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ONCOLOGY NURSING

G0

hibernating cells
Cancer drugs cannot affect this
cycle

Sarcoma
-Cancer of connective tissues
(bones, cartilage, fat)

G1

RNA synthesis (messenger)


DNA component replication

DNA production / Interphase

Lymphoma
-Cancer of lymphocytes
(Hodgkins painless swelling of neck)

G2

Premitotic phase
Gathering in order to reproduce

Myeloma / Leukemia
-Cancer of blood forming cells of
bone marrow (Myeloid)

Cell division / Mitosis (P-M-A-T)

PATHOGENESIS

*Terminally differentiated cells

Cause: UNKNOWN

RAPID

Theories
GI nausea, vomiting, diarrhea
Skin alopecia
Bone marrow bleeding,
anemia, prone to infection

SLOW (S/Sx are slow & late to show)


Reproductive prostate, uterine
Pancreas
*5 YEARS in order to be considered
cancer free
CELL ALTERATION
Hyperplasia increase in cell number
Hypertrophy increase in cell size
Atrophy decrease in cell size
Metaplasia change in form
Dysplasia abnormal maturation
Anaplasia cell is mature but reverted
to immature non-functioning cells
because of carcinogen
Neoplasia new growth
Metastasis ability to infiltrate nearby &
far away structures
CATEGORIES
Carcinoma
-malignant cells from epithelial
cells (lines cavities, structures on top of
connective tissues)

Derangement Theory normal


cell transformed into ugly cells
Failure of immune response

CARCINOGENESIS
>Initiation exposure to risk factors
(Carcinogens- stimulates CA cell
production)
>Promotion genetic change &
increase in cell number. Still looks the
same
>Transformation genetic change.
Looks ugly & bigger
>Progression genetic change, bigger
& uglier & increase in number
PRE-DISPOSING FACTORS
>Age ( incidence in middle adulthood
and elderly )
>Gender
#1 in Men : Prostate
#1 in Women : Breast
>Viruses & Bacteria
HPV Cervical CA
Hep B, C Liver CA
H. pylori Gastric CA
>Precancerous Lesions
>Diet ( Fiber , Fat )
>Obesity ( Endometrial CA )

ONCOLOGY NURSING
>Occupation / Environmental / Physical
Agents ( Stress can cause CA )
>Genetics
>Hormones ( Estrogen Breast CA )
>Geographic location ( Rural areas are
Smog-free)
>Sexual Practices
>Chemical Agents ( Nitrates, Nicotine,
Alcohol)
>Immunocompromised states
TUMOR STAGING
T

extent of primary tumor

regional lymph node metastasis

distant metastasis

CANCER STAGING
0

cancer in situ

tumor limited to the disease of


origin

lymph nodes involvement limited


spread

spread locally & regionally

widespread metastasis

TUMOR
Tx

Cant be assessed

T0

no tumor

Tis

Carcinoma in situ (in its place)

T1-4

up in tumor size & involvement

NODES
Nx

Cant be assessed

N0

no lymph nodes

N1-4

disease in regional

METASTASIS
Mx

Cant be assessed

M0

No metastasis

M1-4

metastasis to areas of the body

DIAGNOSTIC EXAMS
>Papanicolau (Pap) Smear
Vaginal spotting is expected
>Self-Breast Exam
1 week after menstruation OR at
the same day every month for
non-menstruating women
>Clinical Breast Exam
>Mammography
>40 yrs old
Check for density
>Breast Ultrasound
Used to detect abnormalities
found in mammogram
More ACCURATE
>Prostate Exam (Digital Rectal Exam +
PSA)
>40 yrs old
>Digital Rectal Exam (for men)
>Testicular Self Exam (for men)
>Fecal Occult Blood Test (Guiac Test)
Upper GI bleeding
No dark meat 3 DAYS before test
>Sigmoidoscopy / Colonoscopy
Every 1 yr or 2 yrs
>50 yrs old
>Biopsy ( MOST RELIABLE )
>Rapid Frozen Section / Cryosection
OTHERS:
>MRI (MOST ACCURATE)
>CT Scan
>Ultrasound
>Endoscopy

