Management of Oncological Disorders
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Questions and Answers

What characterizes the energy metabolism of cancer cells compared to normal cells?

  • Cancer cells primarily use oxidative phosphorylation for energy.
  • Cancer cells derive most energy from glucose through glycolysis. (correct)
  • Cancer cells require normal oxygen levels for energy production.
  • Normal cells utilize glycolysis as their primary energy source.

Which statement accurately describes the structural differences between normal cells and cancer cells?

  • Both normal and cancer cells divide in an orderly manner.
  • Cancer cells are created without control and have abnormal DNA. (correct)
  • Normal cells can be overactive in their functions.
  • Normal cells have abnormal DNA while cancer cells have normal DNA.

How do growth factors differ between normal and cancer cells?

  • Normal cells produce excessive growth factors.
  • Cancer cells have no growth factors present.
  • Normal cells produce a normal amount of growth factors. (correct)
  • Cancer cells produce fewer but more active growth factors.

Which of the following statements reflects the vascular differences between normal and cancer cells?

<p>Normal cells have a built-in blood vessel system. (B)</p> Signup and view all the answers

In which population is the incidence of cancer highest, according to epidemiological data?

<p>African American men and women (B)</p> Signup and view all the answers

What is the main difference in cell characteristics between benign and malignant tumors?

<p>Benign tumors have well-differentiated cells while malignant tumors have variable differentiation. (C)</p> Signup and view all the answers

Which of the following statements accurately describes the mode of growth for malignant tumors?

<p>Malignant tumors grow by infiltration and destroy surrounding tissues. (D)</p> Signup and view all the answers

What factor affects the rate of growth in malignant tumors?

<p>Is determined by the degree of differentiation of the tumor. (D)</p> Signup and view all the answers

What is a characteristic of benign tumors in terms of metastasis?

<p>Benign tumors do not metastasize. (B)</p> Signup and view all the answers

Which steps are involved in the pathophysiology of the malignant process during initiation?

<p>Carcinogens cause mutations in cellular DNA. (C)</p> Signup and view all the answers

In the promotion stage of carcinogenesis, what is the effect of promoting agents?

<p>They enhance proliferation of initiated cells. (D)</p> Signup and view all the answers

What occurs during the progression stage of carcinogenesis?

<p>Initiated cells may begin to show malignant behaviors. (B)</p> Signup and view all the answers

What is a common outcome associated with malignant tumors compared to benign tumors?

<p>Malignant tumors can lead to extensive tissue damage and death. (D)</p> Signup and view all the answers

What is the primary role of oncogenes in cell division?

<p>To promote cell division (D)</p> Signup and view all the answers

What is the main function of suppressor genes in the context of cell division?

<p>Limiting cell division when it is unnecessary (A)</p> Signup and view all the answers

Which of the following is NOT a common carcinogenic agent?

<p>Vaccination (A)</p> Signup and view all the answers

What is the primary objective of primary prevention in cancer management?

<p>Health promotion and risk reduction (A)</p> Signup and view all the answers

In the TNM classification system, what does 'N' represent?

<p>Lymph node involvement (D)</p> Signup and view all the answers

What is the best method for monitoring the nutritional status of a patient with cancer?

<p>Weighing the patient daily (C)</p> Signup and view all the answers

What type of surgery is considered palliative?

<p>Surgery to relieve symptoms (D)</p> Signup and view all the answers

What is the purpose of external radiation therapy?

<p>To destroy cancer cells while sparing normal cells (A)</p> Signup and view all the answers

Which statement best describes brachytherapy?

<p>Delivers low dose radiation over an extended period (C)</p> Signup and view all the answers

Which treatment goal is focused on minimizing symptoms and improving quality of life?

<p>Palliation (A)</p> Signup and view all the answers

What is the primary purpose of intrathecal drug delivery?

<p>To deliver drugs into the spinal cord (B)</p> Signup and view all the answers

What is a primary indicator of extravasation during chemotherapy administration?

<p>Resistance to flow of IV fluids (D)</p> Signup and view all the answers

Which of the following is considered a vesicant?

<p>Chemotherapy agents that can damage tissue (C)</p> Signup and view all the answers

Which medication is commonly prescribed to manage nausea and vomiting caused by chemotherapy?

<p>Benadryl (B)</p> Signup and view all the answers

What condition is characterized by a reduction in bone marrow function due to chemotherapy?

