1. tumors or cells that reproduce abnormally
  2. cluster of cells that is not normal to the cell but cancerous
    benign tumor
  3. do all neoplasms contain cancer cells
    no, but neoplastic cells are responsible for making tumors and is a lively growing cell
  4. a group of cells that grows out of control, taking over the function of the affected organ
  5. these cells are defined as poorly constructed, loosely formed and without organization; a confused cell.
    cancer cells
  6. property of normal cells in which contact  by the cell with another cell or tissue signals them to stop dividing
    contact inhibition
  7. first step of cancer growth, it causes an alteration in the genetic structure of the cell (DNA)
  8. second step of cancer cell growth, a tumor forms from mutated cell reproduction
  9. oncoviruses are linked to cancer in humans. which oncovirus is associated with burkitt's lymphoma
  10. neoplasms occuring in the epithelial cells
  11. most common type of cancer and includes cells of the skin, GI system and lungs
  12. cancer cells affecting connective tissues including fat, the sheath that contains nerves, cartilage, muscle and bone
  13. abnormal growth of white blood cells
  14. neoplastic cells that remain in one area are considered localized or _____  cancers
    in situ
  15. the term used to describe the spread or the tumor from the primary site into separate and distant areas
  16. what are the 3 steps in the formation of metastasis
    • 1. invation of blood or lymph vessels
    • 2. movement by mechanical means
    • 3. lodging and growing in a new location
  17. name some factor that influence the formation of cancers
    • long term use of estrogen
    • chronic irritation
    • high-fat, low-fiber diets
    • altered immunity
    • chemicals
    • radiation
    • virii
    • genetics
  18. metastic tumors
    • carry the cell characteristics of the original tumor site
    • lung tissue found in brain suggests a primary lung tumor with metastasis to brain tissue
  19. when should women start pap smears
    21 and every 1 to 2 years after
  20. incisional biopsy
    removes small amount of tissue for inspection
  21. excisional biopsy
    removes entire tissue mass
  22. needle aspiration biopsy
    insertion of needle to remove fluid or aspirate tissue
  23. stereotactic biopsy
    • evaluates lesions in brain or breast
    • biopsy site immobilized
    • site is scanned for location and a fiber optic instrument inserted
  24. frozen section biopsy
    • sample is removed during surgery
    • sample is frozen for microscopic examination
    • provides quick analysis and directs remainder of  surgical procedure
  25. most common system used for staging tumors
  26. tumor-node-metastasis system
    • tumor: TX (tumor cant be evaluated), T0 (no evidence of primary tumor), Tis (carcinoma in situ), T1,2,3,4 (size and/or extent of primary tumor)
    • regional lymph node: NX (lymph nodes cant be evaluated), N0 (no cancer found), N1,2,3 (# and/or extent  of spread)
    • distant metastasis: MX (cant be evaluated), M0 (no distant metastasis), M1 (distant metastasis)
  27. what are the typical system reactions to radiation therapy
    • fatigue
    • nausea, vomiting and anorexia
    • mucositis
    • xerostomia
    • desquamation
    • bone marrow depression
  28. mucositis and its treatment
    • inflammation of mucous membranes, especially of the mouth and throat
    • advise pt to perform mouth care before meals and every 3 to 4 hours
  29. xerostomia and its treatment
    • dry mouth
    • encourage frequent mouth care
  30. desquamation
    • skin peels from radiation, varies to mild redness and moistness
    • keep skin dry, free from irritants and protect from exposure to direct sunlight
    • desquamation irritants are powder, lotions and restrictive clothing
  31. why are two or more chemotherapy drugs (antineoplastics) used to treat a pts cancer
    • increases effectiveness
    • decreases side effects and  and possiblity of tumor becoming resistant
  32. which cells are affected the most by chemotherapy and radiation
    fast growing epithelial cells such as hair, blood, skin and GI tract
  33. term(s) used for a low white blood cell count
    • leukopenia or neutropenia
    • neutrophils respond to bacterial infections and are the most plentiful
  34. term used for a low platelet count
  35. term used for inflammation of the mouth
  36. normal platelet level
    • 150,000 - 300,000
    • potential for bleeding at 50,000
    • spontaneous bleeding at 20,000
  37. nursing care for a pt with thrombocytopenia
    • give numega which stimulates platelet production
    • avoid IM, subQ and rectal meds
    • apply pressure for at least 5 min to venipuncture or injection sites
    • teach the pt about gentle oral care, no flossing
    • avoid trauma to rectal tissue
    • no NSAIDS or aspirin
    • no sex
    • observe for bruising, petechiae, bleeding gums, tarry stools and black emesis
  38. why do we weight pts and monitor their food and fluid intake?
