-
resulting from the incontrolled growth of cells, which causes malignant cellular functions
caner
-
what is 2nd leadng cause of death in the us
cancer
-
any abnormal growth of new tissue, can be found in any body tissue
neoplasms
-
not progressive, favorable for recovery
benign
-
becoming progressively worse and often resulting in death
malignant
-
how do cancer cells grow?
in a rapid and they grow for no useful purpose and gow in the healthy tissue
-
what do cancer cells look like?
irregular- with fingerlike proections
-
how can cancer cells spread
they multiply quick and spread via bloodstream and lymph system
-
cancers occuring in infection fighting organs, such as lymphatic tissue
lymphomas
-
cancers occuring in blood forming organs such as spleen and in bone marrow
leukemias
-
cancero ccuring in connective tissue, such as bone
sarcomas
-
cancers occuring in epithelial tissue, such as skin
carcinomas
-
abestos-lung, coal tar, creasote, arsenic or radium, skin and 2nd hand smoke
environmental
-
tobacco, sun exposure, heavy alcohol consumptions, esophageal and fatty diets
lifestyle
-
causes of breast cancer
family history, high fat diet, obesity, alcohol consumptin, postmenopausal estrogen and progestin, first child after 30
-
causes of cervical cancer?
multiple sex partners, sex at early age, smoking and HPV exposure
-
causes of colorectal cancer?
family history, low fiber diet,history of rectal polyps
-
causes of esophageal cancer
heavy alcohol and smoking consumption
-
causes of lung cancer?
smoking, asbestos, arsenic, and radon exposure, 2nd hand smoke and tuberculosis
-
causes of skin cancer?
exposure to uv ray, fair complexion, work with coal, tar, pitch or creosote and multiple or atypical moles
-
causes of stomach cancer?
family history and diet heavy in smoked, pickled or salted foods
-
causes of testicular cancer?
undescended testicles, consumption of hormones by mother in pregnancy
-
causes of prostate cancer?
increasing age, family history, diet high in animal fat
-
how often should ages 20-39 get cancer checkups
every 3 years
-
how often do ages 40 and over get cancer checkups?
anually
-
TNM classification
- t=anatomical size of primary tumor
- n=extent of lymph node involvement
- m=presence of absence of metastasis
-
the process where normal body cells have individual characteristics that allow them to perform different body functions
differentiation
-
tumor cells retain many of the identifiable tissue characteristics of the origional cell ex grade 1
well differentiated
-
tumor cells have little similarity to the tissue of orgin, ex grade 5
undifferentiated
-
stage 1 cancer?
< 2cm, mobile, superficial and confined to organ of orgin, no lymph and no mets
-
stage 2 cancer?
tumor 2-5 cm, not as mobile extends into adjacent tissue, lymph >2-3 cm and firm, no mets
-
stage 3A cancer?
tumor >5cm, not mobile, no lymph, no mets
-
stage 3B cancer?
<2 or >5 mobile or not, localized or extended, and lymph is >2-3 cm and firmer and no mets
-
stage 4A?
tumor>10 cm, extension in another organ arteries or veins, lymph >2-3 cm firmer and no mets
-
stage 4B?
tumor >10 cm and lymph is 3-5, partially moveable, firstmer or >5 and extended and fixed to bone, vessels skin or nerves and no mets
-
stage 4C cancer?
timore >10cm, fixed and destructive, extension into second stations, mets are solitary or multiple
-
CAUTION?
- C=change in bladder or bowel
- A= sore that does not heal in good time
- U= unusual bleeding or discharge from ant body orfice
- T= thickening of or the presence of a lump
- I=indigestion of difficulty swallowing
- O= obvious change in wart or mole such as color, size or texture
- N= naggin cough or hoarsness that is prolonged
-
types of care for the caner pt?
surgery, pallitive, reconstructive, radiation
-
2nd most common healing method?
radiation
-
breakage of choromosomes inside the cell, preventing the ability to replicate
internal radiation
-
shrinks size of tumor
preoperative radiation
-
decrease risk of local recurrence
postoperative radiation
-
how is radiation classified?
curative or pallitive
-
how is external radiation noted?
thru skin markings that should not be washed off
-
how long are external radiation treatments?
1-3 min and is painless
-
how should the nurse prepare for radiation
prepare all the equipment outside the room, limit exposure and wear lead apron
-
drugs used in chemo that inhibit the growth and reproduction of malignant cells, most are CCS or CCNS
antineoplastics
-
attack cancer cells when the cells enter a certain phase of reproduction, most effective against rapidly growing tumors, best results when administered in multiple repeated doses
CCS (cell cycle specific)
-
destroy cancer in any phase of the cell cycle, cells are destroyed based on the amount of the drug given
CCNS (Cell cycle nonspecific)
-
usually administered after surgery or radiation
anticancer agents
-
routes of cytoxic agents
oral and IV but can be topical, sq, im, intracathecal
-
agents that are so irritating that they can blister and cause necrosis so all sites must be monitored for leakage of fluid from the vein into the surrounding tissue or extravasation
vesicants
-
what are s/s of vesicants?
pain or burning at site, absent or sluggish blood return, swelling , redness 6-12 hrs later, diffuse hardening,
-
where should laundry be placed that chemo patients have with any bodyily fluids?
special laundry sack
-
side effects of chemo?
clay colored stool, unusual bleeding, loss of taste, tingling of the face fingers or toes, rash, sore throat, jaundice, yellowing of the eyes, dark urine, dyspnea
-
aspirated and stored while the client is exposed to high doese of chemo or total body irridation the bone marrow is reinfused when treatment is complete
bone marrow
-
hospital stay for a bone barrow?