ONCOLOGY NURSING
TUMOR MARKERS
Carcino Embryonic Antigen (CEA)
Indicates recurrence
Effectiveness of Chemotherapy
Elevated in Biliary Disease
Used when there is hyperactivity
in the GI
Alpha Feto Protein (AFP)
Hepatocellular carcinoma
Monitor result of Chemo
Human Chorionic Gonadotropin (HcG)
Produced by placenta, by
embryo
Germ cell tumor : Cellular
differentiation (uterus
choriocarcinoma, testicular CA,
H. Mole)
Bence Jones Protein (in urine)
Produced by neoplastic plasma
cells
Malignant bone marrow CA
(multiple myeloma)
NOT DETECTED in Routine
Urinalysis
Acid Phosphatase enzyme in organs
Prostate Acid Phosphatase
prostate CA
Alkaline Phosphatase
Concentrated in liver bile duct,
kidney, bone, placenta
leukocyte alkaline level
chronic myelogenous leukemia
Beta-2 microglobulin
levels - multiple myeloma,
chronic lymphocytic leukemia
levels - kidney disease, hepatitis
Bladder Tumor Antigen
-Bladder CA
-Kidney stones, UTI

Human Epidermal Growth Factor


Receptor ( HER1 )
If , CA is fast in growth
Human Epidermal Growth Factor
Receptor ( HER2 )
CHON that promotes CA cell
growth
Breast CA
WARNING SIGNS OF CANCER
C Change in bladder or bowel habit
*painless hematuria / constipation
A A sore that doesnt heal
U unusual bleeding or discharge
T thickening or lump
I indigestion or dysphagia
O obvious change in wart or mole
N nagging cough or hoarseness
A anorexia
L loss of weight (cachexia)
METASTASIS
Lymphatic spread
Hematogenous spread
Angiogenesis
Carcinogenesis ( Maliganant
transformation)
CA PREVENTION & DETECTION
Primary Healthy Lifestyle
Secondary Risk Assessment
MANAGEMENT
Primary Treatment
Adjunct
-used together with Primary Tx
-Assists Primary Tx

ONCOLOGY NURSING
Adjuvant
-Tx given POST primary Tx to increase
cure
Neo-Adjuvant
-Tx given PRIOR to surgery to tumor size
so surgery is not extensive
SURGERY
Diagnostic histopath
Curative
Palliative
Pain Management
Placement of PEG tube
BIOPSY
Incisional
For large tumor
Apply pressure dressing for 6-8 hrs
Excisional
Early access tumors
Skin, UGI, Upper Respi, Breast
Needle Biopsy
Breast, Thyroid, Liver, Lungs
RADIATION
-Beam of high energy waves or streams
of particles
-Localized Tx
-Destroys rapidly dividing cells
Types:
External Teletherapy
Non-radioactive ; Non-threat
Internal Brachytherapy
Radioactive
TELETHERAPY External
Adverse RXN : Burns, Erythema
NRSG CARE
-Do NOT remove the marks!
-No application of cream, lotion,

powder or occlusive dressings


-Do not wash off. Wash with warm
water, NO SOAP (Very mild soap is
permitted)
-No scrubbing, rubbing or scratching.
Wear loose fitting, soft clothes over
areas
-Silk & Wool CANNOT be worn irritating.
Cotton is permitted
-Protect from sun exposure for at least 1
year post discharge treatment
BRACHYTHERAPY Internal Radiation
Sealed (Encapsulated)
Placed directly on tumors
Pins, needles, implants
NO mixing of body fluids
Slightly radioactive
Unsealed
Radioisotope is NOT ENCASED in
a container
Given via INJECTION or ORAL
Mixed with Body Fluids
(+) RADIOACTIVE
Factors affecting exposure:
Time
Distance
Shielding

30 minutes
6 ft away frm Pt
LED Apron

PRECAUTION for INTERNAL RADIATION


-Private room with a private bath
-Place a RADIATION sign
-Cluster care ( assignments are rotated)
-Limit visitors
-Not allowed inside room (<18 y.o ,
pregnant)
-30 minutes contact per shift
-Prevent dislodgement (Sealed implant)
Bedrest, logrolling
Foley Catheter
Low residue diet, anti-diarrheals
as ordered
-Dont care for more than 1 patient
-Lead container should always be at the
bedside

ONCOLOGY NURSING
IF DISLODGEMENT OCCURS:

G2 Antitumor Antibiotics

Get LED Apron, take the long forcep


and take the seed and place it in the
LED container and call Oncologist.
Dont handle with hands or anything
else aside from forceps.

