NCLEX - oncology

The nurse should only care for ____ client(s) with radiation implant in a given shift.

1

who emits radiation - brachytherpy or teletherapy

brachytherapy

Alcohol + Smoking =

co-carcinogenic (makes cancer develop more quickly)

RBC transfusion must be free of ___

CMV (leukoredduction)

2 types of cancer

Solid tumors and hematologic malignancies

When is testicular cancer most common?

15-35 teach TSE, grow quickly

A child is being discharged home following a bone marrow transplant. When providing discharge instructions to the parents, what information is most important for the nurse to include? You answered this question Correctly 1. Clean toothbrush weekly with alcohol. 2. Avoid eating raw fruits and vegetables. 3. Drink bottled water the day. 4. Apply heating pad to bruised areas of the skin.

2. Correct:The greatest risk to clients following a transplant is the chance of infection from any source since the client is severely immune-compromised for an extended period of time. There are numerous precautions necessary to avoid bacteria, but one area of concern is food storage, preparation, and consumption. Raw fruits with no skin to peel, such as strawberries, and raw vegetables like broccoli and cauliflower, present a serious risk for bacterial contamination and should not be consumed by new transplant clients. 1. Incorrect: Precise mouth care is vital following a bone marrow transplant; however, rinsing a toothbrush in alcohol is unsafe. Any residual alcohol would cause irritation and trauma to gum tissue, placing the client at risk for mouth inflammation and infection. Clients are instructed to brush teeth twice daily with a soft bristle brush, using a fluoride toothpaste. Some clients are instructed to soak the toothbrush once weekly in a special bleach solution, then rinse in hot water, while others need to replace the toothbrush weekly, based on lab test results. 3. Incorrect: Standing water of any type quickly builds up bacteria, including flower vases and vaporizers. Although bottled water may seem a safe choice, after that bottle is opened, bacteria begins to quickly build up, even if the bottle is recapped. Any water standing more than 15 minutes is considered old and must be thrown out. 4. Incorrect: With bone marrow transplant clients, it will be months before the body begins to stabilize and produce normal blood cells. Bruising and low platelet counts are to be expected for a period of time. When clients develop bruising, the approved treatment is cold compresses or ice packs applied for 15 minutes a couple times per day, and never a heating pad. Additionally, the healthcare provider should be notified so that a current platelet count can be obtained.

Tx of neutropenia

prophy abx neutropenic precautions (same as infection precautions) + VS Q4, antimicrobial soap, no invasive procedures *no IM, no rectal meds, no indwelling caths, no NG *no Tylenol

difference between sarcoma and carcinomas

sarcoma - begin in connective tissue carcinoma - epithelial tissue (breast, prostate, lungs, liver)

brachytherapy can be ___ or _____ difference between the 2

sealed - pt emits radiation, but body fluids are not radioactive implanted into target tissue unsealed - pt and body fluids emit radiation radioisotope thats give PO or IV

after radiation, pt must: stay 6 ft away from people for _____ not sleep in same bed with someone for _____ flush the toilet ______ times

stay 6 ft away for 2-3 days don't sleep in same bed for 1 week flush toilet 2-3 times can't go to work, use public transportation or share utensikls/cook for people

Bone Marrow vs Stem Cell Transplant

stem cell - when the stem cells come from the blood bone marrow - when the stem cells come from bone marrow

3 types of cancer tx

surgery radiation chemo

where is mass usually in breast cancer

tail of spence upper outer quadrant

what do you do if the implant dislodges

tell pt to lie still use forceps to pick it up put in lead container contact dr document **never take out of room

what is the period of the greatest bone marrow suppression called

the nadir

how is most chemo given

through IV via a port

#1 cause of preventable cancer

tobacco

total hysterectomy bilateral oophorectomy bilateral salpingectomy

total hysterectomy - uterus and cervix oophorectomy - ovaries salpingectomy - tubes

what is external radiation

uses focused beam of high energy rays precise pt doesn't emit radiation

Teaching for External Radiation

wash gently with warm water (don't wash off markings) no washcloth no lotion dry in patting motion avoid UV exposure

What information should the nurse include in teaching an oncology client the purpose of taking epoetin? You answered this question Incorrectly 1. Emergency treatment of anemia. 2. Improves quality of life. 3. Used for the prevention of pure red cell aplasia (PRCA). 4. Decreases the need for transfusion.

