Med Surg REVIEWER Oncology

Med Surg Exam 3 Oncology
Study online at https://quizlet.com/_4c4zyh
1. Cancer is characterized by A series of cellular and genetic changes that

what? cause a loss of normal cell regulation
Lack differentiation
Loss of contact inhibition
Abnormal cell proliferation
Unchecked local growth and invasion of sur-

rounding tissue
Ability to metastasize
2. What makes a tumor malig- sustaining proliferative signaling

nant
evading growth suppressors
activating invasion and metastasis
enabling replicative immortality
inducing angiogenesis
resisting cell death
3. Do the following describe a 1. NORMAL. cancer cells have large number

cancer or normal cell: of dividing cells
1. small number of dividing
cells 2. CANCER
2. large variable shaped nu-
clei 3. NORMAL- cancer cells have small cyto-
3. large cytoplasmic volume plasmic volume relative to nuclei
relative to nuclei
4.variation in cell size and 4. CANCER
shape 5. CANCER
5. loss of normal specialized 6. CANCER
cell features 7. CANCER
6. disorganized arrangement
1 / 26
of cells
7. poorly defined tumor
boundary
4. malignant cells invade neigh-

boring tissues and can enter
bloodstream and metastasize
to different sites
5. describe relationship to tis- benign- typical of origin

sue of origin for benign v. ma- malignant- atypical of origin
lignant tumors
6. rate of growth for benign v. benign- usually slow

malignant tumors
malignant- may be slow, rapid, or very rapid
7. progression for benign v. ma- benign- slowly progresses,

lignant tumors rarely fatal if treated
malignant- usually progressive

almost always fatal if untreated
8. mode of growth benign v. ma- benign- expansion w/capsule

lignant tumor
mal- Local infiltration and/or metastasis to
distant sites
9. tissue destruction benign v. benign- none

malignant
malignant- common, ulceration and necro-
sis
10. recurrence, benign v. malig- benign- rare

nant
malignant- common
11. prognosis benign v. malig- benign- fatal only if surgically inaccesible

nant
malignant- fatal if not controlled
2 / 26
12. primary prevention for can- lifestyle change:

cer avoid tobacco
sunscreen
limit alcohol
healthy diet
safe sex
staying fit/active
vaccinations
13. secondary prevention breat exams/mammograms

pap smears
prostate exam/PSA
testicular exam
colonoscopy
genetic counseling
14. TMN system, what is T, what tumor

is TX, T0, Tis, T1-T4? TX- tumor can't be measured or found
T0- no evidence of primary tumor
Tis- means cancer is in situ- tumor has not
started to grow into surrounding structures
T1-4- describes size and or level of invasion

into nearby structures, higher the T number,
larger the tumor
15. TMN, system, what is the N? NX- nearby lymph nodes can't be measured
what do the numbers mean, or found, surgically cannot reach
what do X and 0 mean? N0- means nearby lymph nodes don't con-
tain cancer
n1-3 higher the number, more involved

lymph nodes
16. TMN, what is M? metastases

MX- metastasis can't be measured or found
M0- no known distant mestastases
m1- distant metastases are present
3 / 26
17. warning signs of cancer C- change in bowel/bladder habits
A- a sore that does not heal
U-unusual bleeding or discharge
T-thicking or lump in breast/tissue
i- indigestion or difficulty in swallowing
o-obvious change in mole/wart
n- nagging cough or hoarseness
18. treatment is usually a combo local: radiation and surgery

of what two therapies
systemic: chemo, targeted therapy, im-
munotherapy, stem cell transplant
19. what is radiation therapy the use of high-energy ionizing beams or

x-rays to treat malignancy
Cell kill occurs by primarily two mechanisms,
the direct and indirect hit
20. what is the maximum tissue Dose of radiation that an organ can tolerate
tolerance dose?
21. is goal of radiation always cu- no could be acute management of symp-

rative? toms (mass pressing on airway or spinal
cord- shrink)
or palliative- relieve pain/symptoms by

shrinking tumor
22. what is stereotactic radio- high power energy on small area

surgery not real surgery
ex- gammaknife
23. safety principles for caring time- limit to 1/2-1 hour per shift
for brachytherapy patient distance- 3 feet
shield- lead shield
24. what is teletherapy? what is teletherapy- external beam

