Term
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Definition
Complimentary and Alternative therapies/medicine (CAM)
non-traditional cancer treatment methods |
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Term
| what is complimentary medicine? |
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Definition
| given along with chemotherapy, so that it compliments standard treatment methods. |
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Term
| what is alternative medicine? |
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Definition
| is given in place of chemotherapy and includes non-approved, non-tested treatments that can be harmful. It may interfere with conventional approaches and is not covered by insurance so it can place financial burden on the client. |
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Term
| What is integrative medicine? |
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Definition
| denotes a combination of conventional medicine and CAM that have a strong scientific base for use and safety. combines conventional treatment w/ some type of CAM therapy and based on scientific evidence. |
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Term
| what are the factors that motivate clients to seek CAM therapy? |
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Definition
fear (maybe of disease process, potential outcome, etc.)
ignorance (a lack of knowledge of the planned treatment)
desperation or hopelessness that results from the course of their disease
pressure from family or significant others to try different treatments
to treat unpleasant side effects that the client maybe having from their traditional treatments |
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Term
| what are other motivating factors for a pt. to seek CAM therapy? |
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Definition
impatience with the rate of improvement in their condition (they want to get better quicker)
they may want to maintain control over their healthcare and make their own decisions about treatments
cultural background (some cultures utilize alternative treatments as a standard therapy, or some ppl have their own view on chemo as being "unhealthy chemicals" etc. |
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Term
| what are some examples of CAM therapies? |
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Definition
dietary regimens: example- a western diet that uses an oil-protein mixture plus quark, which is like German cottage cheese. This diet provides essential omega 3 fatty acids and can supposedly cure cancer
pharmacologic therapies-claim to treat or cure cancer, for example in 1976 Vitamin C was big and was thought to cure or slow cancer growth but trials found this is not true and that high doses may actually accelerate tumor growth or cause kidney damage.
mind-body techniques, thermal therapy, aromatherapy, art therapy and bio-feedback-may not be harmful but can be combined with standard treatments, complimentary therapies |
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Term
| what is the assessment role of the nurse for clients using CAM? |
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Definition
the nurse first needs a relevant history that includes information about the use of CAM
ask about why they may be using it-
cultural or personal beliefs?
pressure from family or partner? |
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Term
| what nursing diagnoses would be included with the client who uses CAM? |
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Definition
knowledge deficit (unknown interactions between different treatments, lack of knowledge)
decisional conflict (family maybe pressuring the pt. from personal choice or beliefs or the family's cultural beliefs)
health seeking behaviors |
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Term
| what are the nursing interventions for a client doing CAM therapy? |
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Definition
the nurse should be aware of characteristics common to fraudulent therapies and inform the pt and their family so they can be informed and cautious about other therapies too
the nurse should also be aware of any other meds or herbal supplements/vitamins/etc. that may interact w/ the treatments they are receiving, this can help prevent side effects or dangerous interactions
to protect clients you must establish a trusting relationship using open communication
provide supportive care and promote hope
provide truthful responses in a non-judgmental manner so you don't give the client guilt
also support other nurses/co-workers in making sure you share any important information you learn w/ them
education is the key! |
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Term
| What is the goal of cancer treatment? (5, "CCPPR) |
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Definition
cure- eradicate the cancer
control- after initial treatment pt is put on maintenance therapy for prolonged survival, so cancer doesn't come back, treated as a chronic condition
palliation- relief of symptoms
prophylaxis- treatment when the pt is known to be at high risk
reconstruction-reconstruct acquired defects to restore or improve function |
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Term
| what are the different treatments available? |
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Definition
surgery
radiotherapy
chemotherapy
immunotherapy (biotherapy)
complimentary/ alternative therapy (CAM)
clinical trials
*different treatment methods may be combined and a team of healthcare workers decides on the best plan |
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Term
| what are the factors that affect a patient's response to therapies? |
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Definition
| Age, health status, nutritional status, presence of co-morbid conditions (other chronic diseases), cancer type, disease stage, tumor location, and tumor grade |
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Term
| what is radiation therapy and what is the guiding principle for it? |
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Definition
the use of ionizing radiation to interrupt cellular growth
principle- the radiation dose should be large enough to eradicate the tumor but small enough to minimize adverse affects on surrounding tissues |
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Term
| what does ALARA stand for? |
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Definition
as low as reasonably achievable
*used to minimize exposure to radiation workers |
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Term
| What is the target of radiation in the cell? |
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Definition
| the target for radiation damage is cellular DNA, it breaks the strands of the DNA helix leading to cell death but normal and cancer cells are vulnerable. Side effects result from radiation to the normal cells/tissues |
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Term
| What is external beam radiation therapy? (EBRT) |
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Definition
radiation source is outside of the body.
