NUR 356 Exam 4 Test With Complete Solution

NUR 356 Exam 4 Te st With Complete Soluti on What are the two major dysfunctions in the process of cancer development? - ANSWER Defective cell proliferation (growth) Defective cell differentiation Process of Cancer Developmett - ANSWER 1. Initiation: mutation of genes - can be inherited or acquired 2. Promotion: reversible proliferation of altered cells 3. Progression: increased growth of tumor, invasiveness, metastasis Reversible activities of promotion - ANSWER Obesity, smoking, alcohol use, dietary fat Carcinogens - ANSWER cancer causing agents Failure of protective mechanisms lets them enter cells Examples: chemical, radiation, viral Chemical carcinogens - ANSWER - benzene - arsenic - formaldehy de Radiation - ANSWER Damages DNA UV radiation associated w/ melanoma & squamous/basal cell carcinoma Viral Carcinogens - ANSWER -Human pappilomavirus (HPV) (squamous cell carcinoma) -Hepatitis B Virus (hepatocellular carcinoma) -Epstein-Barr virus (EBV) (lymphoma) -HIV (Kaposi sarcoma) Tumor Classification - ANSWER Anatomical Histology (grading severity) Extent (staging) TNM classification system - ANSWER T: tumor size and invasiveness (1- 4) N: spread to lymph nodes (0- 2) M: metastasis (0- 1) Clinical staging classifications - ANSWER 0: Cancer in situ 1: Tumor limited to tissue of origin; localized tumor growth 2: Limited local spread 3: Extensive local and regional spread 4: Metastasis What is the only definitive means to diagnose cancer? - ANSWER pathological evaluation of a tissue Lifestyle habits to reduce cancer risks - ANSWER - recommended cancer scree nings - self-examination - know the 7 warning signs - seek medical care early - avoid/reduce exposure to carcinogens (cigarettes, sun exposure) - healthy diet and weight - limit alcohol - regular exercise and rest - family risks Goals of cancer treatment - ANSWER cure, control, palliation Cancer Tx: surgery - ANSWER Prevention: eliminate/reduce risk of cancer Cure and control: remove necessary tissue, follow with chemo or radiatio n Supportive/palliative care: gastric feeding tube, fixation of bones at risk for pathologic fracture Cancer Tx: Chemotherapy - ANSWER Antineoplastic: chemical therapy, for most solid tumors and hematologic cancer, effects against dividing cells, proble ms: resting/non cycling cells as tumors get large and cells become inactive - typically given in combination - route: PO, IM, IV (most common) - deliver high concentration of drugs directly to tumor - delivery methods: intraarterial intraperitoneal, intrathecal/intraventricular, intravesical bladder - can't distinguish between normal and cancer cells - mutated cancer cells can become resistant Cancer Tx: radiation - ANSWER Used to treat a carefully defined area of the body - low energy beam = quick, short penetration, used for skin - high energy beam = greater penetration, used for internal targets - divided delivery - used alone or with chemo or surgery Cancer Tx: side effects of chemo & radiation - ANSWER - bone marrow suppres sion - reduction in RBC & WBC (infection risk) - fatigue - GI disturbances - integumentary/mucosal reactions - pulmonary effects (cough, SOB, pulmonary edema) - cardio - cognitive: chemo brain/mental fog - reproductive effects: fertility preservation - skin reactions in radiation treatment field - secondary cancers: leukemia, angiosarcoma, skin cancer Cancer Tx: immunotherapy - ANSWER Uses the immune system to fight cancer Aka biological therapy Boost/manipulate immune system Create environment not conducive for cancer cells Attack cancer cells Cancer Tx: targeted therapy - ANSWER Interferes w/ cancer growth by targeting specific cell receptors and pathways that are important in tumor growth