Term
| Which gender tends to catch their cancer earlier? |
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Definition
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Term
| Which age has the better prognosis when diagnosed with cancer? |
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Definition
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Term
| Do married people tend to do better dealing with cancer than single people? |
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Definition
| Yes because of their social support |
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Term
| How might occupation help/hurt dealing with cancer? |
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Definition
| May cause the cancer, helps have to have an understanding boss. Goals for rehab may include work related things |
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Term
| How does the type of cancer effect pts? |
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Definition
| Determines the PT treatment, goals, and motivation |
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Term
| What should you as a PT look at when your patient has had surgery? |
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Definition
| Surgical sites, healing, pain level |
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Term
| Name 11 evaluation considerations for cancer pts |
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Definition
1. Gender
2. Age
3. Marital status
4. Occupation
5. Type of CA
6. Extent of tumor
7. Metastasis
8. Surgery
9. Activity level goals
10. Functional status
11. Deconditioning |
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Term
| Name the 4 types of treatment goals |
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Definition
Preventative
Restorative
Supportive
Palliative |
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Term
| This treatment goals focuses on building up endurance and strength. Uses conditioning exercises prior to disability (ex: before chemo or surgery) |
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Definition
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Term
| This treatment goal usually occurs after chemo/radiation. Restores and maximizes function within disability, normal strength, and mobility |
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Definition
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Term
| This treatment goal occurs when the cancer is inoperable, but not terminal. Provides increased independence with residual cancer, encourages functional activities, and prevents secondary disabilities (weakness, pressure sores, contractures). Helps to maintain function and lessen the chemo effects. |
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Definition
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Term
| This treatment goal usually occurs when the cancer is terminal (6 mo or less to live). It helps to increase and maintain independence and comfort, determine pt and family goals, as well as focuses on positioning and pain control. It always gives the pt the opportunity to refuse a given treatment or treatment session. Main goals would be positioning, education, mobility, equipment training, and transfer training. |
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Definition
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Term
| Name 2 hematological complications related to cancer treatment |
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Definition
Myelosuppression
Disseminated Intravascular Coagulation (DIC) |
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Term
| A chemotherapy or radiation therapy induced temporary reduction in the rapidly growing cells in the bone marrow. |
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Definition
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Term
| What are the 3 primary side effects and toxicities of the rapidly dividing cells. |
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Definition
Leukopenia
Thrombocytopenia
Anemia |
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Term
| When a pt has myelosuppression, what are several common symptoms the pt may experience? |
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Definition
Infection
Bleeding
Fatigue
SOB
Tachycardia |
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Term
| Occurs when the WBC count falls below 300. The normal count is between 5,000-10,000. Pt may experience fatigue and are at increased risk for infection so they may be in reverse isolation and PT would need a mask on and not ever go in if sick. Good hygiene is important. |
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Definition
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Term
| An abnormal decrease in the number of circulating platelets. The normal platelet count is 150,000-450,000. Increased risk for bleeding exists when platelets are below 50,000. Make sure all equipment is safe and free of sharp edges, only do gentle stretches to decrease internal bleeding risk, and do not use razors to shave. Straining to sneeze or poop is contraindicated as it can cause internal bleeding as well. |
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Definition
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Term
| A decrease in the number of circulating RBCs needed to meet the oxygenation needs of normal tissues. Mild to moderate exists if hemoglobin is between 8-12. Severe exists if hemoglobin is less than 7.5. Monitor HR before and after activites; fatigue is a factor. Increased pressure sore risk. Do not do long treatment sessions but more frequent short sessions. Pt will need lots of rest so teach the pt conservation techniques and they may need a rolling walker to decrease energy expenditure. When changing positions, orthostatic hypotension is also a risk. |
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Definition
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Term
| This pt may be in reverse isolation if the pt is febrile and WBC are below 5,000. Therapist should not treat if they are sick themselves. Utilize good hand washing techniques before seeing pt. |
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Definition
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Term
| Therapist should wear a mask if pt is in reverse isolation. Clean all exercise equipment brought into room with disinfectant. If pt leaves room they should wear mask. Walk/exercise the pt in non-crowded areas. |
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Definition
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Term
| Monitor fatigue secondary to potential fever with these pts. Ongoing education on the importance of good oral,body and environmental hygiene to help prevent infections |
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Definition
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Term
| Check the platelet count prior to seeing this pt. Encourage pt to watch for and report S&S of bleeding. Instruct pt to not use razor blades and to avoid straining with blowing nose or bowel movements. |