>Bleomycin
-S/E: Febrile RXN on 1st day
-Pulmonary Fibrosis (scars):
Pulmonary Fnx Test
-Monitor lung status of patient
before each course of therapy

CHEMOTHERAPY
1) Cell-Cycle SPECIFIC
G1 Asparaginase & Prednisone
-for leukemia
-S/E: Pancreatitis, Anaphylaxis
Nrsg Considerations
>Have stand-by :
Epinephrine
Benadryl
Corticosteroids
>Start Allopurinol BEFORE therapy
>Monitor for signs of pancreatitis
S Antimetabolites
>Cytrabine (Cytosar-U)
>5-FU
>Mercaptopurine (Purithenol)
>Methotrexate + Leucovorin
-for Leukoblastic Leukemia
>Hydroxy Urea (Hydrea)
-for Leukemia, Melanoma
-S/E: Megaloblastosis (immature
RBC)
Nrsg Considerations: Antimetabolites
(Folic Acid Antagonists)
>Avoid Folic Acid
-beans, wheat
-will interfere with antimetabolic
function
>Avoid Probenecid
- toxicity of Methotrexate
>Avoid alcohol
>Patient to avoid getting pregnant
during & after therapy

M Plant / Vinca Alkaloid


>Vincristine
-A/E: Neuropathy, loss of DTR,
constipation, hyponatremia,
photosensitivity
-drug is FATAL is given
INTRATHECAL
>Etoposide
-A/E: somnolence/sleepy, N/V,
watch for hypotension
>Vinblastine
-Monitor for bronchospasm,
stomatitis, may cause urinary
retention

2) Cell-Cycle NON-SPECIFIC
Alkylating Agents
Carboplatin
Chlorambucil
Cisplatin
Cyclophosphamide
Ifosfamide
Mechloritamine
Melphalan (can also cause CA)

ANTIBIOTICS
+ Doxorubicin (RED DRUG)
-A/E: skin & nail
hyperpigmentation
-Monitor for cardiac dysrhythmias

ONCOLOGY NURSING
NURSING CONSIDERATIONS
-Dexrazosane is given 30 minutes prior to
drug
-Stop infusion if cardiac problem occurs
- OFI
-Inform that Urine is RED color for 1-2
days
+ Mitomycin
+Dactinomycin

Cyclophosphamide
Antidote: MESNEX / MESNA
Urotoxic (hemorrhagic cystitis)
Mechlorethamine: Severe vesicant
tissue necrosis
Methotrexate
Antidote: Leucovorin
Folic Acid Antagonist
Cisplatin
Antidote: Amifostine
Ototoxicity
Busulfan
Antidote: Allopurinol
Hyperuricemia
Mechlorethamine
Antidote: Sodium Thiosulfate
Severe Vesicant
Ifosfamide
Antidote: MESNA / MESNEX
Hemorrhagic Cystitis
5-FU
Hyperuricemia Allopurinol
Metabolic Acidosis Na Bicarb
NURSING CONSIDERATION: CHEMO
PRECAUTION

>Wear PPE chemo gloves, long sleeved


gowns, mask with shield PRN
>Double-Flush all fluids contain
chemo thats why Double flush!
>Check for EXTRAVASATION only in
peripheral line
>Observe chemo precautions until 72
hrs post last Chemo treatment
IF EXTRAVASATION OCCURS:

-Stop infusion
-aspirate remaining drug from needle
-Cold compress 20 mins 3x/4x per day
for first 48-72 hrs
-Vasoconstriction diminished
spread extravasate
-Doxurubicin
-Not used in Vinca Alkaloid
-Warm compress
- blood flow to affected areas
-NOT USED IN DOXORUBICIN
-Vinca Alkaloids ( blood flow )
* Allowed attempts for inserting
peripheral line for chemo Tx : 2 ATTEMPTS
ONLY!
Implanted Vascular Access Device
Portacath (Intradermal)
Underneath the skin
-Port-a-cath
-Mediport
Huber needle used for access
CENTRAL IV LINES
Flush with Heparin:
Subclavian Catheter
Intrajugular ( IJ ) catheter
Triple Lumen Catheter
Quad Lumen Catheter
Non-flush with Heparin:
Groshong/Hickman/Dialysis Cath
Peripherally Inserted Central Line
Cath
COMPLICATIONS OF RADIATION &
CHEMO THERAPY
Nausea/Vomiting
-Administer anti-emetic as
ordered
-ice chips
-NPO 4-6 hrs before
-Frequent mouth care
-Monitoring of I/O, Wt &
Electrolyte
-Administer IV therapy as ordered

