Oncology Basics
This diagnostic test uses radioactive glucose to identify cancer activity.
PET scan
What type of radiation therapy involves implanting radioactive seeds near the tumor?
Brachytherapy
This appetite stimulant carries a major NCLEX safety risk requiring monitoring for leg swelling, warmth, and SOB.
What is megestrol (risk of thromboembolism)?
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 7–14 days after treatment.
Monitor for infection!
What is pancytopenia?
A deficiency of red blood cells, white blood cells, and platelets.
This lab pattern is the hallmark of TLS.
What is hyperuricemia + hyperkalemia + hyperphosphatemia + hypocalcemia?
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.)
The provider must be notified immediately when a neutropenic patient has this single clinical finding—even without other symptoms.
What is fever >100.4°F (38°C)?
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. Ice and/or heat, elevate extremity after.
This is the best dietary teaching for neutropenic precautions: “Avoid ____.”
What are raw/undercooked foods and unwashed fruits/vegetables?
Ex. raw sushi / deli meats, unwashed fruits/veggies
This emergency causes hyponatremia with weight gain without edema + neuro symptoms
What is SIADH?
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.
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.
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.
This infiltrative emergency has manifestations including muffled heart sounds.
What is cardiac tamponade?
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).
Cancer spreading to bones causes activation of osteoclasts -> bones break down -> calcium released in bloodstream
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
A chemo patient has platelets of 18,000/mm³. The nurse should question an order for this OTC medication class.
What are NSAIDs (or aspirin)?
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. Place in High fowler's, radiation, chemotherapy
3. Administer bisphosphonates (*Zoledronic acid)
4. Aggressive IV hydration, allopurinol
This client symptom requires immediate follow-up while on epoetin/darbepoetin.
What is chest pain, SOB, unilateral leg swelling, neuro deficits (clot/stroke symptoms)?