Module 2-Cellular Regulation

nursebrandy17's version from 2016-10-04 02:12

Cancer Overview

Question Answer
0Insitu (IS)-precancer; cancer cells only growing in superficial layer of tissue
1Tumor limited to tissue of origin; localized tumor growth
2Limited local spread
3 Extensive local and regional spread
TNMTumor; Nodes (lymph); Metastasis
CausesChemical (household etc), Viral (HPV, HIV, HepB, EBV), Radiation (UV)
PreventionLimit exposure to causes
Patient in TreatmentNO fresh fruits, veggies, or flowers

Drugs for Complications

Question Answer
AnemiaEpogen (RBCs), Neupogen (WBCs)
Anxiety & DepressionCannabis, Benzos, SSRIs
Pain (generalized)morphine, hydromorphone (Dilaudid), oxycontin, cannabis (NO OTC NSAIDS-lower platelets, affect liver)
Rashcorticosteroid-based cream
MucositisMagic Mouthwash, Moprhine, Dilaudid, Cannabis, Oxycontin
Diarrhealoperamide (Imodium)
N/Vondansteron (Zofran), promethazine (Phenergran), gansitron (Kytril), Cannabis

Labs of Concern

Question Answer
ANCNormal 2,000-8,000
NeutropeniaANC less than 2,000 (slight risk for infection)
Mild NeutropeniaANC more than 1,000 and less than 1,500 (minimal risk for infection)
Moderate NeutropeniaANC more than 500 and less than 1,000 (moderate risk for infection)
Severe NeutropeniaANC less than 500 (severe risk for infection)
ANC & ChemoChemotherapy is usually NOT given to a patient with an ANC less than 1,000 (but depends on circumstance)
HGBo2 carrying protein in RBCs
Hemoglobin (HGB)Male 14 to 18; Female 12 to 16
Hematocrit% of RBCs
RBCMale 4.7-6.1; Female 4.2-5.4
Rule of 3'sTo get RBC=HGB/3; To get Hematocrit=HGBx3

Acute Transfusion Reactions

Question Answer
Acute Hemolytic ReactionReaction to donors RBC's or wrong type; D/C transfusion
Prevention of Acute Hemolyticverify and document
Febrile, Non-Hemolytic ReactionReaction to donors WBC's, plates or plasma; D/C transfusion
Prevention of Febrile, Non-Hemolyticgive premeds, use washed units
Mild Allergic ReactionReaction to foreign plasma proteins, common in people w/ hx of allergies; D/C transfusion
Prevention of Mild Allergicgive premeds, use washed units
Anaphylactic/ Severe Allergic ReactionDonor has IgA proteins and patient is IgA deficient with IgA antibodies; D/C transfusion
Prevention of Anaphylacticuse washed RBC's w/ removed plasma, use IgA deficient donor
Circulatory Overload ReactionFluid admin faster than circulation can accommodate; SLOW INFUSION RATE
Prevention of Circulatory Overloadpatients with cardiac or renal disease are at risk; adjust transfusion
Sepsis ReactionTransfusion of bacterially infected blood; D/C transfusion
Prevention of Sepsisuse standard procedure
Transfusion Related Lung InjuryReaction between donors anti-leukocyte antibodies and recipients leukocytes causing pulmonary inflammation & capillary leak; D/C transfusion
Prevention of TRLIuse leukocyte-reduced products
Massive Blood Transfusion ReactionWhen replacement RBC's or blood exceeds total blood volume within 24 hours; MONITOR PATIENTS LEVELS
Prevention of Massive Blood Transfusionuse warming equipment; infuse 10% calcium gluconate
Pre MedsBenadryl,Tylenol etc.

Chemo/RAD/Bone Marrow/Stem Cell

Question Answer
Most Common Side EffectBone Marrow Suppression
Other Side Effectsfatigue, GI issues, Integumentary & mucosal reactions, Pulmonary, Reproductive, CV, Mental effects
TX-Induced Reduction of WBCs & RBCsInfection, Hemorrhage, Overwhelming Fatigue
Secondary MalignanciesMultiple myeloma and Non-Hodgkin's Lymphoma
Bone MarrowTaken from OR and given to host
Stem CellsA machine is use to take stem cells out of blood
AllogeneicDonor stem cells
SyngeneicTwin Donor stem cells
AutologusStem cells from self/patient
Graft .vs. HostPatient rejects donor cells
Dry DesquamationBurn from Radiation; treated with steroid cream; risk for infection
Wet DesquamationBurn from Radiation; dress the area capturing moisture, DO NOT USE CREAM

Infection & Cancer

Question Answer
Most Common Cause of DeathInfection, Septic Shock
Usual Sites of InfectionLungs, GU tract, Mouth, Rectum, Peritoneal Cavity, Blood
Infection CausesUlceration of mucosal tissue, Compression of vital organs by tumor, Neutropenia caused by disease or treatment
Anemiais very common in cancer patients; levels must be constantly monitored
S/S of AnemiaINCREASED Respiration's, DECREASED o2, INCREASED Heart rate, Longer cap refill, White sclera of eyes

Hospice .vs. Palliative Care

Question Answer
3 C's of CancerCure, Control, Comfort
Palliative Careanyone with chronic life threatening disease; improves quality of life; relief/control of symptoms
Curative TX PalliativePalliative Care Patient CAN still receive curative treatment in palliative care
Hospice Carefor patients that have 6 months or less to live; provides comfort, support and care in last phase of illness
Curative TX HospiceHospice Patients DO NOT recieve curative treatment in hospice care