chapter 18

When preparing a response to this client, the nurse should be aware of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?

Different proteins in the cell membrane

The results of a 22-year-old college student's most recent Papanicolaou (Pap) test are suggestive of cervical cancer. Since learning of this news, the patient has asked numerous questions of all members of the health care team, including the nurses at the campus medical clinic. What patient teaching should the nurse at the clinic prioritize in this patient's care?

The relationship between viruses and cervical cancer

Which of the following would be consistent with a benign neoplasm?

Usually progressive and slow

Guillain-Barré syndrome

causing muscle weakness and sometimes paralysis.

The nurse is teaching a client newly diagnosed with cancer about chemotherapy. The nurse tells the client he'll receive an antitumor antibiotic. The nurse knows that this type of medications is:

cell-cycle nonspecific.

Cancer

characterized by abnormal, unrelated cell proliferation

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

hyperkalemia

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values:

hypomagnesemia

malignant

invasive and capable of spreading

Carcinogenesis

is the process of malignant transformation./development of cancer DNA

A client has been treated for shock and is now at risk for which secondary but life-threatening complications?

kidney failure disseminated intravascular coagulation acute respiratory distress syndrome

A decrease in circulating white blood cells is

leukopenia.

New growths of abnormal tissue are called

neoplasms or tumors.

A client without symptoms receives a diagnosis of prostate cancer after a routine physical. What factors contributed to this diagnosis?

client history risk factors tumor markers

A patient with a diagnosis of renal cell carcinoma is being treated with chemotherapy. During a previous round of chemotherapy, the patient's tumor responded well to treatment but the chemotherapy caused intense nausea and vomiting. How should the patient's potential nausea and vomiting be addressed during this current round of treatment?

Administer antiemetics in anticipation of the patient's nausea.

The hospice nurse is caring for a client with cancer who is living at home. The nurse has explained to the client and the family that the client is at risk for hypercalcemia and has educated them on that signs and symptoms of this health problem. What else should the nurse teach this client and family to do to reduce the client's risk of hypercalcemia?

Consume 2 to 4 L of fluid daily.

The nurse is caring for a client who is to begin receiving external radiation for a malignant tumor of the neck. While providing client education, what potential adverse effects should the nurse discuss with the client?

Impaired nutritional status

As the body tries to adjust to accommodate injury and avoid shock, many physical responses are expected. When the physiologic compensations are not sufficient, which stage of shock does the client experience?

decompensation/progressive stage

brachytherapy

delivered to a localized area inside the body through the use of an implant

Cystology

examines cell structure and function

A client is brought into the ED with extensive traumatic injuries. The paramedic reports that the client has "shock." What are the etiologies of shock? Select all that apply.

heart fails as effective pump blood volume decreases peripheral vascular dilation

A patient with cancer who developed neutropenia several days ago has consequently been placed in a single-bed room that has positive pressure. His daughter has just come to visit her father after arriving from her home in another state and has asked you for his room number. You notice that the daughter has reddened eyes, sniffles, and a dry cough. What instruction should you provide to the daughter?

"Even though it might be difficult, it's best for your father's health if you get well before visiting him in person, since he's so vulnerable right now."

During a client's examination and consultation, the physician keeps telling the client, "You have an abdominal neoplasm." Which statements accurately paraphrase the physician's statement? Select all that apply.

"You have a new growth of abnormal tissue in your abdomen." "You have an abdominal tumor."

Four primary treatment options are used to treat cancer

(1) surgery, (2) radiation therapy, (3) chemotherapy, and (4) hematopoietic stem cell transplantation.

metastasis

(spreading)

Tumor-associated antigens

, found on tumor cells and normal cells; the qualitative and quantitative differences allow the tumor-associated antigens to distinguish normal from abnormal.

Interferon

, generated in response to a viral invasion, has some ability to fight malignant cells.

Immune T cells or antibodies

, known as tumor antigens, recognize most molecular makeups of tumor cells (Grossman & Porth, 2014). These fall into two categories:

tumor-specific antigens

, proteins located in the cell membrane, which develop as cells become less differentiated

An oncology client has just returned from the postanesthesia care unit after an open hemicolectomy. This client's plan of nursing care should prioritize which of the following?

Assess the client's wound for dehiscence every 4 hours.

A patient with uterine cancer is being treated with internal radiation therapy. What would the nurse's priority responsibility be for this patient?

Explain to the patient that she will continue to emit radiation while the implant is in place.

Chemotherapeutic agents have which effect associated with the renal system?

Increased uric acid excretion

A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?

Indigestion

A client's most recent diagnostic imaging has revealed that his lung cancer has metastasized to his bones and liver. What is the most likely mechanism by which the client's cancer cells spread?

