Cancer Basics
This process describes the transformation of a normal cell into a malignant cell.
What is carcinogenesis (oncogenesis)?
A neutropenic patient has a temperature of 100.8°F.
What is the nurse's FIRST action?
Notify the provider immediately and begin neutropenic fever protocol.
Which blood cell count places the patient at greatest risk for infection?
Neutrophils (ANC)
This emergency commonly develops after chemotherapy rapidly destroys many cancer cells.
Tumor Lysis Syndrome
A patient receiving chemotherapy asks,
"Can I eat sushi?"
How do you respond?
No. Avoid raw foods during neutropenia.
This stage of carcinogenesis involves the first irreversible genetic mutation.
What is initiation?
During chemotherapy the patient suddenly reports burning at the IV site.
What is your FIRST action?
Stop the chemotherapy infusion immediately.
This chemotherapy side effect causes painful mouth ulcers.
Mucositis
This electrolyte imbalance is commonly seen in Tumor Lysis Syndrome.
Hyperkalemia
(accept hyperphosphatemia or hypocalcemia)
A platelet count of 15,000 requires which nursing precautions?
Bleeding precautions.
Cancer cells spread to distant organs through this process.
What is metastasis?
A patient receiving chemotherapy suddenly develops facial swelling, neck vein distention, and shortness of breath.
What complication is occurring?
Superior vena cava syndrome.
This side effect causes numbness and tingling of the hands and feet.
Peripheral neuropathy
The priority nursing intervention for suspected sepsis in a chemotherapy patient.
Obtain cultures and administer broad-spectrum antibiotics rapidly.
A patient receiving radiation says, "My skin is peeling."
What is your priority nursing intervention?
Assess skin integrity and reinforce proper radiation skin care.
A patient has breast cancer that has spread to the bones. The cancer is still classified as this.
What is metastatic breast cancer?
A chemotherapy patient develops severe back pain followed by leg weakness.
What complication should the nurse suspect?
Spinal cord compression.
Name three nursing interventions for radiation dermatitis.
Which laboratory value is most concerning?
A: Platelets 150,000
B: ANC 250
C: Hgb 10.2
D: Calcium 8.9
ANC 250
A chemotherapy patient reports increasing fatigue.
The CBC reveals: Hgb 7.8
What complication is occurring?
Anemia
Explain the difference between grading and staging.
Grading describes how abnormal the cancer cells look.
Staging describes how far the cancer has spread.
A chemotherapy patient has: K=6.5
Peaked T waves
Urine output=15 mL/hr
What is the priority?
Treat hyperkalemia from Tumor Lysis Syndrome and place on cardiac monitor.
Which chemotherapy drug complication causes tissue necrosis when the medication leaks into surrounding tissue?
Extravasation
Name four oncologic emergencies discussed in this chapter.
The patient with leukemia suddenly develops:
Temp 102°F
BP 82/46
HR 134
RR 32
What are your FIRST three nursing interventions?
Notify provider/Rapid Response
Obtain cultures
Begin broad-spectrum IV antibiotics and IV fluids (per orders/protocol)