NSG 170 Cellular Regulation

grading

determining both tissue origin and its histological grade/degree of differentiation

chemotherapy

pharmacological agents used to prevent cancer cells from multiplying, invading, or metastasizing; systemic treatment; requires symptom management

Which assessment finding would the nurse question for a client who is considering oral contraceptives? blood clots heart disease breast cancer impaired liver function undiagnosed vaginal bleeding smoking more than 15 cigarettes/day

blood clots heart disease breast cancer impaired liver function undiagnosed vaginal bleeding smoking more than 15 cigarettes/day

pathology

examination of malignancy, tissue type, grade of tumor (biopsy, bone marrow aspiration)

Which discharge instructions would the nurse include for a woman who has undergone breast-conserving surgery (lumpectomy) for breast cancer? -assuring her that a supportive brassiere is unnecessary -emphasizing the importance of breast self-examination -instructing her to return the next day for removal of the drain -explaining why it is unnecessary to exercise the arm on the unaffected side

-emphasizing the importance of breast self-examination

Thrombocytopenia

abnormally low amount of platelets circulating in the blood; can lead to clot development

example of anaplasia

malignancies

each cell contains

46 human chromosomes, 2m DNA, 3 billion DNA subunits, 25,000 genes code for proteins that perform all life functions

labs

CBC, chemistry panel, genetic or tumor maker test

Example of dysplasia

HPV on cervix

A complete blood count is prescribed before each round of a client's cancer chemo. Which component of the CBC is of greatest concern to the nurse? platelets hematocrit RBCs WBCs

WBCs

proliferation

a rapid increase/production of new cells though cell growth and division

cell nucleus

genes, DNA, chromosomes (make up genome)

What information from a client's history would the nurse identify as risk factors for the development of colon cancer? hemorrhoids increased age high-fiber diet ulcerative colitis low hemoglobin level

increased age ulcerative colitis

When a client with acute myelocytic leukemia who is receiving chemo develops tumor lysis syndrome, the nurse will anticipate a need to implement which collaborative action? offer analgesics frequently infuse large amounts of fluids administer antibiotic therapy give anticoagulant medication

infuse large amounts of fluids

meiosis

sex cell reproduction (daughter cells are different)

example of metaplasia

smokers lungs

example of hyperplasia

uterine cells during pregnancy, myocardial tissue re: hypoxia

radiographic tests

x-rays, magnetic resonance imaging (MRI), computed tomography (CT), radioisotope scans, ultrasound, diagnostic mammography

metaplasia

(normal DNA control) change in normal pattern of differentiation such that dividing cells differentiate into other cell types NOT normally found at that location. some cells are less functional than cells they replace. REVERSIBLE

Which client care activity may the nurse safely delegate to an unlicensed health care worker? -assessing the clients mastectomy incision for signs of inflammation -assisting a client who is recovering from an abd hysterectomy to the bathroom -providing information about the side effects to a client receiving chemo for breast cancer -evaluating the effectiveness of an antiemetic that was administered to a client to relieve nausea

-assisting a client who is recovering from an abd hysterectomy to the bathroom

cellular regulation

All functions carried out within a cell to maintain homeostasis, including its responses to extracellular signals (e.g., hormones, cytokines, and neurotransmitters) and the way each cell produces an intracellular response.

consequences of malignant neoplasm

Without tx- fatigue, weight loss, pain, organ failure, and death. Fear, stress, anxiety. Changes in family dynamics. Financial challenges: loss of work. Change in self image & interpersonal relationships

Neutropenia

a decreased number of neutrophils; can be caused by cancer; when neutrophil count is < 500 or between 500-100 on chemo

mitosis

divide and develop normal tissues or replace lost or damaged tissues (heal/maintanence)

exam findings (bodily function)

difficulty swallowing, unexplained weigh loss, changes in appetite, unusual/unexplained bleeding/pain/cough/fatigue

radiation therapy

energy delivered specifically to targeted tissue areas to damage or kill cancer cells; require symptom management