4. Correct: Epoetin is prescribed to treat a lower than normal number of red blood cells (anemia) caused by chronic kidney disease in clients on dialysis, in HIV clients receiving zidovudine and in cancer clients receiving chemotherapy that develop anemia. Epoetin stimulates the bone marrow to produce more RBCs. 1. Incorrect: Epoetin does not work raoidly enough to be used for the emergency treatment of anemia (RBC transfusion). 2. Incorrect: Epoetin has not been proven to improve quality of life, fatigue, or sense of well-being in clients with cancer. 3. Incorrect: Pure red cell aplasia (PRCA) is a type of anemia that starts after treatment with epoetin or other erythropoetin medications.

what race has the highest incidence of cancer?

African Americans

risk factors for cervical cancer

HPV** repeated stds multiple sexual partners smoke immunosuppression

Is there a ceiling for Opiod administration in cancer patients?

No-treat without regard to a ceiling and causing dependence.

most important risk factor of cancer is........

aging. after age 60 increased risk because of decreased immune system

#1 complication of hysterectomy

bleeding monitor pads - more than 1 pad per hour is excessive #2 - infection

cancer/tx s/e

body image (alopecia, scars) fatigue n/v pain infection neutropenia thrombocytopenia dvt

#1 cause of cancer deaths #2

infection dvt

2 types of radiation

internal - brachytherapy external - teletherapy

how are stem cell transplants given

into vein like blood transfusion

what should you do with bed linens

keep in room until pt is gone/implant removed (not radioactive once implant is removed)

radiation is localized or generalized

localized

temp to report

100.4 slight increase in temp could mean sepsis (decreased neutrophils means pt won't have typical sign of infection)

A child diagnosed with acute lymphocytic leukemia (ALL) is receiving vincristine sulfate during the induction phase of chemotherapy. What client side effect should the nurse report immediately to the primary healthcare provider? You answered this question Correctly 1. Anemia 2. Paresthesia 3. Nosebleeds 4. Alopecia

2

What should a nurse teach a group of teenage boys who admit to using smokeless tobacco? You answered this question Incorrectly 1. Smokeless tobacco increases risk for lung cancer. 2. Inspect mouth frequently for lesions. 3. White patches in mouth should be reported to healthcare provider. 4. Risk for stomach cancer can be decreased by not swallowing smokeless tobacco juice. 5. Report decreased saliva to primary healthcare provider. 6. Smoking cessation.

2., 3., & 6. Correct: The mouth should be inspected frequently for painless lesions that do not heal. This may be a sign of oral cancer and should be reported to the primary heathcare provider. White patches (leukoplakia) is a sign of potential oral cancer as well. Nicotine is addictive and is found in smokeless tobacco. Clients using smokeless tobacco can benefit from smoking cessation information/classes. 1. Incorrect: Use of smokeless tobacco increases the risk developing of esophageal cancer, cancers of the mouth, throat, cheek, gums, lips, tongue, pancreatic cancer, stomach cancer, kidney cancer. 4. Incorrect: This is an incorrect statement. Some amount of tobacco juice will be swallowed and can lead to esophagus and stomach cancer. 5. Incorrect: Decreased saliva is not associated with oral cancer.

How often is chemotherapy scheduled?

every 3-4 weeks

increased or decreased incidence of cancer in immunosuppressed

increased

main s/e from external radiation

****fatigue skin symptoms where radiation was (redness, shedding)

A nurse is conducting an initial admission history on a client who is reporting bone pain secondary to cancer with metastasis to the bone. What does the nurse determine is the most important information to gather during this initial screening? You answered this question Incorrectly 1. The physical assessment of the client 2. The hemoglobin and hematocrit levels 3. The amount of pain medication the client is receiving 4. The client's description of the pain

. Correct: The most important information to gather during the initial screening is the client's perception and description of the pain. Pain is subjective, based on the client's perception. This is also the primary complaint of the client upon admission. 1. Incorrect: The question is asking about the client's pain. The physical assessment is important but does not address the client's perception of their own pain. 2. Incorrect: RBCs are produced in the bone marrow. The H&H might be affected but will not be the cause of the pain and assessed later with admission lab and diagnostics. 3. Incorrect: The amount of pain medication is important, but is not the most important information to gather from a client who is reporting pain, particularly with cancer and metastatic bone pain.

