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oncology SOPN
SOPN Oncology
| Question | Answer |
|---|---|
| Oncology Epidemiology: | Normal cells multiply and differentiate into specialized individual types become organized units of tissue & systems |
| Anaplasia: | Loss of diffentiation of cells. Irreversible alteration in adult cells characterists of tumor cells |
| Tumor: | Swelling |
| Neoplasms: | New Growth |
| Benign Tumor: | Non-malignat is not recurrent. Favorable. Encapsule of fibrous tissue. |
| Malignant Tumor: | Has properties of Anaplasia. Invasive & metastasis. |
| Metastasis: | Means secondary growth with usual reproduction of the cellular structure of the primary gowth site well enought to determine primary growth |
| Carcinoma | Arise from the epithelial tissue. Skin, Mucuous Membranes |
| Sarcoma | Arises from the connective tissue, highly malignant metastates through the lymph channels |
| Where do Carcinoma infiltrate: | Surrounding cells of epithelias and surrounding tissue |
| Sacroma named from connective tissue Example | Osteosarcoma & Liposarcoma - fat cells. |
| Serious Conditions with Ca | Anemia, Infection, Ascites, Malnutrition, Pain, edema, obstruction |
| Para-neoplastic Syndrome | Certain lung Ca caused by treatments such as hormones, enzymes & antigens |
| T N M | T: Tumor N: Node M: metastases |
| To: | To: no evidence of tumore |
| Tis: | Tumor insitu: it is confiend to the epithelium (not invasive) |
| Tx: | Tx: washing is postive for cancer cells with no eveidnece of tumor |
| T1 T2 T3 T4 | T1<3cm, T2>3cm, T3> cm with no extension, T4 invasive to other structures |
| No, NX | No: no node NX: lymph node cannot be assessed |
| Mo | Mo: no eveidence of metastasis |
| A | Genetic Factors, Hormonal, chromosomes ex:BRCA1, BRCA2 |
| B | Hormonal |
| C | Chronic Irritation, wind, dirt, smoking |
| D | Immunological Factors, virus, HIV |
| E | Environmental Factors, radiation, drugs |
| Seven Warning Signs: CAUTION | |
| Precautions | Colon exam, Quit Smoking, Breast exam, Skin exam, Oral Care |
| Vaginectomy | Removal of Vagina |
| Simple Vulvectomy | Removal of the vulva with wide skin margins |
| Wertheims Operation | Excision of the vulva with deep lymph node dissection |
| Lymphadectomy | Excision of Lymph Node |
| Exenteration: | Total pelvic exenteration with removal of uterus, fallopian tubes, ovaries, cervix part of the bladder and vagina. |
| Anterior exenteration: | Same as Exenteration but bowels are not resected |
| Posterior exenteration | Same as Exenteration but bladder is not resected. |
| Chemotherapy: | Interferes with the cancer cell by interfering with duplication and growth, Also acts on normal cells. |
| Protein Supplement when loose the taste for red meat: | Mac & Cheese, Ice Cream, Peanut Butter |
| Drug for Nausea & Vomit | Compazine |
| Drug for vomit | Reglan: Metoclopramide antimetic |
| Drug Increase Appetite | THC Marrinol |
| TX mouth sores from Chemo | avoid coffee, ETOH, gingerale, mouth care every 2 hours, bland diet, swish & swallow Nystatin antifungal |
| Alopecia: | Advise to get wig before hair loss |
| Anemia | Iron Supplement: Ferrous Sulfate, Epogen or Proctit |
| Thrombocytopenia: | Lowered platelets. Common is nose bleeds. If does not stop may need platelet transfusion, or bone marrow suppression |
| Constipation | Push fluids |
| Temp to report | over 100 |
| Xerostomia | Dry mouth, use antacids, benadryl & lidocaine, they cleanse and don't cause build up. NPO 1 hr after Lidocaine |
| Alkylating Agents | Affects DNA of cells |
| Alkylating Agents Nitrogen Mustard | also know as Mechlorethamine given IV |
| Alkylating Agents Cytoxan | Given PO or IV, Hodgkins or Leukemia, Breast Ca, Caution: Nephrotoxic: monitor kidney function *look for blood in urine* |
| Antimetabolites | Resemble nutrients so cell picks it up and eats it |
