NURS 372 EXAM 1 QUESTIONS AND CORRECT ANSWERS,
WITH COMPLETE SOLUTION.
Causes of Cancer
1. Age (increased risk for people over 65)
2. Gender (more cancers deaths in men than women per year)
3. Geographic location
4. Genetics (accounts for 15% of cancers. Cancers with familial relationships include
breast, colon, lung, ovarian, and prostate)
5. Immune disturbance (viruses increase risk: Epstein-Barr, herpes, papillomavirus, hep
B, cytomegalovirus (CMV))
6. Chemical agents (exposure to carcinogens)
7. Race (higher rates of cancer in African Americans)
8. Tobacco, Alcohol, Diet
What is the best test to confirm cancer?
Biopsies; make sure to know med hx beforehand and if on blood thinners
Primary Prevention of Cancer
- Avoid/Limit tobacco & alcohol use
- Fight off Infections (HPV, HIV, H. Pylori)
- Limit UV radiation & use sunscreen
- Achieve and maintain a healthy weight throughout life
- adequate rest
- learn and practice self exams
- reduce stress
- have regular leisure/relaxation time
- Adopt a physically active lifestyle.
- Consume a healthy, balanced diet with an emphasis on plant food
Breast Cancer Screenings
- Women 45 - 54 y/o = mammography screening
- Can start at 40 y/o if fly hx
- 55+ = biennial screening
Cervical Cancer Screening
- Women 21 - 65 y/o = PAP screen q 3 yrs
- Women 30 - 65 y/o = PAP + HPV screening (preferred)
- Women 66+ y/o = can choose not to get PAP
Endometrial Cancer Screening
- watch for menopausal bleeding
Prostate Cancer Screenings
- Screening not routinely recommended
- Men > 50 y/o with 10+ year life expectancy
- Digital rectal exam and PSA
Testicular Cancer Screenings
- Can occur at any age; commonly dx: 20 - 34y/o
- self-exams!!!
Colorectal Cancer Screenings
,- Screening begins @ 50 y/o for average risk
- Non-invasive exams (Fecal Occult Blood test (FOBT), fecal immunochemical test
(FIT), Stool DNA)
- Home testing recommended
- Various endoscopic exams (Flex sig q 5 years), colonoscopy q 10 years)
Lung Cancer Screenings
- Smokers w/ 30 pack-year HX (quit 15 yrs to be a non smoker)
- LDCT (low dose helical CT scan)- expensive and not done often
CAUTION
C - hange in bowel or bladder habits
A - sore that does not heal
U - nusual bleeding or discharge from any body orifice
T - hickening or a lump in the breast or elsewhere
I - ndigestion or difficulty in swallowing
O- bvious change in a wart or mole
N - agging cough or hoarseness
Clinical Staging Classification System of Cancer
Stage 0: Cancer in situ
Stage I: Tumor limited to the tissue of origin; localized tumor growth
Stage II: Limited local spread
Stage III: Extensive local and regional spread
Stage IV: Metastasis
Benign Tumors vs Malignant Tumors
Benign: well differentiated; usually encapsulated; metastasis is absent; rarely recur
Malignant: range from well differentiated to undifferentiated; able to metastasize;
frequent recurrence; rarely encapsulated; moderate to marked vascularity
How many years until considered cancer free?
5 yrs
Goal of Cancer Treatments
- Cure (surgery)
- Control (debulking/cytoreductive procedure, chemo, radiation)
- Comfort (Palliative)
Neoadjuvant therapy
administration of therapeutic agents before a main treatment (hormone therapy prior to
radical radiotherapy for adenocarcinoma of the prostate)
Adjuvant therapy
therapy that is given in addition to the primary, main, or initial therapy to maximize its
effectiveness; modifies the effect of another agent (marijuana TX in conjunction with
opioids for pain management)
Cancer Treatment: Chemo
- Action: Use of chemicals given as a systemic therapy for cancer; mainstay for most
solid tumors and hematologic cancers; can offer cure, control, or palliative care; cannot
distinguish between normal and cancer cells
- Implications: may pose an occupational hazard (drugs may be absorbed through skin,
inhalation, during preparation, transportation, and administration); only properly trained
, personnel should handle drugs; monitor and report infection or bleeding
- Methods of Admin: Oral, IM, IV (most common), Intracavitary, Intrathecal, Intraarterial
Central vascular access device (VAD) administration
placement in large blood vessels; frequent, continuous, or intermittent administration;
can be used to administer other fluids (blood, electrolytes, etc.)
