NUR 131 Cellular Aberrations - TranxCN PDF

TABLE OF CONTENTS BATCH 2026 TRANXCN TEAM DEPUTY HEADS Chavez, Bettina Gabrielle D. Roales, Julianne Cassandra C. TRANXCN TEAM Mickaela Beyonce S. Aventurado Sofia Pauline B. Bartolo Dhana Mae S. Delos Santos NUR 13...

TABLE OF CONTENTS BATCH 2026 TRANXCN TEAM DEPUTY HEADS Chavez, Bettina Gabrielle D. Roales, Julianne Cassandra C. TRANXCN TEAM Mickaela Beyonce S. Aventurado Sofia Pauline B. Bartolo Dhana Mae S. Delos Santos NUR 131 Lexis Mei G. Mendoza Nathalie Kyle A. Mendoza Josh Merrill E. Turingan Ritscal Alek Caballes MEDICAL-SURGICAL Maria Andrea Midge A. Matibag Romina Catherine F. Dizon Reese Stefanie C. Reyes Chynna Marionne B. Bicomong NURSING 1: Charlene M. Bundal Fritz Ashley Valenzuela Gelsey Marie Jamilah B. Escol Frances Charra I. Ducay Yesha Margaret Dusaran Ella Shammel L. Porte Patricia Mae T. Ponce Concept Jabez Roel A. Villaflor TranxCN: CANCER RELEASE A.Y. 2024-2025 Maria Michaela D. Reyes Merced Eliza C. Diokno Kristina Amiella Lyn P. Leyva Guidelines: The Tranx CN is NOT FOR SALE and shall only be utilized by the bona fide nursing students from De La Salle medical and Health Sciences Institute. The students are permitted to download and print the Tranx CN. However, reproducing, imitating, altering or tampering any information on the transcriptions is strictly prohibited. Failure to abide by the Tranx CN guidelines will result in immediate termination of access to the transcriptions. Disclaimer: Please use at your own discretion. Tranx CN is not intended as a substitute for resource materials such as handouts, videos, and books provided by the college. All information on these transcripts is provided in good faith and is subjected to quality control. Regardless, the Tranx CN Team makes no representation or warranties of any kind regarding the accuracy, and completeness of any information in the transcripts. The College of Nursing Faculty/Professors are not liable for any mistakes or false information that may inadvertently be included in this transcript. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 NAMING CANCERS OUTLINE Prefix Meaning A. What is Cancer? Adeno- Gland a. Naming Cancer b. Types of Cancer Chondro- Cartilage B. Normal Cell vs Cancer Cell Erythro- Red blood cell C. Beginning of Cancerous Growth D. Angiogenesis Hemangio- Blood Vessels E. Types of Tumors a. Malignant Hepato- Liver b. Benign Lipo- Fat F. Why Cancer is Potentially Dangerous? G. Tissue changes Lympho- Lymphocyte a. Hyperplasia b. Dysplasia Melano- Pigment cell c. Carcinoma in Situ H. Tumor Grading and Staging Myelo- Bone marrow a. Types of Staging Myo- Muscle b. TNM Staging c. Roman Numeral Osteo- Bone d. Cancer Grading WHAT IS CANCER? TYPES OF CANCER Cancer is many different diseases involving CARCINOMA uncontrolled growth of body cells. Carcinomas are the most common type of cancer. A cancer fails to respond to signals that maintain They are formed by epithelial cells. orderly growth in normal cells. A disease process whereby cells proliferate ADENOCARCINOMA abnormally, ignoring growth-regulating signals in the Cancer that forms in epithelial cells that produce environment surrounding the cell. fluids or mucus. It is the depletion of genetic material Most common: breast, colon, and prostate cancer BASAL CELL CARCINOMA Cancer that begins in the lower or basal (base) layer of the epidermis. Ex. skin cancer It is more treatable than adenocarcinoma if there is no progression of cancer yet SQUAMOUS CELL CARCINOMA Cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Ex. tongue, stomach, intestine, bladder, kidney TRANSITIONAL CELL CARCINOMA Cancer that forms in a type of epithelial tissue called transitional epithelium