Oncology and Chemotherapy Quiz

Oncology

• Cancer warning signs include changes in bowel/bladder habits, sores that don't heal, unusual bleeding, thickening/lumps, indigestion, swallowing problems, and changes in moles or warts.
• Common cancer characteristics are aggressive invasion and destruction of adjacent tissues, high proliferation rate, and metastasis to distant sites.
• Modifiable colon cancer risk factors include obesity, smoking, alcohol use, and red meat consumption.
• Non-modifiable colon cancer risk factors include male sex, family history of polyps, inflammatory bowel disease (IBD), and specific ethnicities such as African American and Ashkenazi Jewish people.
• Hospice care is for patients with a life expectancy of six months or less. Palliative care addresses symptoms, family support, and psychosocial needs throughout an illness, including bereavement care.

Chemotherapy Side Effects

• Common chemotherapy side effects include nausea, vomiting, hair loss and mucositis/stomatitis.
• Interventions such as premedication with antiemetics and oral hygiene measures during chemotherapy can reduce side effects.

Extravasation

• Extravasation is the leakage of chemotherapy drugs into the surrounding tissues.
• Prevention is critical, as vesicants (chemotherapy drugs that cause tissue damage) should not be administered in peripheral veins of the hands or wrists.
• PICCs or implanted access devices should be used for prolonged administration.
• Indicators of extravasation include absence of blood return from the IV, resistance to IV flow, and local pain, swelling, or redness at the site.

Tumor Lysis Syndrome

• Tumor lysis syndrome (TLS) occurs when cancer cells are destroyed and released into the bloodstream, often after cancer treatment.
• Early treatment and prevention are beneficial.

Hyperkalemia and Hyperuricemia

• Hyperkalemia (high potassium) and hyperuricemia (high uric acid) can cause severe end-organ damage, primarily affecting the cardiovascular system, kidneys, and central nervous system.
• Hydration therapy, allopurinol, sodium polystyrene sulfonate, glucose, and insulin infusions may be used to treat these complications.
• In some cases dialysis may be necessary.

Superior Vena Cava Syndrome (SVC)

• SVC syndrome develops when a tumor compresses the superior vena cava, the large vein returning blood from the upper body to the heart.
• Early symptoms include facial swelling, particularly around the eyes, and periorbital edema.
• Progressive SVC syndrome results in upper body edema, upper body dyspnea, and other symptoms, including neck vein distention, erythema, epistaxis.

Radiation Therapy

• Sealed radiation sources (implants) require safety precautions due to the radioactive nature of the implants
• The patient is radioactive, but not excreting the radiation.
• Non-sealed radiation therapy involves an external radiation beam aimed at specific areas of the body.
• Precautions such as limiting time, discouraging pregnant staff and visitors, and separating visitors from the source are essential to mitigate side effects or exposure risks.

Brachytherapy

• Patients undergoing brachytherapy are radioactive, and guidelines for safe handling and care, including patient assignment, private rooms, caution signs, dosimeter badges, and lead aprons, are implemented.

Adverse Effects of Radiation

• Skin reactions like dermatitis are common, as well as other effects such as alopecia, stomatitis, xerostomia, loss of taste, fatigue, malaise, anorexia, nausea, and possible fibrosis or scarring of surrounding tissue.

Hematology

• Anemia is a low red blood cell count resulting in insufficient oxygen delivery to the body tissues. Anemia can be microcytic (small red blood cells) or macrocytic (large red blood cells).
• Megaloblastic anemias often result from vitamin B12 or folate deficiencies.
• Symptoms of megaloblastic anemia include fatigue, weakness, pallor, and tingling or numbness in the extremities resulting from nerve damage.
• Microcytic anemias often result from iron deficiency.
• Symptoms include fatigue, weakness, pallor, brittle nails, and pica (craving or eating non-food items).

Sickle Cell Crisis

• Sickle cell crisis is characterized by vaso-occlusive events in the small blood vessels.
• It is triggered by factors that cause local or systemic hypoxia; these include infections, dehydration, and temperature extremes.
• Treatment often involves managing symptoms through medication (pain relievers, oxygen therapy, blood transfusions).

Thrombocytopenia

• Thrombocytopenia is characterized by a low platelet count.
• This condition can be caused by various factors, including autoimmune diseases, medications, and some infections.
• Symptoms are related to easy bruising, bleeding, and petechiae.

Blood Transfusions

• Assessment of vital signs before and during transfusions is extremely important, including hourly checks to identify complications or reactions.
• Interventions for blood transfusion reactions such as febrile reactions, bacterial reactions, circulatory overload, hemolytic reactions, and allergic reactions are critical for patient safety.
• In case of acute reaction, immediately discontinue, notify doctor, monitor vitals, and provide supportive care.
• Careful monitoring is essential for the care of patients receiving blood transfusions to maintain safe and efficient treatment.
• Potential reactions include chills, tachycardia, fever, hypotension, tachypnea resulting from anti-WBC antibodies in the blood; bacterial contamination leads to tachycardia, hypotension, infection, and shock; and circulatory overload (dyspnea, bounding pulse, high blood pressure).
• Hemolytic reactions involve blood type or Rh incompatibility, resulting in fever, chills, apprehension, headache, chest pain, low back pain, and impending doom.

Renal Function

• Renal function is assessed using specific lab tests such as specific gravity, 24-hour urine tests, and serum creatinine levels.
• These tests help to monitor kidney function and detect potential problems in glomerular filtration or tubular function.

Acute Pyelonephritis

• Acute pyelonephritis is an infection of the kidney characterized by structural deformities or an obstruction, causing issues with bacterial infections.
• Risk factors include recurrent UTIs, pregnancy, enlarged prostate, and immunosuppression.
• Chronic pyelonephritis results from structural issues like reflux and obstructions.
• Symptoms include fatigue, headache, poor appetite, excessive thirst, weight loss, hypertension (potentially end-stage renal disease), nocturia (frequent urination at night), and possible electrolyte imbalances (hyperkalemia).

Chronic Prostatitis

• Chronic prostatitis is a persistent inflammation of the prostate.
• Symptoms include chronic pelvic pain syndrome (CPPS) and other symptoms, such as frequency, urgency, hesitancy, nocturia, and urethral discharge.
• Treatment varies but often addresses symptoms through antibiotics, and other medications, and may include avoiding irritating foods and maintaining a healthy lifestyle.

Nephrolithiasis

• Nephrolithiasis involves the formation of kidney stones within the urinary tract.
• Risk factors may include family history, dehydration, obesity, high calcium intake, and certain dietary patterns.
• Manifestations often involve pain in the flank, abdomen, back, or groin, which may spread to the genitals or inner thigh.
• Diagnosis often involves urine tests, blood tests, ultrasound or CT, to aid in determining the nature of the stones, location, and treatment plan.
• Treatment involves hydration measures, medications or surgical intervention to remove the stones.

Ileal Conduit

• This is a urinary diversion procedure.
• Nursing care includes monitoring urine output and providing proper stoma care.
• Skin care and managing potential complications are vital to patient well-being.

Intravenous Urography

• Intravenous urography is a procedure in which a contrast agent is injected into the vein, and X-rays are taken to visualize the urinary tract.
• Important patient preparations include allergy assessment (to contrast dyes, eggs, milk, shellfish) and discontinuation of medications (e.g., metformin) to reduce risks.