Lymphatic circulation

A nurse is creating a plan of care for an oncology client and one of the identified nursing diagnoses is risk for infection related to myelosuppression. What intervention addresses a leading cause of infection-related death in oncology clients?

Provide skin care to maintain skin integrity.

The nurse is describing some of the major characteristics of cancer to a client who has recently received a diagnosis of malignant melanoma. When differentiating between benign and malignant cancer cells, the nurse should explain differences in which of the following aspects? Select all that apply.

Rate of growth Ability to cause death Ability to spread

A nurse is administering a peripheral chemotherapeutic agent. What nursing actions are used for extravasation of a chemotherapeutic agent?

Stop the medication infusion at the first sign of extravasation Aspirate any residual drug from the IV line Administer an antidote, if indicated

The home health nurse is performing a home visit for an oncology client discharged 3 days ago after completing treatment for non-Hodgkin lymphoma. The nurse's assessment should include examination for the signs and symptoms of what complication?

Tumor lysis syndrome (TLS)

biopsy

the removal of living tissue from the body for diagnostic examination

The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment?

Brachytherapy

Which of the following is a characteristic of a malignant tumor?

It gains access to the blood and lymphatic channels.

A client is diagnosed with metastatic adenocarcinoma of the stomach. The physician orders mitomycin and other chemotherapeutic agents for palliative treatment. How does mitomycin exert its cytotoxic effects?

It inhibits deoxyribonucleic acid (DNA) synthesis.

A critical care nurse is aware of the high incidence of ventilator-associated pneumonia (VAP) in clients who are being treated for shock. What intervention should be specified in the client's plan of care while the client is ventilated?

Performing frequent oral care

S phase

Drugs that are cell-cycle specific in the S phase include topoisomerase I inhibitors and antimetabolites.

A client is receiving IV administration of the vesicant doxorubicin when the nurse detects signs of extravasation. After stopping administration, what nursing action would be taken to treat this complication?

Elevate and rest the extremity.

frozen section (FS)

a surgical technique that involves cutting a thin piece of tissue from a frozen specimen for immediate pathologic examination

Four main cancerous tumor classifications according to tissue type are

carcinomas (cancers originating from epithelial cells), lymphomas (cancers originating from organs that fight infection), leukemias (cancers originating from organs that form blood), myelomas (cancers originating from plasma cells, and sarcomas (cancers originating from connective tissue, such as bone or muscle).

A patient is taking vincristine, a plant alkaloid for the treatment of cancer. What system should the nurse be sure to assess for symptoms of toxicity?

nervous system

benign,

not invasive or spreading,

The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects:

Bleeding

Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. Why would the patient receive this form of treatment?

For cancer of the bladder

The nurse in the medical ICU is caring for a client who is in respiratory acidosis due to inadequate ventilation. What diagnosis could the client have that could cause inadequate ventilation?

Guillain-Barré syndrome

A nurse has agreed to draft a medication teaching plan for a patient who is taking the hormonal agent, Aromasin, an aromatase inhibitor for postmenopausal women with breast cancer. The nurse knows that a major teaching point is to tell the patient to:

Increase her intake of calcium-rich foods.

An oncology client will begin a course of chemotherapy and radiation therapy for the treatment of bone metastases. What is one means by which malignant disease processes transfer cells from one place to another?

Invading healthy host tissues

The nurse is preparing to assess a client whose chart documents that the client experienced extravasation when receiving the vesicant vincristine during the previous shift. The documentation also notes that an antidote was administered immediately. The nurse prepares to assess for which conditions?

Sloughing tissue Tissue necrosis Effectiveness of the antidote

Staging of Tumors

Stage 0: The cancer is in situ (CIS), which means the malignant cells are confined to the layer of cells in which they began, with no signs of metastasis. Stages I, II, and III: Higher numbers indicate that the tumor is of greater size and/or the spread of cancer is to nearby lymph nodes and/or organs near the primary tumor. Stage IV: Cancer has invaded or metastasized to other organs of the body.

TNM classification:

T indicates the size of the tumor, N stands for the involvement of regional lymph nodes, and M refers to the presence of metastasis T indicates the size of the tumor, N stands for the involvement of regional lymph nodes, and M refers to the presence of metastasis

Macrophages,

T lymphocytes, B lymphocytes, antibodies, and natural killer (NK) cells work to eradicate malignant cells

endocopy

visual examinaton within(a hollow organ or body cavity)

best way for the nurse to assess the nutritional status of a patient with cancer?

weight patient

Kaposi's sarcoma,

which is associated with HIV and AIDS