NRSG102 Med Surg Exam 2 - Cellular Regulation
Stage III
Late locally advanced Ex: Breast Cancer - Larger tumor with extensive lymph node involvement or tumor extension to chest wall or skin
Secondary Chemical Mediators
Leukotrienes Bradykinin Serotonin
Stage I
Localized Ex: Breast Cancer - small tumor confined to the breast
Inflammatory Process
Localized reaction intended to neutralize, control or eliminate offending agent NOT INFECTION
Nursing Care of Patient with Cancer
Maintain tissue integrity Stomatitis Radiation-associated impairment of skin integrity Alopecia Malignant skin lesions
Allergic Reaction
Manifestation of tissue injury resulting from interaction between an antigen and an antibody Body encounters allergens that are types of antigens Body's defenses recognize antigens as foreign
Stage IV
Metastasized Ex: Breast Cancer - Distant metastasis (bones, liver, lungs)
Angiogenesis
formation of new blood vessels involves migration, growth and differentiation of of endothelial cells, which line the inside wall of blood vessels Cancer cells need blood flow to be able to multiply
Cancer
group of disorders characterized by abnormal cell proliferation, in which cells ignore growth-regulating signals in the surrounding environment begins when a cell is transformed by a genetic mutation of cellular DNA
Alopecia
hair loss can occur as a side effect of chemo/radiation therapy can be temporary or permanent
Primary Prevention
health promotion risk reduction strategies nutrition exercise
Cancer Vaccines
immunotherapy designed to stimulate the body's immune system to recognize and attack cancer cells used as a treatment for existing cancer or to prevent cancer recurrence HPV vaccine Hep B Virus
Memory Formation
in adaptive immunity memory cells are created, allowing the immune system to respond more effectively upon future encounters with the same pathogen
Allergic Reaction
inappropriate, often harmful, response of the immune system hypersensitive reaction to an allergen initiated by immunologic mechanisms that is usually mediated by IgE antibodies
Stomatitis
inflammation of the mucous in the mouth, which may result in pain, swelling and ulceration of the oral tissues
WBC Count
insight into the body's immune response to infections, inflammation and other immune-related conditions
Psychoneuroimmunologic Factors
interaction between the nervous and the immune systems bidirectional Cytokines playing a pivotal role in this relationship
Thrombocytopenia
lower than normal number of platelets in blood platelets play crucial role in blood clotting increased risk of bleeding and difficulty in forming clots to stop bleeding
Carcinogenesis
malignant transformation 3 Step Process: 1.) initiation: apoptosis 2. ) Promotion: preneoplastic/benign lesions 3.) Progression: angiogenesis
Genetic Engineering DNA Technology
manipulation of an organism's genetic material to introduce specific traits or characteristics
Nonmyeloablative
mini-transplant from a donor that uses a less aggressive combination of chemotherapy and/or radiation to prepare the patient for the transplant
Tertiary Prevention
monitoring for and precenting recurrence of the primary cancer screening for development of secondary malignancies in cancer survivors genetic mutations related to inherited cancer syndromes environmental exposures and lifestyle factors
Phagocytosis
monocytes responsible for engulfing and destroying foreign bodies and toxins
Secondary Prevention
screening early detection activities identifying precancerous lesions and early-stage cancer community-based screening and detection programs
Septic Shock
severe and life-threatening condition that occurs in response to an infection Systemic, dysregulated response of the body to an infection Leading to widespread inflammation, organ dysfunction and dangerously low blood pressure
Immunoglobulins
specialized proteins produced by the immune system to defend against pathogens like bacteria, viruses, and parasites
Apoptosis
the death of cells which occurs as a normal and controlled part of an organism's growth or development
Cell Kill
the destruction or elimination of a certain percentage of cells within a tumor population due to a specific treatment, such as radiation therapy or chemotherapy
Variables that Effect Immune System Function
- Age and gender - Nutrition - History of infection or immunization - Allergies - Presence of conditions or disorders, autoimmune disorders, cancer, neoplasm, chronic illness, surgery or trauma - Medications and transfusions - Lifestyle - Psychoneuroimmunologic factors
Assessing Immune System
- Health history - Nutrition - Infections - Immunizations - Allergies - Autoimmune Disorders - Cancer - Chronic Illness - Physical exam - lymph node assessment - Skin examination - Other body systems
Extravasation
the leakage of blood, lymph or other fluid such as an anticancer drug, from a blood vessel or tube into the tissue around it Take immediate action: Stop infusion or injection immediately Remove IV cannula or needle Elevate affected limb to reduce spread of substance Notify healthcare tems Cold or warm compress depending on the substance Antidote (sometimes) Wound care (if severe) Follow up/monitor
Cell Cycle
the series of events that a cell goes through as it grows and divides into two daughter cells. tightly regulated process that ensures the proper growth, development and maintenance of organisms
Bone Marrow
the soft, spongy tissue found in the cavities of bones, where blood cells are produced A biopsy is important for diagnosing and monitoring various blood disorders and conditions
Brachytherapy
treatment of cancer, especially prostate cancer, but the insertion of radioactive implants directly into the tissue