A client with a severe cough is suspected of having lung cancer. When preparing the client for testing to confirm a diagnosis of cancer, which tests should a nurse anticipate? You answered this question Incorrectly 1. Chest x-ray 2. Arterial blood gas 3. Bronchoscopy 4. Computed tomography (CT) 5. Pulmonary function test

.1, 3., & 4. Correct: Chest x-ray, bronchoscopy, and CT scan are evidenced-based tests used in the diagnosis of lung cancer due to the efficacy of the tests. 2. Incorrect: Arterial blood gas measures the quantity of oxygen in the blood and acid-base status. 5. Incorrect: Pulmonary function test is used to diagnose obstructive lung diseases, such as emphysema.

A client, scheduled for a total hysterectomy for advanced cervical cancer, is crying and states, "I want to have more children! I do not know if I should have this procedure." Which responses by the nurse are appropriate? You answered this question Incorrectly 1. Allow the client to discuss her fears. 2. Tell client how not having children will give her more freedom. 3. Explain to the client that her ovaries can be frozen for egg harvesting at a later time. 4. Advise the client to put off having the surgery until she is sure. 5. Encourage client to talk to primary healthcare provider again.

1. & 5. Correct: This may be anticipatory grieving and being scared. Let the person talk and encourage them to talk again to the primary healthcare provider. They need reassurance that they are making the right decision. 2. Incorrect: This is not her fear and not helpful in this situation. 3. Incorrect: Ovaries are not frozen. The eggs can be frozen after stimulating the ovaries with hormones to produce multiple eggs. 4. Incorrect: The cancer is already in an advanced stage. Will the waiting help her survive?

After completing several rounds of chemotherapy, a client's laboratory results indicate severe neutropenia. Following admission assessment, what is the nurse's priority action for this client? You answered this question Incorrectly 1. Notify dietary no fresh, unpeeled fruits or vegetables. 2. Avoid all venipunctures or IM injections. 3. Have client wear mask when leaving room. 4. Instruct client to use a soft toothbrush.

1. Correct: Neutropenia is an abnormally low white blood cell count caused, in this case, by the recent chemotherapy. The greatest concern is the client's inability to fight off infection. Fresh fruits and vegetables have a high bacterial count and present an increased risk for infection. Asking dietary to remove fresh fruits and vegetables from meal trays is an important priority action by the nurse. 2. Incorrect: Avoiding venipunctures of any type, including IM injections, is an important precaution for neutropenia, in which infection is the main concern. However, the word "ALL" makes this statement to definite. The client may need an IV. Remember, nothing is that definite in the world. 3. Incorrect: This immunocompromised client is at risk for infection, as indicated by a low neutrophil count. While airborne bacteria may be a concern at some point, there is another action by the nurse which takes priority. 4. Incorrect: A soft toothbrush is used as part of the precautions for clients at risk for bleeding, which would not apply to this client. The nurse here is concerned about infection control secondary to a low neutrophil count.

Which client is at the greatest risk for developing pancreatic cancer? You answered this question Incorrectly 1. 70 year old obese client who smokes one pack of cigarettes a day 2. 64 year old client who had gallbladder surgery less than 5 years ago 3. 58 year old client with Chron's Disease 4. 52 year old client whose mother died from pancreatic cancer

1. Correct: The incidence of pancreatic cancer increases with age. Cigarette smoking, exposure to industrial chemicals or toxins in the environment, and a diet high in fat, meat, or both are associated risk factors. 2. Incorrect: Diabetes and pancreatitis are associated with pancreatic cancer. 3. Incorrect: Diabetes and pancreatitis are associated with pancreatic cancer. 4. Incorrect: The inherited risk is small.