    • it is an objective measurement to determine if intake is enough to maintain weight
    • weight gain is also a possible sign of fluid retention
  39. what kind of food would you provide a pt going through chemotherapy or radiation?
    • small, high calorie meals; prevents pt from feeling full and nauseated
    • room temp or cold foods; have fewer odors and are more comfortable to eat
    • sour foods help control nausea
  40. what is the purpose of the medications epogen and procrit?
    stimulates production of RBCs
  41. superior vena cava syndrome
    • tumor from lung cancer or cancers of the mediastinum block circulation in the vena cava
    • causes edema of head, neck and arms
    • symptoms: shortness of breath, cough, chest pain, facial redness, and swollen neck veins
  42. when the bone starts to deteriorate what is a common secondary problem?
    • hypercalcemina; Ca ions leech into the blood
    • IV meds and hydration lower the concentration
  43. disseminated intravascular coagulation
    • abnormal activation of the clot formation and fibrin mechanisms in the blood use up all the coagulation factors and platelets
    • pt is placed on bleeding precautions and at high risk for thrombus formation
  44. term for small purplish hemorrhagic spots under the skin
  45. hemorrhage into the skin, mucous membranes and organs
  46. where are the best sites for bone marrow aspiration
    iliac crest, sternum and spinous process of vertebrae
  47. what are the protocols involved during a blood transfusion
    • 2 nurses are required
    • all info for the pt and what's listed on blood bag must match 
    • 18 or 20 gauge catheteris required
    • only normal saline is allowed to piggyback
    • allow 2 - 4 hrs for transfusion
    • monitor pt for first 15 minutes
  48. which nutrients are essential for the production of healthy RBCs?
    iron, folic acid and vitamin B12
  49. anemia is related to which 3 conditions
    • impaired RBC product, i.e. aplastic anemia
    • increased destrucion of RBC, i.e. hemolytic or sickle cell anemia
    • massive or chronic blood loss
  50. Pallor, tachycardia, tachypnea, irritability, fatigue and shortness of breath are common symptoms of which hematologic disorder?
    • anemia
    • all if not most represent poor oxygenation
  51. signs and symptoms associated with pernicious anema (lack of B12)
    numbness in hands or feet and weakness, fissures at corners of mouth, an inflamed tongue (glossitis) and spoon shaped fingernails
  52. foods high in iron
    • red meat
    • dark green leafy vegetables
    • dried fruits
    • enriched, fortified or whole-grain products
  53. techniques to enhance absorption of iron
    ingest vitamin c and stewing acidic foods in iron cookware
  54. good sources of folic acid
    liver, green leafy vegetables, legumes and enriched grain products
  55. food sources of vitamin b12
    • derived from animal sources
    • meat, fish and shellfish, poultry and milk
  56. vitamin b12 is essential for what?
    • manufacture of RBCs
    • maintenance of myelin which facilitates the transmission of nerve impulses
  57. name some therapeutic measures for anemic pts
    change cooking habits, take dietary supplements, decrease alcohol intake
  58. if a pt has pernicous anemia will he need vitamin b12 shots for life?
