Combo with NCLEX: Cancer and 1 other

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Are breast and

ovarian cancer
linked? Who is at
greatest risk for
getting these types of
CA?

Yes linked and nuns at high risk bc

don't bear children.

Can someone who is

immunocompromised
have lettuce?

No but an apple is good.

How are benign

neoplasms
differentiated?

Well-differentiated.

How are malignant

neoplasms
differentiated?

Range from well-differentiated to

undifferentiated.

How are Tumors

classified?

According the anatomic site,

histologic grading, and extent of
disease (staging).

How are tumors

identified in anatomic
classification?

Tissue of origin, the anatomic site,

and the behavior of the tumor
(malignant or benign).

How are tumors

identified in
histologic grading?

The appareance of cells and the

degree of differentiation are
evaluated pathologically. Four
grades are used to evaluated based
on the degree to which the cells
resemble the tissue of origin.

How can Genetics

cause cancer?

5 - 10% display a familial

predispotion. Oncogenes.

How can hormonal

agents cause cancer?

Disturbance in bodies own

hormonal balance, and
administration of hormones with
oral contraceptives and esotrogen
replacement therapy.

How can Tumors be

classified?

Benign or malignant.

How do Cancer cells

divide?

Indiscriminately and haphazardly

and sometimes produce more than
two cells at the time of mitosis.

How does the immune

system combat
cancer?

Recognizing tumor cell antigens

and damaging or killing the cells
with NK cells and T lymphocytes.

How many stages does

the clinical staging
classification system
use?

5 - from in situ to metastasis.

PLT at what level for a

CA patient allow them
to be discharged?

100,000

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What activates
anticipatory
vomiting in a
person with
chemo?

The vomiting center is activated by the

cerebral cortex and limbic system,
responding to anxiety and sensual
stimulation previously associated with
chemotherapy.

What are adverse

reactions to
anticancer drugs?

Bone marrow suppression, anorexia,

N&V, GI disturbances, alopecia, avoid
pregnancy, decreased Hgb=anemia,
decreased WBC=infection.

What are
appropriate
nursing
interventions for
a burn pt?

Assess body image (art therapy), splints

to prevent contractures, compression
dressing to decrease scarring, curling's
ulcer d/t stressful situation (antacid,
carafate, etc.) and there is always
scarring present.

What are Benign

Cells?

Continuous or inappropriate cell growth

that show specific morphology and have
a small nuclear cytoplasmic ratio.
Normal cells that grow in the wrong
place at the wrong time. Perform
differentiated functions. Adhere tightly
together. Are nonmigratory. Grow in an
orderly manner.

What are
characteristics of
malignant
melanoma?

ABCD= Asymmetry, Border irregularity,

Color variation, and Diameter greater
than 6mm (pencil eraser).

What are
characteristics of
Normal Cells?

Limited cell division, show specific

morphology, have a small nuclear
cytoplasmic ratio, perform specific
function, adhere tightly together, are
non migratory, grow in an orderly and
well regulated manner, and are contact
inhibited.

What are
Malignant Cells?

Rapid or continuous cell division, low

specific appearance, have large nuclear
cytoplasmic ratio, lose differentiated
functions, adhere tightly together, are
able to migrate, grow by invasion, and
are not contact inhibited.

What are
Oncofetal
antigens?

Type of tumor antigen that can be used

as tumor markers that may be clinically
useful to monitor the effect of therapy
and indicate tumor recurrence.

What are
oncogenes?

A developmental gene expressed at an

inappropriate time, capable of
transforming a normal cell into a cancer
cell.

What are
Protoonocogenes?

Normal cellular genes that are

important regulators of normal cellular
processes that keep them in their
mature, functioning state.

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What are
RF for
bladder
CA?

Men, smoking, and increased infections.

What are
RF for
testicular
CA?

Undescended testes and men 15-35

What are
risk factors
for breast
CA?

Family Hx, >50, no children, 1st baby after 35,

period before 12 yo, menopause after 55, high
animal fat diet, exogenous estrogen, hx
ovary/colon/or endometrial CA

What are
risk factors
for cervical
CA?

Multiple sex partners, 1st intercourse young,

herpes, HPV/warts, STD, smoking, AA, and
>35

What are
risk factors
for colon
CA?

Hx of polyps, high fat, low fiber diet, men>50

yo, ulcerative colitis.

What are
risk factors
for
esophagus
CA?

Women, Smokers, and alcohol use.

What are
risk factors
for larynx
CA?

Smoking and alcohol

What are
risk factors
for ovarian
CA?

Infertile, without children, hx of endometriosis.

What are
risk factors
for
pancreas
CA?

Men, smokers, and high fat diets

What are
risk factors
for
prostate
CA?

High fat diet and high testosterone level

What are
risk factors
for
stomach
CA?