Regional Administration of Chemo
delivery of drug directly into tumor site; higher concentrations of drug can be delivered
with less systemic toxicity; delivery methods are intraarterial, intraperitoneal, intrathecal,
and intravesical
Intraarterial Chemotherapy
delivers drug through arteries supplying tumor; method has been used for the treatment
of osteogenic sarcoma, cancers of the head and neck, bladder, brain, and cervix,
melanoma, primary liver cancer, and metastatic liver disease
Intraperitoneal Chemotherapy
delivers drug to peritoneal cavity for treatment of peritoneal metastases; chemotherapy
is generally infused into the peritoneum in 1 to 2 L of fluid and allowed to "dwell" in the
peritoneum for a period of 1 to 4 hours; following the "dwell time," the fluid is drained
from the peritoneum.
Intrathecal or Intraventricular Chemotherapy
Involves lumbar puncture and injection of chemotherapy into subarachnoid space
Intravesical Bladder Chemotherapy
Agent added to bladder by urinary catheter and retained for 1 to 3 hours
Management of Cancer Pain
- Drug options for pain management (Morphine, Dilaudid); think about addiction
- Analgesics taken on a scheduled basis - with additional doses for breakthrough pain
- Relaxation therapy and imagery
Management of Cancer Treatment Related Nausea
- prophylactic administration of antiemetics (Zofran)
- avoid offending odors
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- tell caregiver to avoid eating in front of pt who is on chemo
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements (cold foods, bland foods,
avoid spicy)
Management of Cancer Treatment Related Diarrhea
- increase fluids
- OTC Imodium (antidiarrheals)
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements
Management of Cancer Treatment Related Mucositis
- Use saliva substitutes or drink water frequently
- Choose soft, nonirritating, high-protein, high-calorie foods
WITH COMPLETE SOLUTION.
Causes of Cancer
1. Age (increased risk for people over 65)
2. Gender (more cancers deaths in men than women per year)
3. Geographic location
4. Genetics (accounts for 15% of cancers. Cancers with familial relationships include
breast, colon, lung, ovarian, and prostate)
5. Immune disturbance (viruses increase risk: Epstein-Barr, herpes, papillomavirus, hep
B, cytomegalovirus (CMV))
6. Chemical agents (exposure to carcinogens)
7. Race (higher rates of cancer in African Americans)
8. Tobacco, Alcohol, Diet
What is the best test to confirm cancer?
Biopsies; make sure to know med hx beforehand and if on blood thinners
Primary Prevention of Cancer
- Avoid/Limit tobacco & alcohol use
- Fight off Infections (HPV, HIV, H. Pylori)
- Limit UV radiation & use sunscreen
- Achieve and maintain a healthy weight throughout life
- adequate rest
- learn and practice self exams
- reduce stress
- have regular leisure/relaxation time
- Adopt a physically active lifestyle.
- Consume a healthy, balanced diet with an emphasis on plant food
Breast Cancer Screenings
- Women 45 - 54 y/o = mammography screening
- Can start at 40 y/o if fly hx
- 55+ = biennial screening
Cervical Cancer Screening
- Women 21 - 65 y/o = PAP screen q 3 yrs
- Women 30 - 65 y/o = PAP + HPV screening (preferred)
- Women 66+ y/o = can choose not to get PAP
Endometrial Cancer Screening
- watch for menopausal bleeding
Prostate Cancer Screenings
- Screening not routinely recommended
- Men > 50 y/o with 10+ year life expectancy
- Digital rectal exam and PSA
Testicular Cancer Screenings
- Can occur at any age; commonly dx: 20 - 34y/o
- self-exams!!!