  59. what are the side effects associated with iron supplements
    nausea, diarrhea, constipation and dark stools
  60. what is aplastic anemia
    • bone marrow becomes fatty and incapable of producing adequate amounts of RBC
    • results in pancytopenia
  61. term for reduced number of all formed elements from the bone marrow (RBC, WBC and platelets)
  62. signs and symptoms of aplastic anemia
    progressive weakness, fatigue, pallor, shortness of breath and headaches
  63. therapeutic measures for aplastic anemia
    • bone marrow transplant, steroid therapy and colony stimulating factors
    • colony stimulating factors: epogen, filgrastim, neupogen
  64. sickle cell anemaia
    • mutation in RBC makes hemoglobin sensitive to oxygen changes.  
    • Times of low oxygenation or high stress change RBCs into sickles that are rigid and easily broken
  65. list the interventions for a pt at risk for infection
    • private room
    • staff and visitors must wash hands before entering room
    • pt must wash hands before and after toileting as well as before and after eating
    • prevent ppl with infections from entering the room
    • pt must not handle flowers and can't have plants in her room
    • pt must avoid raw fruits, vegetables and milk products
    • avoid use of indwelling urinary catheters and other invasive devices
    • use strict aseptic technique when performing invasive procedures
    • use acetaminophen if an antipyretic is needed; aspirin can induce bleeding
  66. interventions to prevent bleeding in a pt with thrombocytopenia
    • use an electric razor
    • soft toothbrush or gauze to clean teeth
    • avoid invasive procedures including enema, douches, suppositories and rectal temps
    • avoid IM injections
    • avoid blood draws and try to draw only once per day
    • maintain pressure on IV, blood draw and other puncture sites for 5 minutes
    • encourage use of slippers or shoes when out of bed
    • keep area clutter free to prevent bumps and bruises
    • avoid drugs that interfere with platelet function such as aspirin and NSAIDS
    • give stool softeners
    • turn pt gently to avoid bruising
    • pt should blow nose gently and only when necessary
    • consult physician on whether sex is safe
  67. what are some conditions that may lead to sickle cell crisis
    • pneumonia with hypoxia
    • exposure to cold
    • diabetic ketoacidosis
    • severe infection
    • anesthesia and blood loss during surgery
    • postoperative dehydration
  68. common symptoms during sickle cell crisis
    • severe pain and swelling in the joints, abdominal pain (swelling of spleen and vital organs), hypoxia, fever, pain, priapism
    • symptoms of renal failure
  69. nursing care for a pt with sickle cell anemia includes increasing or maintaing tissue perfusion how can this be achieved
    • encourage fluids to dilute and aid in eliminating cell debris
    • warm compress to painful areas, cover pt with a blanket and keep room above 72 F to reduce vasoconstriction
    • avoid cold compresses which cause vasoconstriction and may trap additional sickled cells
    • avoid restrictive clothing and raising the knee gatch of the bed
  70. which medication should be avoided when a pt is having a sickle cell crisis
    aspirin, it may increase acidosis which can worsen the crisis
  71. what should the nurse teach a pt with sickle cell to help prevent  acute episodes
    • avoid tight fitting clothing that restricts circulation
    • avoid strenuous exercise
    • avoid things that cause vasoconstriction such as smoking and the cold
    • avoid alcohol
    • encourage fluids to maintain hydration and lower blood viscosity
  72. Condition in which RBCs, platelets and WBCs are overproduced
  73. what causes secondary polycythmia
    • long term hypoxia which causes the pt to make more RBCs
    • COPD, cardiovascular problems such as chronic heart failure, living in high altitudes and smoking
  74. common lab values for a pt with polycythemia
    hemoglobin greater than 18mg/dl, hematocrit > 55%
  75. signs and symptoms of polycythemia