ONCOLOGY NURSING
-Bland food & Small Frequent
Feeding
Constipation
-fluids & high fiber foods
-stool softener or laxative as
ordered
-AVOID Enema!
Diarrhea
-offer liquids & low fiber diet
-Anti-diarrheal meds as ordered
-Good perineal care
-Stool for occult blood as ordered
-Observe for dehydration
Stomatits
-Good for oral hygiene
-Avoid spicy or hot foods
-Offer topical agents for pain
relief
-Offer popsicle
-Avoid acidic, alcoholic,
tobacco
-Apply KY Jelly
-Apply Nystatin oral suspension as
ordered
Dermatitis
-Wash affected areas with plain
water & pat dry ; Avoid soap
-Use cornstarch, calamine lotion
for itching
-Avoid exposure to heat, wearing
wool & silk
Alopecia
-Plan for wig, scarf, turban or hat
BEFORE hair loss
-Reassure patient that hair will
grow back after therapy
MYELOSUPPRESSION
Thrombocytopenia (platelets: 150,000400,000)
-protect patient from injury
-Avoid use of aspirin products
-Soft bristle toothbrush, electric
razor
-NO IM injections
-Use small gauge needles

-Administer platelet transfusion as


ordered
Leukopenia (WBC 4.5-10) / Neutropenia
(Granulocytes)
-Isolate from those with known
infection or newly received
vaccine individual
-Frequent periods of rest
- CHON diet
-Reverse isolation precaution
-Avoid crowded places
-Avoid fresh fruits, raw foods, fresh
flowers, potted plants, stagnant
water
Anemia (RBC)
-Promote rest
-Oxygen PRN as ordered
-Administer blood components as
ordered ( Iron prep, Folic Acid,
Vitamin B, Vitamin C, MVI )
-Diet rich in iron, Folic Acid,
Vitamin C
Tx: Bone Marrow Transplant (Hips
Red Marrow )
Infertility
-Sperm Bank (Men)
-Oophoropexy (Female)
Nephrotoxicity
-Force fluids
-Monitor BUN, Creatinine level
-Empty bladder often
-Diuretics, Mannitol as ordered
BREAST CANCER
Risk Factors
Age
Sex
Familial History
Early Menarche (before age 11)
Late Menarche (55 years old)
Nulliparity
Obesity
Assesment
Asymptomatic
-lump on upper outer quadrant

ONCOLOGY NURSING
Late signs (malignant)
-irregularly shaped mass
-fixed nodules, adheres to chest
wall
-asymmetry of breasts
-Peau de Orange (orange skin)
Diagnostic Exam
Biopsy (MOST DEFINITE)
Breast Self-Exam (SBE/CBE)
Mammography
Medical Mngt
Administer Anti-Estrogen receptor
(Tamoxifen Citrate / Taxol)
Chemotherapeutic Agents:
-Cyclophosphamide
-Methotrexate with Leucovorin
Surgical Mngt
Lumpectomy/Partial Mastectomy
Simple Mastectomy
-Breast tissue removal
-Breast tissue & lymph node
removal
-Axillary Lymph nodes: Levels II
-Axillary Lymph nodes: Levels III
Modified Radical Mastectomy
-removal of ONLY the lining of the
pectoralis lining
Radical Mastectomy
-Removal of everything (Lymph
nodes, Pectoralis Major & Minor,
Breast)
NURSING MANAGEMENT
Pre-Operative
Assess self-esteem, body image
Emotional support
Breast reconstruction &
prosthetics
Post-Operative
Analgesic RTC as ordered
Perform DBE
ARM PREC (Take the VS on the
legs)

Prevent Complications:
Bleeding
Infection
Atelectasis
Lymph Edema (elevate the arms)
perform hair combing-like
exercise
NURSING MANAGEMENT
-Fowlers position
-promote mobility
-assist with grief & adaptation
-Perform following:
-use lanolin cream
(Sheeps wool) several
times a day
-call MD if signs of
inflammation occur
-Avoid heavy weight lifting,
wearing jewelry, constrictive
clothing and positioning on
OPERATIVE side while sleeping
LARYNGEAL CANCER
Risk Factors
Smoking
Alcohol
Voice Abuse
Chronic Laryngitis
Genetics
Assessment
EARLY:
Hoarseness of voice
Throat lump or pain
LATE:
Coughing
Dysphagia
Dyspnea
Enlarged Cervical Lymph Nodes
Weight Loss
Muffled Voice
Diagnostic Exam
Laryngoscopy visualization of
the Larynx
Bronchoscopy