or urothelium. Most commonly found in organs that expand Manifestation of SOB & problem in output of patient because of the damage in the renal tubules. Ex. bladder, kidneys, ureter, urethra CHAVEZ, ROALES, DUCAY, PORTE 2 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 SARCOMA NORMAL CELL VS CANCER CELL Cancer that forms in bone & soft tissues, including muscle, fat, blood vessels and fibrous tissues. Most common: leiomyosarcoma Nerve fiber is also affected. ○ Neural pain = soft tissue ; neurotic pain = nerve endings LEUKEMIA Cancers that begin in the blood-forming tissue of the bone marrow. Known as “double jeopardy” Forms on the bone marrow Lymphoblastic / onset ○ Iif dx is < 18 y/o ○ More room for development Myeloid ○ If dx is > 18 y/o ○ No room for development, that is why it is more fatal. ○ Once the mature cells are hit, all the blood products are affected. NORMAL GROWTH LYMPHOMA Cancer that begins in lymphocytes (T cells or B cells) Hodgkin ○ Most common ○ Innervated from B cell ○ Reed Stenberg (B cell) BEGINNING OF CANCEROUS GROWTH Non hodgkin ○ T or B cell INVASION AND METASTASIS Cancer cells invade MULTIPLE MYELOMA surrounding tissues Cancer that begins in plasma cells, another type of and blood vessels. immune cell. Seen in renal or kidney CA Cancer cells are transported by the circulatory system, MELANOMA to distant sites. Cancer that begins in cells that become melanocytes, which are specialized cells that make Cancer cells melanin. reinvade and grow at At risk: people with fair skin and exposed to new locations. radiation Metastasis: when the cancer cells use the circulatory systems to transport. HEMANGIOMA Cancer of the blood vessel ANGIOGENESIS OSTEOMA Formation of new network of blood vessels Cancer of the bone Angio: Blood vessels; Genesis: New formation Can cause weakness and entanglement and is very painful. Osteosarcoma: Cancer of the bone and muscle CHAVEZ, ROALES, DUCAY, PORTE 3 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 TUMOR ANGIOGENESIS MICROSCOPIC APPEARANCE OF CANCER CELLS From a small localized tumor → tumor that can grow and spread TYPES OF TUMORS MALIGNANT Invades neighboring tissues, enter blood vessels, and metastasize to different sites BENIGN WHY CANCER IS POTENTIALLY DANGEROUS? Not cancer Grows only locally and cannot spread by invasion or metastasis CHARACTERISTICS OF TUMORS Benign Malignant Cell Well differentiated & Undifferentiated with resembles normal little resemblance to cells. normal cells. If it affects vital organs, it's fatal. Mode of Grows by Grows at the periphery TISSUE CHANGES THAT ARE NOT CANCER growth expansion; does & sends out processes not infiltrate the that infiltrate & destroy surrounding the surrounding tissues; usually tissues. encapsulated. Rate of Slow Variable. The more growth anaplastic, the faster its growth Metastasi Does not spread Gains access to blood s & lymphatic channels; metastasizes to other HYPERPLASIA parts Tissue growth based on an excessive rate of cell division, leading to a larger than usual number of General Localized effects Generalized i.e., cells. effects anemia, weakness, Ex. hand callus weight loss Tissue Does not cause Often causes extensive DYSPLASIA destructi tissue damage. tissue damage. An abnormal type of excessive cell proliferation on characterized by loss of normal tissue arrangement and cell structure. Cells revert back to normal behavior, but Fast growing cells occasionally they gradually become malignant, ○ Skin, Nails, & Hair needing treatment. ○ If the cancer is near the gastric area. Because there is nutrition & blood vessels. CHAVEZ, ROALES, DUCAY, PORTE 4 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 CARCINOMA IN SITU In Latin, the