ATI_Concept_Base_3

ATI_Concept_Base_3 (A guaranteed) Cellular Regulation: Ch. 89 General Principles of Cancer Risk Factors: ● Age; older higher risk ● Race ● Genetics ● Exposure to chemicals, tobacco & alcohol ● High fat, red m ...

ATI_Concept_Base_3 (A guaranteed) Cellular Regulation: Ch. 89 General Principles of Cancer Risk Factors: ● Age; older higher risk ● Race ● Genetics ● Exposure to chemicals, tobacco & alcohol ● High fat, red meat, & low fiber ● Exposure to sun, UV, & radiation Staging ● T: tumor higher number bigger tumor ● N: node # of lymph nodes involved ● M: Metastasis: 0 no evidence 1 evidence Risk for malnutrition ● Hypermetabolic state due to presence of carcinoma ● Impair ability to ingest, digest, absorb nutrients Ch. 90 Cancer Screening & Diagnostic Procedures C: change in bowel or bladder habits A sore that doesn’t heal Unusual bleeding or discharge Thickening or lump of breast or elsewhere Indigestion or difficulty swallowing Obvious changes in warts or moles Nagging cough or hoarseness Diagnostics: ● Biopsy provides definitive diagnosis ● Imaging secondary tool; CT, MRI, PET scan, or ultrasound Ch. 91 Cancer Treatment Options ● Remove tumor: tumor excision ● Chemotherapy: damages cell’s DNA or destroys rapidly dividing cells ○ Unintentional harm to normal rapidly proliferating cells ■ Hair, mucous membranes in GI, & bone marrow ○ Implanted port or central catheter ■ High risk for infection Protect & teach ■ Monitor VS temp 100F reported right away & WBC <1000 Neutropenic precautions ● Colony stimulating production ● Avoid crowds,, changing litter box,, avoid yard work & gardening, avoid room temp drinks sitting for more than 1 hr, ● Dishes washed in hot soapy water in dishwasher ● Toothbrushes washed daily don’t share personal items ● Avoid food containing bacteria fresh fruits & vegetable, undercooked meat, fish & eggs, pepper & paprika ○ Administer antiemetic meds ■ Prior, during, afterwards ■ Smells or supplies triggering nausea remove from room ■ Meds to improve appetite & mouth care prior to meals ■ Avoid drinking liquids while eating, inbetween, ○ High protein high calorie & nutrient dense diet & supplement ○ Alopecia ■ 7-10 after initiation to chemo ○ Mucositis: inflammation of tissues in mouth ■ Avoid glycerin based mouthwash or mouth swabs ■ Non alcoholic anesthetic mouthwashes recommended ■ Avoid salty acidic or spicy foods ■ Offer oral hygiene before & after meals ■ Moisturizing agent to counteract dry mouth ■ Use half saline half peroxide rise 2x a week ■ Soft bristled toothbrush ■ Diet bland & soft ○ Anemia & Thrombocytopenia ■ Monitor for s/s: fatigue, pallor, SOB ■ Provide frequent rest periods ■ Administer Epoetin alfa & ferrous sulfate = improve iron levels ■ Monitor for blood in stool, urine, & vomit ■ Monitor for petechiae, ecchymosis, bleeding of gums, nosebleeds ■ Avoid IV, injections taking blood if so apply pressure 10mins ■ Encourage electric razor ■ Soft bristled toothbrush ■ Avoid blowing nose vigorously ■ Administer thrombopoietic meds OPRELVEKIN ■ Avoid NSAIDs and prevent injury ● Radiation Therapy: ○ Skin marked with tattoos to help guide positioning of external radiation ○ Skin care ■ Gently wash skin mild soap & water ■ DON’T apply powder, ointment, lotion, perfumes, deodorant ■ Soft clothing avoid tight and constricted ■ No sun or heat source of site ● Hormonal therapy: ○ Estrogen dependent cancer ○ Tamoxifen ● Immunotherapy ○ Interleukins & interferons Ch. 92 Cancer Disorders ❖ Skin cancer ➢ Leading cause: sunlight exposure ■ Squamous cell cancer rough scaly type lesion ■ Basal cell cancer small waxy nodule most common ■ Melanoma: cancer of melanocytes ➢ ABCDE: asymmetry, border, color, diameter, evolving ➢ s/s: irregular shape & border w/ multiple colors, new moles or change in existing moe, itching, cracks, ulceration, & bleeding (possible) ➢ Treatment: liquid nitrogen to freeze it, topical chemotherapy 5 fluorouracil cream ➢ Prevention: limit exposure to sunlight, apply sunscreen, use sunblock, avoid indoor tanning, wear protective clothing ❖ Leukemia: ➢ Cancer of WBCs; invade and destroy bone marrow, overgrowth of leukemic cells prevents growth of other blood components such as platelets and RBC ■ Risk for infection & bleeding ❖ Lymphoma: ➢ Cancer of lymphocytes ❖ Nursing care: no fresh fruits & vegetables, no visitors who are sick, prevent injury ❖ Treatment: Chemo, radiatio, bone marrow transplant ➢ Report manifestations of infections or illness immediately to provider ➢ The nurse should instruct the cli