nur-410- geriatrics-
final-exam-cancer-
overview-and-nursing-
care-notes
o Cancer
o Metastasis = Cancers may start in one location and spread
o Cell changes in order: hyperplasia, dysplasia, carcinoma in situ
- Hyperplasia = increased number of cells
- Dysplasia = abnormal cells present
- Carcinoma in situ = group of abnormal cells in one area
o Malignant cells:
- Mutated and grow faster than healthy cells.
- Don’t die (avoid apoptosis) and keep reproducing.
- Can spread to other areas.
- Create their own blood supply (angiogenesis) to survive and grow.
o Findings:
- Nausea
- Decreased appetite (GI)
- Constipation (GI)
- Lymphedema
▪ Nursing Intervention
1. Elevate
2. Apply pressure garments
3. Avoid BP taken on affected area
- Hypercalcemia (above 10.5mg)
- Myeloma (WBCs)
o Lab test:
- Imaging test
- Biopsies
- Tumor Markers
• BRCA1 = gene mutation (breast)
pg. 1
, • BRCA2 = gene mutation (breast)
• PSA = tumor marker for prostate
o TNM (tumor, node, metastasis) is the most commonly used staging system.
- T = size and extent of the primary tumor
- N = number of nearby lymph nodes that show cancer
- M = whether the cancer has metastasized
o Breast Cancer
o Types:
- Situ (non-invasive) = begin in milk duct & hasn’t spread
- Ductal (invasive; most common) = lobes, nipples, OR elsewhere
o Manifestations:
- A lump or mass in the breast (1st early detection).
- Swelling, nipple discharge, or retraction.
- Skin changes (like orange peel texture).
- Pain and swollen lymph nodes (underarm or collarbone).
o Lab Testing
- Mammograms
- Clinical Breast exam
- Self exam
- HER2/neu = proteins larger than normal
o Treatment:
- Lumpectomy: Removal of a benign mass or cancerous tumor while preserving
breast tissue.
- Quadrantectomy: Removal of a portion of the breast with the tumor.
- Mastectomy: Removal of one or both breasts. A simple mastectomy removes
only breast tissue, while a modified radical mastectomy removes breast tissue,
skin, and axillary lymph nodes.
- Radiation therapy is often used for larger tumors, those invading the chest wall
or skin, or those spreading to lymph nodes. It may be delivered through
external beam radiation or brachytherapy.
pg. 2
, - Chemotherapy is commonly used and typically delivered in cycles over 3-6
months: cyclophosphamide, methotrexate, 5-fluorouracil (CMF), doxorubicin,
and epirubicin.
- Hormone therapy is used for hormone-receptor-positive breast cancer.
Tamoxifen blocks estrogen receptors on cancer cells, while aromatase
inhibitors reduce estrogen production.
- Targeted therapy targets HER2/neu-positive cancers, using monoclonal
antibodies to attack the HER2 protein, often combined with chemotherapy.
- Vitamin D and tamoxifen to reduce the risk of breast cancer
o Risk Factors:
- Family history of breast cancer
- BRCA1 and BRCA2 gene mutations
- Personal history of breast cancer
- High estrogen levels
- Early menarche
- Late menopause
- Obesity
- Alcohol consumption
- Radiation exposure
o Breast cancer Screening
¨ Females 20-39: Clinical breast exam (CBE) every 3 years.
¨ Females 40-54: Annual mammogram.
¨ Females 40-44: Option to start annual mammograms.
¨ Females 55+: Option for mammogram every 1-2 years.
¨ High-risk or breast changes: Screen earlier, more frequently, and include MRI.
¨ Males at increased risk: Discuss screening with provider
o Adenocarcinoma
o Starts in glandular tissues, which produce and secrete substances like mucus,
digestive juices, and hormones.
pg. 3
, o Types:
- Lung Adenocarcinoma: Originates in airway glands; smoking is a major risk
factor. Diagnosed via chest X-ray, CT scans, and biopsies.
i. Nursing Care:
1. Assess for respiratory distress
2. Administer oxygen as prescribed
3. Manage chest tubes if present following surgery
- Colon Adenocarcinoma: Starts as a polyp; early detection through
colonoscopy is key. Treatment may involve surgery, chemotherapy, and
radiation.
i. Nursing Care:
1. Monitor for bowel function
2. Manage ostomy care if present
3. Educate the client about dietary modifications.
- Pancreatic Adenocarcinoma: Aggressive cancer, often diagnosed late.
Diagnosed with imaging and biopsy; treatment focuses on palliation.
i. Nursing Care:
1. Manage pain effectively
2. Provide nutritional support through enteral
feedings or
TPN
3. Monitor blood glucose levels.
- Liver Adenocarcinoma: Can be primary or metastatic. Diagnosed with
biopsy, imaging, and blood tests; treatment depends on cancer stage.
i. Nursing Care:
1. Observe for signs of bleeding
2. Manage ascites if present
3. Administer blood products as prescribed
o Pancreatic Cancer
o Diagnosed in late stages after liver or gall bladder involvement.
