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Oncology HIV DIC Study Guide Adam
Oncology HIV DIC Study Guide Adam
hyperplasia: tumor cells, growth in size of tissue due to extra cells. (this is cancer)
hypertrophy: enlargement of the tissue due to enlargement of existing cells. (this is not cancer)
anaplsia: less differentiated cells results in less maturity of the cells, which results in increased malignancy
Cancer management:
1. cure: early detection is key
2. control: limit metastases
3. palliation
Surgery is almost always primary treatment, if available.
1. tumor removal
2. prophylactic surgery: removing non-vital tissue that are at a increased risk
3. reconstructive surgery
4. palliative surgery: removing tissue that may affect other vital organs even though cancer is
non-removable
Radiation therapy:
1. Cure, control, palliative
2. External radiation: most common
3. Internal radiation, aka brachytherapy, like implanted seeds. Low does radiation patients remain on bed
rest to make sure not to displace the internal seeds
4. Radiation effects: can be toxic to surrounding tissue:
Fast mitosis cells are more effected by radiation, this is why bone marrow, lymph tissue, hair, GI, and
reproductive organs become effected by radiation.
Well oxygenated tumors are more effected by radiation
Nursing care for patient with radiation therapy:
1. limit visitor activity: cant be within 6 ft, limit time frame ect.
2. no pregnant women
3. wear dosimeters to record level of radiation exposure
Chemotherapy:
agents used to destroy tumor cells that interfere with cellular function and
replication
1. treats mostly systemic disease
2. goals include: cure, control and palliative
3. often used with radiation due to synergistic effects
4. need prolonged treatment for necessary eradication of tumor so patients own immune system may take
over and remove the rest of tumor
5. like radiation, active mitosis type cells are most sensitive to chemo.
6. do not need to know specific drug names that correlate with chemo agent types, so smile.
Administration
1. can be IV or PO
2. problem of extravasation: when the IV blows the vein, huge problem with IV chemo, can cause severe
damage to interstitial tissue.
on test: first thing nurse does is turn off IV if one suspects a blown IV (such as redness, swelling, pain
ect)
3. fluid and electrolyte imbalances: from vomiting, replace as needed.
4. risk for infection
5. Risk for bleeding
6. protection of caregivers
Bone Marrow Transplants: used for hematological cancers (like luekemia) and solid tumors
Types:
1. Allogeneic: outside donor (specific tissue type), destroy all bone marrow first, then replace with
someone elses marrow
2. Autologous: self donation (with a transplant after)
3. Syngeneic: identical twin
Graft versus host disease: number one problem is rejection of new bone marrow from an allogeneic
transplant
Liver dysfunction: number 1 cause of death
Onocoligic Emergencies:
1. Superior vena cava syndrome: tumor occludes SVC, which leads to back up into head
2. spinal cord compression: permanent neurological impairment
3. Pericardial effusion/ cardiac tamponade: from radiation and chemo
4. Syndrome of inappropriate secretion of antidiuretic hormone: from pituitary tumor
5. Tumor lysis syndrome: development of acute renal failure.
Prevention:
1. Standard precautions
2. Safe sex
3. Do not share injection equipment
4. blood screening and treatment of blood products
HIV life cycle: dont need to know the specifics
1. effects the treatment of HIV
2. effective treatment means interrupting this lifecycle at as many places at a time, due to the high mutation
of the disease
3. enzyme immuno assay: detects antibodies against HIV.
4. viral lobe test: detects HIV-RNA in blood plasma
Breast Disorders
Risk factors:
1. female
2. age
Ovarian cancer
Facts:
1. threefold increase risk for breast cancer
2. BRCA-1 gene: increased risk for breast and ovarian cancer
3. BRCA-2 gene: increased risk for male and female breast cancer and ovarian cancer
4. 75% are detected in late stages, because it is deep in cavity and therefore is found late
Risk factors: same as breast cancer . oral contraceptives, however, are a protective measure for ovarian
cancer
Clinical Manifestations:
1. increase abdominal girth
2. pelvic pressure
3. bloating
4. back pain
5. indigestion
6. flatulence
Uterine Cancer
Risk Factors:
1. Age
2. Postmenopausal bleeding
3. Obesity
4. Estrogen therapy: oral contraceptives, HT
5. Nulliparity
6. Late menopause
Testing: annual exam, need to evaluate for irregular bleeding
Medical management:
1. Total abdominal hyterectomy with bilateral salpingo-oopherectomy
2. CA-125: genetic marker
3. Radiation, Chemotherapy, Brachytherapy
Cervical cancer:
Ranked number 3 female cancer
Risk factors:
1. sexual activity
2. HPV
3. HIV
4. smoking
5. low socioeconomic status
6. nutritional deficiencies
7. chronic cervical infection
Prevention: primary intervention is education and smoking cessation
1. pelvic exams
2. eduation
3. smoking cessation
4. HPV immunization
Clinical manifestations:
1. rare to have symptoms in early stage
2. watery thin discharge
3. irregular bleeding
Late stage manifestations:
4. leg pain
5. dysuria
6. rectal bleeding
7. edema of extremities
Medical Management:
For preinvasive: LEEP, conization
Invasive: Brachytherapy (this will be on the test), surgery