115 final chapter 24

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  1. tumor Lysis Syndrome
    a large number of cells are destroyed rapidly, resulting in intracellular contents (K+ & purines) being eliminated into the bloodstream faster than the body can eliminate them.
  2. Tumor lysis syndrome can cause what
    cardiac dysfunction from hyperkalemia and Kidney failure from uric acid crystal accumulation in tubules
  3. treatment for tumor lysis syndrome
    • hydrate with 3-5 liter daily
    • drug therapy with Allopurinol or Rasburicase to treat uric acid and IV insulin and glucose to decrease hyperkalemia
  4. how is radiation given
    radiation is usually given in a series of divided doses because of the varying responses of all cancer cells within a given tumor

    small doses daily then they rest ex; 5 on 2 off
  5. why is radiation given in small doses daily
    it has a greater destruction of cancer cells and reducies destruction of normal cells
  6. what is teletherapy
    • an external beam
    • it is delivered from outside the body so the patient is not radioactive or hazardous
    • the exact point of the cancer is located and marked and the pt receives the radiation in the same spot while in the same position everytime
  7. brachiotherapy
    • the radiation is inside the pt
    • the pt will emit radiation
    • where PPE
    • limit time with pt
  8. a nurse caring for a radioactive pt must wear a _____.
    dosimeter, it measures the radiation exposure
  9. what is the purpose of radiation therapy for cancer?
    to destroy cancer cells and have minimal damaging affects to the surrounding tissue/cells
  10. what is the purpose of cancer management?
    to prolong survival time or improve the quality of life
  11. consequences of cancer on the human body
    • reduced immunity and blood producing functions
    • altered GI structure and functions
    • motor and sensory deficits
    • decreased resp function
  12. what are some side effects of radiation therapy
    • skin changes and hair loss are local but are often perm.
    • development of aversion/dislike the taste of red meat
    • radiation induced fatigue can be debilitating and last for months
  13. what is the definition of chemotherapy
    the treatment of cancer with chemical agents, used to cure, to increase survival time and improve quality of life
  14. discuss the term exposure
    exposure is the amount of radiation delivered to a tissue
  15. discuss the term dose, when talking about radiation therapy
    • radiation dose is the amount of radiation absorbed by the tissue
    • radiation dose is always less than exposure because some energy is always lost on the way into the tissue
  16. sealed radiation sources are contained so they
    DO NOT contaminate your clients urine, sweat, blood or vomitus
  17. an unsealed source of radiation ____
    DOES contaminate your clients blood, sweat, urine and vomitus
  18. you should never remove any ___ from a patient going through radiation therapy. Why?
    • never remove any markings
    • the marks are used to make sure the patient is in the same place in the same position every time they have radiation tx
  19. skin care is important for patients undergoing radiation Tx.

    what is important to know about when to apply skin care medications
    never put ointment, lotion medication on patients skin before they go for radiation
  20. some tissues are more sensitive than radiation than others include
    • ova and sperm
    • hair folicles
    • mucous membranes
  21. patient that have had radiation therapy should avoid the sun for how long after
    at least a year after last Tx
  22. ______ tissue can tolerate more radiation than the _____ can

  23. normal cells that are affected by chemotherapy are ___
    those that divide rapidly, skin, hair, intestinal tissues, spermatocytes, and blood forming cells
  24. nursing intervention for young male going to start chemotherapy
    sperm bank
  25. what is extravasation? what is your role as a nurse regarding extravasation?
    a serious complication of IV infusion when the drug leaks into the surrounding tissues most important nursing intervention is Monitor close to prevent  leakage
  26. what is nadir
    • the time when bone marrow activity and WBC counts are at their lowest.
    • patient will feel miserable, sick, weak
    • Do Not give 2 chemotherapy drugs with same nadir
  27. what are vesicants?
    chemicals that damage the skin on direct contact
  28. Dose-Dense Chemotherapy
    • higher doses of chemo given more often
    • used in aggressive cancer treatment
  29. how do you clean the mouth for patient on chemotherapy
    soft bristled tooth brush or swab
  30. if stomatitis is present what food should be avoided
    hot, spicy, hard food
  31. side effects of chemotherapy
    • anemia, neutropenia, alopecia, mucositis
    • diarrhea, constipation, weakness, fatigue
    • chemo brain
  32. what is chemo brain
    • a mild cognitive
    • it causes memory lapses, trouble concentrating, trouble remembering details, slower thinking, slower processing
  33. what ia anemia
    • decreased number of red blood cells and hemoglobin
    • s/s tiredness, weakness, fatigue
  34. neutropenia
    • decreased number of white blood cells
    • s/s infection

    • this is a life treating event it requires isolation of the patient
    • treat with Neulasta, or Neuvagen
  35. thrombocyctopenia
    • decreased numbers of platelets
    • s/s bruising, bleeding, risk for injury

    give platelets
  36. sepsis
    • blood infection
    • cancer patient are high risk because decreased immune function
    • DIC a problem with clotting process, caused by gram negative sepsis in cancer patients
  37. SIADH
    syndrome of antidiuretic hormone
    • cancer is a common cause
    • water is reabsorbed by the kidney and put back into circulation
    • restrict fluid and add sodium
  38. Hypercalcemia
    • occurs most often in pts with bone metastasis
    • then cancer in the bone causes the bone to release calcium into the blood stream

    s/s fatigue, loss of appetite, n/v, constipation, muscle weakness, dehydration
  39. Superior Vena Cava
    • pt has some type of cancer that is pressing on the superior vena cava
    • that might limit their ability to breath, facial edema, epitaxis, strokes sign, change in mental status, may turn blue
  40. Tumor Lysis Syndrome
    • a large number of tumor cells are busted up and being released into the bloodstream faster than the body can eliminate them.
    • cardiac dysfunction from hyperkalemia and acute renal failure for uric acid crystal accumulation in tubules
    • hydrate 3-5 liters day
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115 final chapter 24
final 115, chapter 24
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