<p>Myelosuppression (C)</p> Signup and view all the answers

What should be done immediately if extravasation is suspected during chemotherapy?

<p>Stop the medication immediately (B)</p> Signup and view all the answers

Which is a characteristic of nadir in relation to chemotherapy?

<p>Lowest absolute neutrophil count following chemotherapy (A)</p> Signup and view all the answers

What can be an effective approach to prevent hypersensitivity reactions during chemotherapy?

<p>Administer premedications like Benadryl and Phenergan (D)</p> Signup and view all the answers

What role does Erythropoietin serve in chemotherapy management?

<p>Stimulates RBC production (B)</p> Signup and view all the answers

Which medication is specifically used for white blood cell stimulation?

<p>Filgrastim (C)</p> Signup and view all the answers

What is a significant long-term effect of chemotherapy on patients?

<p>Osteoporosis (B)</p> Signup and view all the answers

Which of the following is NOT recommended for managing risks for infection during chemotherapy?

<p>Participating in large gatherings (D)</p> Signup and view all the answers

What dietary approach is recommended for patients experiencing cancer-related anorexia-cachexia syndrome?

<p>Small frequent meals (A)</p> Signup and view all the answers

What is the primary benefit of using megestrol acetate in patients with cancer?

<p>Improves appetite and promotes weight gain (B)</p> Signup and view all the answers

What complication may arise from rapid tumor cell lysis during chemotherapy?

<p>Acute kidney injury (C)</p> Signup and view all the answers

Which of the following is a potential complication that should be monitored in cancer patients?

<p>Infection due to neutropenia (A)</p> Signup and view all the answers

Which nursing intervention is crucial in managing chemotherapy-induced fatigue?

<p>Helping patients plan their activities (D)</p> Signup and view all the answers

Which intervention is NOT recommended to improve nutritional intake for cancer patients?

<p>Encourage unpleasant sights and sounds during meals (A)</p> Signup and view all the answers

Which method is used to protect tissues during cancer treatment?

<p>Amifostine administration (D)</p> Signup and view all the answers

What is one of the central focuses of hospice care for patients with end-stage cancer?

<p>Family-centered care (D)</p> Signup and view all the answers

What cardiovascular condition requires monitoring during chemotherapy treatment?

<p>Heart failure (C)</p> Signup and view all the answers

What does tumor lysis syndrome primarily lead to?

<p>Electrolyte imbalances (B)</p> Signup and view all the answers

Which treatment is used for pain relief in patients with bone cancer?

<p>Dexamethasone and analgesics (B)</p> Signup and view all the answers

How can scalp pulling benefit cancer patients experiencing hair loss?

<p>It may psychologically boost their confidence (D)</p> Signup and view all the answers

Flashcards

Cancer

A disease where cells grow uncontrollably due to DNA mutations.

Normal cell structure

Cells divide in an organized way with normal DNA.

Cancer cell energy

Cancer cells get most of their energy from glycolysis, not oxygen.

Cancer cell blood vessels

Cancer cells do not have a built-in blood vessel system like normal cells.

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Growth Factors in Cancer

Cancer cells have overproduced and more active growth factors.

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Malignant Tumor Growth

A tumor that grows uncontrollably, infiltrates surrounding tissues, and can spread to distant sites.

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Undifferentiated Cells

Cells that lack the specialized features of normal cells, indicating a loss of control over cell division.

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Metastasis

The spread of cancer cells from the original tumor to other parts of the body.

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Carcinogenesis (Initiation)

The process where carcinogens (cancer-causing agents) damage DNA, leading to mutations that can drive uncontrolled cell division.

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Promotion Stage

The phase where mutated cells are stimulated to proliferate and expand, contributing to tumor growth.

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Promoters

Substances that enhance the growth of initiated cells, often including normal hormones and proteins.

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Progression Stage

The phase where cancerous cells continue to change, develop their own blood supply (angiogenesis), and become more aggressive.

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Angiogenesis

The formation of new blood vessels from existing ones, which tumors exploit to sustain their growth.

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Oncogenes

Genes that promote cell division when activated. They code for proteins like cyclins that drive cells through the cell cycle.

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Suppressor Genes

Genes that limit cell division by controlling the amount of cyclins present. They ensure cell division only happens when needed.

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Malignant Transformation

The process of a normal cell turning into a cancerous cell due to changes in its DNA.

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Carcinogenic Agents

Factors that increase the risk of cancer development. They can be viral, bacterial, physical, chemical, genetic, or lifestyle related.

