Sherpath - Pancreatic Cancer
The family of a patient with recently diagnosed pancreatic cancer asks the nurse why a positron emission tomography (PET) scan is being done since the patient already has a cancer diagnosis. Which is the best response by the nurse? "A PET scan will show tumor spread and will help the health care provider determine the stage of the cancer." "A PET scan is the most accurate imaging available to detect which cancer cells will respond to targeted therapies best." "A PET scan provides slice-by-slice photos of the pancreas and allows the primary health care provider to confirm the diagnosis." "A PET scan will help the health care provider determine which chemotherapy treatment regimen is most beneficial to treat the cancer."
"A PET scan will show tumor spread and will help the health care provider determine the stage of the cancer." A PET scan is used to determine the stage at time of diagnosis and monitor progress and response to therapy.
The nurse is assessing a patient admitted for evaluation of abdominal pain and suspected pancreatic cancer. The patient reports upper abdominal pain. Which question should the nurse ask the patient to obtain more information about the pain? "Have you had any significant weight loss?" "Have you experienced any blood in your stools?" "Does the pain radiate to your back and down your left arm?" "Have you had pain radiating to your hip and down your leg?"
"Have you had any significant weight loss?" Pancreatic cancer causes weight loss as a lack of digestive enzymes results in poor absorption.
The nurse is teaching a community group of working adults about ways to reduce their risk for pancreatic cancer. Which statement by a participant indicates a need for further teaching? "I need to reduce the amount of fat in my daily diet." "Having diabetes is a risk factor for pancreatic cancer." "I should be careful and limit my exposure to chemicals." "I should decrease the number of cigarettes I smoke per day."
"I should decrease the number of cigarettes I smoke per day." Rationale:The patient needs further teaching to understand that smoking is the biggest risk factor for developing pancreatic cancer. Smoking cessation, not reducing the amount one smokes, would lower a patient's risk for pancreatic cancer.
A nurse is teaching a patient about self-management following a total pancreatectomy secondary to pancreatic cancer. Which statement by the patient indicates an understanding of the impact of self-management needs following surgery? "I will need to use pancreatic supplements once a week." "I can take glucophage to control my blood glucose levels." "I will need to give myself insulin injections for the rest of my life." "I will have to wear an ostomy pouch to collect excess pancreatic drainage."
"I will need to give myself insulin injections for the rest of my life." The pancreas is responsible for making insulin. Since the patient's pancreas is removed, the patient will need to receive insulin injections for life.
The nurse is caring for a patient with diagnosed pancreatic cancer. The patient asks why chemotherapy and radiation are required, in addition to surgery. Which is the nurse's best response? "Radiation alone has not been proven to be effective in pancreatic cancer treatment." "Surgery along with radiation and chemotherapy eliminates the risk of tumor metastasis." "Chemotherapy enhances the effects of radiation and provides better patient outcomes for patients after surgery." "A regimen of chemotherapy and radiation plus surgery has been shown to increase the 5-year survival rate to 50% in patients."
"Radiation alone has not been proven to be effective in pancreatic cancer treatment." Pancreatic cancer does not usually respond well to the use of radiation only. It does respond better with a rounded approach of surgery, chemotherapy, and radiation
A patient with newly diagnosed pancreatic cancer is admitted to the medical floor with jaundice. The patient asks the nurse why he has yellowish skin when his father with pancreatic cancer never had it. Which is the nurse's best response? "Not everyone develops the same symptoms with a disease." "The yellowish tint to your skin is a side effect of chemotherapy." "The yellowish skin color means the tumor is blocking the release of bile from the liver." "Jaundice happens with a few patients because most cancers originate in the tail of the pancreas."
"The yellowish skin color means the tumor is blocking the release of bile from the liver." Rationale:Jaundice occurs when a tumor on the head of the pancreas obstructs biliary ducts.
A nurse is planning hospice care for a patient with advanced pancreatic cancer. Which action is the most significant to include in the nursing care plan? Evaluate patient life expectancy Monitor frequency of bowel movements Assess the patient for depression and anxiety Ensure the patient has three full meals per day
Assess the patient for depression and anxiety Rationale:The nurse should assess the patient's psychological status and coping mechanisms when planning hospice care. Depression and anxiety are common and require psychological support.
A patient presents with abdominal pain and jaundice secondary to biliary obstruction related to metastatic incurable cancer in the pancreatic head. The nurse should expect to prepare the patient for which procedure? Distal pancreatectomy Cholecystojejunostomy Laparoscopic cholecystectomy Endoscopic retrograde cholangiopancreatography (ERCP)
CholecystojejunostomyRationale: For cancers that cannot be surgically removed, a cholecystojejunostomy is performed to relieve biliary obstruction.
A patient with advanced pancreatic cancer reports severe abdominal pain and anorexia. Which collaborative care procedure would the nurse expect to prepare for the patient? Hospice care Chemotherapy External radiation Pancreaticoduodenectomy
External radiation Rationale:Radiation is a collaborative care procedure that can be used to provide symptomatic pain relief for a patient with pancreatic cancer. Depending on their size, tumors can put pressure on nerves. Radiation decreases tumor size.
Which should the nurse include in the plan of care for a client undergoing external beam radiation therapy for pancreatic cancer? Skin care Blood glucose monitoring Biliary stent management Gemcitabine administration
Skin care Rationale:Radiation therapy can cause skin irritation at the radiated site. Therefore, the nurse should include meticulous skin care in the care plan.
A patient has been recently diagnosed with late-stage pancreatic cancer. The family tells the nurse they do not understand how this could happen as the patient never showed signs of cancer or complained of pain. Which would be the best response by the nurse?
Tumors that start in the tail of the pancreas do not show symptoms until the cancer has already progressed and spread." Rationale:The tumor most likely originated in the tail of the pancreas, these are often silent tumors until they are very advanced
Which is the rationale behind the primary health care provider ordering an endoscopic ultrasound (EUS) for a patient admitted with suspected pancreatic cancer? To look for gallstones lodged in the biliary ducts To determine the presence of any metastatic areas To determine the diagnosis and stage of the disease To view the pancreas and obtain a biopsy of the tumor
To view the pancreas and obtain a biopsy of the tumor Rationale:EUS allows the user to see the pancreas via the endoscope and makes it easy to obtain a fine-needle aspiration of the tumor for pathologic examination.