term “in situ” means “in place”, so ROMAN NUMERAL STAGING carcinoma in situ refers to an uncontrolled growth of Stage 1 Cancers are localized to one part of the body cells that remains in the original location Carcinoma in situ may develop into an invasive, Stage 2 Cancer has spread into surrounding tissues, metastatic malignant, and therefore, is usually but not beyond the location of origin removed surgically, if possible. Stage 3 Regional cancer has spread nearby the lymph TUMOR GRADING AND STAGING nodes Grading Identification of the type of tissue from Stage 4 Distant cancers have metastasized or spread which the tumor originated. to other parts of the body Degree to which tumor cells retain functional and structural characteristics. CANCER GRADING Staging The process of determining the size and Cancer grading reflects how abnormal the cancer spread, or metastasis of the tumor. cells look under the microscope TYPES OF STAGING GX Grade cant be determined CLINICAL STAGING Estimate of how much cancer there is based on the G1 Well differentiated results of the physical exam, imaging tests, and endoscopic procedures. G2 Moderately differentiated G3 Poorly differentiated PATHOLOGIC STAGING Estimate of the extent of the cancer based on the G4 Undifferentiated microscopic examination of the tumor after surgery. Also known as biopsy TNM STAGING SYSTEM Used for solid tumors EXAMPLE T1: the cancer is no larger than 3 cms., has not spread to the visceral pleura and does not affect the main branches of the bronchi N0: No spread to lymph nodes M1: distant spread is present CHAVEZ, ROALES, DUCAY, PORTE 5 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 VIRUSES Virus inserts and changes genes for cell growth. OUTLINE EXAMPLE OF HUMAN CANCER VIRUS A. Population-based Studies Virus Type of Cancer B. Risk factors of Cancer C. Genes and Cancer Epstein-Barr Virus Burkitt’s lymphoma D. Subjective Data Human papillomavirus Cervical cancer POPULATION-BASED STUDIES Regions of Highest Incidence Hepatitis B virus Liver cancer ○ Australia: Skin Cancer ○ Brazil: Cervical Cancer Human T-cell lymphotropic Adult T-cell leukemia ○ Canada: Leukemia virus ○ China: Liver Cancer ○ Japan: Stomach Cancer Kaposi’s sarcoma - Kaposi’s sarcoma associated herpesvirus ○ United Kingdom: Lung Cancer ○ United States: Colon Cancer AIDS & KAPOSI’S SARCOMA RISK FACTORS OF CANCER BEHAVIOR TOBACCO USE Causes cancer in the lungs, mouth, larynx, esophagus, stomach, pancreas, kidney, and bladder. BACTERIA & STOMACH CANCER HIGH-STRENGTH RADIATION Radiation therapy is used in cancer treatment and exposure to radioactive materials at nuclear weapon manufacturing sites in the past have been associated with a higher incidence of leukemia. Excessive exposure to the ultraviolet rays of the sun, especially in fair skinned people, increases the risk of skin cancer. CHAVEZ, ROALES, DUCAY, PORTE 6 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 HEREDITY & CANCER GENES & CANCER HEREDITY CAN AFFECT MANY TYPES OF CANCER Inherited Mutations that can increase Risk for Cancer. Name of Condition Type of cancer ONCOGENES Damage genes that stimulate the development of Hereditary retinoblastoma retinoblastoma cancer Xeroderma pigmentosum Skin The precursor of cancer. Promote growth of cancer cells. Wilm’s tumor Kidney If you have oncogenes, it will determine the risk or percentage of cancer cells. Li-Fraumeni Syndrome Sarcomas, Brain, Breast, Leukemia Familial Adenomatous Colon, Rectum Polyposis Paget’s Disease of Bone Bone Fanconi’s aplastic anemia Leukemia, Liver, Skin CANCER RISK & AGING Normal cell = Normal genes regulate cell growth Cancer cell = Mutated/damaged oncogene PROTO-ONCOGENES & NORMAL CELL GROWTH Proto-oncogenes