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Questions and Answers
What type of electrolyte imbalance is the client experiencing and why?
Hypercalcemia
Which nursing action is the priority for the client with bone cancer?
Which action will the nurse perform first for a client with a fractured tibia and ineffective pain relief from morphine?
What are the three main characteristics of cancer?
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Which of the following are causes of cancer? (Select all that apply)
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Cancer can spread through the body via metastasis.
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What is the definition of osteoarthritis?
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Tumor grading refers to the classification of ________ cells.
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Which of the following are risk factors for osteoarthritis? (Select all that apply)
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Match the types of management with the correct description:
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Gout is characterized by the deposition of monosodium urate crystals within ______ and other tissues.
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Fibromyalgia is a chronic pain syndrome associated with 11 specified tender points.
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Match the following clinical manifestations with the corresponding disorder:
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What is the characteristic clinical manifestation of carpel tunnel syndrome?
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Study Notes
Cancer Pathophysiology and Causes
- Loss of normal cell regulation
- Abnormal cell growth
- Invasion of surrounding tissue
- Metastasis
Causes of Cancer
- Viruses and bacteria
- Physical agents
- Chemical agents
- Genetics/Family History
- Dietary factors
- Hormones
Cancer Prevention
- No specific information provided
How Cancer Spreads
- No specific information provided
Cancer Diagnosis
- Determine presence of tumor
- Identify metastasis
- Evaluate function of involved body parts/organs
- Obtain tissue sample
Staging and Grading
- Staging: determines size of tumor and extent of disease
- Grading: refers to classification of tumor cells
Management of Cancer
- 3-pronged approach:
- Surgery
- Radiation
- Chemotherapy
Management with Surgery
- Types:
- Diagnostic
- Primary Treatment
- Prophylactic
- Palliative
- Post-op nursing care:
- Assess for complications
- Educate client
Management with Radiation
- External:
- Delivered by x-ray
- Site permanently marked
- Site may become irritated
- Considerations:
- Assess for redness, cracking
- Moisturize skin
- Avoid skin irritants
- Use lukewarm water
- Avoid sun exposure, heat/cold to the site
- Internal:
- Delivered through implant
- Placed in OR
- Temporary or Permanent
- Precautions:
- Time, Distance, Shielding
- Limit contact with high-risk groups
Side Effects of Radiation
- Alopecia: hair loss
- Stomatitis: inflamed oral and GI mucosa
- Xerostomia: excessive dry mouth
- Thrombocytopenia: low platelet count
Thrombocytopenic Precautions
- Skin assessment
- Monitor labs
- Monitor for bleeding
- Avoid invasive procedures
- Patient education
Management with Chemotherapy
- Systemic treatment
- Can be combined with other treatments
- Can be administered by various routes
- Side effects:
- GI effects: N/V, anorexia, diarrhea, constipation
- Reproductive system effects: sterility, loss of libido, impotence
- Myelosuppression: leukopenia, neutropenia, thrombocytopenia, anemia
- Tumor lysis syndrome
Tumor Lysis Syndrome
- Pathophysiology: malignant tumor cells burst due to chemotherapy
- Treatment: aggressive hydration, sodium bicarbonate IV, kayexelate/patiromer, insulin/dextrose, allopurinol, rasburicase
- Nursing considerations: strict I&O and weights, assessment of electrolyte disturbances
Alternative Treatments
- Targeted therapies
- Immunotherapy
- Stem cell transplants
Graft Versus Host Disease
- Occurs with allogenic or syngeneic transplants
- Clinical manifestations:
- NVD
- Mucositis
- Liver failure
- Red rash on palms of hands and soles of feet
- RUQ pain and abdominal pain
- Treatment: immunosuppressive drugs
End of Life Care
- Focus on quality of life, palliation of symptoms, psychosocial and spiritual support, and empathy
- Hospice care: facilitates symptom management, approaches death with dignity, and provides support to families
Cancer-Related Pain
- Associated with cancer
- May be acute or chronic
- Pain assessment review:
- Every shift, before intervention, and after intervention
- COLDSPA
- Pain management:
- Nonpharmacological
- Pharmacological:
- Medication form
- Opioids and non-opioids
- Various routes and methods
Note: The rest of the text is related to Rheumatic Disorders and Musculoskeletal Disorders, which is a separate topic.### Musculoskeletal Disorders
- Osteoporosis:
- Risk factors: Figure 41-8, p. 1195
- Clinical manifestations: Kyphosis, decreased height, low back pain
- Treatment: Increase Ca and Vitamin D, medications (Alendronate, Calcitonin, Teriparatide), bowel elimination, resistance/impact (weight-bearing) exercises, fracture management
Paget Disease
- Definition: Abnormal bone destruction and regrowth
- Diagnosis: Serum test for ALP
- Clinical manifestations: Usually asymptomatic, skeletal deformities, bowed legs, enlarged skull, pain, warm skin, fractures
- Treatment: Medications (Acetaminophen/NSAIDS, Calcitonin), walking aids, shoe lifts, PT, fracture management
Osteomyelitis
- Definition: Infection of the bone usually caused by staph aureus
- Clinical manifestations: Swelling, redness, warmth, pain, fever, leukocytosis, positive (+) cultures, sepsis
- Treatment: Antibiotics, surgical debridement if needed, relieve pain, immobilize, elevate, analgesics, activity restriction, sterile dressing changes, diet high in protein and vitamin C, prevention is key
Bone Cancers
- Primary: Benign and malignant bone tumors
- Secondary: Metastatic bone disease
- Diagnosis: CT, bone scans, biopsy, MRI
- Clinical manifestations: Swelling, pain, pathologic fractures, hypercalcemia
- Treatment: Surgical removal/amputation, radiation, chemotherapy, palliative care, nursing management: pain relief, safety, monitor for complications
Musculoskeletal Trauma
- Strains, Sprains, and Contusions:
- Treatment: RICE (Rest, Ice, Compression, Elevation) and monitor neurovascular status
- Joint Dislocation:
- Definition: Occurs when articular surfaces of bones are no longer in anatomic alignment
- Clinical manifestations: Acute pain, change in contour of joint, shortening of affected limb, loss of normal mobility
- Treatment: Immobilize, dislocation reduced, ROM
- Fractures:
- Definition: Break in continuity of bone
- Clinical manifestations: Pain, loss of function, deformity, shortening of affected limb, crepitus, swelling/discoloration
- Treatment: Provide emergency care, immobilize, assess pain, temperature, color, sensation, capillary refill, bone will be reduced (closed or open - ORIF)
Fractures - Nursing Management
- Teaching related to treatment regimen
- Relieve pain
- Improve physical mobility
- Maintain adequate neurovascular function
- Assess the 5 P's
- Monitor for complications: fat embolism, delayed union, malunion, nonunion, sepsis, peripheral nerve damage, hemorrhage, DVT/PE, compartment syndrome
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Description
This quiz covers the pathophysiology of cancer, including the characteristics, causes, prevention, diagnosis, and spread of cancer. Topics include abnormal cell growth, metastasis, and diagnostic evaluation.