the dose is dependent on the size of the target tissue and the tumor size, the dose is fractioned and given over several weeks. |
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Term
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Definition
| the dose that will destroy 95% of the tumor yet preserve normal tissue |
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Term
| what causes radiation toxicity? |
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Definition
toxicity is confined to localized area being irradiated
the toxic effects are caused by the destruction of normal cells and when the regeneration of new cells falls behind
toxic effects are also dose dependent- higher the dose the worse the effects
*pt is not a source of radiation contamination to others |
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Term
| what is radio-sensitivity and what cells are sensitive to radiation and which are not? |
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Definition
the faster the cell type divides the more sensitive it is to radiation, therefore the more effective the radiation treatment, the reactions occur faster
sensitive tissues- bone marrow, lymphatic tissue, GI epithelium, gonads, and hair follicles
radio-resistant tissues- muscle, cartilage and connective tissues |
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Term
| what are cytoprotective agents? give an example |
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Definition
research is developing cytoprotective agents to protect normal/healthy tissues
example- amifostine (ethyol) used in pts receiving radiation to head and neck to reduce xerostomia (dry mouth) |
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Term
| what are some tips for the patient receiving radiotherapy? |
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Definition
Markers on skin to guide therapy; do not wash off (may be permanent tattoos)
no lotions, creams, deodorants, and powders
wear loose fitting clothing, maintain good skin care, maintain good nutrition and fluid balance, and monitor for s/s of infection |
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Term
| what are some common side effects from radiation therapy? |
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Definition
mouth- dry mouth, decreased salivation, change or loss of taste, stomatitis, mucositis, esophageal irritation, anorexia, diarrhea
chronic- necrosis of tissues, malabsorption, fistulas, decreased sperm counts
common- may permanently change skin characteristics, delayed healing, fatigue, n/v, headache, and bone marrow suppression |
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Term
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Definition
can be sealed or unsealed sources
sealed- an internal implant is inserted to deliver high doses, can be temporary or permanent, gives off radiation until removed or decay occurs
unsealed- beta particles or gamma rays are given IV, PO, or intracavity from unsealed radioactive sources |
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Term
| what is selective internal radiation therapy and who is it given to? (SIRT) |
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Definition
spheres, or micro spheres
injected into a internal catheter?
pt must meet per-selected criteria
used on pts w/ Primary Liver Cancer, Inoperable metastatic colon cancer spread to liver, Sufficient Healthy liver
liver cancer pts. |
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Term
| what are some safety guidelines for the nurse administering brachytherapy? |
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Definition
| time- 30 mins/shift, intensity increases and distance decreases, use a lead-lined shield between nurse and source, if implant becomes dislodged use long forceps to place in container, internal implant pts are radioactive, pt gets private room w/ private bath, use intercom to communicate when possible, limit visitor time, no children or pregnant women allowed to visit, mark room and chart w/ radiation safety labels, check linens, bedpans, etc. for signs of a dislodged implant, use gloves when handling secretions, triple flush, room considered hot until cleared, disposable food trays and utensils used, trash and linens kept in room |
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Term
| what are some nursing interventions for radiation therapy? |
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Definition
| let pt know side effects such as fatigue, and that this is common, teach family and pt how to manage these effects, explain the treatment plan and the need for isolation, assess hydration and nutrition and treat if needed, maintain fluid and electrolyte balance, assess need for financial assistance, refer to outside resources, ensure adequate safety measures will be used at home, provide support |
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Term
| what are some surgical interventions used for cancer? |
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Definition
oldest and most frequently used form of cancer treatment
local excision-tumor removed with the margin of normal tissue
debulking- procedure used if entire tumor cannot be removed, as much of the tumor as possible is removed |
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Term
| what are some local and systematic effects of surgical treatment? |
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Definition
local- delayed wound healing, wound infection, loss of limb or other body part
systematic- fluid or electrolyte imbalance, malnutrition, constipation |
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Term
| what types of cancer are used for surgical interventions? |
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Definition
breast cancer
endometrial cancer
vulvar cancer
prostate cancer |
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Term
| what is breast conserving therapy? (BCT) |
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Definition
preserves the breast by only removing the tumor and the surrounding tissue, and axillary lymph node
followed by radiation therapy |
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Term
| what are some contradictions for BCT/ breast conserving therapy? |
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Definition
2 or more gross malignancies in separate quadrants
prior therapeutic radiation to the breast
large tumor in a relatively small breast
tumor exceeding 3-4 cm |
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Term
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Definition
total- complete removal of all breast tissue, includes skin, areola, nipple, lymph nodes left intact. the remaining tissue is usually irradiated.