- Usually adenocarcinoma
o Expected Findings:
- Boring back and abdominal pain
pg. 4
final-exam-cancer-
overview-and-nursing-
care-notes
o Cancer
o Metastasis = Cancers may start in one location and spread
o Cell changes in order: hyperplasia, dysplasia, carcinoma in situ
- Hyperplasia = increased number of cells
- Dysplasia = abnormal cells present
- Carcinoma in situ = group of abnormal cells in one area
o Malignant cells:
- Mutated and grow faster than healthy cells.
- Don’t die (avoid apoptosis) and keep reproducing.
- Can spread to other areas.
- Create their own blood supply (angiogenesis) to survive and grow.
o Findings:
- Nausea
- Decreased appetite (GI)
- Constipation (GI)
- Lymphedema
▪ Nursing Intervention
1. Elevate
2. Apply pressure garments
3. Avoid BP taken on affected area
- Hypercalcemia (above 10.5mg)
- Myeloma (WBCs)
o Lab test:
- Imaging test
- Biopsies
- Tumor Markers
• BRCA1 = gene mutation (breast)
pg. 1
, • BRCA2 = gene mutation (breast)
• PSA = tumor marker for prostate
o TNM (tumor, node, metastasis) is the most commonly used staging system.
- T = size and extent of the primary tumor
- N = number of nearby lymph nodes that show cancer
- M = whether the cancer has metastasized
o Breast Cancer
o Types:
- Situ (non-invasive) = begin in milk duct & hasn’t spread
- Ductal (invasive; most common) = lobes, nipples, OR elsewhere
o Manifestations:
- A lump or mass in the breast (1st early detection).
- Swelling, nipple discharge, or retraction.
- Skin changes (like orange peel texture).
- Pain and swollen lymph nodes (underarm or collarbone).
o Lab Testing
- Mammograms
- Clinical Breast exam
- Self exam
- HER2/neu = proteins larger than normal
o Treatment:
- Lumpectomy: Removal of a benign mass or cancerous tumor while preserving
breast tissue.
- Quadrantectomy: Removal of a portion of the breast with the tumor.
- Mastectomy: Removal of one or both breasts. A simple mastectomy removes
only breast tissue, while a modified radical mastectomy removes breast tissue,
skin, and axillary lymph nodes.
- Radiation therapy is often used for larger tumors, those invading the chest wall
or skin, or those spreading to lymph nodes. It may be delivered through
external beam radiation or brachytherapy.
pg. 2
, - Chemotherapy is commonly used and typically delivered in cycles over 3-6
months: cyclophosphamide, methotrexate, 5-fluorouracil (CMF), doxorubicin,
and epirubicin.
- Hormone therapy is used for hormone-receptor-positive breast cancer.
Tamoxifen blocks estrogen receptors on cancer cells, while aromatase
inhibitors reduce estrogen production.
- Targeted therapy targets HER2/neu-positive cancers, using monoclonal
antibodies to attack the HER2 protein, often combined with chemotherapy.
- Vitamin D and tamoxifen to reduce the risk of breast cancer
o Risk Factors:
- Family history of breast cancer
- BRCA1 and BRCA2 gene mutations
- Personal history of breast cancer
- High estrogen levels
- Early menarche
- Late menopause
- Obesity
- Alcohol consumption
- Radiation exposure
o Breast cancer Screening
¨ Females 20-39: Clinical breast exam (CBE) every 3 years.
¨ Females 40-54: Annual mammogram.
¨ Females 40-44: Option to start annual mammograms.
¨ Females 55+: Option for mammogram every 1-2 years.
¨ High-risk or breast changes: Screen earlier, more frequently, and include MRI.
¨ Males at increased risk: Discuss screening with provider
o Adenocarcinoma
o Starts in glandular tissues, which produce and secrete substances like mucus,
digestive juices, and hormones.
pg. 3
, o Types:
- Lung Adenocarcinoma: Originates in airway glands; smoking is a major risk
factor. Diagnosed via chest X-ray, CT scans, and biopsies.
i. Nursing Care:
1. Assess for respiratory distress
2. Administer oxygen as prescribed
3. Manage chest tubes if present following surgery
- Colon Adenocarcinoma: Starts as a polyp; early detection through
colonoscopy is key. Treatment may involve surgery, chemotherapy, and
radiation.
i. Nursing Care:
1. Monitor for bowel function
2. Manage ostomy care if present
3. Educate the client about dietary modifications.
- Pancreatic Adenocarcinoma: Aggressive cancer, often diagnosed late.
Diagnosed with imaging and biopsy; treatment focuses on palliation.
i. Nursing Care:
1. Manage pain effectively
2. Provide nutritional support through enteral
feedings or
TPN
3. Monitor blood glucose levels.
- Liver Adenocarcinoma: Can be primary or metastatic. Diagnosed with
biopsy, imaging, and blood tests; treatment depends on cancer stage.
i. Nursing Care:
1. Observe for signs of bleeding
2. Manage ascites if present
3. Administer blood products as prescribed
o Pancreatic Cancer
o Diagnosed in late stages after liver or gall bladder involvement.
- Usually adenocarcinoma
o Expected Findings:
- Boring back and abdominal pain
pg. 4
