NUR 220 Oncology 1
- Effects of cancer before treatment begins
Answer Impaired immune/hematopoetic function. Anemia, thrombocytopenia, immune dysfunction.(This even BEFORE chemo beings.)
Altered GI structure/function. Obstruction. Malabsorption with malnutrition and weight loss (also because of increased metabolic rate of rapidly dividing cancer cells). Liver metastases cause clotting dysfunction and impair metabolism of medications.
Motor/sensory deficits Effects of compression from tumors in spinal canal and brain.Paraneoplastic syndromes.Decreased respiratory function Infiltrates, effusions.
- Treatment goals for cancer
- Most important factors in determining cancer treatment
Answer Cure. Control.Palliation.
Answer Tumor type. Performance status.
- Performance status
Answer Quantitative measure of cancer patient's general well-being and ability to perform ADLs. 1 / 4
- Reasons for surgery in cancer
Answer Diagnostic
Biopsy. Primary treatment
Local or wide excision, debulking.
Prophylactic
Removing nonvital tissues or organs at risk for developing cancer (colectomy, mastectomy, oophorectomy).
Palliative
Relieve ulcerations, obstructions, pain, malignant effusions. Reconstructive.
- Local excision
Answer Removal of mass and small margin around it (good for small tumor).
- Wide excision
Answer AKA, radcial excision or en bloc dissection. Removal of primary tumor, lymph nodes, adjacent structures, and tissues that might be at risk for tumor spread.
- BRCA-1 and BRCA-2
Answer Clinical markers associated with hereditary development of breast and ovarian cancer. Tumor suppressor gene. Mutation causes cancer risk. With BRCA-1, 85% chance of breast and 45% chance of ovarian cancer before age 85.
- Nursing care after cancer surgery 2 / 4
Answer Address physical and psychological effects. Effect on body image, self-esteem, functional ability. Also, with biopsy, may have anxiety of having to wait for results.
General postsurgical care.Specific care for organ dysfunction, immune dysfunction, coagulopathies. High DVT risk.Impaired wound healing. Altered respiratory and renal function. Increased risk with chemo/radiation.
- Difficulty of diagnosing DVT
Answer 50% of patients are asymptomatic. Look for pain in calf aggravated by standing or walking.Asymmetry of limbs as well as warmth and erythema. Venous distention that persists despite elevation. Low fever and tachycardia.
- Uses of radiation therapy
Answer Cure. Control.
Prophylaxis
Prevent leukemic infiltration of brain and spinal cord.
Palliation
Treat painful bone mets. Treat emergencies like SVC syndrome or spinal cord compression.
- 2 types of ionizing radiation used in radiation therapy
Answer Electromagnetic rays (x-ray and gamma ray).Particles (electrons, protons, neutrons, alpha particles). 3 / 4
- How radiation therapy works
Answer Ionizing radiation disrupts malignant cell proliferation through alteration in DNA structure, breaking double helix and causing cell death. Goal is to destroy as many cancer cells as possible and sparing normal cells.
- Why radiation therapy damages other tissues besides tumor
Answer Cells undergoing DNA synthesis and mitosis are most susceptible to damage. Tissues that undergo frequent cell division are susceptible
Bone marrow, lymphatic tissue, epithelial tissue of GI tract, hair cells, gonads. Slower growing tissues are radioresistant
Muscle, cartilage, connective tissue.
- 2 types of radiation delivery
Answer External
Has to pass through a lot of normal tissues to get to cancer cells. If it passes through bone, for instance, there may be pathological fracture. Formerly, only external was available, but now doing a lot of brachytherapy.
Internal (brachytherapy)
Delivers high dose of radiation to local area. Implantation of radioisotopes. E.g., intracavitary radiation to cervix and vagina. Also, oral administration of I-131 for thyroid cancer. Spares noncancerous tissue.
- Sealed versus unsealed radiation
- / 4
Answer Sealed