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CHA 2 Exam 2- Cancer and GI | Comprehensive Questions and Answers Latest Updated 2024/ With 100% Verified Solutions What is leukemia? - The uncontrolled production of immature WBCs ("blast" cells) in the bone marrow. This over crowds the bone marrow with immature, nonfunctional cells and decreases the production of normal blood cells What is cancer staging? - Staging determines the exact location of the cancer and its degree of metastasis at diagnosis Explain cytoreductive surgery in the cancer patient - Removes part of the tumor when removals of entire mass is not possible. It is also known as "debulking" surgery and decreases the size of the tumor and number of cancer cells, which can alleviate symptoms and enhance the success of other types of cancer treatments. Could increase survival time Explain cancer grading 1 - Closely resembles normal cells, low grade malignant change, slow growing Explain cancer grading 2 - moderately differentiated, retains some characteristics of normal cells but more malignant characteristics Explain cancer grading 3 - poorly differentiated but tissue of origin can be established; few normal characteristics Explain cancer grading 4 - No normal cells, poorly differentiated Explain how a cancer cell differs from a normal cell - The development of cancer cells is due to the continual unregulated proliferation (dividing) of the specific cells whereas normal cells respond appropriately to signals within the body to turn on and off cell differentiation and division. Normal- Apoptosis, cancer cells don't have that cell death Identify 3 psychosocial concerns a newly diagnosed cancer patient may face after receiving their diagnosis - 1. anxiety
- Fear
- Depression
- Stress
- Anger/Frustration Explain what palliative treatment is in the care of a patient with cancer - Focuses on providing symptom relief and improving quality of life but is not curative. Example removal of tumor that is causing pain, obstructions or difficulty swallowing, and the treatment of neuropathic pain from bone metastasis, pain management What is secondary cancer prevention? - Secondary prevention of cancer includes regular screenings and genetics screenings. Some examples include breast examinations, yearly mammograms, yearly pap smears between the ages of 21-35, colonoscopy at age 50, and prostate exams starting at age 50. What is primary cancer prevention? - Avoidance of known or potential carcinogens. For example: use skin protection, do not use tobacco. Modify associated factors: diet &decreased alcohol to decrease risk of colon cancer, safer sex practices. Explain what encopresis is? - The repeated passing of stool (usually involuntarily) into clothing. Typically it happens when impacted stool collects in the colon and rectum. The colon becomes too full liquid stool leaks around the retained stool and stains underwear Provide 2 examples of education given to a patient with severe diarrhea due to ulcerative colitis - 1. Drink plenty of fluids
- Monitor labs and electrolytes
- Avoid carbonated drinks, prune juice, milk
- Eat small meals List 2 examples of education you will give to someone with a diverticulitis diagnosis - 1. Treated with bed rest
- Stool softeners
- Diuretics List 2 ways that we can manage ascites in the patient with cirrhosis of the liver - 1. Promote rest
- Low-Sodium Diet
- monitor serum albumin levels
- Diuretics
- Paracentesis What causes the yellowing of skin and eyes of jaundice - It is causes by excess of the pigment bilirubin and typically caused by obstructions of bile ducts, by liver disease, or by excessive breakdown of red blood cells What is a priority nursing intervention for someone with acute pancreatitis - Pain control What 2 Diagnostic test used to determine if a patient has pancreatic cancer - 1. CT scan
- PET scan
- MRI
- Ultrasound List 2 ways to reduce discomfort in a patient with acute pancreatitis - 1. Treat and mange pain
- Maintain NPO status
- Fluids via IV
- Medications via IV Explain one of the two function of pancreas - Endocrine- insulin secretion and metabolism Exocrine-Enzyme secretion Explain auto-digestion in pancreatitis - pancreatic enzymes destroy its own tissue leading to inflammation. The inflammation may be sudden (acute) Or ongoing (chronic). Acute pancreatitis usually involves a single "attack", after which the pancreas returns to normal
List two pieces of education you will provide to a parent whose child is experiencing severe diarrhea - 1. Plenty of fluids
- provide oral rehydration
- avoid milk or milk based products