encode components of the cell's normal growth-control pathway. We are PRO = PROTO-oncogenes NOT oncogenes. CHAVEZ, ROALES, DUCAY, PORTE 7 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 P53 TUMOR SUPPRESSOR PROTEIN TRIGGERS CELL SUICIDE Cell suicide is normal, but if left inside, it can replicate. P53 protein = Triggers cell suicide. ONCOGENES ARE MUTANT FORMS OF PROTO-ONCOGENES TUMOR SUPPRESSOR GENES ACT LIKE A BRAKE PEDAL TUMOR SUPPRESSOR GENES Normal genes whose absence can lead to cancer If there is damage to the helix, the damage gene will be replicated. DNA REPAIR GENES Correct errors that arise when cells duplicate their DNA prior to cell division. Repair genes are for mismatch. Without it, cancer. Normal cell = Prevent cancer. Cancer cell = Damage to both genes lead to cancer. CHAVEZ, ROALES, DUCAY, PORTE 8 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 CANCER TENDS TO INVOLVE MULTIPLE CANCER TENDS TO CORRUPT SURROUNDING MUTATIONS ENVIRONMENT Growth factors = There is a lot of factors happening Proteases & cytokines = Inflammatory mediators MUTATIONS & CANCER Genes Implicated in cancer. SUBJECTIVE DATA Significant subjective data from client: ○ Change in bowel or bladder habits The prime suspects But Alteration constipation and diarrhea is the Mutations in: Other mutations also occur most characteristic manifestation of colon in: cancer. Change in bladder habits may signify Oncogenese Cell Death genes bladder or prostate cancer Tumor suppressor genes Cell signaling genes ○ A sore that does not heal Tumor causes impaired circulation and DNA repair genes Cell cycle checkpoint oxygenation in the area leading to tissue genes necrosis, ulceration, bleeding, and infection. Cell cycle checkpoint genes ○ Usual bleeding or discharge Caused by impaired circulation and Cellular senescence oxygenation in the area leading to tissue genes necrosis, ulceration, erosion of capillaries in the affected area causes bleeding and Cellular differentiation infection resulting in unusual discharge. genes ○ Thickening or lump in breast or elsewhere May signify abnormal cellular growth Metastasis/invasion ○ Indigestion or difficulty in breathing genes Usual initial manifestation of gastric Carcinogen cancer. ○ Activating genes ○ Obvious change in wart or mole ○ Deactivating genes Sudden growth in size of wart or mole, uneven coloring, change in the texture may signify transformation into cancerous lesions. ○ Nagging cough or hoarseness Signify cancer of the larynx or cancer of the lungs. ○ Unexplained anemia The cancer cells take up iron faster than the normal cells. Bleeding contributes to anemia Cancer cells tend to destroy normal RBC CHAVEZ, ROALES, DUCAY, PORTE 9 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 ○ Sudden unexplained weight loss Due to excessively rapid metabolism caused by the cancer cells. Rapid metabolism is caused by rapid multiplication of the cancer cells. CAUTION US SIGNS AND SYMPTOMS LOCAL SYMPTOMS Are restricted to the site of the primary cancer. Can include lumps or swelling (tumor), hemorrhage (bleeding from the skin, mouth or anus), ulceration and pain. Although local pain commonly occurs in advanced cancer, the initial swelling is often painless. METASTATIC SYMPTOMS Due to the spread of cancer to other location in the body ○ Lymphadenopathy ○ Hepatomegaly ○ Splenomegaly ○ Pain or fractures ○ Neurological symptoms SYSTEMIC SYMPTOMS Occur due to distant effects of the cancer that are not related to direct or metastatic spread. Weight loss, poor appetite, cachexia, night sweats, anemia CHAVEZ, ROALES, DUCAY, PORTE 10 of 59 The CNSC does not intend to substitute learning materials provided by the College and its faculty. Use at your