ONCOLOGY NURSING
Surgical Mngt
(Stages III/IV)
-Total Laryngoscopy
-Radical Neck Dissection/
Modified Neck Dissection
Pre-Operative
-Partial Loss of smell
-Air goes into stoma, not
the nose
-Closed Yawning / Polite
Yawning
-Avoid activity that
intra-thoracic pressure
Post-Operative
-Semi-fowlers position
-Slight neck flexion position
-Support head of patient
-ice collar to patients neck
-NGT, offer clear liquids as
ordered
-Check for signs of bleeding
-Avoid water sports & contact
sports
-Medic ALERT bracelet
-Assist the patient to use trachea
esophageal devices
Electrolarynx
HODGKINS DISEASE
Cause: Unknown
-painless, progressive
enlargement of lymph nodes
*REED-STERNBERG giant cells
-owls eyes
-Large, multi-nucleated cells from
the B lymphocytes
(Ultimately fatal if untreated)
Risk factors
Male (15-40 y.o)
Immunosuppressed individuals
History of mononucleosis or high
titer of EPSTEIN BARR VIRUS
-Human Herpes virus 4
-Cause infectious
mononucleosis (Kissing
Disease)

SIGNS & SYMPTOMS


Painless swelling of lymph nodes
B Symptoms: (B Lymphoctes)
Persistent fever without
chills
Night sweats
Weight loss
Fatigue / Lethargy
Malaise
Pruritus (unexplained)
Appetite Loss
LATE
Hepatomegaly
Splenomegaly
Dyspnea
Facial Edema
Enlargement of lower extremity
Diagnostic Exam
Biopsy
(+) Reed Sternberg Cells BEST
X-Ray
CT Scan
Serum Alkaline Phosphatase
Interventions
Mustargen
Oncovin
Procarbazine
Prednisone
Adriamycin
Bleomycin
Vinblastin
Dacarbazine
NURSING INTERVENTION
-Health Teaching
-Comfort Measures
- OFI
-Balance activity with rest
-Avoid infections
-Reverse Isolation precaution
CERVICAL CANCER
Cause: Unknown
Risk Factors
HPV / STDs
Oral Contraceptive use

ONCOLOGY NURSING
Frequent douching
Early age at first coitus (<18 y.o)
Mutiple sexual partners
Tobacco use
Diethylstilbestrol Hormone
EARLY (Asymptomatic)
Postmenopausal bleeding
Bleeding after douching or sex
Irregular vaginal bleeding
Metrorrhagia (inter-menstrual
heavy bleeding)
Leukorrhea (white vaginal
discharge)
Polymenorrhea (menstruation
every 21 days or less)
Signs & Symptoms may include:
-Abnormal Bleeding (between
menses, after menopause, after
sex, after pelvic exam)
-Heavier, long-lasting periods
-Unusual vaginal discharge
-Pelvic pain
Diagnostic Exam
PAP Smear
Colposcopy (visualization of the
cervix)
Biopsy
Surgical Mngt
Cryosurgery
Radiotherapy
Hysterectomy ( TAH / TAHBSO )
NURSING INTERVENTION
-Signs of bleeding post-surgery
-May feel pressure, minor
abdominal cramps, pinch from
forceps
-Pain minimal post pinching
-Expect discharge or spotting for
about a week (Biopsy)
-Avoid douching, use of tampons
nor sex during spotting
-Follow up PAP Smear within 3-4
months post procedure
-Observe radiation precaution

PROSTATE CANCER
Causes: Unknown
Risk Factors
Fat Diet
STD
Hormones
Multiple Sexual Partners
Diagnostic Exam
Biopsy
Prostate Specific Antigen (PSA)
Digital Exam
Assessment
Asymptomatic
Hematuria
Dysuria
Enlargement of Prostate
Low Back Pain
Perineal & rectal discomfort
Medical Mngt
Estrogen Hormones
-Diethylstilbestrol
-Estradiol
-Chlorotrianisine
Synthetic Gonadotropin
Releasing hormone Analog
Leuprolide 3.75 mg q
month
Gseriline Acetate(Zoladex)
Finasteride (Proscar)
Radiation Therapy
Radioactive IODINE & GOLD is
given
Surgical Mngt
Orchiectomy (testes)
TURP
Prostatectomy
NURSING MANAGEMENT
S/P TURP *Urine is bloody for 24-48 hrs
-

