Term
| Tumor Lysis Syndrome: abnormal labs |
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Definition
Uric acid: Elevated
K+: elevated
Phosphorous: Elevated
Calcium: Decreased |
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Term
Tumor Lysis Syndrome:
clinical manifestations |
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Definition
Nausea/Vomiting, Lethargy
Fluid Volume Excess, Edema, CHF
Seizures |
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Term
Tumor Lysis Syndrome:
Treatment [AH SILK] |
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Definition
Allopurinol
Hemodialysis (if levels are high enough)
Sodium bicarbonate
IV fluids
Lasix
Kayexalate |
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Term
Hypercalcemia:
Found in these cancers |
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Definition
Breast cancer
Lymphoma
Multiple myeloma
Squamous cell lung cancer |
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Term
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Definition
Excessive production of parathyroid hormone
Bone metastasis |
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Term
Hypercalcemia:
Clinical manifestations (think hyperparathyroidism) |
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Definition
Painful bones
Renal stones
Abdominal groans
Strange heart tones
Psychic moans |
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Term
Hypercalcemia:
Treatment [LIB] |
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Definition
Lasix IV
IV NS
Bisphosphonate |
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Term
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Definition
| Excessive release of ADH: causes a retention of fluids |
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Term
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Definition
Fluid retention r/t tumors or certain chemo drugs
May be caused by a brain tumor pressing on the pituitary gland. |
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Term
SIADH:
Electrolyte imbalance |
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Definition
Hyponatremia
<115, life-threatening |
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Term
SIADH:
Clinical manifestations
[High Water Levels Seem To Increase Hypertension] |
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Definition
H - headache
W- weight gain
L - lethargy, fatigue
S- Seizures
T- tachycardia
I- irritability (OFTEN THE FIRST SIGN)
H - hypertension |
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Term
SIADH:
Intervention [RIDDS, think: we need to "rid" this person of the excess fluid) |
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Definition
R - restrict fluid intake, < 1 L/day
I - I&O (monitor)
D - daily weights
D - declomycin (inhibits ADH levels, protects kidneys) |
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Term
Superior Vena Cava Syndrome:
Clinical manifestations [BCDES] |
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Definition
B- BP high in arms/low in legs
C - Cough, non-productive
D - Dysphagia
E- Edema in head/neck
S- Shortness of breath, dyspnea |
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Term
Superior Vena Cava Syndrome:
Intervention [CORE] |
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Definition
C- Corticosteroids to reduce edema
O - O2
R- Respiratory support: sit this patient up
E - Emergent radiation/chemo to shrink tumor |
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Term
Cisplatin (Platinol):
Class |
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Definition
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Term
Cisplatin (Platinol):
Side effects |
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Definition
Bone marrow suppression
Nephrotoxic |
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Term
Cisplatin (Platinol):
Important considerations |
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Definition
CBC
Bun/Creatinine, K+, I&O
Hydration |
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Term
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Definition
Antimetabolites
Crosses the blood-brain barrier |
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Term
5-FU, Methotrexate:
Side effects |
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Definition
Nephrotoxic
Hepatotoxic
Photosensitivity (5-FU) |
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Term
5-FU. Methotrexate:
Important considerations |
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Definition
Can be used with brain tumors: neuro assessments, LOC
Monitor LFTs
Monitor renal labs
Sun protection
Hydration |
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Term
Vinblastine and Vincristine:
Class |
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Definition
Miotic inhibitors
Targets the nervous system |
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Term
Vinblastine and Vincristine:
Side effects |
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Definition
Neurotoxic
-Paresthesias
-Motor weakness
-Paralytic ileus |
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Term
Vinblastine and Vincristine:
Important considerations |
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Definition
Assess DTRs (may be decreased)
Assess bowel sounds and GI function |
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Term
Doxorubicin (adriamycin):
Class |
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Definition
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Term
Doxorubicin (adriamycin):
Side effects |
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Definition
| Cardiotoxic: damages heart muscle |
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Term
Doxorubicin (adriamycin):
Important considerations |
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Definition
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Term
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Definition
| Hormonal agent: antiestrogen |
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Term
|
Definition
DVTs/clots
Menopausal symptoms: hot flashes, irregular menses
Increased risk of uterine cancer |
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Term
Tamoxifen:
Important considerations |
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Definition
Monitor for DVTs
Monitor for uterine cancer |
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Term
Cancer
Primary prevention: |
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Definition
What we can DO to prevent cancer:
Stop smoking
Eat healthier
Use sunscreen |
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Term
Cancer
Secondary prevention: |
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Definition
Screenings: identify it early
Pap smears
Mammograms
Self-breast exam
Testicular exams
PSA
Digital rectal exam
Colonoscopy
Hemoccult
Skin checks |
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Term
|
Definition
C- change in bowel/bladder habits
A- a sore that does not heal
U - unusual bleeding or discharge
T - thickening or lump in breast or elsewhere
I - indigestion or difficulty swallowing
O- obvious changes in a wart or mole
N - nagging cough or hoarseness |
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Term
|
Definition
I-IV
I: well-differentiated and best prognosis
IV: least differentiated and worst prognosis |
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Term
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Definition
| How much the tumor cell looks like/resembles the parent cell |
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Term
|
Definition
Classifies the extent or severity of the cancer using the TNM method.
