Chapter 24 Test Questions – Flashcards
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Cancer
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-Cancer can develop in any organ or tissue, but tends to occur more commonly in some tissues. -Cancer destroys normal tissue and function in that organ or tissue. -Cancer can cause death or disrupt critical physiological processes by metastasizing to vital organs.
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General Disease Related Consequences of Cancer if untreated
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-Reduced immune and blood-producing function -Altered GI structure and function -Motor and sensory deficits -Decreased respiratory function
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Cancer Treatments
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-surgery -radiation -chemotherapy -hormonal manipulation -photodynamic therapy -immunotherapy -targeted therapy
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Radiation therapy for Cancer
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-Purpose—destroy cancer cells with minimal damaging effects of surrounding normal cells -Radiation source with patient is a hazard to others - may be in body fluids, cavities, implants, seeds, needles, held in place with applicators
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-Teletherapy
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- radiation source outside patient
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-Brachytherapy
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- radiation source in direct contact with tumor tissues for a specific amount of time
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side effects of radiation therapy
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-Vary according to site -Local skin changes and hair loss (likely permanent depending on total absorbed dose) -Altered taste sensations -Fatigue related to increased energy demands -Inflammatory responses that cause tissue fibrosis and scarring
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Nursing Care of Patients Undergoing Radiation Therapy
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-Teach accurate objective facts to help patient cope -Do not remove markings -Administer skin care -Use lotions to protect skin according to department policy -Avoid direct skin exposure to sunlight -Care for xerostomia (dry mouth) -Bone exposed to radiation more vulnerable to fracture
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Chemotherapy
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-Treatment of cancer with chemical agents -Major role in cancer therapy -Cures and increases survival time -Some selectivity for killing cancer cells over normal cells -Normal cells most affected—skin, hair, intestinal tissues, spermatocytes, blood-forming cells
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Chemotherapy Drugs
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Antimetabolites Antitumor antibodies Antimitotic agents Alkylating agents Topoisomerase inhibitors Miscellaneous chemotherapeutic agents Combination chemotherapy
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What is the most common nursing intervention in chemotherapy is what?
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EXTRAVASATION
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Chemotherapy risks
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Infection risk Chemotherapy-induced nausea and vomiting (CINV) Mucositis Alopecia Changes in cognitive function Peripheral neuropathy
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Antiemetic therapy for CINV
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Ondansetron (Zofran) Granisetron (Kytril) Granisetron transdermal (Sancuso) Dolasetron (Anzemet) Palonosetron (Aloxi)
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Hormone manipulation
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-Some hormones make hormone-sensitive tumors grow more rapidly. -Some tumors require specific hormones to divide; decreasing the hormone amounts to hormone-sensitive tumors can slow cancer growth rate
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side effects of hormone therapy
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-masculinizing effects in women -feminizing effects in men -risk for venous thromboembolism -acne -hypercalcemia -liver dysfunction -boneless
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photodynamic therapy
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-Selective destruction of cancer cells via chemical reaction triggered by different types of laser light -Patient teaching -General sensitivity to light for up to 12 weeks after injection of photosensitizing drug
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Immunotherapy: Biological Response Modifiers (BMRs)
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Modify patient's biological responses to tumor cells Cytokines—enhance immune system Interleukins, interferons Side effects—generalized, sometimes severe inflammatory reactions, peripheral neuropathy, skin rashes
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Targeted therapy of cancer
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-External events indicate to cells that cell division is needed -Overall, cancer cells have more active signal transduction pathways and transcription factors that lead to excessive division of cancer cells -Targeted therapies take advantage of differences in one or more parts of the signal transduction pathway to block it.
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Examples of Targeted Therapy
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Tyrosine Kinase Inhibitors Epidermal Growth Factor/Receptor Inhibitors Vascular Endothelial Growth Factor/Receptor Inhibitors Multikinase Inhibitors Proteasome Inhibitors Angiogenesis Inhibitors Monoclonal Antibodies
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oncologic emergencies
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Sepsis, disseminated intravascular coagulation Collaborative management: Prevention (best measure) IV antibiotic therapy Anticoagulants, cryoprecipitated clotting factors
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syndrome of inappropriate antidiuretic hormone
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-Most commonly found in carcinoma of the lung *Caused by increased antidiuretic hormone from pituitary Water is reabsorbed to excess by kidneys; put into system circulation Collaborative care: Patient safety Restore normal fluid balance Supportive care
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spinal cord compression
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Early recognition and treatment Palliative High-dose corticosteroids High-dose radiation Surgery External back or neck braces to reduce pressure in spinal cord
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hypercalcemia
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Occurs most often with bone metastasis Fatigue, loss of appetite, nausea and vomiting, constipation, polyuria, severe muscle weakness, loss of deep tendon reflexes, paralytic ileus, dehydration, ECG changes
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superior vena cava syndrome
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Superior vena cava compressed or obstructed by tumor growth Can lead to painful, life-threatening emergency Signs—facial edema, Stokes' sign, edema of arms and hands, dyspnea, erythema, epistaxis
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tumor lysis syndrome
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Large numbers of tumor cells destroyed rapidly, results in intracellular contents being released into bloodstream faster than the body can eliminate them
