Cancer Basics
What is the difference between benign and malignant tumors?
List 2 differences.
Benign tumors are non-cancerous and do not spread, while malignant tumors are cancerous and can invade other tissues
What type of radiation therapy involves implanting radioactive seeds near the tumor?
Brachytherapy
What is the main cause of anemia in chronic kidney disease?
Reduced erythropoietin production.
Name a symptom of superior vena cava syndrome (SVCS).
Facial edema, Jugular vein distention (JVD)
Which medication is used to reduce uric acid levels in tumor lysis syndrome?
Allopurinol.
What does the acronym "CAUTION" stand for in cancer warning signs?
Change in bowel or bladder habits, A sore that does not heal, Unusual bleeding or discharge, Thickening or lump, Indigestion or difficulty swallowing, Obvious change in a wart or mole, Nagging cough or hoarseness.
*also weight loss!
Thoroughly explain the term “nadir” in chemotherapy and what occurs.
The lowest point of white blood cell count, typically occurring 7–10 days after treatment.
Monitor for infection!
What is pancytopenia?
A deficiency of red blood cells, white blood cells, and platelets.
What electrolyte imbalance occurs in tumor lysis syndrome?
Hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia.
What is the priority intervention for a patient presenting with spinal cord compression due to metastatic cancer?
Immediate administration of corticosteroids (e.g., dexamethasone) to reduce inflammation and prevent further neurological damage.)
Which diagnostic test identifies cancer at the cellular level?
Biopsy
How does extravasation of vesicant chemotherapy agents occur, and what are the immediate nursing actions?
Extravasation occurs when vesicants leak into surrounding tissue, causing necrosis. Immediate actions include stopping the infusion, aspirating remaining drug, and administering antidotes.
Identify one key nursing intervention for a patient with thrombocytopenia.
Avoid invasive procedures to reduce the risk of bleeding.
What are 3 key teaching points to educate your client on at discharge for effectively managing their anemia at home?
1. Encourage foods rich in iron (e.g., red meat, poultry, fish, leafy greens, beans) and foods high in vitamin C (e.g., oranges, strawberries, bell peppers) to enhance iron absorption.
2. Warn about common side effects like dark stools, constipation, or nausea, and suggest increasing fluid and fiber intake to prevent constipation.
3. Take prescribed iron supplements on an empty stomach for better absorption.
What are 4 important nursing considerations for external beam radiation.
1. Do not wash off marks of the body
2. Wear loose-fitting cotton clothing
3. Do not use heat or ice.
4. No perfume, medicated lotion, powder, deodorant, etc.
5. Monitor the skin where the radiation has been focused.
What are the two primary differences between hospice and palliative care, specifically in terms of time and focus?
1. Hospice care is provided when a patient is expected to have six months or less to live, whereas palliative care can be offered at any stage of a serious illness, even alongside curative treatments.
2. Hospice care focuses on comfort and quality of life without curative treatment, while palliative care focuses on symptom management and improving the patient's quality of life regardless of the stage of illness or whether curative treatments are being pursued.
A patient undergoing external beam radiation for head and neck cancer complains of mucositis. What nursing interventions can help alleviate symptoms?
List 3 minimum.
Use a saline rinse, avoid spicy or acidic foods, apply topical anesthetics, and encourage good oral hygiene.
Describe how polycythemia vera increases the risk of both bleeding and thrombosis.
Elevated red blood cells and platelets increase blood viscosity and clot formation, but dysfunctional platelets also impair clotting, leading to bleeding.
Patient's experiencing hypercalcemia (metabolic emergency) likely have what condition?
Hypercalcemia in cancer pts is often due to Bone Mets (especially in breast, lung, or prostate cancers), or secretion of the PTH due to a tumor (increasing blood Ca+ levels).
What is a lab value that would be present for a patient ordered filgrastim?
Give a specific number that would indicate the need for filgrastim.
WBC, ANC (Neutrophils)
*Give filgrastim if ANC is less than 1,000!
What is the most important nursing action for effectively managing cancer pain?
Thorough PAIN ASSESSMENT
Describe 4 nursing considerations for clients undergoing brachytherapy.
-Wear film badge always
-Limit visits to 30 mins (visitors also)
-No pregnant women or children
-Cluster care for minimal exposure
-6 ft apart
Platelet counts below this level significantly increase the risk of spontaneous bleeding, requiring immediate intervention in cancer patients.
20,000
List the priority interventions for each oncologic emergency:
1. Spinal Cord Compression
2. Superior Vena Cava Syndrome
3. Hypercalcemia
4. Tumor Lysis Syndrome
1. Give high dose corticosteroids, radiation, decompressive surgery.
2. Radiation, chemotherapy, place in high fowler
3. Administer bisphosphonates (*Zoledronic acid)
4. Increase hydration, allopurinol
A patient receiving filgrastim therapy for neutropenia asks about possible side effects. What is a common adverse effect of filgrastim, and how should the nurse monitor for it?
A common adverse effect of filgrastim is bone pain, which occurs due to the rapid increase in neutrophil production. The nurse should assess the patient for signs of pain, and consider administering analgesics if necessary. The nurse should also monitor the white blood cell (WBC) count and assess for splenomegaly.