What should the nurse include in the teaching plan for a client receiving external beam radiation? You answered this question Correctly 1. Small marks will be placed on the skin to mark the treatment area. 2. Lotion may be used around the treatment area to decrease dryness. 3. The radiation therapist can see, hear, and talk with you at all times during treatment. 4. Stay away from babies for 24 hours. 5. You will have to hold your breath during radiation treatment.

1., & 3. Correct: Small ink marks or small tattoos will be placed on the skin to mark the treatment area. Do not remove the marks. The radiation therapist can see, hear, and talk to the client at all times during treatment. Relieve anxiety by letting client know he/she is not alone. 2. Incorrect: Do not put lotion, powder or deodorant near or on treatment area. 4. Incorrect: Client is not radioactive and will not radiate others. The client can safely be around other people, babies, and children. 5. Incorrect: The client will need to stay very still so radiation goes to the exact same place each time, but can breathe as always and does not have to hold breath.

What should the nurse include in a discharge plan for a client diagnosed with lymphoma who will be receiving outpatient treatment? You answered this question Incorrectly 1. Avoid uncooked meats, seafood or eggs and unwashed fruits and vegetables. 2. Take bleeding precautions. 3. Do not take influenza or pneumonia vaccine during treatment. 4. Avoid individuals with infections. 5. Emphasize importance of frequent oral hygiene with an alcohol based mouthwash.

1., 2., & 4. Correct: The client with lymphoma is susceptible to infection and should eat foods low in bacteria. The client should avoid uncooked meats, seafood or eggs and unwashed fruits and vegetables as the bacteria count will be higher than desired. Instruct client and family about bleeding precautions and management of active bleeding due to thrombocytopenia. They should be advised to avoid activities that place them at risk for injury or bleeding (including excessive straining). This client is at risk for infection due to low white count, so the client should avoid individuals who are ill. 3. Incorrect: Encourage clients to maintain current immunizations for influenza and pneumonia. They are more susceptible to infection. Cancer and cancer treatment can weaken the immune system, which puts them at higher risk of serious problems if they get the flu or pneumonia. Only live vaccines (MMR, varicella, oral polio) are contraindicated in clients receiving chemotherapy. 5. Incorrect: This client is at risk for bleeding and infection due to low platelet and white cell counts. The client needs frequent oral care with a soft toothbrush and alcohol free mouthwash. Alcohol-based mouthwashes can dry out the gum and increase bleeding.

A client diagnosed with cancer has been losing weight. What should the nurse teach the client regarding methods for improving nutritional needs to maintain weight? You answered this question Incorrectly 1. Add butter to foods. 2. Cup of cubed beef broth. 3. Add powdered creamer to milkshake. 4. Use biscuits to make sandwiches. 5. Fish sauted in olive oil. 6. Put honey on top of hot cereal.

1., 3., 4., & 6. Correct: Butter added to foods adds calories. This client needs more calories and more protein. Spread peanut butter or other nut butters, which contain protein and healthy fats, on toast, bread, apple or banana slices, crackers or celery. Use croissants or biscuits to make sandwiches which provides more calories. Add powered creamer or dry milk powder to hot cocoa, milkshakes, hot cereal, gravy, sauces, meatloaf, cream soups, or puddings to add more calories. Top hot cereal with brown sugar, honey, dried fruit, cream or nut butter. 2. Incorrect: One cube of beef broth is 11 calories. Supplementing the diet with beef broth would not add significant calories. 5. Incorrect: Although cooked in olive oil, fish is low in calories.

While preparing to administer intravenous of chemotherapy the nurse accidently pulls the tubing apart, spilling the solution onto the floor. After clamping the tubing, what is the nurse's immediate action? You answered this question Correctly 1. Use disposable towels to clean up the liquid. 2. Obtain spill kit specific to this type of solution. 3. Complete an incident report for supervisor. 4. Call housekeeping to help clean up the floor.