modified radical- removal of the above plus a axillary or sentinel lymph node dissection
radical- removal of modified radical plus underlying pectoral muscles, and internal mammary and pectoral nodes |
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Term
| what are some nursing interventions used after breast cancer surgery? |
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Definition
relief of pain, positioning, wound care, and nutrition
prevent fluid accumulation under the chest wall incision by maintaining patentcy of surgical drains
promote venous lymphatic drainage by elevating affected arm and placing a sign that says no BP, needle sticks, or injections in that arm
exercise to prevent lymphedema (accumulation of lymph fluid in soft tissues)
encourage pt to gently use affected arm when doing ADL's, brushing teeth, brushing hair, washing face, etc.
follow up care is regular exams for rest of life
must continue doing breast self exams on both breasts or remaining breasts and masectomy site
refer pt to resources
provide emotional support |
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Term
| what are the different types of hysterectomies? |
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Definition
total- removal of uterus and cervix TAH- total abdominal hysterectomy, TVH- total vaginal hysterectomy
TAH w/ BSO- bilateral salpingoopherectomy, removal of uterus and cervix and includes ovaries and fallopian tubes- LAH- left RAH-right
radical- TAHBSO plus partial vaginectomy, and dissection of pelvic lymph nodes
Pelvic Exenteration: radical with removal of
bladder and bowel. |
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Term
| nursing diagnosis for hysterectomies? |
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Definition
| risk for infection/ risk for bleeding/ body image disturbance/ altered sexuality/ sexual dysfunction/ ineffective individual coping or ineffective family coping/ knowledge deficit/ altered urinary elimination from manipulation of bladder during surgery/ constipation from pain meds or delayed from surgery/ pain |
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Term
| what are some nursing interventions for hysterectomy? |
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Definition
pre-op: standard perineal or abdominal preparation, vaginal douche or enema may be given
post-op: help w/ elimination, comfort (may have PCA for pain control), watch activity levels, antiembolytic stockings, help w/ coping |
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Term
| what are some of the side effects of chemotherapy? |
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Definition
hematopoietic- bone marrow suppression
integumentary system- alopecia, photosensitivity, stomatitis, mucositis
GI- nausea and vomitting, diarrhea, anorexia
other- system toxicity w/ certain agents |
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Term
| what are some safe handling tips for chemotherapy? |
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Definition
given by safe, specially trained RN's
wear chemo gloves 48-72 hours after last chemo admin
wear disposable, long sleeved gowns when preparing or adminstering chemo agents
dispose of all equipment and chemo wastes appropriately per protocol
chemo spills need special treatment per institution |
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Term
| what is extravasation/vesicant? |
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Definition
when something goes wrong when administering chemo drugs?
indications- absence of blood return, resistance to flow of IV fluid, burning, pain, swelling, redness
what to do- stop chemo infusion, apply cold or heat depeding on drug, leave needle in place and attempt to aspirate drug from tissue, avoid pressure or rubbing the site, elevate the arem, notify MD, circle area on skin and document |
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Term
| what is the role of cure, control, palliative, and prophylaxis in chemotherapy? |
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Definition
cure- total tumor eradication
control- arrest or slowed tumor growth
palliation- alleviation of symptoms to improve comfort
prophylaxis- use of agents to prevent the development of cancer, used on high risk pts. |
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Term
| which chemo drugs are cell cycle specific and which are cell cycle non-specific? |
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Definition
cell cycle specific- drugs that act during specific phases of the cell cycle ex- antimetabolites, plant alkaloids
cell cycle non-specific- drugs that act during any phase of the cell cycle
ex- alkylating agents, antibiotic antineoplastics |
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