brachytherapy
Interstitial implant (prostate, brain)
surgically placed
4 / 26
isotope decays over the period of time spe-
cific to the element
Sealed radiation source
Intracavitary implant (endometrial or cervi-

cal)
removed at end of treatment
Sealed radiation source
25. if implant falls out what do if on floor- find lead container, use forceps-
you do? should be in the room- then get the hell out
of the room
call radiation safety officer
if in an emergency- all precautions are sus-

pended
26. if caring for patient with cervi- assess:

cal implant, make sure to do Placement of appliance
what? Patency of foley catheter- need to put in
prior!
do bowel prep prior!
antidiarrheal- to reduce changes of it being
dislodged
Vital signs, pain score
logroll patient to avoid dislodgement

patient CAN'T get up, sit up, or walk
Head of bed must be no higher than 15

degrees
Minimize risk of perforating the uterus with
the appliance
or appliance falling out
27. side effects of head/brain ra- N/V

diation Brain swelling, leading to somnolence/fa-
tigue
5 / 26
Cognitive deficits
Leukoencephalopathy
Thyroid
Hypothyroidism
HPA deficits
Infertility
Teeth
Enamel dysplasia
Halted permanent teeth eruption
28. side effects optic radiation Dry eyes

At risk for eye injury
Corneal necrosis
Cataracts
Damage to 8th cranial nerve

Sensorineural hearing loss
29. side effects of pulmonary ra- Acute pneumonitis

diation Dyspnea
Dry or wet cough
Tachypnea
Pulmonary infiltrates on CXR
30. side effects of GI radiation Salivary glands

in viscosity/volume of saliva
Taste alterations
Oral mucosa
Epithelial desquamation at doses
Mucositis
Xerostomia
Esophagus
Dysphagia
Epithelial desquamation
6 / 26
31. side effects integumentary Erythema
Hyperpigmentation
Dry and moist desquamation
Permanent hair loss
With high dose radiation
32. we should educate patients Educate patient about possible skin reac-
receiving radiation about tions/skin care
what regarding skin care? Emphasize importance of keeping skin
clean and dry
All skin products should be washed off prior
to treatment
May use water based/lanolin lotions (noth-
ing within 4 hours of treatment.
Use sunscreen if outside
Do not use adhesive on site
Avoid shaving
Do not remove radiation landmarks
33. chronic side effects of EBRT occurs any time after six months
or late effects
skin skin- fibrosis, permanent darkening, atrophy
34. late effects GI fibrosis, adhesions, obstructions, strictures
35. late effects oral permanent xerostomia and taste alteration
36. late effects pulmonary fibrosis
37. other chronic/late side ef- secondary malignancies

fects of ERBT permanent sterilization or ovarian failure
arrested growth/hypoplastic bone changes
38. chemotherapy terminology, Used as primary treatment or in combination

what is adjuvant, neoadju- with others.
vant, myeloablative Adjuvant: given after a primary treatment
(usually surgery); Goal-curative
Neoadjuvant: given before a primary treat-

ment (usually surgery to shrink tumor)
7 / 26
Myeloablative: doses sufficient to ablate or

deplete the bone marrow
Salvage
Palliative
39. what does intrathecal mean? into the spinal fluid via lumbar puncture or
ommaya reservoir
40. other rapidly dividing cells RBC, WBC, platelets

that are killed by chemo in- Hair
clude all mucosa mouth to anus, constantly repro-
ducing
41. what is a CVAD? indicated for central venous access device

who?
Poor IV access
Need for prolonged therapy
Continuous infusion vesicant administration
Frequent administration of irritants
Patients requiring multiple medications and
therapies via IV (blood products, antibiotics,
etc)
Parenteral nutrition
Patients who will be treated with infusional
therapy in the home setting
42. contraindications for CVAD? SVC syndrome

complications? Bacteremia
Radiation to chest
Mastectomy with lymph node dissection
Pacemaker, ICD
IVC Filter (no femoral access)
Platelets < 50*
INR > 1.5*
Injury during insertion

