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