Oncology & Hematology PDF

Oncology & Hematology Radiation Monitor pt for infection due to leukopenia Metastasis Common sites: liver, brain, bone, lung, lymph Breast Cancer Modifiable risk factors: alcohol consumption, smoking, sedentary lifestyle, poor diet high in fat Non-modifiable risk factors: BRCA1 & BRCA2...

Oncology & Hematology Radiation Monitor pt for infection due to leukopenia Metastasis Common sites: liver, brain, bone, lung, lymph Breast Cancer Modifiable risk factors: alcohol consumption, smoking, sedentary lifestyle, poor diet high in fat Non-modifiable risk factors: BRCA1 & BRCA2 mutations, having a 1st degree relative with breast cancer, history of uterine cancer, menarche before 12 years old, menopause after 55 years old Exam: check for lumps or hard knots in the shower, under arms and around entire breast area. Examine any changes in the shape of the breast and nipple by looking in the mirror. Perform exam monthly, preferably post menstrual bleeding. If postmenopausal, exam should be done the same date every month. Mammography is helpful in early detection Treatment depends on stage of disease: mastectomy, chemotherapy, radiation, hormonal therapy Post Mastectomy Elevate arm to avoid lymphedema, avoid heavy activity and lifting, do not wear constrictive clothing or get BP reading from affected arm Testicular Cancer Small, hard lump on the front or side of testicle At risk: men whose testes have not dropped into the scrotum or whose testes dropped after age 6 All men 14 years and older should do self exams monthly in the shower Multiple Myeloma Cancer of plasma cells (WBC’s that produce antibodies) Myeloma cells prevent the normal production of antibodies → infection Radioactive Iodine ***FLUSH with at least 3-4 liters/day for 2 days and flush the toilet twice Limit contact with others to 30 minutes/day No pregnant nurses, visitors, and no kids Immunosuppression Most oncologic meds cause immunosuppression → prevention of infection is vital Place pt in private room. Pt should NOT eat raw fruits or vegetables Tumor Lysis Syndrome Tumor cells release their contents into the bloodstream Causes hyperkalemia requires insulin to IV solution to decrease potassium level. *Check blood glucose Thrombocytopenia Place on bleeding precautions Give soft bristled toothbrush Decrease IM meds and do not insert anything (enema or suppositories) Iron Deficiency Anemia Give iron PO with vitamin C or on an empty stomach Iron given IM- Inferon via Ztrack Pernicious Anemia Needs to take Vitamin B12 for LIFE- due to lack of intrinsic factor in the gastric mucosa S/sx: tachycardia, pallor, beefy red tongue Shilling Test- determines how well one absorbs Vit. B12 *If a patient has low hematocrit and/or hemoglobin, assess for signs of bleeding (i.e. dark stools)