Malposition
Occlusion
8 / 26
Infection (#1)
Thrombosis
Extravasation & Infiltration
43. CVAD line care? Dressings changed weekly

Site cleansed with chlorhexidine
Port needles changed every 7 days
PICCs & Hickmans require daily flushing in
the home setting and more frequently in the
hospital setting
Activity restrictions
44. what is a stem cell transplant High dose chemotherapy and/or radiation
that is intense enough to kill the cancer, but
then requires the patient to be "rescued" by
normal stem cells
45. targeted therapy nursing adherence to oral medication regimen: swal-

challenges lowing, reliability, cost
safe handling/storage of meds
timing- empty stomach v. food, missed dos-

es
educate pts on side effect management
medication interactions- most subject to b/c

metabolized by p450
46. chemotherapy infusion major Hypersensitivity

related event and interven-
tions S/s: flushing, rash, anxiety, bronchospasm,
hemodynamic collapse
Premedication
Intervention
-oxygen support
-maintain intravenous
Emergency medications
9 / 26
47. when administrating chemo no needs to have a luer lock!!

is it just a needle?
48. if priming chemo bag, empty biohazard bag

into what? if spills on sheets
do what? have to mark the laundry! and also put in
biohazard container
49. chemotherapy safety precau- eye and face shield need to be worn
tions thick gloves, change after each wear, 30
min, or spill
non-absorbent gown
dispose of all syringes/bags or material with
chemo in special biohazard bags and then
into solid biohazard bin
use face shield/wear gloves when disposing
of all bodily fluids for 48 hours following ad-
min
verify orders against protocol with 2nd per-

son
50. s/s of extravasation S/s:

Absence of blood return from the IV catheter
Resistance to flow of IV fluid
Swelling, pain, or redness at the site, or if
using a central venous access device, pain
in the upper arm, upper back, chest, neck,
or jaw
51. nursing things to do related Administer anti-emetics prior to chemother-

to nutrition and chemo apy and radiation on schedule
Consider relaxation techniques, imagery,
distraction
Encourage small frequent meals of their
choice
Eat high calorie/protein food
Discourage smoking/alcohol intake
Consult nutritionist if necessary
10 / 26
Assess changes in taste, recommend differ-
ent foods
52. types of chemo induced n/v anticipatory
acute: 24-48 hours
delayed- 1-4 days
continuous
53. what is mucositis? what inflammation or ulceration of the mucous

should patients who have membranes of the GI tract
this avoid using?
can be from mouth to anus
avoid mouthwash w/alcohol
54. you should assess mouth assess mouth, gums, tongue for sores/le-
for? sions/ulcerations
infection
dental caries
pain
swallowign abiliiyt
report lesions
55. what is myelosuppresion? Bone marrow precursors=stem cells pro-

duce:
WBC
RBC
Platelets
Cell lines suppressed by

Chemotherapy
Radiation therapy
Infection
Other drugs
11 / 26
Most common dose limiting toxicity of cy-
totoxic cancer therapy
56. normal WBC count 5,000 - 10,000
57. neutropenia commonly oc- occurs 7-21 days after chemo

curs utilize infection prevention precautions
58. what is a seg? what is a fully mature neutropil is seg

band? what is a blast? baby neutrophil is band
baby baby neutrophil is blast
59. if patient comes to ER, find take immediately to private room

out his ANC is below 500 and he is at high risk for infection/septicemia
he is taking chemo, do what? no visitors- sick
mask, gloves, everyone
look for infection all over
may not see obvious signs- like redness,
edema, tenderness- b/c no WBC!!!
60. the only sign of neutropenia FEVER

in a cancer patient may be?
why? normal signs of infection such as pain, red-
ness, swelling may not be present because
immune system is so depressed. Only sign
may be a FEVER! Febrile neutropenia is
defined as, a single temperature of e 38.3
(100.9 F) C orally or e 38 C (100.4 F) over
one hour
61. a temperature higher than 100.4

what is considered an emer- patient needs to prophalatically start taking
gency in this population antibiotics
62. neutropenia below? leukope- 500

nia below? is considered se-
vere
63. as a nurse we should report Temperature >100.4 F (38° C) or <97 F (36

related to infection s/s ° C)
12 / 26
Shaking chills
Tachycardia (HR >90)
Tachypnea (RR >20)
Hypotension
Mental status changes
Peripheral mottling, cold, clammy skin
Abdominal pain, diarrhea
Skin breakdown
Urinary output <30cc/hr (or balance more
than 500cc positive or negative)
64. we should instruct patients Temp > 38.3ºC (100.4ºF)