2. CORRECT: Chemotherapy spill kits are pre-packaged supplies specific to the type of cytotoxic drugs used and are kept in close proximity to the location the chemo is administered. These kits vary slightly but all follow the basic guidelines. Individuals cleaning up the spill must be completely covered head to toe to prevent any contact with the drug. This includes inhalation. This option contains the word solution, which also appears in the question. 1. INCORRECT: Disposable towels are not acceptable to clean up a chemotherapy spill. Although these towels are absorbent for kitchens and bathrooms, only special absorbent pads can be used to clean up cytotoxic drugs. 3. INCORRECT: While it is true that the nurse will need to complete an incident report regarding the chemotherapy spill, it is certainly not the nurse's immediate action. Focus on staff and client safety first. 4. INCORRECT: The responsibility for cleaning up cytotoxic drugs is for the nursing staff involved at the time. Special training and knowledge is required to handle this issue.

A client receiving chemotherapy for lung cancer reports increased fatigue. The family confirms client is sleeping most of the day and night. What priority action would the nurse take? You answered this question Correctly 1. Discuss the risks of immobility with client and family. 2. Check current lab values of hematocrit and hemoglobin. 3. Suggest family seek counseling for the client's depression. 4. Request a referral from the healthcare provider for physical therapy.

2. CORRECT: The side effects of chemotherapy can impact all body systems, including the blood and circulatory system. The nursing process requires the nurse to first assess and gather data before proceeding with a plan. Though fatigue in cancer clients can have many causes, the nurse should check current laboratory results for decreased RBCs, hematocrit or hemoglobin caused by chemotherapy. Decreased levels of these elements are a side effect of chemotherapy and could definitely contribute to fatigue or exhaustion. 1. INCORRECT: While the nurse may want to discuss many topics with client or family, effects of immobility does not address the present issue of exhaustion or fatigue. The nursing process always begins with collection of data. 3. INCORRECT: Individuals respond to a terminal disease in different ways but certainly depression is common. Though a possible symptom of depression can be constantly sleeping, the nurse has not collected evidence to support that assumption. Potential physical causes for behavioral changes must be eliminated first. 4. INCORRECT: This action is premature since the nurse has not completed an assessment or collected data. While physical therapy may help to strengthen the client, an exact cause for the fatigue must first be established.

A female client receiving chemotherapy for breast cancer reports vomiting, stomatitis, and a 10 pound weight loss over the past month. The primary healthcare provider orders an antiemetic and daily mouthwashes. When the home care nurse evaluates the client one week later, what change described by the client would best indicate improvement? You answered this question Correctly 1. Eating three meals daily. 2. Weight gain of two pounds. 3. No further mouth pain. 4. Improved skin turgor.

2. Correct: Chemotherapy typically causes gastrointestinal disturbances severe enough to interfere with a client's ability to eat or absorb nutrients. A ten pound weight loss over one month is significant but expected because of the reported vomiting and stomatitis. A weight gain of two pounds in a week would be the best specific indicator of improvement. 1. Incorrect: The ability to eat three meals daily does not mean that the client is actually absorbing those nutrients successfully. This option suggests that the antiemetic is working well, but there is not enough evidence to demonstrate significant client improvement. 3. Incorrect: The client's denial of any further mouth pain signifies that the mouthwashes have decreased mouth inflammation and stomatitis. While this is a positive change in the client's condition, it is not the best evidence noted by the nurse. 4. Incorrect: Skin turgor specifies the hydration status of a client. Since this client had previously been vomiting, improved skin turgor would indicate the antiemetic is working well and the client is able to retain fluids. While this is a positive change, it is not the most significant indicator of client improvement.