The nurse is performing an assessment on a child who has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia (ALL). Which early clinical findings would the nurse expect to identify? nosebleeds and papilledema fatigue and ecchymotic areas abd pain and reddened complexion enlargement of axillary and groin lymph nodes

fatigue and ecchymotic areas

Which nursing intervention would the nurse implement when providing care for pediatric clients with leukemia on chemo protocols? prevention of physical activity during this time checking vitals every 2 hours having them avoid contact with infected persons reducing unnecessary stimuli in their environment

having them avoid contact with infected persons

A school-age child with acute lymphoid leukemia is neutropenic. Which etiology would the nurse recognize as the cause of neutropenia? internal bleeding overwhelming infection increased immature cell growth decreased intake of iron-rich nutrients

increased immature cell growth

myelosuppression of blood cell production

increased susceptibility to infections (neutropenia)

A 50-year-old client seen for a routine physical asks why a stool sample for occult blood testing has been ordered. Which is the correct nursing response?

it is performed routinely starting at your age as part of an assessment for colon cancer

A client is diagnosed with cancer of the rectum and has surgery for an abdominoperineal resection and colostomy. Which nursing care would be implemented during the postop period? limiting fluid intake for several days withholding fluids for 72 hours having the client change the colostomy bag keeping the client's skin around the stoma clean

keeping the client's skin around the stoma clean

When a client with a history of chronic myelogenous leukemia and splenomegaly is admitted to the hospital, which finding will the nurse expect during the assessment? increased urinary output report of recent weight gain left upper quadrant tenderness elevated numbers of erythrocytes

left upper quadrant tenderness

dysplasia

loss of DNA control over differentiation occurring in response to adverse conditions. abnormal variations in size, shape, and appearance. REVERSIBLE

secondary prevention

mammogram, prostate-specific antigen, colonoscopy, guaiac test for occult blood

A client's clinical manifestations include dysuria, hesitancy, urinary urgency, and urinary leakage. The client's serum prostate-specific antigen (PSA) level is 5 ng/mL, and the client has an elevated prostatic acid phosphate (PAP) level. Which disorder would the nurse suspect? orchitis hydrocele prostatitis prostate cancer

prostate cancer

A 25-year-old on estrogen therapy has a history of smoking. Which complication would the nurse anticipate in the client? Osteoporosis hypermenorrhea Endometrial cancer pulmonary embolism

pulmonary embolism

bone marrow transplant

replaces diseased/destroyed cells from bone marrow with normal healthy cells; autologous or allogenetic

hormonal therapy

treat hormonally responsive cancers: breast, uterine, prostate; hormones act as agonists/antagonists to block specific receptors w/ targeted tissues

A client develops severe bone marrow suppression related to cancer treatment. Which instruction is important for the nurse to include in the client's teaching? be prepared to experience alopecia increase fluids to at least 3L/day use a soft toothbrush for oral hygiene monitor your intake and output of fluids

use a soft toothbrush for oral hygiene

biologic therapy

use of biological agents to activate the immune system as cancer treatment including: colony-stimulating factors, monoclonal antibodies, gene therapy, nonspecific immunomodulating agents

Differentiation

occurs over many cell cycles that allow cells to specialize in certain tasks; changes in cellular shape, size, and responsiveness

direct visualization

colonoscopy and endoscopy

anaplasia

(no longer under DNA control) regression of cell to immature or undifferentiated cell type. Damage inside of cell result in loss of function. NOT REVERSIBLE

hyperplasia

(normal DNA control) increase number or density of normal cells. occurs in response to stress, increased metabolic demands, increased hormone levels. REVERSIBLE

A client is receiving cancer chemo asks the nurse why an antibiotic was prescribed. Which tissue affected by chemo will the nurse consider when formulating a response? liver blood bone marrow lymph nodes

bone marrow

The nurse is performing a breast assessment. Which statement made by the client indicates a risk of breast cancer? I had a late onset of menarche My first child was born when I was 32 I noticed a slight discharge from a nipple I perform breast self-examinations frequently I consume two to four glasses of alcohol a day