Smoked foods, men>40 yo, low intrinsic factor

What are
S&S of
bladder
CA?

Painless hematuria

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What are S&S of breast

CA?

Non tender mass, dimpling,

inverted nipple, and discharge
from nipple.

What are S&S of cervical

CA?

Discharge, spotting between

period, and spotting after
intercourse.

What are S&S of colon

CA?

Abd pain, change in bowel

habits, increased abdomen,
decreased weight, and blood in
stool.

What are S&S of

esophagus CA?

Difficulty eating

What are S&S of external

radiation?

Severe N&V, Hematuria,

Alopecia, Anemia, Diarrhea,
and Evaluate skin for
redness/dryness.

What are S&S of larynx

CA?

Hoarseness, localized pain,

lump, dysphagia, and decreased
weight.

What are S&S of ovarian

CA?

Increased girth, constipation,

vague abd discomfort, urinary
frequency.

What are S&S of

pancreas CA?

N/A

What are S&S of prostate

CA?

Increased frequency, decreased

stream, hematuria, retention,
and nocturia.

What are S&S of stomach

CA?

Anorexia, N&V, belching,

heartburn, blood in stool.

What are S&S of

testicular CA?

Increased size of testes, pain,

firm mass, hydrocele, and dull
ache.

What are substances

thought to reduce risk of
cancer related to
dietary?

HIgh fiber food, cruciferous

vegetables, carotenoids,
possibly vitamins E, C, Zinc and
Selenium.

What are the altered cell

surface antigens for
cancer cells?

Tumor-assoicated antigens.

What are the different

types of Staging?

Clinical, Surgical, and

Pathologic.

What are the most

frequent sites of
metastasis?

Lungs, bone, brain, liver and

adrenal glands.

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What are the

seven
warning
signs of
cancer?

Change in bowel or bladder habits, a sore that

does not heal, unusual bleeding or discharge
from any body oriface, thickening or a lump
in the breast or elsewhere, indigestion or
difficulty swallowing, obvious change in a
wart or mole, nagging cough or hoarseness.

What are the

stages of
cancer?

Initiation, promotion and progression.

What are the

three
parameters
for the TNM
classification
system?

Tumor size and Invasiveness (T), presence of

absence of regional spread to the lymph nodes
(N), and metastasis to distant organ sites
(M).

What are the

two major
dysfunctions
present in
the process
of Cancer?

Defective cellular proliferation (growth), and

defective cellular differentiation.

What are
tumorassociated
antigens a
result of?

Malignant transformation.

What are you

worried
about with
patients who
experienced
burns?

BURNS=Breathing, Urine output,

Resuscitation of fluid, Nutrition, and shock.

What causes
cancer?

Viruses or bacteria, physical agents, sunlight

or radiation, chronic irritaiton, tobacco use,
chemical agents, tobacco smoke, chemical
substances found int he workplace, genetics,
hormonal agents, obesity and dietary factors.

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What does a
diagnostic
plan include
for the
person
whom cancer
is suspected?

Health history, idenification of risk factors,

physical examiniation, and specific
diagnostic studies.

What does
Primary
Prevention
consist of?

Teaching the client to avoid known

carcinogens, adopt dietary and lifestyle
changes known to decrease risk, and
participate in cancer prevention programs.

What does
Secondary
Prevention
consist of?

Being knowledgeable with ongoing

developments for clients at risk, planning
education, prevention and screening
programs.

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What does
Staging do?

Determines the cancers exact location and

degree of metastasis present at diagnosis.

What drug is
used to prevent
infection in
burn pts?

Silvadene

What drug will

enhance
immune
system for use
in cancer
patients?

Nupagen

What happens
when the
immune
system fails
with cancer?

Failure to recognize the malignant cell,

when tumor antigens hide, when the body
becomes depleted or immune system drops,
when abnormal concentrations of host
suppresor T lymphocytes.

What is a good
nursing
diagnosis for a
burn pt?

Impaired skin integrity

What is a
major concern
with multiple
myelomas?

Hypercalcemia. Need to give calcitonin to

decrease and reduce bone destruction.
Increased fluids also help decrease calcium
with diuresis. Patients should also
ambulate and take pain medication for
comfort along with chemo. Broken bones
are common.

What is
Angiogenesis?

The process of developing new blood

vessels.

What is
Cancer?

Encompasses a broad range of diseases of

multiple causes that can arise in any cell of
the body capable of evading regulatory
controls over proliferation and
differentiation.

What is
Hyperplasia?

Increase in number of cells of a tissue.

Most often associated with rapid growth.

What is
Hypertrophy?

Growth that causes tissue to increase in

size by enlarging the individual cells.

What is
immunologic
escape?

The process by which cancer cells evade the

immune system.