A client with hemophilia has been scheduled for extraction of wisdom teeth. The nurse anticipates that the client will receive what priority intervention before this procedure? You answered this question Incorrectly 1. Prophylactic antibiotics 2. A unit of cryoprecipitate 3. Packed red blood cells 4. Fresh frozen plasma

2. Correct: Hemophilia is a heredity disease characterized by a deficiency of specific clotting factors, including Factor VIII, Factor XIII, and fibrinogen. Clients with hemophilia are given cryoprecipitate prophylactically prior to invasive procedures to replace these deficient factors and prevent hemorrhaging. 1. Incorrect: The priority concern is the potential for bleeding during the procedure. Although infection is always a concern and antibiotics may be considered, it is not the main issue for this client. 3. Incorrect: Packed red blood cells (PRBC's) mean the liquid portion of the blood has been removed so only the cells are infused. PRBC 's are generally administered in the face of severe hemorrhaging or very low hemoglobin and hematocrit. Bleeding is the main concern for this client, but packed red blood cells would not be the correct intervention prior to the procedure. 4. Incorrect: Although hemophilia affects the blood's coagulation ability, fresh frozen plasma (FFP) is not the correct intervention. FFP is generally used in situations such as massive hemorrhaging, severe anemia, cardiac bypass, or DIC. Another prophylactic intervention would be considered priority for the hemophilia client.

limit each visitor to ____ visitors must stay ___ away no visitors less than ___ age no _____ vistors/nurses

30 mins per day 6 ft away no one less than 16 no pregnant people

A child with acute lymphocytic leukemia (ALL) is receiving chemotherapy through a single lumen Groshong catheter. During the infusion, the child reports nausea and has vomited. The primary healthcare provider has prescribed ondansetron IV. What action should the nurse take? You answered this question Incorrectly 1. Ask primary healthcare provider for an oral antiemetic. 2. Give ondansetron IVPB with the chemotherapy. 3. Wait until chemotherapy is complete to infuse ondansetron. 4. Stop chemotherapy temporarily and flush line to give ondansetron.

4. Correct: A Groshong catheter is implanted when other venous access sites are no longer useable. The child has begun to react to the chemotherapy and needs medicated now. Because this implanted device has only one lumen, the nurse must stop the chemotherapy infusion temporarily, flush the port, administer the ondansetron, flush again and restart the chemotherapy infusion. 1. Incorrect: Because this client is vomiting, changing the medication to the oral route would not be effective. The medication takes longer to work if given orally, which means the client may vomit again before the medication activates, losing part of the dose. 2. Incorrect: Chemotherapy infusions should not be mixed with other categories of drugs, such as an antiemetic, because of the possibility of drug interactions. Certain chemical mixtures could also cause precipitates to form in the tubing, which is dangerous to the child. 3. Incorrect: The child is experiencing nausea and vomiting at this time. Waiting to give the antiemetic until after the chemotherapy is completed causes the child to suffer needlessly. The nurse should take action immediately to alleviate symptoms.

Which client should the nurse recognize as being at greatest risk for the development of cancer? You answered this question Incorrectly 1. Smoker for 30 plus years 2. Body builder taking steroids and using tanning salons 3. Newborn with multiple birth defects 4. Older individual with acquired immunodeficiency syndrome

4. Correct: Cancer has a high incidence in the immune deficiency client and in the older adult with both of these risk factors together, this one is the highest risk for cancer. 1. Incorrect: Although smoking is a known environmental carcinogen, this one risk factor alone is not the highest risk. 2. Incorrect: These are known environmental carcinogens, but do not rank as highly as aging and immune deficiency. 3. Incorrect: Birth defects are not a risk factor for cancer.

Which risk factor should the nurse include when planning to educate a group of women about breast cancer? You answered this question Correctly 1. Menopause before the age of 50 2. Drinking one glass of wine daily 3. Multiparity 4. Early menarche

4. Correct: Early menarche before age 12 is a known risk factor for breast cancer. The increased risk of breast cancer linked to a younger age at first period is likely due, at least in part, to the amount of estrogen a woman is exposed to in her life. A higher lifetime exposure to estrogen is linked to an increase in breast cancer risk. The earlier a woman starts having periods, the longer her breast tissue is exposed to estrogens released during the menstrual cycle and the greater her lifetime exposure to estrogen. 1. Incorrect: Studies show women who go through menopause after age 50 have increased risk of breast cancer. The risk for breast cancer increases as time period between menarche and menopause increases. 2. Incorrect: Small increase in risk with moderate alcohol consumption, not one glass of wine daily. Drinking low to moderate amounts of alcohol, however, may lower the risks of heart disease, high blood pressure and death. But, drinking more than one drink per day (for women) and more than two drinks per day (for men) has no health benefits and many serious health risks, including breast cancer. Alcohol can change the way a woman's body metabolizes estrogen (how estrogen works in the body). This can cause blood estrogen levels to rise. Estrogen levels are higher in women who drink alcohol than in non-drinkers. These higher estrogen levels may in turn, increase the risk of breast cancer. 3. Incorrect: Nulliparity (no pregnancies) is a known risk factor for breast cancer. Factors that increase the number of menstrual cycles also increase the risk of breast cancer, probably due to increased endogenous estrogen exposure.