"to call" when Chills/rigors
Mouth sores; inability to eat or drink
Perineal pain/pain with elimination
Cough/SOB
Any redness/swelling/tenderness
Diarrhea/vomiting
65. what is thrombocytopenia? low platelet count

s/s
Bruising/petechiae
Epistaxis/heavy menses
Bleeding with mouth care
66. platelets should be? 150-450,000

thrombocytopenia classified
as Classified by severity
Mild 50,000- 75,000
Moderate 20,000 - 50,000
Moderately severe <20,000
Severe < 10,000 (risk for spontaneous
bleeding
67. so not really concerned around 20,000 start to monitor

about platelets in chemo pa- below 10,000- if sneeze can have brain
tient until when? bleed
68. should transfuse when? less than 10-20k

actively bleeding
13 / 26
69. if platelets are less than what, 50,000

should surgery not be done?
70. thrombocytopenia nursing No rectal temperatures/suppositories!!!!

care Fall prevention
Avoid constipation!!!!
Gentle oral care- no hard toothbrushes
No shaving (electric razor ok)
Avoid ASA/ibuprofen, cold/flu products
No invasive procedures
Hold pressure to venipuncture sites 3 min-
utes
71. patient education for throm- No driving

bocytopenia No contact sports or other high-risk activities
(i.e. biking, roller-blading)
No anal or vaginal intercourse
No shaving unless electric razor
Gentle toothbrush with soft bristles
No ASA, NSAIDs
When to call the MD/go to ED
72. so treatment for thrombocy- give platelets back!

topenia is basically
73. what is anemia Decrease in RBC production, increased

RBC destruction, or blood loss
74. normal hemoglobin, normal hemoglobin- 15

hematocrit hematocrit- 45
75. anemia s/s Fatigue

Dyspnea on exertion
Pallor (conjuctiva, nailbeds, sclera)
Weakness
Headache
Hypotension
Tachycardia
Tachypnea
14 / 26
76. if patient is anemic, what are packed RBC (not whole!)- person doesn't
treatment options? need platelets or plasma just HG
or Erythropoietin
77. what are the dogs with ery- hypertension

thropoietin clotting- hypercoagulability
78. if give patient 1 unit of packed Hg by 1

RBC, we expect Hg to go up crit by 3
by what? and crit to go up by
what?
79. anemia management Determine underlying cause

Supplement iron, folic acid, B vitamins
RBC transfusions for symptomatic anemia,
active bleeding, or HgB <8g/dl
Discontinue medications that interfere with
RBC production or maturation
Erythropoietic stimulating agents (ESAs)
Transfuse for Hct <25%
Oxygen if symptomatic
80. anemia nursing interventions Assist patient with energy conservation

strategies
Assist with ADLs if needed
Dietary consult to maximize intake of folic
acid, iron, B vitamins
Teach patient safety strategies:
Change position slowly
Report shortness of breath, active bleeding
81. what is SCC? spinal cord compression

compression of thecal sac by tumor
majority in thoracic area, given cancer of

breast, lung, etc.
82. early signs of SCC

15 / 26
neck/back pain- MOST COMMON
"shooting, burning, deep, sharp"
may be local or radiate
weakness
loss of touch sensation
see signs/symptoms on related dermatome
83. C3-C5 does what? keeps you alive
if C5 or above, could get pulmonary insuffi-

ciency or distress
also relates to spinal shock
84. how many letters are in 5

shock? this helps to remem- T5 or above is sympathetic chain
ber if not innervated- neurogenic shock
if no sympathetics- bradycardia
get vasodilitation
so s/s
bradycardia, warm skin, flush
85. in SCC pain is worsened by Pain worsened by coughing, bending,

sneezing, or, in 20% of patients, simply lying
flat
86. if patinet comes into hospi- could be impinging tumor on nerve

tal with cancer diagnosis and
is showing sign of weakness,
back pain- and we are think-
ing orthopedic, what else
should we be thinking?
87. late signs of SCC Loss of deep pressure sensation