Stages 0-4 |
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Term
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Definition
Tumor: relative tumor size, depth of invasion, surface spread
Node: presence and extent of lymph node involvement
Metastasis: presence or absence of distant metastasis |
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Term
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Definition
| Eliminate the tumor or malignant cells and CURE the patient |
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Term
| Palliative treatment [PQRS] |
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Definition
Palliative treatment:
Quality improvement for patient's life
Relieve the symptoms
Slow the growth |
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Term
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Definition
| Complements another therapy; in conjunction with another therapy. |
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Term
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Definition
| Surgical augmentation to restore function or appearance |
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Term
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Definition
| Aims to remove tissue or organs that are likely to develop cancer |
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Term
| Nadir (in relationship to chemo therapy) |
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Definition
Lowest point
When RBCs, WBCs, and platelet counts drop to their lowest points.
Typically 1-2 weeks after start of treatment for WBCs, platelets and 2-3 weeks after start for RBCs |
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Term
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Definition
| Abnormally low neutrophils (which are our infection fighters) |
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Term
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Definition
Neutrophils < 1700
WBC < 4000
ANC < 500 (HIGH risk for infection) |
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Term
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Definition
No raw fruits/veggies
No deli meats
No live plants
No sick people in room
Good hand hygiene
Wear mask/gloves upon entering room
Mask patient if he goes out.
Keep the door closed. |
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Term
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Definition
Leukine: build the neutrophil level back up
Antibiotics/antivirals: prophylactically
Monitor VS: even a small increase can indicate sepsis
Monitor CBC: especially WBC |
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Term
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Definition
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Term
Thrombocytopenia:
Lab values |
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Definition
Normal: 150,000-400,000
Thrombocytopenia: < 150,000 |
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Term
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Definition
CBC
Bruising/bleeding
-stool
-oral mucosa
-urine
-skin |
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Term
Thrombocytopenic precautions:
RANDI |
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Definition
R: razor, electric
A: avoid aspirin
N: needles, small gauge (#22 is best)
D: decrease needle sticks, hold pressure for at least 5 min
I: injury, protect by avoiding douches, tampons, rectal temps, hard toothbrushes, flossing. NO invasive procedures. |
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Term
GI symptoms from chemo:
Cachexia |
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Definition
Unexplained weight loss
Extreme wasting and malnutrition |
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Term
GI symptoms from chemo:
Treatment |
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Definition
Megace: stimulate appetite
Diet: smaller meals. Do NOT give at the same time that the chemo is reaching its peak.
Be alert to the fact that chemo may alter taste buds |
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Term
Integumentary symptoms from chemo:
STEAM |
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Definition
S: stomatitis
T: thrush
E: extravasation
A: alopecia
M: mucositis |
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Term
Radiation:
May be used to |
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Definition
Reduce tumor size
Decrease pain
Relieve an obstruction |
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Term
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Definition
Internal, interstitial, intercavity
Radioactive source inside of patient that allows for high doses of radiation |
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Term
Brachytherapy precautions:
Nursing |
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Definition
May only care for one patient on this therapy at a time
Wear a film badge |
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Term
Brachytherapy precautions:
In general |
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Definition
Private room
Limit visitors: no pregnant women, no one under age 16
Visitors stay at least 6 feet from patient
Sign on the door |
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Term
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Definition
| Patient AND body fluids emit radiation |
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Term
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Definition
Put the radioactive material in the body, close to the tumor.