Syngeneic
type of allogeneic transplant, meaning it comes from a donor You can only receive if you have an identical twin or triplet who can donate stem cells
Immunoglobulin E (IgE)
type of antibody that plays a central role in the body's immune response one of the 5 main classes of immunoglobulins
Immunotherapy
use of medications or biochemical mediators to stimulate or suppress components of the immune system to kill cancer cells
Autologous
uses healthy blood stem cells from your own body to replace your diseased or damaged bone marrow
Sequence of events of Inflammation
vasodilation increased vascular permeability leukocytic cellular infiltration
Lymphocytes
white blood cells that have receptors capable of recognizing specific antigens (molecules on the surface of pathogens)
Metastasis
Abnormal cells invade surrounding tissue and gain access to lymph and blood vessels carrying them to other areas of the body
Toxicity
Acute radiation syndrome (ARS) acute illness caused by irritation of the entire body (or most of the body) by a high dose of penetrating radiation in a very short period of time (usually a matter of minutes)
Chemotherapy
Agents used in attempt to destroy cancer cells by interfering with cellular function, replication May be combined with surgery, radiation therapy or both Curative, control or palliative Cell kill and cell cycle
2 Main Lymphocytes
B Cells - produce antibody molecules that can latch on and destroy invading viruses or bacteria T Cells - direct fighters of foreign invaders, and also produced cytokines, which are biological substances that help activate other parts of the immune system
Malignant Process
Cell proliferation: - genetically altered cells clone and proliferate abnormally - evade normal intra/extracellular processes such as growth regulating and immune system defenses - abnormalities lead to cancer development - ultimately metastasis occurs
Benign Neoplasms
Cells closely resemble normal cells slower growth encapsulated: enclosed in a fibrous capsule separating from surrounding tissues non-invasive Localized effects Generally not life-threatening Good prognosis Surgery
Tumor Staging
determines the size of the tumor, the existence of local invasion, lymph node involvement and distant metastasis
Stage 0
Carcinoma in situ - early form
Immune System
Complex network of cells, tissues and organs that work together as the body's defense against harmful pathogens (bacteria, viruses, fungi, parasites) Finely tuned system sometimes mistakenly attack the body's own cells leading to autoimmune diseases if not strong enough, it can fail to defend against infections
Radiation Therapy
Curative, control or palliative external radiation internal radiation radiation reactions brachytherapy toxicity
Preneoplastic Lesions
Development of primary tumors is often preceded appearance of lesions consist of genetically and phenotypically altered cells exhibiting a higher risk of malignant evolution than normal cells
Complement Component Tests
Diagnose and monitor conditions related to complement deficiencies, autoimmune disorders and other immune-related diseases Abnormal results can provide valuable information for guiding treatment decisions and managing patients with complement-related conditions
Phagocytic Cell Function Test
Diagnostic procedures used to evaluate the ability of phagocytic cells, particularly neutrophils and macrophages, to engulf and destroy foreign particles, such as bacteria, fungi and cellular debris Important for assessing the functionality of the first line of defense against infections Front line warrior test
Hypersensitivity Tests
Diagnostic procedures used to identify and characterize allergic reactions or hypersensitivity reactions in individuals Help healthcare providers determine specific allergens or substances that trigger an abnormal immune response
Surgical Treatment
Diagnostic surgery Biopsy (excisional, needle, incisional) Tumor Removal (wide excision, local excision) Prophylactic surgery Palliative surgery Reconstructive surgery
Myeloablative
High-intensity uses high doses of chemotherapy and may use radiation therapy to destroy cancer cells
Primary Chemical Mediators
Histamine Eosinophil chemotactic factor of anaphylaxis Platelet-activating factor Prostaglandins
Carcinogenic Agents and Factors
ESTROGEN (female sex hormone) viruses and bacteria sunlight, radiation, chronic irritation Tobacco, asbestos Genetic familial factors Lifestyle factors Hormonal agents
Stage II
Early locally advanced Ex: Breast Cancer - Larger tumor with or without lymph node involvement
Radiation-associated Impairment of Skin Integrity
Erythema (redness) Dryness/Peeling Pruritus (itching)
Chemotherapy Toxicity
Gastrointestinal Hematopoietic (neutropenia, thrombocytopenia, anemia) Renal Cardiopulmonary Reproductive Neurologic Cognitive Fatigue *** Remember neutropenic precautions
Stem Cells
Have the ability to restore an immune system that has been destroyed
Activation
Immune cells become activated, triggering a cascade of responses that aim to eliminate the threat
Recognition
Immune cells identify foreign substances in the body, such as antigens on the surface of pathogens
Effector Phase
Immune cells, like T Cells and antibodies produced by B Cells, target and eliminate the specific pathogen
Proliferation
Increase in cells Follows/overlaps the inflammatory phase includes processes where blood flow increases to the affected area, bringing the immune cells and nutrients to fight the infection
Passive Immunity
Natural Passive Immunity - Breast milk or placenta Artificial Passive Immunity - antivenom serum or similar that contain antibodies specific to the need