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Primary Prevention

Measures to prevent cancer before it develops, such as vaccines, healthy lifestyle choices, and avoiding carcinogens.

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Secondary Prevention

Detecting cancer early through screening and monitoring, increasing chances of successful treatment.

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Tumor Staging

Classifying the size, spread, and extent of a tumor using the TNM system (Tumor, Nodes, Metastasis).

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Tumor Grading

Evaluating the aggressiveness of cancer cells based on their appearance and growth patterns, graded from I (least aggressive) to IV (most aggressive).

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Curative Treatment

Cancer treatment aiming to completely eliminate the cancer.

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Teletherapy

External radiation therapy where a machine directs beams of radiation to the tumor.

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Intrathecal Administration

Delivering medication directly into the spinal fluid via an injection.

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Intra-arterial Chemotherapy

Chemotherapy delivered directly into an artery, often used for liver cancer.

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Intracavitary Radioisotopes

Radioactive substances placed within a body cavity, particularly for treating certain gynecologic cancers.

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Extravasation

The leakage of chemotherapy drugs from a vein into surrounding tissue, potentially causing damage.

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Signs of Extravasation

Absence of blood return from the IV, resistance to IV fluids, burning/swelling/redness at the site.

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Nadir

The lowest point of neutrophil count after chemotherapy, indicating suppressed immune system.

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Myelosuppression

Suppression of bone marrow function, leading to decreased production of blood cells.

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Chemotherapy Toxicity: Gastrointestinal

Side effects like nausea, vomiting, mouth sores, and diarrhea.

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Erythropoietin

A hormone that stimulates the production of red blood cells (RBCs). It is used in cancer treatment to combat anemia caused by chemotherapy.

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Filgrastim (Neupogen)

A medication that stimulates the production of white blood cells (WBCs). It helps protect against infections during chemotherapy, which weakens the immune system.

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Rapid Tumor Lysis Syndrome

A potentially life-threatening complication of cancer treatment where the rapid breakdown of tumor cells releases harmful substances into the blood, overwhelming the kidneys.

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Hemorrhagic Cystitis

Inflammation and bleeding of the bladder, often a side effect of chemotherapy.

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Ejection Fraction (EF)

The percentage of blood that is pumped out of the heart with each beat. A lowered EF indicates heart weakness.

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Chemotherapy-Induced Neurotoxicity

Damage to the nervous system caused by chemotherapy, affecting the brain, nerves, and muscles.

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Managing Fatigue (Chemotherapy)

Helping patients plan their day and conserve energy to cope with fatigue caused by chemotherapy.

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Allogenic Hematopoietic Stem Cell Transplantation (HSCT)

A transplant where stem cells are taken from a healthy donor, such as a sibling or unrelated person, and are infused into the patient to rebuild their immune system after chemotherapy or radiation.

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Stomatitis

Inflammation of the mouth and surrounding tissues.

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Alopecia

Hair loss.

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Megestrol acetate

Medication used to improve appetite and weight gain.

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Malabsorption

Difficulty in absorbing nutrients from food.

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Septic shock

A life-threatening condition where bacteria in the bloodstream cause widespread inflammation and organ dysfunction.

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Thrombocytopenia

Low platelet count in the blood.

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Tumor Lysis Syndrome

A serious condition caused by the rapid breakdown of cancer cells, leading to electrolyte imbalances.

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Hospice

A program that provides specialized care for individuals with serious illnesses, focusing on comfort and quality of life.

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Study Notes

Management of Patients with Oncological Disorders

  • Cancer is a disease process arising from genetic mutations in cell DNA.
  • Epidemiology of cancer is influenced by factors such as gender, race/ethnicity, geography (e.g., tobacco exposure), and other factors.

Normal vs. Cancer Cells

  • Normal Cells: Divide in an ordered pattern, mostly using oxygen for energy, with built-in blood vessels, and a normal amount/activity level.
  • Cancer Cells: Divide uncontrollably; use mostly glucose for energy; lack a built-in blood vessel system; overproduced and overactive or underactive.

Benign vs. Malignant Tumors

  • Benign: Well-differentiated cells, encapsulated growth, slow growth rate, localized, does not cause generalized effects, usually does not cause tissue damage, and usually does not cause death.
  • Malignant: Undifferentiated cells, grows, infiltrates and destroys tissues, variable growth rate, potential for metastasis, causes generalized effects, often causes extensive tissue damage, and eventually causes death.