    • most issues are related hypervolemia, hyperviscosity and engorgement of the capillary bed
    • htn, vision changes, headache, vertigo, dizziness, and ringing in the ears
    • nosebleeds, bleeding gums, retinal hemorrhage, exertional dyspnea, chest pain
  76. panmyelosis
    • increased level of all bone marrow components (RBC, WBC,  platelets)
    • associated with polycythemia
  77. treatment for pt with polycythemia
    • therapeutic phlebotomy; 350 - 500 mL removed every other day (goal is hematocrit = 45%)
    • low dose aspirin to reduce thrombus formation
    • chemotherapy or radiation to reduce production of WBCs 
  78. education for a pt with polycythemia
    drink at least 3L of water, smoking cessation, avoid tight clothing, elevate feet when resting, ambulate frequently
  79. Disseminated intravascular coagulation
    • accelerated clotting causes all clotting factors and platelet supplies to be exhausted and clots can no longer be formed
    • organ and limb necrosis is caused by massive clotting in blood vessels
    • develops secondary to major trauma
  80. what causes disseminated intravascular coagulation
    major trauma; overwhelming infection, abruptio placentae, leukemia, severe crush injuries, etc
  81. therapeutic measures for a pt with disseminated intravascular coagulation
    blood, fresh frozen plasma, platelets, vitamin K, cryoprecipitate
  82. idopathic thrombocytopenic purpura
    increased platelet destruction by the immune system
  83. what causes idiopathic thrombocytopenic purpura
    usually occurs after an acute viral illness such as rubella or chickenpox, may also be drug induced or associated with pregnancy
  84. therapeutic measures for the pt with idiopathic thrombocytopenic purpura
    • give steroids to prolong platelet life
    • remove spleen; primary site of platelet destruction
    • acute episodes treated with blood transfusion, platelets and vitamin k
  85. hemophilia
    • hereditary bleeding disorders that result from a lack of specific clotting factors
    • hemophilia is a deficiency of clotting factor VIII
    • hemophilia is a deficiency of clotting factor IX
  86. common hemophilia myths
    • ppl bleed faster
    • they are at risk from small scratches
  87. hemarthrosis is associated with hemophilia what is its
    bleeding into muscles and joints, repeated episodes may cause deformities
  88. therapeutic measures for hemophilic pts
    • inhalation of desmopressin
    • providing pt with clotting factors (IX or VIII)
  89. severity of  hemophilia
    • mild: excessive bleeding is associated with surgery or significant trauma
    • moderate: occasional spontaneous bleeding
    • severe: more frequent spontaneous bleeding
  90. leukemia
    • too many immature WBCs are created by bone marrow
    • reduced RBC production
    • pt is anemic and prone to infections
  91. multiple myeloma
    • cancerous plasma cells cause tumors in bone tissue and weaken them
    • bones of the skull, pelvis, ribs and vertebrae are usually affected
  92. signs and symptoms of myeloma
    • skeletal pain, joint swelling and tenderness, low grade fever, 
    • hypercalcemia because calcium leaves the bones
    • kidney failure due to excess calcium in bones
  93. nursing care for pts with multiple myeloma
    • keep pt mobile to keep calcium within bones
    • intake more than 4L daily
    • give enough fluids so pt excretes 1500 mL of urine
  94. therapeutic measures for multiple myeloma
    • corticosteroids and oral or IV chemotherapy
    • monitor for hypercalcemia, hyperuricemia, dehydration, respiratory infection, renal problems and pain
  95. hodgkins lymphoma
    • reed-sternberg cells found in lymph system
    • most curable
    • usually starts with painlessly enlarged lymph nodes of cervical, axillary and inguinal areas
    • most common in pts that had mononucleosis
    • alcohol induced pain
  96. non-hodgkins lymphoma
    • no reed-sternberg cells
    • usually starts with painlessly enlarged lymph nodes of cervical, axillary and inguinal areas
    • cancer cells may be found in other lymph tissue (tonsils, thymus or bone marrow)
Card Set
hematology and cancer