand and cooperate with the treatment plan, experience minimal side effects and complications associated with disease and it treatments, fell hopeful and supported during the periods of treatment.