Incontinence
Paralysis
16 / 26
Muscle atrophy
Sexual impotence
88. gold standard for diagnosing gandolium enhanced MRI

SCC?
CT is less sensitive
89. when diagnosing SCC, how image entire spine!

much of back should be im- many patients have multiple sites of metas-
aged? tasis
90. patients with severe back sedation

pain may need what for the may not be able to lay flat
scan?
91. SCC Nursing interventions Pain

assessment Sensory
Motor-strength
Bowel and bladder function
PT/OT consult
Prompt administration of steroids

Pain management
Bowel regimen
92. fastest treatment for SCC is emergency radiation!!!

other treatments
high dose corticosteroids- reduce inflamma-
tion
surgery to stabalize spine

chemo
brace
pain medication
93. so if hear band-like pain SCC

around abdomen, impotence,
problem peeing and pooping,
17 / 26
and bone cancer, what do we
think diagnosis is?
94. what is the superior vena main vessel for return of blood from head
cava syndrome? and thorax
low pressure vessel
easily compressed
cancer growing obstructing venous flow into

heart
95. so obstruction of the SVC can increased venous pressure

result in what? decreased venous return
dilation of collateral veins--> decreased car-
diac output
Venous obstruction can increase edema in

the luminal diameter of the pharynx and lar-
ynx which can result in stridor.
96. first s/s to be aware of? can't tie shirt button
97. most common symptoms of edema

SVCS neck veins full
plethora- red face
dyspnea
decreased CO--> tachycardia
98. what type of shock could obstructive

SVCS turn into
99. how different than FVE blood only stuck in top

not whole body
CO drops
100. late signs of SVCS Respiratory distress

Stridor
dysphagia
18 / 26
due to increased ICP:

Mental status changes
Syncope, cyanosis
Vision changes
101. nursing interventions for Monitor airway

SVCS Elevate HOB!!!!
Avoid invasive procedures in the affected
areas (no BP or IVs in arms)
Remove restrictive clothing, watches, rings
bowel prep- don't want them pushing any-
more
Avoid valsalva
Balance activity & rest
102. what would by symptoms Changes in perfusion

that alert nurse of SVCS pro- Low bp
gression? Cyanosis
Changes in mental status
103. As a nurse we should be CT or MRI with contrast

anticipating what with SVCS
and set up IV access MRI used if patient has CT contrast allergy
104. SVCS treatment treat underlying cause
steroids/radiation- immediate interventions
chemo
stenting- in severe cases
if thrombosis is cause- anticoagulants,

thrombolysis
rarely used- diuretics
19 / 26
Symptoms usually develop gradually so
treatment is rarely a true emergency
105. what is cardiac tamponade fluid accumulation in pericardial sac

impairs heart ability to fill and pump
decreases cardiac output and perfusion
Cancer cells can invade via direct extension

or via blood or lymph leading to excess fluid
accumulation
106. cardiac tamponade patho increased fluid volume in pericardium leads

to
increased interpericardial pressure leads to
decreased venous return to RA
decreased ventricular expansion and filling
decreased SV and CO
increased compensatory mechanisms: in-
creased HR, peripheral vasoconstriction,
107. if swann-ganz was in, what would be equalized pressure in all chambers
would happen to pressures
108. how diagnose cardiac tam- echocardiogram

ponade Right atrial collapse in late diastole is a sen-
sitive marker
Diastolic RV collapse
chest x-ray
Increase in transverse cardiac diame-
ter—"water bottle heart"
EKG
Low amplitude waveforms
Electrical alternans
109. what is electrical alternans Electrical alternans is an electrocardio-

graphic phenomenon of alternation of QRS
20 / 26
complex amplitude or axis between beats
and a possible wandering base-line. pro-
duced by the heart swinging backwards and
forwards within a large fluid-filled pericardi-
um
Produced by heart swinging back and forth
due to extra fluid
Now inconsistent QRS
110. what is paradoxical pulse systolic BP decreases by more than