| 5 FU = Florouracil, Cytosar, Methotrexate | Antimetabolites |
| Anticancer Antibiotics modify the DNA function interfer ewith RNA trascription | Adimycin, Mithracin, Bleomycin, Mitomycin, Mytamycin, Doxorubicin |
| Plant Alkloids | Vinblastin, Vincristin |
| Hormone Chemo Med | Presnisone, DES, contraindicated with pregancy, Androgens: suppress tumor growth |
| Hirsutism | Abnormal Hairiness in women with hormone therapy |
| What do you do when IV site is reddended and swells | Discontinue the IV and start a new one. This is Sign of *Phlebitis*. |
| Prevention of Infections | No visitors that are sick,m reverse isolation, protective isolation especially pts with low WBC |
| Why give Allopurinol to Chemo Pt | To lower uric acid and increase fluids. Caution toxic to kidney Monitor I&O and kidney function |
| Nursing Care Chemo | Check WBC, RBC, Anemia, Platelet, Fluid & Electrolte, assess skin, preserve markings, pain, pain med schedule better than PRN, Patient Control |
| Active Immunotherapy | **Patient injected with antigen which stimulates the development of antibodies by the patient. Usually a protein that causes the formation of an antibody and reacts specifially with aht antibody*** |
| Passive Immunotherapy | **Transfer of immune system form a donor - cadaver, harvest self or twin to a patient with active neoplasm*** |
| External Radiation | Delivered by a machine to lessions. High energy Gamma rays to stop the cancer from growning. Destroy normal cells too. Used before surgery to shrink. Also post, pre and intra op. |
| Contraindicated with external radiation | Do not use soap on area, do not wash off markings, area will be sunburned avoid sun, hot water bottles heating pads and cold treatments. |
| Why would MD stop External Radiation? | Low WBC, unitl WNR |
| Drugs to admin with External Radiation | Compazine: Nausea, Lomotil for diarrhea |
| Diet with External Radiation | Increase protein, and Carbs. |
| Diet for Diarrhea: | Bland Diet, small frequent meals with increase protien to relive nausea. *low residue diet* |
| Internal Radiation Two Common Isotopes: | *Radium & Cesium* radioactive material inside body. *Teflon catheter* |
| Nsg Intervention Internal Radiation | Bed Rest No bathroom privilages Absolute bed rest for implant. Private room, lead aprons protective equip, no longer than 30 min nurse in room per day Work far away. Do not touch radio active material |
| Ca of the Vulva | Confined to epidermis or epithelum, over 50, post menopausal cause unknown, common with Breast Ca, HPV, STD Slow growing tumors and more curable than other reproductive CA |
| Diagnosis of Ca of the Vulva | Colposcopy, a biopsy for the diag and staging, direct visulization with microscope. |
| Sign & Symptoms of Ca of the Vulva | Asymptomatic, or *pruitis & surface lessions, soreness, bleeding, edema, foul smell, pain, increase risk with DM, HTN, |
| What do lessions of CA of the Vulva look like? | Scaly white, red, ulcerated or irregularity pigmented. Increase risk immunosuppressed pts. |
| Tx Ca of the Vulva | If in situ: total vulvectomy, simple vulvectomy; removal of the vulva save the clitoris |
| More TX ca of the Vulva | Plastic surgery, Foley cath, hemovacs, cleanse area daily with normal saline, expose wound to air. Sitz, pillow between legs, TEDS, ambulation, sexual counseling |
| Meds for Nsg Intervetions with CA of the Vulva | Stool softners, pain meds, anticoagulant therapy to prevent DVTS, LOW residue diet |
| Reoccurrrance with CA of the Vulva | Common follow up is critical! |
| Cancer of the Vagina Risk Factors | DES exposure, mother took this while prego |
| Adenocarcinoma: | Young females whom mother took DES while prego with them most common squamous cell carcinoma. |
| DX of Ca of the Vagina | Pap Smear, Biopsy, colposcopy, evaluation of the vagina with direct biopsy of lessions. |
| S/S Cancer of the Vagina | Pruritus, Pain, Bleeding, foul smell, |
