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48 Cards in this Set
- Front
- Back
common sites if metastasis
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breast cancer(bone, lung)
lung cancer(brain) colorectal cancer(liver) prostate cancer (bone, spine, legs) brain tumors (CNS) |
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grading 1-4
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grading 1- cells differ slightly from norm cell, well differentiated(mild dysplasia)
grade 2- cells more abn. moderately differentiated(moderate dysplasia) grade 3- cells very abnormal, poorly differentiated (severe dysplasia) grade 4- cells immature(anaplasia) undifferentiated, origin difficult to determine |
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staging
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stage 0- cancer in situ
stage 1- tumor limited to tissue of origin, diff to determine stage 2- limited local spread stage 3- extensive local regional spread stage 4- metastasis |
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seven warning signs of cancer "CAUTION"
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Change on bowel/bladder habits
Any sore that doesnt heal Unusual bleeding of discharge Thickening or lump of breast/elsewhere Indigestion Obvious change in wart/mole Nagging cough, hoarseness |
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breast self examination- WHEN?
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perform 7-10 days after menses
postmenopausal or hysterectomy should select specific day to perform BSE |
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chemotherapy
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kills/inhibits reproduction of neoplastic cells
systemic effects- affects both healthy and cancerous cells combination chemotherapy is planned avoid meds w nadirs(immunosuppression) |
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radiation therapy
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destroys cancer cells w minimal exposure to norm cells. Cells are damaged and die or become unable to divide.
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types of radiation therapy
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external beam radiation- doesnt emit radiation,doesnt pose as a threat to anyone
brachytherapy- client emits radiation CAN pose a hazard to other clients |
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two types of brachytherapy
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unsealed radiation-via oral/IV or body cavities,. not confined to 1 body area, enters body fluids, eliminated via various excreta(radioactive and harmful to others)eliminated within 48hours
sealed radiation- solid implant within tumor target tissues, emits radiation when implant is in place, excreta not radioactive |
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radiation for therapy for cancer- client education
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1. wash everyday w water alone, mild soap and water
2. use hands rather than washcloth 3. dont remove marking where beam is to be focused 4. dry w patting motions, clean soft towel 5. no powders, ointment,lotions, creams at radiation site unless pres. 6. avoid area to sun exposure, or heat |
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sealed radiation source- client care
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1. private room/bathroom
2. caution sign outside clients door 3. limit 30min exposure per hcp per 8 hour shift 4. wear dosimeter to measure radiation exposure 5. wear lead shield to reduce exposure 6. visitors for 30 min stay 6ft away 7. save bed linens until source is removed the dispose normally |
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how is bone marrow administered??
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bone marrow is administered through the clients central line similar to that of a blood transfusion
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bone marrow transplantation- post transplantation period and complications
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post transplantations period-
1. client remains w/o natural immunity until donor bone marrow begins to proliferate & engraftment occurs 2. infection and thrombocytopenia major concern until engraftment |
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leukemia- description
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malignant exacerbation # of leukocytes(immature stage) in bone marrow
acute-sudden onset, short duration chronic- slow onset, persistant over years cause- unknown,involve gene cell damage |
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leukemia- s/s
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aneroxia, fatigue, weakness, dyspnea, exertion, weight loss
bleeding; nosebleeds, gum bleeding, rectal petechiae, prolonged bleeding, ^temp normal, elevated, reduced WBC decreased hmg &hematocrit |
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leukemia- infection
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common sites- GI, resp tract, skin
protective isolation everyone wears mask when entering room |
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classification of leukemia
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acute lymphocytic - mostly lymphoblasts present in bone marrow, age- younger than 15
acute myelogenous- mostly myeloblasts present in bm, age-15-39 chronic myelogenous- mostly granulocytes in bm, age-older than 50 chronic lymphocytic- lymphocytes in bm- 50 years older |
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lymphoma(Hodgkin's Disease)-description
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malignancy of lymph nodes that originate in single lymph node or single chain
metastasis occurs 3. usually involves lymph nodes, tonsils, spleen, bone marrow 4. characterized by presence of Reed-Sternberg cells in nodes 5. causes- viral infections, prev. exposure to alkylating chemical agents |
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lymphoma(Hodgkin's disease)- s/s
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night sweats, positive biopsy of lymph nodes, cervical nodes most often affected.