Colorectal Cancer Screenings
,- Screening begins @ 50 y/o for average risk
- Non-invasive exams (Fecal Occult Blood test (FOBT), fecal immunochemical test
(FIT), Stool DNA)
- Home testing recommended
- Various endoscopic exams (Flex sig q 5 years), colonoscopy q 10 years)
Lung Cancer Screenings
- Smokers w/ 30 pack-year HX (quit 15 yrs to be a non smoker)
- LDCT (low dose helical CT scan)- expensive and not done often
CAUTION
C - hange in bowel or bladder habits
A - sore that does not heal
U - nusual bleeding or discharge from any body orifice
T - hickening or a lump in the breast or elsewhere
I - ndigestion or difficulty in swallowing
O- bvious change in a wart or mole
N - agging cough or hoarseness
Clinical Staging Classification System of Cancer
Stage 0: Cancer in situ
Stage I: Tumor limited to the tissue of origin; localized tumor growth
Stage II: Limited local spread
Stage III: Extensive local and regional spread
Stage IV: Metastasis
Benign Tumors vs Malignant Tumors
Benign: well differentiated; usually encapsulated; metastasis is absent; rarely recur
Malignant: range from well differentiated to undifferentiated; able to metastasize;
frequent recurrence; rarely encapsulated; moderate to marked vascularity
How many years until considered cancer free?
5 yrs
Goal of Cancer Treatments
- Cure (surgery)
- Control (debulking/cytoreductive procedure, chemo, radiation)
- Comfort (Palliative)
Neoadjuvant therapy
administration of therapeutic agents before a main treatment (hormone therapy prior to
radical radiotherapy for adenocarcinoma of the prostate)
Adjuvant therapy
therapy that is given in addition to the primary, main, or initial therapy to maximize its
effectiveness; modifies the effect of another agent (marijuana TX in conjunction with
opioids for pain management)
Cancer Treatment: Chemo
- Action: Use of chemicals given as a systemic therapy for cancer; mainstay for most
solid tumors and hematologic cancers; can offer cure, control, or palliative care; cannot
distinguish between normal and cancer cells
- Implications: may pose an occupational hazard (drugs may be absorbed through skin,
inhalation, during preparation, transportation, and administration); only properly trained
, personnel should handle drugs; monitor and report infection or bleeding
- Methods of Admin: Oral, IM, IV (most common), Intracavitary, Intrathecal, Intraarterial
Central vascular access device (VAD) administration
placement in large blood vessels; frequent, continuous, or intermittent administration;
can be used to administer other fluids (blood, electrolytes, etc.)
Regional Administration of Chemo
delivery of drug directly into tumor site; higher concentrations of drug can be delivered
with less systemic toxicity; delivery methods are intraarterial, intraperitoneal, intrathecal,
and intravesical
Intraarterial Chemotherapy
delivers drug through arteries supplying tumor; method has been used for the treatment
of osteogenic sarcoma, cancers of the head and neck, bladder, brain, and cervix,
melanoma, primary liver cancer, and metastatic liver disease
Intraperitoneal Chemotherapy
delivers drug to peritoneal cavity for treatment of peritoneal metastases; chemotherapy
is generally infused into the peritoneum in 1 to 2 L of fluid and allowed to "dwell" in the
peritoneum for a period of 1 to 4 hours; following the "dwell time," the fluid is drained
from the peritoneum.
Intrathecal or Intraventricular Chemotherapy
Involves lumbar puncture and injection of chemotherapy into subarachnoid space
Intravesical Bladder Chemotherapy
Agent added to bladder by urinary catheter and retained for 1 to 3 hours
Management of Cancer Pain
- Drug options for pain management (Morphine, Dilaudid); think about addiction
- Analgesics taken on a scheduled basis - with additional doses for breakthrough pain
- Relaxation therapy and imagery
Management of Cancer Treatment Related Nausea
- prophylactic administration of antiemetics (Zofran)
- avoid offending odors
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- tell caregiver to avoid eating in front of pt who is on chemo
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements (cold foods, bland foods,
avoid spicy)
Management of Cancer Treatment Related Diarrhea
- increase fluids
- OTC Imodium (antidiarrheals)
- assess for signs & symptoms of alkalosis, dehydration, and I & O
- monitor carefully to avoid weight loss
- weigh twice weekly
- recommend small, frequent meals & nutritional supplements
Management of Cancer Treatment Related Mucositis
- Use saliva substitutes or drink water frequently
- Choose soft, nonirritating, high-protein, high-calorie foods