Pathophysiology of Malignant Process

  • Initiation: Carcinogens (chemicals, physical factors) cause DNA mutations, leading to cell division and resulting in not reversible mutations.
  • Promotion: Repeated exposure to promoting agents (e.g., hormones, proteins) leads to proliferation and expansion of initiated cells.
  • Progression: Altered cells exhibit malignant behaviors. Oncogenes drive cell division; suppressor genes limit division. Malignant transformation converts normal cells to cancer cells. This is influenced by factors like viruses, physical agents (sunlight, radiation), chemical agents (tobacco, asbestos), genetics, family history, and lifestyle factors.

Cancer Detection and Prevention

  • Primary prevention: health promotion (vaccines).
  • Secondary prevention: Screening and early detection.
  • Tertiary prevention: monitor and prevent recurrence.
  • Diagnostic procedures include determining the presence, extent of tumor, and evaluating involved/uninvolved body systems and organs.

Cancer Management

  • Treatment goals: cure, control, or palliation.
  • Treatment types include surgery, radiation, chemotherapy, hematopoietic stem cell transplantation, and targeted therapies.
  • Methods to monitor nutritional status in cancer patients include weighing the patient daily.
  • Surgical treatment encompasses: diagnostic surgery (biopsy), primary treatment (local excision, wide, radical, or minimally invasive techniques), prophylactic surgery, palliative surgery, and reconstructive surgery.
  • Radiation therapy aims to destroy cancer cells with minimal damage to normal cells, through methods like teletherapy (external) and brachytherapy (internal).
  • Chemotherapy is a systemic treatment aimed at killing cancer cells.

Patient Education and Management

  • Education: No children, pregnant people, and limited visitors are allowed. Patients may experience radiation toxicity (local reactions, altered skin integrity, alterations in oral/GI mucosa), bone marrow toxicity, late effects (permanent tissue damage/changes), and the need for meticulous skin care during radiation.
  • Nursing Management: Includes skin care, oral care, avoiding extremes of temperature/pressure to skin, avoiding potential ulcers/irritations, proper nutrition and adequate hydration.
  • Patient Education: Focuses on preventing infections, bleeding, and pain. Measures to educate patients on potential complications like sepsis and bleeding are important given the risk of infection in patients being treated with chemotherapy.

Chemotherapy Toxicity

  • Gastrointestinal: Nausea, vomiting, stomatitis, mucositis, diarrhea [medication management].
  • Hematopoietic: Myelosuppression (depression of bone marrow function) [risk for infection/bleeding, monitoring of labs].
  • Renal: Can experience rapid tumor cell lysis, potentially leading to acute kidney injury [hydration].
  • Cardiopulmonary: Monitor EF, s/sx of HF and respiratory failure.
  • Reproductive: Issues related to infertility, men and women.
  • Neurologic: Chemo-induced neurotoxicity.

Additional Treatments and Procedures

  • HSCT (Hematopoietic Stem Cell Transplantation): Different types including allogenic (donor), autologous (from the patient), syngeneic (identical twin), myeloablative, or non-myeloablative. May lead to complications like infection/bleeding, graft-versus-host disease (GVHD).
  • Immunotherapy: Boost the immune system to fight cancer cells.
  • Spinal cord compression: Tumor can enter the spinal cord; symptoms include back pain, loss of sensation, local inflammation, neurological dysfunction, bladder and bowel dysfunction [diagnosis and treatment].
  • Superior vena cava syndrome (SVC): Tumor pressing on SVC (e.g., edema, shortness of breath, and difficulty swallowing), [diagnostics and management].
  • Hypercalcemia: Excess calcium in the blood, potentially life-threatening [symptoms and management strategies].
  • Tumor lysis syndrome (TLS): Release of intracellular contents from rapidly dividing tumor cells, resulting in electrolyte imbalances. [monitoring for and management of TLS]

Other Important Points

  • Care Focus: The focus of care prioritizes both the patient and their family.
  • Hospice and Palliative Care: The needs of patients with end-stage illness are best met by comprehensive interdisciplinary specialty programs.

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Oncological Disorders Management PDF

Description

This quiz focuses on the management of patients with oncological disorders, exploring the differences between normal and cancer cells, as well as benign and malignant tumors. Test your knowledge of cancer epidemiology and cell behavior to better understand the complexities of cancer treatment.

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