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Definition
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Term
| Monitor this pts hemoglobin/hematocrit counts as guidelines for determining the appropriate exercise intervention estimating the amount of activity that may be tolerated and understanding the pt's response to exercise/activity |
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Definition
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Term
| If this pt's hemoglobin is low, there is a decreased O2 carrying capacity potentially creating an increased heart rate and increased ventilations at rest and with activity. Monitor HR, BP, and RR before and with activity |
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Definition
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Term
| Teach this pt energy conservation techniques, encourage self care but provide equipment as needed. Provide assistance/equipment with ambulation/transfers for safety as needed. Monitor skin integrity secondary to decreased blood O2 and nutrients to skin periphery. |
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Definition
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Term
| Encourage frequent changes in position. Recommend bed/chair cushions as needed. Avoid sudden changes in position due to inceased risk for orthostatic hypotension |
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Definition
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Term
| An acute or chronic abnormality of the coagulation system with widespread clotting within the arterioles or capillaries occurring simultaneously with hemorrhage. |
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Definition
| DIC (disseminated intravascular coagulation) |
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Term
| Patients at risk for this should be monitored and observed closely for evidence of clotting and bleeding. Fingers and toes may turn black and need to be amputated. |
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Definition
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Term
| Increased risk for clotting. May lose distal circulation. |
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Definition
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Term
| What should the PT do with DIC pt? |
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Definition
-Monitor blood counts, especially platelets, prior to your intervention each time
-Provide assisted ambulation/ADLs as needed secondary to possible weakness, orthostasis, decreased platelets, etc.
-Assist with bed positioning, ROM, good skin care, arrangement of appropriate bed/chair cushions, etc. if activity is limited
-Watch for and report signs of bleeding or bruising and educate pt to do the same
-Watch for signs of DVT or PE |
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Term
| Compression of the spinal cord or nerve roots, in at least 85% of cancer pts, is caused by __ to the vertebral column. Direct tumor outgrowth from the vertebral body generally causes this condition. Less frequently, compression is caused by a pathological fracture. |
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Definition
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Term
| If a pt has this, be aware of the sequence of symptoms and provide this info to pts who have vertebral metastasis. It may be difficult to distinguish: pain caused by pre-existing bone metastasis from pain related to this. |
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Definition
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Term
| __ should be suspected in pts who are experiencing a change in their pain, or increased intensity. Motor and sensory exams are done regularly as symptoms can progress very rapidly. |
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Definition
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Term
| What 4 things should PT do for pt with spinal cord compression |
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Definition
1. Instruction in protective body mechanics (especially if pt is still ambulatory)
2. Strengthening, functional training and ADL's willd epend on the degree of lost function.
3. Assess and obtain the appropriate equipment. (rental w/c)
4. Assist with pain management |
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Term
| Increased ICP most often occurs as a result of what? |
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Definition
| Brain metastasis (from lung/breast cancer) |
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Term
| What are some common S&S of ICP? |
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Definition
N&V
HA
TIA may occur
Aphasia
Vision problems |
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Term
| Most chemotherapy treatment does not cross what? The brain mets may develop without dz progression outside the CNS. |
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Definition
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Term
| 60% of people with brain mets have what? |
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Definition
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Term
| 85-90% of brain mets are located where? |
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Definition
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Term
| These usually occur in the setting of advanced systemic dz. Monitor neuro changes. Be aware of early S&S when working with pts with metastatic lung or breast cancer. |
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Definition
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Term
| When a pt is being treated for ___, monitor for sequelae for increased pressure. Monitor pulse for a decrease in rate, BP for widening pressure, and respiration changes. Eval and monitor for sensory changes. Assess level of consciousness and cognition. |
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Definition
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Term
| Name 3 things PT should do to avoid an increase in ICP. |
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Definition
1. Elevate head of bed at 30 degress to promote venous drainage
2. Position head in midline and do not lay flat with body
3. Avoid isometric muscle contractions |
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Term
| When a person has this condition, minimize their external stimulation and maintain a calm evironment to decrease stress during treatment. Also work on muscle re-education, balance/coordination activities, functional mobility and ADLs will depend on the degree of lost function. |
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Definition
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Term
| An accumulation of excess fluid in the pericardial sac that completely surrounds the heart. The cavity is normally filled with 50ml of fluid. |
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Definition
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Term
| Caused by lymphatic or hematogeneous spread from a primary tumor, obstruction of lymphatic or venous drainage of the heart by a tumor related process, infection, direct tumor extension or radiation therapy. |