Active Immunity
Natural active immunity - exposed to live pathogen, gets sick and recovers Artificial Active Immunity - deliberately exposed to weakened or inactivated form of a pathogen through vaccination
Hospice
Need Order referred to in a timely fashion Comprehensive, multidisciplinary approach to care of patients with terminal illness, their families Focus on: - quality of life - palliation of symptoms - psychosocial, spiritual care - Grief
Graft vs Host Disease
condition that occurs when donated stem cells or bone marrow (the graft) see the healthy tissue in the patient's body (the host) as foreign and attack them Can also occur in organ transplant prevented with immunosuppressant drugs (cyclosporine)
Nurse Role in Evaluating Immune System
Offer Support Reduce Anxiety Provide patient education and counseling ensuring comprehensive and patient-centered care
Tumor Grading
Pathologic classification of tumor cells
Malignant Neoplasms
Poorly differentiated Fast growth infiltrative to nearby tissues invasive and can spread systemic effects-widespread symptoms Prognosis varies widely multimodal approach-therapy, radiation, chemo, immunology, surgery
Nursing Management in HSCT
Pretransplantation care providing care during treatment posttransplantation care (donor and recipient)
Allogenic
Procedure in which a patient receives healthy blood-forming cells (stem cells) from a donor to replace their own stem cells that have been destroyed by treatment with radiation or high does of chemotherapy
Nursing Care for Patients with Cancer
Promote nutrition Relieving Pain Decreasing fatigue Improving body self-image Sex
Five Stages in Immune Response
Recognition Proliferation Response Effector Memory Formation
Atopy
Refers to IgE-mediated diseases, such as allergic rhinitis, that have a genetic component
Inflammatory Response
Response to injury or invading organisms Chemical mediators minimize blood loss wall off invading organisms activate phagocytes promote scar tissue and regeneration of injured tissue
Nursing Care for Radiation Therapy
Skin is very fragile; gentile cleansing, discourage lotions, perfumes. Encourage loose fitting clothing Protect from sunlight listen, validate, educate, refer encourage hydration, balanced diet manage side effects: fatigue, N/V, skin reactions, hair loss
Cancer Management
Specific to type, stage, grade of cancer cure control palliation
Immunopathology
The study of diseases that results from dysfunction within the immune system
Lymph Nodes
contribute to the body's ability to maintain health and combat threats Command centers for the immune system Swollen indicates a problem meeting points for immune cells to meet, interact and respond to potential threats
Regeneration
defect is gradually repaired by proliferation of the same cells as destroyed
Diagnosis of Cancer
determine presence, extent of tumor identify possible disease metastasis evaluate functions of involved and uninvolved body systems and organs Obtain tissue and cells for analysis, including evaluation of tumor stage and grade
Primary Function of Immune System
To recognize and eliminate foreign invaders to maintain homeostasis
Nonspecific Immunotherapy
boosts the immune system to enhance cancer cell destruction
Checkpoint Inhibitors
cancer treatment that works by blocking certain proteins on immune cells, allowing them to recognize and attack cancer cells more effectively Has promising results
Targeted Therapy
Use of agents to kill or prevent the spread of cancer cells by targeting a specific part of the cell, with less negative effects on healthy cells than conventional chemotherapy personalization of cancer therapy
Specific antigen-antibody Tests
Used to diagnose a wide range of conditions, including infectious diseases (such as HIV, hepatitis, COVIS-19), autoimmune disorders, allergies and certain types of cancers Used to detect and measure the presence of specific antigens or antibodies in a person's blood
HIV Infection Test
Used to diagnose and monitor HIV infection Detect specific markers associated with the presence of the virus in a person's body
Hematopoietic Stem Cell Transplantation (HSCT)
Used to treat several malignant and nonmalignant diseases Types: - allogeneic - autologous - syngeneic - myeloablative - nonmyeloablative
Humoral and Cellular Immunity tests
Valuable tools for diagnosing immune-related disorders, evaluating vaccine effectiveness, monitoring immune function in individuals with certain conditions (such as immunodeficiencies or autoimmune diseases) assessing responses to treatments or therapies that target the immune system
5 Cardinal Signs of Inflammation
Warmth swelling pain redness loss of function
Replacement
cells of another type fill in the tissue defect and result in scar formation
Malignant Cancer Cells
cells or processes that are characteristic of cancer
Benign cancer Cells
cells that are not cancerous
Cancer-related Anorexia-cachexia Syndrome (CACS)
complex and multifaceted condition that often occurs in individuals with advanced cancer combination of loss of appetite and significant muscle wasting
Monoclonal Antibodies
antibody produced by a single clone of cells or cell line and consisting of identical antibody molecules Type of protein that is made in the laboratory and can bind to certain targets in the body, such as antigens on the surface of cancer cells
Nursing Management in Chemotherapy
assess fluid, electrolyte status assessing cognitive status modifying risks for infection, bleeding administering chemotherapy precenting nausea and vomiting managing fatigue protecting caregivers NURSES CANNOT ADMINISTER CHEMOTHERAPY UNLESS CERTIFIED