OFI to 2400-3000 mL/day


(unless contraindicated)
Monitor for venous bleeding

ONCOLOGY NURSING
-

Expect red(24 hrs) pink


clear (in 3 days)
Cystoclysis (continuous
bladder irrigation)

NURSING MANAGEMENT
-

Intermittent Irrigation
- with MDs order
- Aseptosyringe
- Saline irrigant

Perineal / Retropubic / Suprapubic


Prostatectomy
- Sexual Impotence (erectile
dysfunction)
BLADDER CANCER
Risk Factors
Male (50-70 y.o)
Smoking
Exposure to aromatic amines
Cytoxan exposure
Chronic bladder infection
Assessment
PAINLESS hematuria
Diagnostic Exam
Cytoscopy with Biopsy
Urinalysis
Urine C & S
CT Scan
Excretory Urography
Retrograde Cystography
Surgical Mngt
Removal of bladder with
diversions
-Ureterosigmoidoscopy
-Cutaneous Ureterostomy
Ileal Conduit
Kochs Pouch Urinary Diversion
Nephrostomy
Medical Mngt
Radiation
Chemo
-

Direct bladder installation

Intra-arterial infusion
Oral ingestion

Care of Stoma
o Assess for possible
tumor
Prevent skin breakdown
o Change appliance
PRN only & when urine
production is slowest
o Place square gauze on
stoma opening when
appliance is off
o Wash skin around
stoma with mild soap &
water
MULTIPLE MYELOMA

Malignant neoplasm of the bone


-

Abnormal proliferation of B
lymphocytes in bone marrow

Complications:
Hematopoetic suppression
Hypercalcemia
Proteinuria
Renal Failure
S/Sx
Low Back Pain
Sudden Pathologic fracture
Diffuse osteoporosis
Hypercalcemia
Anemia
Immunosuppression
Risk Factors
Genetics
Familial tendency
Exposure to chemicals
Incidence >40 y.o
Diagnostic Exam
Bone Marrow Biopsy
Blood & Urine Exam
(+) Bence Jones Protein M
CHON in urine

ONCOLOGY NURSING
NURSING MANAGEMENT
-

Combination therapy
Bone Marrow transplant
Reduce calcium level
Encourage activity
OFI

-Provide activity with rest periods


*Radiation Therapy ; Chemotherapy
Surgical Mngt
-

Post-Op: Dorsal
Recumbent or semi
fowlers on affected side

MEDICATION
-

Myocalcin/Calcitonin (nasal
spray)

LUNG CANCER
TYPES

Small Cell
Adenocarcinoma
Epidermal
Large Cell Anaplastic

Risk Factors
Smoking
Environmental & Occupational
exposure
Genetics
Fiber Diet
Assessment
Cough >3 months
Dyspnea
Hoarseness
Hemoptysis
Chest Pain
Anorexia
Weight Loss
Weakness
NURSING MANAGEMENT
-Monitor VS, breathing patterns, breath
sounds & respi impairment
-REVERSE ISOLATION, neutropenic diet
-Assess for tracheal deviation
(pneumothorax)
-Fowlers position
-Oxygen & humidification (to moisten &
loosen secretions)
-Corticosteroid & bronchodilators
- Calorie, CHON, Vitamin diet

Pneumonectomy- removal of
lungs

Lobectomy removal of the


lobe
Post op: Chest tube
Segmentectomy removal of
the segment of a lobe
Post Op: Chest Tube
Wedge Resection removal
of small portion of the lung
tissue
Post-Op: Chest Tube
GASTRIC CANCER

Malignant neoplasm in
stomach
Adenocarcinoma (Most
Common)

S/Sx
EARLY none
LATE detected
Risk Factors
H.Pylori
Chronic Atrophic Gastritis
Genetics
Barrets esophagus
Billroth II atrophic gastritis
Medical & Surgical Mngt
Surgery
Chemotherapy
Radiation Therapy
COLORECTAL CANCER
Causes
Genetics
Fiber Diet

ONCOLOGY NURSING
Fat intake
Inflammatory Bowel Disease
Diagnostic Exam
Abdominal & Rectal Exam
Occult Blood Exam
Barium Enema
Proctosigmoidocopy
colonoscopy
Carcinoembryonic Antigen
-

Tests effectiveness of
treatment
Identify disease occurrence
NURSING MANAGEMENT

Surgery
Colostomy
Radiation
Chemotherapy

STOMA
-

pinkish, reddish in color with


slight edema for 5-7 days
Drains stool 2-4 days post-op
Change bag every week