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Definition
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Term
| An accumulation of excess fluid in pleural space surrounding the lungs, which may restrict lung expansion, reduce lung volume, alter the volume, alter the ventilation and perfusion capacity, result in abnormal gas exchange and/or hypoxia. |
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Definition
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Term
| __ __ in the pleural space can be disturbed resultign in a pleural effusion either by shedding of the pleural sac with cancer cells, implantation of tumor cells on the pleural surface, or obstruction of pleural or pulmonary lymphatic or pulmonary veins by a malignant process. |
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Definition
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Term
| This cavity is covered by serous lining that support the abdominal organs and line the abdominal and pelvic walls. |
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Definition
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Term
| The accumulation of excess fluid in the peritoneal cavity. It occurs when the volume of peritoneal fluid exceeds the capacity of lymphatic channels to drain the cavity. |
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Definition
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Term
| Excess fluids build up from tumor seeding the peritoneum obstructing diaphragmatic and/or abdominal lymphatics. Tumor cells may secrete humoral factors that cause increased capillary leakage of protein and fluid into the peritoneum. |
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Definition
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Term
| Name some PT interventions/implications for pts with peritoneal effusion: ascites |
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Definition
1. GET PT UP AND MOVING
2. Often referred to pt when symptomatic
3. General mobility/ADL assessment/tx
4. Adaptive equipment assessment, teaching, arranging
5. Instruction in energy conservation techniques
6. Instruction in breathing and relaxation techniques
7. Provide comfort measures - cushions, positioning, ROM, etc.
8. Family training to assist pt in mobility/ADLs/transfers
9. Monitor pt tolerance for activity |
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Term
| For these 2 types of effusions you should elevate the head of bed to 45 degrees |
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Definition
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Term
| For this type of effusion, monitor HR and BP when appropriate to mobilize pt and monitor for peripheral edema (may need ted hose or elevate feet) |
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Definition
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Term
| For this type of effusion, recline the pt because sitting them up high may put too much pressure on the abdomen |
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Definition
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Term
| For this type of effusion, avoid restrictive clothing and monitor edema. Do not use gait belt. Skin care protocols for edematous areas - possible use of support stocking in some cases of LE edema |
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Definition
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Term
| Occurs when the rate of calcium mobilization from bone exceeds bone formation and the kidney's ability to excrete extracellular calcium |
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Definition
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Term
| This exists when the serum calcium level is elevated above the normal range of 9-11. |
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Definition
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Term
| Clinically, elevated __ levels depress the excitability of nerve tissue and the contractility of cardiac, smooth and skeletal muscle. |
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Definition
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Term
| What is good to keep calcium in the bones? |
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Definition
| Early mobilization and WB |
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Term
| Name some PT interventions and implications for hypercalcemia |
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Definition
1. Provide activity with assistive personnel or devices as needed. Pts may be lethargic or have decreased mental status.
2. Encourage WB such as standing at bedside, bed to/from chair transfers, up in chair for ADLs, etc.
3. Use foot board in bed? - no b/c not monitored well, better to do tilt table or standing frame
4. Recognition of pts at risk for hypercalcemia for early detection and tx management
5. Support and comfort for pt in terminal phase of illness
6. Pt/family education to recognize and report S&S of hypercalcemia and conditions that may contribute to fluid loss (anorexia, N&V, constipation, lethargy)
7. Encourage adequate hydration
8. Assist in management of pain, which can lead toward improved mobilization |
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Term
| A metastatic dz to bone that alters the mechanical, metabolic, and hematologic properties of bone tissue placing it at risk for this. |
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Definition
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Term
| With this, the majority of mets go to the vertebral column, followed by pelvis and femur. Ribs, sternum, skull, and humerus are also frequently involved. |
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Definition
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Term
| How often should you see a pt with pathological fractures in rehab and in home health? |
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Definition
1-2 weeks max in rehab
3-4 sessions for home health |
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Term
| What type of transfer might be most appropriate for pt with patho fx? |
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Definition
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Term
| What type of rolling is most appropriate for pts with patho fx? |
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Definition
| Log rolling (not segmental) |
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|
Term
Pain management
Equipment order
Fam/pt education
Tranfer training
Frequent position changes |
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Definition
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Term
| Does immobilizing a pts with bony metastases decrease their fx risk? |
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Definition
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Term
| Does mobilizing pt with patho fx increase risk for fx? |
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Definition
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