What is
important to
know about
adverse
reactions of
external
radiation to
head and neck?

Alopecia, mucositis (stomatitis), dry mouth

(xerostomia) can all occur.

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What is
important to
know about
adverse
reactions of
external
radiation to
pelvis?

Diarrhea, Cystitis, vaginal stenosis, and

dyspareunia (vagina is dry like prune so
intercourse is painful (H20 based
moisturizers).

What is
important to
know about
adverse
reactions of
external
radiation to
the skin?

Skin may appear tanned, pink, or edematous,

because radiation damages skin cells as
passes through skin to target, dryness,
itchiness, and flaking can develop.

What is
important to
know about
radium
implants?

Radioactive beads are placed and are very

dangerous. Blood and bodily fluids are not
radioactive. Beads glow but pee/poop not
glowing. No radiation patients in room
together because need to limit exposure to
radiation. Less than 30 mins in room/shift for
nurse. NO Solid foods, NEVER out of bed, pt
should turn q2 hrs, expect dead tissue to come
out of body, stay 6" away, use lead apron when
in room, and chunks of tumor falling
out=normal.

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What is
Initiation?

A mutation in the cells genetic structure

resulting from an inherited mutation, an error
that occurs during DNA replication or from an
inherited mutation, an error that occurs
during DNA replication, or following
exposure to a chemical, radiation or viral
agent.

What is
Invasion?

Growth of the primary tumor into surrounding

host tissue. Mechanical pressure forces
projections into the surrounding tissue
moving everything out, and enzymes destroy
the surrounding tissue allowing for more
invasion.

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What is
Metastasis?

Multistep process in which tumor cells travel

to distant sites via lymphatic and
hematogenous routes.

What is
Neoplasia?

Uncontrolled cell growth that follows no

physiologic demand.

What is
Progression?

The final stage, characterized by increased

growth rate of the tumor, increased
invasiveness, and spread of the cancer to a
distant site (metastasis). Tumor establishes a
blood supply and forms colonies or
subpopulations.

What is
Promotion?

The second stage in development of cancer, is

characterized by the reversible proliferation of
the altered cells. Growth is enhanced, latency.

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What is
seasonal
affective
disorder?

Depression during winter with decrease in

melatonin.

What is the
first step in
confirming
cancer?

Grading.

What is the
goal of
prevention
and
detection of
cancer with
public
education?

Motivate people to recognize and modify

behavior patterns that may negatively impact
health, and to encourage awareness and
partcipation in health promotiong behaviors.

What is the
only
definitive
mean of
diagnosing
cancer?

Biopsy procedures.

What is the
rule of 9s?

Each arm is 9%, each leg is 18%, head is 9%,

front of torso is 18% and back is 18%.

What is the
rule of
palms?

1 palm=1% of the body (use to measure

smaller areas).

What is the
staging
classification
system based
on?

A description of the extent of the disease

rather than on cell apperance.

What kind of
diet should a
CA patient be
on?

High protein and vitamin C (custard with

strawberries). Small frequent feedings and no
fluids with meal. Eat food at room temp and
take Zofran.

What should
be done if a
patients
radioactive
beads fall
out?

Use lead container c tongs or radiation

specialist to pick up.

What should
you teach the
patient
undergoing
radiation
about
hygiene?

Wash skin gently with warm soap and water

and pat dry, don't wash off markings, don't
use creams, lotions, etc., can use water
soluble moisturizers, instruct him to protect
the skin from sun, wear clothes that are loose
and breathable-cotton best, and can use sitz
baths to soothe perineal area. Rinse mouth
out frequently with saline and avoid spicy or
highly acidic foods or drinks. Eat a low
residue diet, drink plenty of fluids, and use
water based vaginal moisturizers.

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What should you

teach to someone
undergoing chemo
about chemoinduced N&V?

Aniemetic must be taken for 72 hours even in the absence of symptoms to be effective, avoid caffeine and
rich/spicy/or fatty foods 24 hours before and 72 hours after chemo, try six small meals instead of three normal,
don't try to eat or prepare food when nauseated, to avoid unpleasant tastes brush teeth before and after meals, if
have anticipatory N&V try avoid the stimuli if can't be avoided then explore systematic desensitization a technique
used to relax and neutralize the stimuli.

What substances
are throught to
increase the risk of
cancer related to
dietary?

Fats, alcohol, salt cured or smoked meats, nitrates.

What teaching
needs to be done
for a patient
undergoing
external
radiation?

They are not radioactive and not dangerous. The can not go swimming, can not be around crowds, and can't be
out in sun. They are immunocompromised so can diet from infection (hole in spot from radiation be careful), and
teach hair will grow back if lose.

What type of
nutrition does
someone suffering
from burns need?

High protein high calories.