what day of the menstrual cycle is best for doing BSE

7-12 if pt has hysterectomy, choose same day every month

when is blood transfused for sympotamitc anemia

8

risk factors for uterine cancer

>50 taking estrogen without progesterone late menopause no pregnancy

what is a vesicant

A type of chemo drug that if it infiltrates will cause tissue necrosis *Need to stay with clientt the entire time receiving it and watch the IV site

warning signs of cancer

C: Change in bowel or bladder habits. A: A sore that does not heal. U: Unusual bleeding or discharge. T: Thickening or lump in the breast or elsewhere. I: Indigestion or difficulty in swallowing. O: Obvious change in a wart or mole. N: Nagging cough or hoarseness.

most common body systems affected by s/e of chemo why?

blood gi integumentary these systems have rapid cell dividing more rapid cell dividing = more symptoms

infection prevention for cancer pt

change dressings and IV tubing daily no flowers no raw fruits/veggies no crowds only drink fresh water (can't drink if left out more than 15 mins) bathe warm/moist areas 2x a day wash hands after touching a pet

chemo precautions

chemo gown 2 pairs chemo gloves goggles/mask if splashing can occur dispose sharps/ivs in yellow chemo bin chemo waste bag for gowns/gloves/disposable items

3 goals of cancer tx

cure - tumor removed or destroyed control - debulking, decreases the number of cancer cells and increases the change that other therapies might be successful palliation - improve quality of life (reduce pain, relieve airway obstruction)

Nursing assignments should be rotated ______, so that the nurse is not continuously exposed.

daily

3 ways cancer can metastasize

direct invasion blood lymph system

#1 symtom of cancer

fatigue

sx of cancer

fatigue anemia leukopenia thrombocytopenia weight loss (cachexia) pain fever

nurses must wear a ____ when caring for internal radiation pts

film badge

tx of thrombocytopenia

give plts *must be room temp, spleen will reject cold plts

complication of stem cell transplants

graft vs host disease graft rejects/attacks host sx - jaundice, dark urine, n/v/d tx - steroids, anti rejection drugs

when are bone marrow or stem cell transplants primarily used

hematologic cancers

tertiary prevention

management for clients with cancer -support groups -rehab programs

___ are the first line defense inside body to protect us from infection

neutrophils

teach for mammogram

no lotion, powder, deodorant will pick up as calcium deposit

positioning after a hysterectomy

not high fowlers - dont want tension on suture line

risk factors of Brest cancer

period before 12 menopause after 50 no pregnancy first birth after 30 *increases 3x if first degree has premenopausal breast cancer

secondary prevention

pick up on cancer early, when there is a greater chance for cure or control -monthly self breast exam -yearly clinical breast exams >40, every 3 years 20-39 -mammogram at 40 -Pap smears every 3 years at 21 -colonscopy every 10 yrs at age 50 yearly fecal occult blood at 50 -monthly testicular exam -digital rectal exam/PSA annually at 50

to prevent n/v with tx...

premeditate before each tx *ondanSETRON acupuncture ginger aromatherapy

primary prevention with cancer

prevent the actual occurrence of cancer -no smoking -exercise -maintain normal body weight -limit alcohol -get vaccines

if you see signs of extravasation, what dod you do

stop infusion, put cold pack on site to vasoconstrict

if a spill happens.. what do you do

wash hands get spill kit from pt room put on facemask put on gown put on gloves put on googles use absorbent pads to wipe up