own discretion. NUR 131: MEDICAL-SURGICAL TERM RELEASE 1 - NR NUR 131 - BSN 35 NURSING 1 MANAGEMENT Determine pain history (location of pain, frequency, duration, and intensity using numeric rating scale OUTLINE (0–10 scale), or verbal rating scale (“no pain” to A. Physiologic Nursing Care “excruciating pain”) and relief measures used. a. Acute Pain Believe the patient's report. b. Altered Nutrition: Less than Body Determine timing or precipitants of “breakthrough” Requirements pain when using around-the clock agents, whether c. Risk for Fluid Volume Deficit oral, IV, or patch medications. d. Fatigue Evaluate and be aware of painful effects of e. Risk for Infection particular therapies (surgery, radiation, f. Risk for Impaired Oral Mucous Membrane chemotherapy, biotherapy). Provide information to g. Risk for Impaired Skin Integrity patients and SO about what to expect. h. Risk for Constipation/Diarrhea Provide non-pharmacological comfort measures i. Risk for Altered Sexuality (massage, repositioning, backrub) and diversional B. Psychosocial Nursing Care activities (music, television) a. Anticipatory Grieving Encourage use of stress management skills or b. Situational Low Self-Esteem complementary therapies (relaxation techniques, c. Risk for Altered Family Process visualization, guided imagery, biofeedback, d. Fear/Anxiety laughter, music, aromatherapy, and therapeutic C. Spiritual Nursing Care touch). a. Spiritual Care Provide cutaneous stimulation (heat or cold, massage). PHYSIOLOGIC NURSING CARE Be aware of barriers to cancer pain management ACUTE PAIN related to patients, as well as the healthcare system. Unpleasant sensory and emotional experience Evaluate pain relief and control at regular intervals. arising from actual or potential tissue damage or Adjust medication regimen as necessary. described in terms of such damage. Inform patient and SO of the expected therapeutic Sudden or slow onset of any intensity from mild to effects and discuss management of side effects severe with anticipated or predictable end and a Discuss use of additional alternative or duration of 50-80 cc/min ○ Any clothes or sheets that have body fluids on ○ Adequate hydration = UO > 120cc/hr them should be washed in your washing ○ Diuretics = Furosemide or mannitol machine — not by hand. Wash them twice in hot water with regular laundry detergent. Do not NURSING MANAGEMENT wash them with other clothes. If they cannot be Prevent infection washed right away, seal them in a plastic bag. Prevent bleeding ○ If using throw-away adult diapers, underwear, or Minimize fatigue sanitary pads, seal them in plastic and throw Promote nutrition/hydration them away with your regular trash. Minimize stomatitis Strengthening coping with altered body image CHEMOTHERAPY SIDE EFFECTS Although chemotherapy is given to kill cancer cells, it also damages normal cells. The normal cells most likely to be damaged are those that divide rapidly, for instance: ○ Bone marrow/blood cells ○ Cells of hair follicles ○ Cells lining the digestive tract ○ Cells lining the reproductive tract COMPLICATIONS FROM CHEMOTHERAPY GI disturbances (N/V, diarrhea) Local reaction = injection site reactions (phlebitis, edema, pain, cellulitis, necrosis if extravasated) Mucositis /Stomatitis Alopecia Hypersensitivity reactions (itchiness, urticaria, Sob, Chest Pain, Abdominal pain, feeling of impending doom) Neurologic Toxicity ○ areflexia, paresthesia, burning or freezing pain, loss of DTRs, tingling sensations Hepatotoxicity ○ fatty liver, cirrhosis Cardiac toxicity-ECG changes ○ ST-T wave changes, Arrhythmias, CHF Pulmonary toxicity ○ cough, chest pain TOXIC EFFECTS Hematologic toxicity - severe bone marrow depression ○ leukopenia (