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Care of the Cancer Patient
Nursing Care
17
Nursing
Undergraduate 4
06/26/2012

Additional Nursing Flashcards

 


 

Cards

Term
General Consequences of the Disease
Definition
  • Reduced immunity and blood producing functions - esp with leukemia & lymphoma
  • Altered GI structure and fxn -
    • Obstruction and decompression fm tumors
    • Cachexia - extreme body wasting
    • Increased protein and carbs for healing and energy
  • Motor and sensory deficits
    • Bone - motility, pain, fxn, spinal cord compression, hypercalcemia
    • Brain - Benign or malignant; sensory, motor, cognitive fxn
    • Nerve compression - sensory damage
  • Reduced oxygenation
    • Often results in death
    • A/W obstruction fm tumors
    • Decreased lung capacity with lung involvement
    • Compression of blood and lymph vessels - tumors pressing on arteries
    • Thickening of alveolar membrane - exchange can't take place
    • Primary OR metastatic lung tumor -- hypoxia.
Term

Cancer Mgmt

 

 

Surgery

Definition

Removal of diseased tissue

Used for:

  • Prophylaxis
  • Diagnosis- biopsy
  • Cure - tumor removal
  • Control - reduce spreading
  • Palliation
  • Assessing therapy effectiveness
  • Reconstruction - breast, oral (jaw)
Term

Cancer Mgmt

 

 

Radiation

Definition
  • Minimal damage to surrounding normal cells
  • Damage greater to dividing that non-dividing cells
  • Ionizing= most common

Exposure vs. Dose:

  • Exposure - amt of radiation delivered
  • Dose- amt absorbed

Pt should be in exact same pos for all treatments

Make sure the markings stay

Term

Cancer Mgmt

 

 

Radiation Delivery Methods

Definition
  • Teletherapy - from a source outside pt
    • Stereotactic body radiotherapy - 3d tumor imaging, more accurate delivery
    • Exact tumor location imperative for therapy
  • Brachytherapy - from within
    • Pt is radioactive and hazardous to others until isotope clears the body
    • Waste included

 

Term

Cancer Mgmt

 

 

Radiation Therapy SE:

Definition

Mostly limited to tissues exposed:

  • Most sensitive tissues - bone marrow cells, skin, mucous membranes, hair follicles, ova and sperm
  • Bone may lose density
  • Increased risk of dental decay
  • Skin very dry and may break down
  • More sensitive to the sun

Systemic effects:

  • Altered taste sensations
  • Aversion to taste of red meat
  • Fatigue
Term

Cancer Mgmt

 

 

Chemotherapy

Definition

Some selectivity for cancer cells - rapid growth most sensitive to chemo

Cytotoxic against healthy cells - rapidly dividing cells most affected

Term

Cancer Mgmt

 

 

Hormonal Manipulation

Definition
  • Can control CA for many years, but does NOT cure
  • Action = interference with hormonal uptake or inhibition of hormone production
  • Masculinizing effects in women/ feminine effects in men

Increased risk for all pt of:

  • DVT
  • Hypercalcemia
  • Liver dysfunction
  • Acne
  • Fluid retention
Term

Cancer Mgmt

 

 

Photodynamic Therapy

Definition
  • Selective destruction thru chemical reaction to laser light
  • Can reduce tumor size for removal or to relieve obstruction
  • Used most often with non-melanoma skin CA, ocular tumors, GI tumors, and lung CA in a/w
Term

Cancer Mgmt

 

 

Photodynamic Therapy: Pt Education

Definition
  • Sensitivity to light up to 12 weeks
    • TEACH PRIOR TO INJECTION
    • Bring protective clothing/gear
    • Protect from direct and indirect sunlight
    • Homebound 1-3 mo
    • If inpatient, all source of light eliminated or reduced
  • NO drugs with photosensitizing properties - some abx and anti-hypertensives
Term

Cancer Mgmt

 

 

Immunotherapy

Definition

BRMs - cytokines

Enhance immune fxn or stimulate faster bone marrow fxn recovery after tx-induced therapy

  • Interleukins (ILs)
    • Regulate inflammation and immune protection
    • Help immune sys recognize and destroy abnormal cells
  • Interferons (INFs)
    • Slow tumor cell division, stimulate NK, inhibit oncogene expression, induce CA cells to more norm appearance/fxn
  • Thalidomide (Thalomid)
    • Reduces tumor angiogenesis factor (TAF)
    • TAF = req'd for CA cell blood supple
    • Tx of multiple myeloma
Term

Cancer Mgmt

 

 

Immunotherapy SE

Definition

General:

  • Skin dryness, itching, peeling
    • No swimming, no sun exposure
    • No topical steroid creams on affected areas

Interferons - Peripheral neuropathy

Interleukins - generalized and severe inflammatory reactions

  • Fluid shifts and capillary leak = edema in most tissues

Growth Factors - mild inflammation during and immediately after dose

  • May have fever (Tylenol), chills, rigors (Demerol), and flu-like malaise
Term
Alkylating Agents
Definition
  • May have adverse effects on nephrotic sys
  • Nursing:
    • Hydration
    • Push fluids to decrease toxic effects on kidney and bladder lining
Term
Antitumor antibiotics
Definition

May cause GI, GU, CV toxicity

Nursing:

  • Cardiac monitoring
  • Mon. bleeding times
  • Mon. for discolored urine (pink or red)
  • Mon. bowel and bladder elimination
Term
Hormonal Agents
Definition

SE of corticos - impaired immune sys, HTN, hirustism, moon face, buffalo hump, wt gain, increased BG

Nursing:

Monitor WBC, VS, BG, antacids for GI upset, diuretics for fluid retention, monitor I&O

Term
Antimetabolite Agents
Definition

May cause renal or hepatic toxicity

Common for leukemia

Hydration, push fluids

Term
Antimimotic Agents
Definition

May cause neurotoxicity - peripheral neuropathy, muscle weakness, constipation and paralytic illeus

Nursing: assess neuromuscular fxn, GI fxn

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