10 mmHg during inspiration, pulse gets
stronger on expiration
111. what is pulse pressure? does difference between systolic and diastolic BP
it widen or narrow in cardiac narrow
tamponade?
112. Assessment of cardiac tam- Chest pain, dull, nonpositional

ponade, early signs Venous distention
Distant heart sounds
Abdominal distention
Weak/absent apical pulse
Anxiety/agitation
113. Assessment of cardiac tam- Paradoxical pulse >10mmHg

ponade, late signs Tachycardia
Tachypnea
Orthopnea
Narrow pulse pressure
Mental status changes, oliguria, peripheral
edema
Chest pain relieved by leaning forward
114. what is beck's triad? JVD

muffled distant heart sounds
low BP
115. acute onset of tamponade beck's traid

would be what syptoms
21 / 26
116. nursing interventions for car- Monitor vs, ekg, i/o
diac tamponade Elevate head of bed
Anticipate emergent pericardiocentesis with
drain placement
Pain management
Anxiety management
Diuresis and positive pressure ventilation
are contraindicated
These interventions decrease venous return
117. The most specific and sen- 2-D Echocardiogram

sitive test used to aid in the
diagnosis of pericardial effu-
sion
118. what is tumor lysis syndrome chemo, steroids, or radiation cause tumor
cells to lyse
tumor cells have higher concentrations of
K+, phosphorus and uric acid
119. number one electrolyte in- K+

side the cell
120. Cairo Bishop lab values for uric acid greater than 8
TLS potassium greater than 6
phosphorus greater than 4.5
calcium less than 7
everything high except calcium

remember phosphorus and calcium have in-
verse relationship
121. what is a normal phosphorus lower than 4.5
122. what one electrolyte is down Ca!- so trosseau and chovsek's sign
in TLS
123. what electrolyte problems hyperkalemia--> cardiac arrythmias, muscle

will you face in TLS weakness
22 / 26
hyperuricemia--> urate crystals-->oliguria
and renal failure, N/V/anorexia
hyperphosphatemia-->hypocalcemia/ phos-
phate/Ca+ --> Tetany, seizures
Oliguria & renal failure
Nausea, vomiting
So need to give patients fluid
124. Tumor Lysis Syndrome Nurs- assess lab values- BUN, Creat, Potassium,
ing Assessment Phosphorus, uric acid, calcium
Aggressive hydration followed by diuresis if

needed
125. high risk patients for TLS elderly

steroids
renal insuffiency
dehydration
increased LDH
126. Chovostek's sign Elicitation:Tapping on the face at a point just

anterior to the ear and just below the zygo-
matic bone
Positive response: Twitching of the ipsilateral
facial muscles
127. Trousseau's sign Elicitation: Inflating a sphygmomanometer

cuff above systolic blood pressure for sever-
al minutes
Postitive response: Muscular contraction in-
cluding flexion of the wrist and metacar-
pophalangeal joints, hyperextension of the
fingers, and flexion of the thumb on the palm
128. for hyperkalemia associated insulin/D50

with TLS, do what? kaexylate
for hyperhphosphatemia? restrict dietary K
for hyperuricemia
23 / 26
phosphate binding agents
allopurinol- baseline
respuricase- good for emergency
give IV solution! NORMAL SALINE- encour-

ages phosphate to drop and helps hyper-
uricemia
129. LDH can indicate just normal damage

have to look at Creat, K+, Ca, etc
have to cluster signs and symptoms
130. indications for dialysis in TLS Severe oliguria or anuria

Persistent hyperkalemia
Hyperphosphatemia induced symptomatic
hypocalcemia
Volume overload
131. in the blood where is the cal- half is bound to proteins like albumin
cium? which calcium does
the body regulate? it is the unbound calcium or IONIZED, that
the body regulates
132. so calcium could be inacu- if person has abnormal levels of protein in

rate when? how to correct for blood
calcium
In the setting of low serum albumin (fre-
quently seen in patients with chronic dis-
eases, hepatic disease or even long term
hospitalization), the formula for corrected
calcium is: CorrCa = Measured serum Ca +
[(4.0 - measured serum albumin) * 0.8].
Thus, if the albumin is low, the measured

