ONCOLOGY NURS EXAM STUDY GUIDE A+
Advance directives:
People have the right to determine the care they want to be provided or not
provided in the event they become incapacitated. Patients should be provided
information upon admission into the hospital. Most ads have a POA designated. POA is
over medical and financial, these should be represented by two people one for the
medical and one for the financial.
A POA does not make decisions unless the patient is not able to do three things
(receive information, evaluate/deliberate, communicate).
A living will be part of an AD. DNR is when you don’t resuscitate.
Religion
Judaism (OD): These patients when ill should not be left alone. Autopsies are not
allowed.
Islam: Death is seen as the beginning of a new/better life. Everybody has an appointed
time to die. Upon death: eyes should be closed, and the body covered. Contact the
mosque to perform bathing rituals.
Spirituality
When a patient is dying, we should always let the family in, and not limit visitors in this
situation.
H vs P
Hospice: Less than 6mo to live. Care is by RNs, social workers, and chaplains. Care is when
treatment is stopped. Doesn’t hasten/postpone death but relieves the symptoms/provides
comfort.
Palliative: Not specified with a time limit. Provided by HCP/NP with follow-up visits.
Post Mortem Care
When providing PMC, you treat the patient as if they are still alive. Ask the family to
participate if they wish. No autopsy = remove all tubes/lines. Close patients’ eyes.
Dentures? put them in. Straighten the patient. Place a pillow under the head. Allow
family in the room to perform religious customs if they wish. Signed death certificate.
Contact morgue/funeral home.
Euthanasia
, Nurses should never participate in active or physician-assisted.
Withdrawing/Withholding life-sustaining: this does not directly cause the patient’s
death, “allowing natural death”.
Active euthanasia (voluntary- patient’s wishes/involuntary- without patient consent).
Physician-assisted suicide: The physician provides the means to a patient with
the knowledge that the patient is going to use it for suicide.
Breakthrough pain
• Give opioids (morphine, hydrocodone)
Patho(Stages):
i. Benign: harmless (moles, skin tags, nasal polyps)
ii. Malignant: serious, will lead to death without intervention. ()
iii. Cancer can develop from one single cell.
iv. Initiation: change in gene expression, penetrates the nucleus and mutates the
DNA.
v. Promotion: promoters enhance the growth of the abnormal cell.
vi. Progression: This is when the cell gets its blood supply which makes a tumor.
The cells clump together and stay together when they are multiplying, unlike
a normal cell that multiplies and divides.
vii. Metastasis: This is when cells break off the original group and move to another
location. Ex. The lungs are where it initially begins but breaks off and moves to
the brain; however, when this happens what is the type of cancer? The cancer
is still lung cancer because that is the original place it that made. So, if you have
lung cancer that metastases to the brain it wouldn’t be brain cancer it would
still be lung cancer even though it’s in the brain too. Bloodborne metastasis is
most common it’s when the cancer cells travel in the blood to another location.
Causes of carcinogenesis
i. The single most preventable source is smoking.
ii. Others: radiation (UV-from the sun, tanning bed. Ionizing- found in
natural elements). Chronic irritation, dietary (low fiber, high red/animal
meat intake).
iii. Aging (>60), immunosuppressed, AIDS.
iv. African Americans have a higher incidence than Caucasian people.
Caution
i. C: change in bowel/bladder
Advance directives:
People have the right to determine the care they want to be provided or not
provided in the event they become incapacitated. Patients should be provided
information upon admission into the hospital. Most ads have a POA designated. POA is
over medical and financial, these should be represented by two people one for the
medical and one for the financial.
A POA does not make decisions unless the patient is not able to do three things
(receive information, evaluate/deliberate, communicate).
A living will be part of an AD. DNR is when you don’t resuscitate.
Religion
Judaism (OD): These patients when ill should not be left alone. Autopsies are not
allowed.
Islam: Death is seen as the beginning of a new/better life. Everybody has an appointed
time to die. Upon death: eyes should be closed, and the body covered. Contact the
mosque to perform bathing rituals.
Spirituality
When a patient is dying, we should always let the family in, and not limit visitors in this
situation.
H vs P
Hospice: Less than 6mo to live. Care is by RNs, social workers, and chaplains. Care is when
treatment is stopped. Doesn’t hasten/postpone death but relieves the symptoms/provides
comfort.
Palliative: Not specified with a time limit. Provided by HCP/NP with follow-up visits.
Post Mortem Care
When providing PMC, you treat the patient as if they are still alive. Ask the family to
participate if they wish. No autopsy = remove all tubes/lines. Close patients’ eyes.
Dentures? put them in. Straighten the patient. Place a pillow under the head. Allow
family in the room to perform religious customs if they wish. Signed death certificate.
Contact morgue/funeral home.
Euthanasia
, Nurses should never participate in active or physician-assisted.
Withdrawing/Withholding life-sustaining: this does not directly cause the patient’s
death, “allowing natural death”.
Active euthanasia (voluntary- patient’s wishes/involuntary- without patient consent).
Physician-assisted suicide: The physician provides the means to a patient with
the knowledge that the patient is going to use it for suicide.
Breakthrough pain
• Give opioids (morphine, hydrocodone)
Patho(Stages):
i. Benign: harmless (moles, skin tags, nasal polyps)
ii. Malignant: serious, will lead to death without intervention. ()
iii. Cancer can develop from one single cell.
iv. Initiation: change in gene expression, penetrates the nucleus and mutates the
DNA.
v. Promotion: promoters enhance the growth of the abnormal cell.
vi. Progression: This is when the cell gets its blood supply which makes a tumor.
The cells clump together and stay together when they are multiplying, unlike
a normal cell that multiplies and divides.
vii. Metastasis: This is when cells break off the original group and move to another
location. Ex. The lungs are where it initially begins but breaks off and moves to
the brain; however, when this happens what is the type of cancer? The cancer
is still lung cancer because that is the original place it that made. So, if you have
lung cancer that metastases to the brain it wouldn’t be brain cancer it would
still be lung cancer even though it’s in the brain too. Bloodborne metastasis is
most common it’s when the cancer cells travel in the blood to another location.
Causes of carcinogenesis
i. The single most preventable source is smoking.
ii. Others: radiation (UV-from the sun, tanning bed. Ionizing- found in
natural elements). Chronic irritation, dietary (low fiber, high red/animal
meat intake).
iii. Aging (>60), immunosuppressed, AIDS.
iv. African Americans have a higher incidence than Caucasian people.
Caution
i. C: change in bowel/bladder