| TX Cancer of the Vagina | Radical Hysterectomy, lymphadenectomy, vaginectomy, radiation: internal & external |
| Cancer of the Uterus Endometrial Cancer Risk Factors | Estrogen esp. unopposed increase in age, nullparity, obesity, Hypertension, DM, family history, pregnancy and BC pills, *Most common cancer of repro organs** |
| Cell type in Uterus CA and Prognosis | Good Prognosis if detected early 94%, speads slowly no pap test for this dx is biopsy, or aspiration & curettage |
| S/S Uterus Ca | Abnormal uterine bleeding, ***musoanguineous discharge*** |
| TX Ca of the Uterus | Transabdominal Hysterectomy and Bilateral Salpingetomy (removal of both tubes) |
| Risk factor Ca of the Uterus | Fat in diet, family history, increase in whites, nulliparis, early menarch or late menopause, infertility RX or hormone replacement. |
| American Cancer Society Recommends with Ca of the Uterus | Endo Biopsy @ menopause then periodically. |
| Ca of the Ovavies spreads how? | Silently, until it causes pressure on adjacent organs or abdominal distention 55-65 common age 5th leading cause of ca deaths |
| DX Ca of the Ovaries | Pelvic Exam, Pelvic Sonogram (ultra sound) **Laparatomy required for definitive diagnosis** |
| Decrease risk of Ca of the Ovaries | >5 year BC, breast feeding, lots of babies, |
| S/S of Ca of the Ovaries | Chief Complaint **Fatigue** , lower abdominal pain, bloating, pelvic heaviness, mild digestive complaints, abdominal distention, urgency both bladder and bowel, dysgeusia (aversion to eating with impaired sense of taste. Pain late symptom. |
| TX Ca of the Ovaries | TAH (trans abdominal hysterectormy with BSO (bilater salpingectomy & oopheectomy or panhysterectormy removal of the entire uterus & cervix = decrease risk eliminate it. |
| Ca of the Fallopian Tubes | Very rare, poor prognosis, least likely site for CA *ususually 2nd to Ovarian CA b/c of metastasis. DX and treatment same as Ovarian CA. |
| CA of the Cervix | cause unknown. slow growing. Highly curable if detected early in Pap Smear. Treat Lessions treat Cervical Cancer. HPV Test may be more effective than PAP. More common in sexually active: protitutes. |
| Other risks of CA of the Cervix | Smoking, early intercourse, multiparity, Papilloma virus, long term contraceptive use. DES exposure, low socioeconomic status, dysplassia, High in African American, Hispanic deaths decreased due to Pap Smear. |
| Diagnosis CA of the Cervix | pap smear, Biopsy with Schiller iodine test malignant cells do not contain glycogen and will not stain when iodine is applied, D&C |
| TX CA of he Cervix | Conization, hot cautery, radiation, laser, chemotherapy, cryotherapy. Complications: bleeding |
| Cervial CA treatment staging 0 | In situ: confined to the epithelium, preserve fertility, tx: conization, TAH |
| Cervial CA treatment staging 1 | Lesion confined to cervix. TX: radical hysterectormy - entire uterus & nearby supporting tisuses including he uppermost part of hte vagina is removed. Recovery rate 75-85%. |
| Cervial CA treatment staging 2 | Vaginal CA. Lesion has spread out of cervix to invade vagina. TX: radical hyserectormy and radiation. Recovery rate 50-75% |
| Cervial CA treatment staging 3 | Cancer involves the lowere 1/3 of the vagina, extending to both walls of the pelvic. TX: radiation. Recovery rate 20-30% |
| Cervial CA treatment staging 4 | Vaginal, pelvic, uterine, cancer has spread to bladder and rectum. TX anterial & posterial pelvic extenteration. Complete removal of pelivic structures, all reproductive organs & adjacent tissues. Recovery rate 1-10%. |
| S/S Cervical Cancer | **Thin watery at times blood tinged vaginal discharge, & foul smelling as disease progresses, bleeding gets heavier. Pain, Constipation , urinary or rectal symptoms. |
Created by:
keldog09
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