- avoid apple juice and caffeine Define Tumor Lysis Syndrome (TLS) - TLS is when large numbers of tumor cells are being destroyed at a rapid rate. The damaged cancer cells are released into the bloodstream faster than the body can eliminate them. Severe or untreated TLS can lead to complication such as tissue damage, acute kidney injury and death What is "chemo brain" - Chemo brain is a common term used by cancer survivors to describe thinking and memory problems that can occur during and after cancer treatment. Chemo brain can also be called chemo fog, cancer-related cognitive impairment or cognitive dysfunction. Describe what happens with an esophagogastroduodenoscopy (EGD) procedure - Patients are lightly sedated with relaxing medications-pt will be awake. MD inserts endoscope, have pt swallow , the swallowing motion guides the endoscope through the esophagus, stomach and duodenum. Examine the mucosa of GI tract, images are displayed on a monitor. Pt needs a ride home due to meds What are terminally differentiated cells - Committed to a particular function where it can no longer divide How does the body normally regulate cell growth? - Cellular regulation is the genetic and physiological processes that control cellular growth, replication, differentiation and function to maintain homeostasis What are cacinogens? - The initiation of cancer formation
Explain lymphoma - cancer of the lymphatic system including lymph nodes, spleen, thymus, and bone marrow nursing priorities for lymphoma - 1. infection prevention
- respiratory sumptoms
- monitor and mange effects of chemo/radiation appendicitis- assessments - 1. pain-McBurney's Point
- diet
- if they have had their appendix removed appendicitis-nursing concerns - 1. Pain management
- NPO status Appendicitis-pt education - 1. monitor for s/sx of infection and bleeding
- limit activities for 1-2 weeks after procedure
- when to call the doctor if pain won't go away or gets worst or pt is unable to eat or drink Diverticulosis-pt education - 1. avoid popcorn, seeds, nuts, strawberries, or any food that has seeds
- eat high fiber foods and whole grains
- increase fluids and decrease alcohol
- avoid laxatives ulcerative colitis-diagnostics - 1. MRI/CT looking for inflammation
- electrolytes may be off
- Upper GI
- colonoscopy ulcerative colitis-medications - No specific medications
Electrolytes may need to be replaced ulcerative colitis- possible complications - 1. nutritional deficiencies
- electrolytes may be off
- depression Crohn's Disease-priority nursing concerns - 1. fluid and electrolyte imbalance
- skin breakdown
- unintentional weight loss GERD-medication - 1. Famotidine- prevents ulcers after trauma or surgery. decreases the production of gastric acids
- Antacids-deactivates pepsin to increase pH
- Histamine antagonist- decreases acid secretion
- PPIs- do not use for long periods of time due risk of pneumonia or GI infection Diarrhea - intervention - 1. treat cause
- fluid and electrolyte replacement
- skin care Diarrhea- priority nursing concerns - 1. precautions
- cardiac for electrolyte imbalance
- skin care Diarrhea- possible complication - 1. dehydration
- cardiac issues
- skin breakdown vomiting-priority nursing concerns - 1. dehydration
- Blood test looking for elevated pancreatic enzymes Pancreatic Cancer- Interventions - 1. Whipple procedure-removal of the head of the pancreas
- Removal of the left side of the pancreas
- Removal of the entire pancreas
- chemotherapy
- radiation Pancreatic Cancer- Assessments - 1. assess weight loss
- assess skin and eyes for yellowing
- monitor urine and stool color
- assess pain Pancreatic Cancer- Pt Education - 1. stop smoking
- maintain healthy weight
- choosing a healthy diet Hepatitis A - fecal-oral route Hepatitis- Assessment - 1. sexual history
- travel history
- living environment
- water sources
- skin assessment- looking for jaundice
- VS
- abdomen assessment-N/V Hepatitis-Interventions - 1. rest to help liver help
- high carb diet with high calories but moderate fat and protein
- small meals
- Anti-nausea
- Anti-viral medication to treat symptoms Cholecystitis- pathophysiology - inflammation of the gall bladder resulting in a lack of bile salts secreted into the small intestine cholecystitis- interventions - 1. ERCP- use dye to locate any stones and potentially remove them
- Cholecystectomy- remove the gallbladder
- Lithotripsy- shock waves to break up the stones
- biliary catheter- open the flow
- NPO, pain management and determine cause, weight/height, I/O Cholecystitis-pt education - 1. lifestyle changes
- stop alcohol/smoking
- low fat diet
- epigastric pain
- incision care