-My first child was born when I was 32 -I noticed a slight discharge from a nipple -I consume two to four glasses of alcohol a day

neoplasm

tumor, abnormal tissue growth that is uncontrolled/progressive

Which common response do clients with cancer experience, regardless of the sites of the cancer, that accounts for their cachexia? depression precipitates anorexia changes in taste and food aversions decreased saliva impedes chewing and swallowing decreased gastrointestinal absorption of nutrients

changes in taste and food aversions

Which complication is of most concern when the nurse is caring for a client with chronic lymphocytic leukemia (CLL)? bleeding fatigue infection cachexia

infection

individual risk factors

age, genetics, low SES, smoking, poor diet (processed foods/meats), lack of physical activity, exposure to UV and radiation, Hep B/C, Helicobacter pylori, HPV, hormone replacement (contraceptives), BRCA 1/2

replication

new cells should be created at the same rate as older cells dies

targeted therapy

use of molecular/genetic biology linked to cell functioning; prevents tumor growth/metastasis by blocking signaling processes responsible for growth/spread of disease

complementary approaches

acupuncture, herbal remedies, supplements, reflexology, massage therapy, meditation training

The nursing student counsels an older 70-year-old female client about changes caused by aging. Which statement made by the client indicates effective learning? I should reduce my calcium intake I should limit my kegel exercises I should have regular breast exams I should avoid eating protein

I should have regular breast exams

Neoplasia

abnormal and progressive multiplication of cells, leading to the formation of neoplasm (tumor)

malignant

abnormal cells that are capable of metastasis, cancerous

malignant neoplasm

abnormal growth patterns, multiple abnormal functions and ability to disseminate to distant sites

A female client is diagnosed as having cancer of the breast and is admitted to the hospital for a lumpectomy to be followed by radiation. While being admitted to ambulatory surgery by the nurse, the client has tears in her eyes and her chin is quivering. In a shaky voice the client says, "I can't believe this is happening." Which is the best response by the nurse? You can't believe this is happening? This must be a scary time for you Do you have any questions at this time? Cancer of the breast has a high cure rate

This must be a scary time for you

A client with carcinoma of the colon is scheduled for an abdominoperineal resection. What would preparation for the surgery include? medications to promote diuresis fluid restriction to 1L/day antibiotics to reduce intestinal bacteria Abdominal exercises to facilitate recovery

antibiotics to reduce intestinal bacteria

staging

define extent or spread of disease; determines size, location, presence or absence of metastasis

The nurse administers erythropoietin 3x a week to a client receiving chemo for cancer. Which client response demonstrates a therapeutic effect? increase in band cells elevated hematocrit normalization of platelets increase in the white blood cell count

elevated hematocrit

benign neoplasm

non cancerous, excessive growth of normal cells that are not capable of metastasis

Which clinical findings would the nurse anticipate when assessing a child with newly diagnosed acute lymphoblastic leukemia? pallor fatigue jaundice multiple bruises generalized edema

pallor fatigue multiple bruises

Which information would the nurse include in his/her teaching for a class on breast health? -breast awareness will help a client know if there are changes in her breasts -body weight makes no difference in the incidence of breast cancer -a specific method of breast self-examination should be performed every month -alcohol intake has no effect on the incidence of breast cancer

-breast awareness will help a client know if there are changes in her breasts

Three days before surgery for a permanent colostomy because of cancer of the colon, a client is receptive to all procedures, responds pleasantly when approached, and does not question staff about interventions or care being received. Which conclusion should the nurse make based on these behaviors? -the client has been fully informed about what to expect -the client is not verbalizing feelings about concerns -the client cannot accept the illness and need for surgery -the client feels reassured by frequent contact with health care staff

-the client is not verbalizing feelings about concerns

The nurse provides postoperative teaching about colostomy care to a client who underwent surgery for cancer of the colon. The education would include which instruction related to skin care around the stoma? -apply liberal amounts of vaseline for 3in around the stoma -wash the area with soap and water and then apply a protective ointment -pour saline over the stoma, and rub the area to remove hard fecal matter -rinse the area with peroxide before applying the fresh gauze bandages

-wash the area with soap and water and then apply a protective ointment

The client asks the nurse how long she will have to take tamoxifen for breast cancer treatment. Which response by the nurse is appropriate? -you will need to take it the rest of your life -your will need to take it for 10 days like an antibiotic -you will need to take it for 5 years after which it will be discontinued -you will need to take it for several months until the bone pain subsides

-you will need to take it for 5 years after which it will be discontinued

Which factor identified in a client's history places her at increased risk for breast cancer? active lifestyle e low-income background delayed onset of menarche late beginning of childbearing

late beginning of childbearing

exam findings (other)

visible lesions, physical asymmetry, palpable masses, abnormal sounds, presence of blood in stool or on pelvic exam, changes to wart/mole