positive computer tomography scan of the liver and spleen |
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stages of lymphoma (hodgkin's disease)
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stage 1- single lymph node region or extralymphatic organ or site
stage 2- two or more lymph nodes regions on same side of diaphragm or localized involvement of an extralymphatic organ stage 3- lymph node regions on both sides of diaphragm stage 4- diffuse/disseminated involvement of 1 or more extralymphatic organs w/or w/o associated lymph node involvement |
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multiple myeloma- description
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malignant proliferation of plasma cells and tumors within the bone
2. excessive # of abn. plasma cells invade the bone marrow, develop into tumors, ultimately destroy the bone 3. abn. cells produce abn. antibody(myeloma protein, bence jones protein)found in bld, urine. 4. < levels of immunoglobulin and antibodies ^ levels of uric acid and calcium, can lead to RF cause-unknown |
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multiple myeloma- s/s
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bone skeletal pain, esp in pelvis, spine, ribs
recurrent infections osteoporosis ^calcium uric acid (RF) spinal cord compression and paraplegia |
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multiple myeloma-interventions
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encourage at least 2L of water per day (offset hypercalcemia, hyperuricemia, proteinuria)
2. encourage ambulation- prevent renal problems, slow done bone resorption |
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types of testicular cancer
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germinal tumors (seminomas, nonseminomas)
nongerminal tumors(interstitial cells tumor, androblastoma) |
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cervical cancer- interventions
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laser therapy, cyrotherapy,
conization(cone shaped area of cervix is removed, long term f/u) hysterectomy |
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tx for cervical cancer
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nonsurgical- (chemotherapy, cryosurgery, external radiation, internal radiation implants, laser therapy)
surgical(conization, hysterectomy, pelvic exenteration) |
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types of pelvic exenteration
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anterior(removal of uterus, ovaries, fallopian tubes, vagina, bladder, urethra, pelvic lymph nodes)
posterior(removal of uterus, ovaries, fallopian tubes, descending colon, rectum, anal canal total (combination of anterior and posterior) |
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breast cancer- s/s
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mass felt in the upper outer quadrant or beneath the nipple.
2. nipple retraction, elevation 3. asymmetry w affected breast being higher 4. skin edema, peau d"orange skin |
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breast cancer- post operative interventions
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position in semi fowlers, turn to unaffected side, affected arms elevated above level of heart
2. place sign above bed stating "No IV, no injections, no BP readings, no venipunctures in the affected arm" 3.Arm is protected for life |
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surgical breast procedures
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lumpectomy(tumor is excised and removed, lymph node dissection may also be performed)
simple mastectomy(breast tissue and nipple removed, lymph nodes are intact) modified rectal mastectomy(breast tissue, nipple, lymph nodes are removed, muscles are left intact) |
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pancreatic cancer- description
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most are highly malignant, rapidly growing adenocarcinomas that originate from epithelium of the ductal system
2. symptoms doesnt occur until tumor is large, prognosis is poor |
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pancreatic cancer- s/s
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jaundice, unexplained weight loss, clay colored stools, glucose intolerance
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surgical interventions for gastric cancer
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subtotal gastrectomy
billroth 1(gastroduodenostomy, partial gastrectomy, remaining segment is anastomosed to the duodenum) billroth 2(gastrojejunostomy, partial gastrectomy, remaining segment is anastomosed to the jejunum) total gastrectomy- called esophagojejunostomy, removal of stomach, attachment of esophagus to jejunum or duodenum |
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intestinal tumors- s/s
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abn. stools- ascending colon tumor(diarrhea), descending colon tumor(constipation, some diarrhea, flat, ribbon like stool)
guarding, abd. distention late sign(abd.mass, cachexia) |
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intestinal tumors- interventions
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signs of intestinal perforation(low blood pressure, rapid weak pulse, distended abd. ^temp)
2. signs of intestinal obstruction(vomiting(fecal matter), pain, constipation, abd. distention) 3. early sign(hyperactive peristaltic activity, obstruction progresses hypoactive) |
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colostomy or ileostomy- post operative
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ascending colon(expect liquid stool)
transverse colon colostomy(loose to semiformed stools) descending colon colostomy(close to normal stool) ileostomy(drainage will be dark greento yellow as pt begins to eat, stool is liquid, dont give suppositories, risk for dehydration and electrolyte imbalance) |
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colostomy irrigation
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lukewarm water 500-1000ml infused water and stool collect in bag.
