MS 4

Oncologic nursing

Cancer- abnormal

Cancer – disease condition wherein a normal cell becomes abnormal and proliferates abnormally.

Stress

Physical

Emotional

Lifestyle

Hereditary

Stress

Recurrent damage on the cell – inflammation – group of inflamed cell

Anti oxydants - free radicals tinatanggal

Tumor - group of inflamed cells

Neoplasm- tumor

Process of tumor formation – neoplasia

Process of cancer formation – anaplasia

Difference bet benign and malignant – presence of capsule

Benign vs. malignant

Capsulated - capsule

Slow growing rapid growing

High survival rate low survival rate

Invasion/expansion metastasis

Affects surrounding tissues affects other organs(CSM bone)

+ pain (compression) + pain (metastasis)

Ideal = surgery radiation, chemo

Fastest route of metastasis (blood stream)

Biopsy definite test for cancer]

Cancer according to target organ

1. Carcinoma (I) Ipithelial tissues (skin, mucosal lining, organs) breast, colon, lung, brain
2. Sarcoma (co) connective tissue (muscle)
3. Lymphoma (lymph) lymph nodes (hodgkins disease) (-) pattern non hodgkins
4. Multiple myeloma (abnormal plasma)
5. Leukemia (immature WBC)
a. Anemia (dyspnea, fatigue)
b. Neutropenia (prone to infxn)
c. Thrompocytopenia (bleeding, (-) platelet)

Hodgkins (inflammation of lymph nodes w/ pattern) w/o pattern (non-hodgkins)

Plasma (

Warning signs of cancer

C – change in bowel movement/habit (alternate diarrhea and constipation) feeling of incomplete

emptying (colon cancer (obstructed) 1 st sign of colon (diarrhea)

A – a sore that does not heal

U – unusual bleeding

T – Thickening of lump

I – Indigestion/dysphagia

O – obvious change in wart/mole

N – Nagging cough/hoarseness

U – unexplained anemia

S – sudden weight loss

+ 3 more of warning signs

Treatment

O – oral therapy DOT short course chemotherapy (6-12 mos)

R – radiation

CHI - chemotherapy

D – bone marrow aspiration (site: pedia : posterior tibia) (adult: iliac crest)

S – surgery

Radiation Chemotherapy

Reduce size of tumor cell cycle

Relieves obstruction affects all rapid dividing cell (n

& cancer cell)

Primarily affects cancer cells alopecia (hair is rapid dividing

cell

Temporary -hair will grow 6

months after chemo

Wear wig before alopecia

No alopecia

Most common mode of treatment = surgery

Radiation therapy

Internal External

Sealed Unsealed Uses beam of light

+ container - container UV rays = complication:

Implants oral = radioactive dermatitis (temporary)

Vit. B12 - oral

beeds IV = phosphorus – 32

Tx: bladder & cervical CA

Brachytherapy Teletherapy
+ residual radiation + residual radiation

shillings test = pernicious anemia

Factors affecting exposure to radiation

S – Shielding

T - Time
D – Distance

A.) Shielding
a. Private room
b. Farthest room possible
c. Avoid pregnant/children<17 y.o.
d. Wear lead apron
e. Implants
i. Bedrest
ii. POC: FLAT (supine)
iii. Bedpan/Catheterization
iv. Turn – log – rolling
v. Pt facing opposite door
vi. Nurse must stand opposite to the implant
vii. Sex is resumed 3 weeks after removal of implant
viii. In case of dislodge, pick up with long forceps/tongs and place in lead container
ix. If not found, close door and leave the room and call radiologic dept (initial
action)
x. Gyger machine – locates the implant
xi. Discharges/secretions
1. Wear rubber gloves and flush 2-3 times
xii. Time:
1. 30 minutes per shift
2. 5 minutes per exposure
3. Enter the room only 6 times
4. Dosimeter: badge, bandage, patch (measures exposure amount of
radiation)
xiii. Distance:
1. 6 feet distance only when not performing procedures