35-40 days
-
complications of bone marrow?
infection, bleeding, GI effect, renal insufficiency, veno occlusive disease, graft vs host disease
-
what should be monitored since malignant and normal cells are killed thru chemo
blood counts
-
low neutropenia means what?
low wbc count and should be on reverse precautions
-
low platelet counts? and what to monitor?
below 50,000 and watch for bleeding, bruises and petechiae
-
what meds should we hold ?
ASA or acetylsalicylic acid containing meds
-
if bleeding occurs how long shoud we hold the bleeding site
pressure for 5min and report is persist for more than 5min!
-
state of malnutrition and protein wasting
cachexia
-
the body digest muscle instead of storing fat
cachexia
-
what is considered malnutrition of a cancer patient?
10% of weight loss and a serum albumin level of 3.4
-
nutritional problems associated with cachexia?
anorexia, NV, altered taste sensation, mucosal inflammation and dysphasia
-
how to handle anorexia in cancer pt?
I and O daily, small frequent meals, high cal foods
-
N/V in cancer PT?
occurs in 3-4 hrs of chemo and last 72 hrs after
-
how to fix N/V?
liquids 30-60 min before mouth care, small feedings, bland foods
-
cancer pt taste what?
bitter
-
how to help with dysphasia?
artificial saliva, soft diet with supplements, avoid dry foods, pureed foods, allow time to eat
-
occurs in 1/2 of cancer pt, occurs 7-14 days after chemo, last 2-3 wks
stomatitis
-
what can cause painful swallowing
mucositis or esophagitis
-
muscosal inflammation can also be found where?
vaginal
-
early signs of mucosal inflammation
edema, ulceration, erythema, excessive salavia, infection
-
interventions for mucosal inflammation
oral care X4/day, avoid rough, chewy foods and acidic foods, mouthwashes containing alcohol, lemon swabs, use straws, posicles numb the mouth
-
what can be ordered of rinses that can be helpful after meals for mucosal inflammation?
xylocaince rinses and saline rinse
-
what can cause chronic pain?
metastatic bone disease, venouse or lymphatic obsrtuction and nerve compression
-
the thinning or loss of hair, may be induced by chemo or radiation treatments, scalp hair is the most common
alopecia
-
true or false?
treatments for cancer interfere with the process of the hair follicle?
-
after treatment when does the hair begin to be lost?
2-3 wks
-
when treatment is completed when does hair grow back?
8wks
-
embarrasment is a big deal with cancer patients for what?
the odor that comes along with it
-
a client can get fluid accumulation in the lungs and we should auscultate lung sounds how often?
q4hr
-
fluid accumulation in the ABD?
ascites
-
procedure where excess fluid is withdrawn from the abd wall
paracentesis
-
whats the first nursing intervention for ascites?
measure the girth of the abd
-
interventions for ascites?
daily weight, fluid restriction, good skin care, fowler postitioning, monitor electrolyte imbalances
-
after chemo what are things that can happen to women?
infertility
-
chemo can cause what in women?
vaginal dryness
-
what can happen to men in chemo treatment?
impotence, decreased libido, interupted sperm production, ejaculation problems
-
s/s of hypercalcemia?
n/v, constipation and weakness
-
later symptoms of hypercalcemia that ca cause problems?
dehydration, renal failure, coma and cardiac arrest
-
treatment for hypercalcemia?
normal saline and lasix which help excrete
-
chief s/s?
spinal cord compression
-
aggrivating factors of spinalcord compression?
lying down, coughing or moving
-
alieviating factors of spinal cord compression
sitting upright
-
caused by an obstruction of the superior vena cava, most likely due to lung cancer or lymphomas
superior vena cava syndrome
-
s/ of superior vena cava syndrome?
dyspnea, swelling of the face and neck, chest pain, coughing, H/A, visual disturbances and LOC
-
treatment of superior vena cava syndrome
o2, keep calm, restful environment, limit activities, monitor resp, dont elevate lower extremities
-
caused by the formation of pericardial fluid, this reduces the cardiac output by compressing the heart
cardiac tamponade
-
s/s of cardiac tamponade
rapid weak pulse, distended neck veins, pleural effusion, ascites, enlarged spleen, lethargy, altered LOC
-
treatment of cardiac tamponade
pericardiiocentesis (aspiration of fluid constricting heart)
|
|