calcium may appear low when in fact it is
physiologically within normal limits.
133.
24 / 26
most common cause of hy- Most commonly caused by increased bone
percalcemia in malignancy is resorption with release of calcium from bone
(80% of pts)
tumor can secrete PTH and bone gets de-

stroyed by osteoclast- causes calcium to
leech out from bone
bone resorption is exceeding bone forma-

tion
134. signs and symptoms of hy- stones- kidney stones, polyuria/dispsia

percalcemia bones- painful bones, Ca getting sucked
from bones
abdominal groans- N/V, constipation,
anorexia
psychic moans- lethargy, confusion, mental
status changes
135. in cardiovascular assess- bradycardia

ment of hypercalcemic pa-
tient will assess EKG changes
shortened QT intervals
widened T waves
depressed ST segments
136. hypercalcemia nursing inter- administer fluids as ordered

ventions monitor for overload
monitor cardiac, renal, mental status
MOBILIZE
seizure precautions is Ca is over 12
I and O
137. hypercalcemia treatment treat underlying cause!

NORMAL SALINE!!!!!!!
diuretics only if hypervolemic
bisphosphonates- ENCOURAGES CALCI-

UM TO GO BACK INSIDE THE BONE
calcitonin
25 / 26
26 / 26

Med Surg REVIEWER Oncology

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Med Surg REVIEWER Oncology

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Med Surg Exam 3 Oncology

Study online at https://quizlet.com/_4c4zyh

1. Cancer is characterized by A series of cellular and genetic changes that

Loss of contact inhibition

Abnormal cell proliferation

Unchecked local growth and invasion of sur-

2. What makes a tumor malig- sustaining proliferative signaling

activating invasion and metastasis

enabling replicative immortality

resisting cell death

3. Do the following describe a 1. NORMAL. cancer cells have large number

4. malignant cells invade neigh-

5. describe relationship to tis- benign- typical of origin

6. rate of growth for benign v. benign- usually slow

7. progression for benign v. ma- benign- slowly progresses,

malignant- usually progressive

8. mode of growth benign v. ma- benign- expansion w/capsule

9. tissue destruction benign v. benign- none

10. recurrence, benign v. malig- benign- rare

11. prognosis benign v. malig- benign- fatal only if surgically inaccesible

12. primary prevention for can- lifestyle change:

13. secondary prevention breat exams/mammograms

14. TMN system, what is T, what tumor

T1-4- describes size and or level of invasion

n1-3 higher the number, more involved

16. TMN, what is M? metastases

18. treatment is usually a combo local: radiation and surgery

19. what is radiation therapy the use of high-energy ionizing beams or

21. is goal of radiation always cu- no could be acute management of symp-

or palliative- relieve pain/symptoms by

22. what is stereotactic radio- high power energy on small area

24. what is teletherapy? what is teletherapy- external beam

Intracavitary implant (endometrial or cervi-

call radiation safety officer

if in an emergency- all precautions are sus-

26. if caring for patient with cervi- assess:

logroll patient to avoid dislodgement

Head of bed must be no higher than 15

27. side effects of head/brain ra- N/V

28. side effects optic radiation Dry eyes

Damage to 8th cranial nerve

29. side effects of pulmonary ra- Acute pneumonitis

Pulmonary infiltrates on CXR

30. side effects of GI radiation Salivary glands

34. late effects GI fibrosis, adhesions, obstructions, strictures

35. late effects oral permanent xerostomia and taste alteration

36. late effects pulmonary fibrosis

37. other chronic/late side ef- secondary malignancies

38. chemotherapy terminology, Used as primary treatment or in combination

Neoadjuvant: given before a primary treat-

Myeloablative: doses sufficient to ablate or

40. other rapidly dividing cells RBC, WBC, platelets

41. what is a CVAD? indicated for central venous access device

42. contraindications for CVAD? SVC syndrome

Injury during insertion

43. CVAD line care? Dressings changed weekly

45. targeted therapy nursing adherence to oral medication regimen: swal-

safe handling/storage of meds

timing- empty stomach v. food, missed dos-

educate pts on side effect management

medication interactions- most subject to b/c

46. chemotherapy infusion major Hypersensitivity

47. when administrating chemo no needs to have a luer lock!!