1. pt is ambulatory, pos. sitting on toilet 2. pt is bedrest turn to side 3. hang bottom of bag shoulder level of pt or little higher 4. carefully insert tube w/o force 5. clamp tube if cramping, release as cramping subsides 6. perform same time each day(1 hour after a meal) |
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lung cancer- post operative
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monitor chest tube drainage system, will drain air and/or blood that accumulates in pleural space.
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cancer of the prostate- s/s
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1.hard pea sized nodule palpated on rectal exam.
2. late signs(weight loss, urinary obstr. , pain radiating from lumbosacral area down the leg) diagnosis- made through biopsy of prostate |
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cancer of the prostate-transurethral resection of the prostate(TURP)
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insertion of scope on urethra excise prostatic tissue
1. bleeding common after turp (MON for BLEEDING) 2. continuous bladder irrigation will be prec. to keep urine pink color 2. bladder spasms are common after surgery 3. dribbling and incontinence may occur post op 4. sterility may/ may not occur |
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cancer of the prostate- suprapubic prostatectomy
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removal of prostate by abd. incision w bladder incision
1. abd. draining may drain copious amounts of urine, needs frequent changing 2. severe hemorrhage is possible NI mon for blood loss 3. bladder spasm are common 4. longer healing time then TURP 5. sterility occurs 6. CBI to keep urine pink (AP) |
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cancer of the prostate- retropubic prostatectomy
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removal of prostate gland by lower abdominal incision w/o opening bladder
1. less bleeding 2. minimal drainage 3. CBI used 4. sterility occurs |
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cancer of the prostate- perineal prostatectomy
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prostate gland is removed through incision made between the scrotum and anus
1. minimal bleeding 2. mon. closely for infection 3. uninary incontinence is common 4. sterility occurs |
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cancer of the prostate- post op interventions
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1. mon urine for hemorrhage and clots
2. increase fluids to 2400-3000 ml day unless CI 3. mon for arterial bleeding (bright red urine w numerous clots)if occurs increase the continuous bladder irrigation, not. dr. 4. mon for venous bleedings (burgundy colored urine output)not physician, may apply traction on catheter. 5. norm light pink urine, amber in 3days 6. cont. urge to void is norm 7. pt avoid attempts to void around the catheter, cause bladder spasm |
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post op: suprapubic prostectomy
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1.(AP)clamp suprapubic catheter after foley cath is removed, client attempt to void, after pt voided, check amountof residual urine in bladder by unclamping the suprapubic catheter and measuring the output.
2. removal of catheter when residual urine is consistently 75ml or less |
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post op: retropubic prostatectomy
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1. bc bladder isnt entered, no urinary drainage
2. check urinary and purulent drainage, if occurs not. physician 3. |
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post op: perineal prostatectomy
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1. incision may or may not drain
2. avoid rectal thermometers, rectal tubes, enemas |
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urinary stoma care
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change in morning,
use non karaya gum products(urine erodes karaya) |