Chapter 6: Pathophysiology of Cancer
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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?

  • Assess for paresthesia of left foot
  • Immobilize the right leg
  • Administer pain medication
  • Monitor for complications (correct)

    • Which action will the nurse perform first for a client with a fractured tibia and ineffective pain relief from morphine?

  • Readjust cast to fit snugly around leg
  • Contact the healthcare provider (correct)
  • Elevate leg above heart level (correct)
  • Palpate bilateral pedal pulses
  • Loosen restrictive clothing

    • What are the three main characteristics of cancer?

    <p>Loss of normal cell regulation, abnormal cell growth, invasion of surrounding tissue, metastasis</p> Signup and view all the answers

    Which of the following are causes of cancer? (Select all that apply)

    <p>Chemical agents</p> Signup and view all the answers

    Cancer can spread through the body via metastasis.

    <p>True</p> Signup and view all the answers

    What is the definition of osteoarthritis?

    <p>Cartilage deterioration in synovial joints and vertebrae</p> Signup and view all the answers

    Tumor grading refers to the classification of ________ cells.

    <p>tumor</p> Signup and view all the answers

    Which of the following are risk factors for osteoarthritis? (Select all that apply)

    <p>Older age</p> Signup and view all the answers

    Match the types of management with the correct description:

    <p>Surgery = Involves physical removal of tumor or tissue Radiation = Delivered internally or externally to target cancer cells Chemotherapy = Systemic treatment that can be combined with other therapies</p> Signup and view all the answers

    Gout is characterized by the deposition of monosodium urate crystals within ______ and other tissues.

    <p>joints</p> Signup and view all the answers

    Fibromyalgia is a chronic pain syndrome associated with 11 specified tender points.

    <p>False</p> Signup and view all the answers

    Match the following clinical manifestations with the corresponding disorder:

    <p>Joint pain/swelling/warmth/redness = Rheumatoid Arthritis Fatigue, joint pain/arthritis, rash = Systemic Lupus Erythematosus (SLE) Hardening of skin, CREST = Scleroderma</p> Signup and view all the answers

    What is the characteristic clinical manifestation of carpel tunnel syndrome?

    <p>Pain, numbness, paresthesias, weakness</p> Signup and view all the answers

    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
    • 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.

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