ONLY the patient emits radiation, not the body fluids. |
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Term
| Brachytherapy: dislodged implant? |
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Definition
Do not touch: use forceps to place implant in lead-line container
Contact appropriate personnel for disposal. |
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Term
| Brachytherapy: preventing dislodgment |
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Definition
Bed rest!
If it is in bladder, keep it from becoming distended. |
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Term
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Definition
Teletherapy, beam radiation
Radiologist will place markings of the patient to indicate where the beams will be pointed. |
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Term
External radiation:
Patient education |
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Definition
Don't wash it off!
No lotion on marking area
Protect area from sunlight: up to a year following completion of treatment |
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Term
External radiation:
Side effects |
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Definition
Depends on which area of body is radiated
Redness to area
Skin breakdown
Altered taste (if upper body is involved in therapy)
Fatigue
Pancytopenia: all counts are low |
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Term
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Definition
Painless vaginal bleeding
Watery, blood-tinged vaginal discharge
Pelvic pain, possibly with intercourse
Leg pain along sciatic nerve
Flank/back pain |
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Term
Cervical cancer:
Treatment |
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Definition
Cryosurgery: freeze the cells
Conization: remove part of the cervix
Radiation/chemo: later stages
Hysterectomy: late stage |
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Term
Uterine cancer:
Risk factors |
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Definition
Family history
Nullipara
Late onset menopause
Usually occurs in women over the age of 50 |
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Term
|
Definition
Post-menopausal bleeding
Low back pain
Pelvic pain |
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Term
|
Definition
Surgical intervention:
Abdominal hysterectomy: incision on lower abdomen
Vaginal hysterectomy: risk for infection
Radical hysterectomy: for mets, may have colostomy/ileostomy |
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Term
Breast cancer:
Risk factors |
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Definition
Early menarche
Nullipara
First child after the age of 30
1st degree relative with breast cancer
Post-menopausal women with exogenous estrogen therapy |
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Term
Breast cancer:
Mastectomy info |
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Definition
Elevate affected arm.
NO needles sticks, BP
Prevent lymphedema: compression sleeve
Exercises |
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Term
|
Definition
Wall climbing
Overhead pulley
Rope turning
Arm swings |
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Term
|
Definition
Cough
Hemoptysis
Hoarseness
SOB |
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Term
|
Definition
Verify consent
NPO: 6 hours prior
Conscious sedation
Monitor respiratory status
Watch for return of gag reflex
Assess for pneumothorax |
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Term
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Definition
Only one lobe is removed.
Position patient on back or slightly turned to either side |
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Term
Lung cancer:
Pneumonectomy |
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Definition
Entire lung is removed
Position patient on back OR surgical side down (good lung up)
Not in a fully lateral position b/c of risk of mediastinal shift |
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Term
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Definition
| Remove the larynx: permanent teach |
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Term
Laryngeal cancer:
Post-op considerations |
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Definition
semi-Fowler's position
Humidified environment
Frequent oral care to reduce bacterial count
Suctioning as needed |
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Term
Laryngeal cancer:
Suctioning |
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Definition
Sterile technique
Hyper-oxygenate before and after
Stop advancing catheter when you meet resistance or your client starts coughing.
Apply suction on the way out: intermittent
Suction for no longer than 10 seconds
Watch for arrhythmias: vagus nerve can be stimulated which drops the heart rate. |
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Term
| Colorectal cancer: treatment |
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Definition
*Surgery, depending on size, may remove part and re-anastomose or remove more and have a permanent or temporary colostomy.
*Radiation
*Chemo |
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Term
|
Definition
BPH symptoms: hesitancy, frequency, frequent infections, nocturia, urgency, dribbling
Painless hematuria: most common sign |
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Term
Prostate cancer:
Diagnosis |
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Definition
PSA: normal is less than 4
Digital rectal exam
Biopsy |
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Term
Prostate cancer:
Treatment |
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Definition
Radical prostatectomy: take out entire prostate
*Impotence/ED/sterility
*Incontinence: teach Kegel's |
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Term
Prostate cancer: TURP
(transurethral resection of the prostate) |
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Definition
Usually used with BPH, may use with prostate cancer for relief of symptoms, as a palliative measure.
Most common compilation: bleeding |
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Term
| Prostate cancer: Murphy drip (continuous bladder irrigation) |
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Definition
Maintains patency
Flush out clots with the three-way catheter
Subtract irrigant from the output |
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