MULTIDIMENSIONAL CARE 2 EXAM
ONE
Cancer Treatment - ANSCancer treatment is dependent on the type of cancer and how far
the cancer has progressed.
Common problems associated with cancer treatment include infections, bleeding, pain,
malnutrition, fatigue, and psycho social issues.
curative surgery - ANSRemoval of the cancerous tumor when confined to a specific body
location
palliative surgery - ANSIs performed to treat the problems that the cancer or treatment of
cancer has created.
prophylatic surgery - ANSIs performed to remove tissues that are not cancerous but can
become cancerous.
diagnostic surgery - ANSIs performed in order to determine if cancer cells are present
Reconstruction/Restorative surgery - ANSIs performed following treatment to restore the
patients body function such as breast reconstruction following a mastectomy.
Pre-operative care - ANSEnsure necessary test are performed such as blood work, EKG
and chest x ray and ensure the patient has remained NPO for the required time frame
Education - ANSPatient education regarding the type of procedure, post-operative,
management to include any restrictions, wound care, signs and symptoms of infection,
medication, follow up treatment, and follow up appointments
Nutrition - ANSEnsure the patient has a consult for the dietitian to assess nutritional and
cultural needs
Pain Control - ANSEnsure adequate pain control by assessing a patients' pain level
frequently and administering the prescribed medications.
Post-op complications - ANSAssess for post operative complications such as bleeding,
infection, respiratory problems such as acute respiratory distress, pneumonia, and deep vein
thrombosis/ pulmonary embolism. Encourage coughing and deep breathing using IS, ensure
the patient has DVT/PE prophylaxis ordered either pharmacological or mechanical
internal radiation therapy - ANSRadiation treatment in which the radiation is placed inside
the body in a solid or liquid form.
,External Radiation therapy - ANSRadiation treatment that is site specific to the area of
cancer. The treatment is administered via an external machine. Ensure treatment targets
specific area by marking the sites.
Assure adequate rest - ANSFatigue is a common side effect of radiation therapy. Be sure the
patient has adequate rest periods by grouping periods of activities to allow more time for
rest.
Skin care - ANSperform frequent skin assessment and implement measures to maintain and
manage skin breakdown
Radiation implants - ANSPlace patient in a private room, maintain bed rest, never touch
implants should they become dislodged, utilize contact precautions when handling linens
and body fluids. Care providers should NOT be pregnant.
radiation enteritis - ANSCommon side effect of radiation therapy. Ensure the patient is
consuming a low fat diet and administer medication to treat nausea and diarrhea.
Emotional support - ANSProvide emotional and spiritual support to the patient and family by
providing education.
Alkylating agents (Chemo types) - ANSKeeps cells from duplicating damaged DNA
Antimetabolites (chemo type) - ANSInterfere with DNA and RNA growth
Anti-tumor antibiotics (chemo type) - ANSChange the DNA to keep it from multiplying
Topoisomerase inhibitors (chemo type) - ANSSeperates the strands of DNA to enable them
to be copied.
Mitotic Inhibitors (chemo type) - ANSStop cells from dividing
Goals of Chemotherapy Include: - ANS- Cure: goal is to destroy cancer
-Control: goal is to shrink or prevent further growth of the tumor
-Palliation: goal is to relieve the symptoms of the cancer, the hope for a cure or control is
dismal
Chemotherapy: Nursing Care - ANS-Ensure the patient maintains adequate intake. Consult
the dietitian to assess nutritional and cultural needs. Administer anti emetics as prescribed.
- Pain control
- Assure adequate rest
- Skin care
-Emotional support
-Chemotherapy precautions
- Monitor for side effects and treat accordingly
Immunotherapy/ Targeted Therapy - ANS- Boost the body's immune system to help fight
cancer
, - Stops or slows cancer cell growth
- Stops the spread of cancer cells
Immunotherapy/ Targeted Therapy: Nursing Care - ANS-Monitor for side effects and treat
accordingly
- Practice safe drug handling to avoid harm to patient and self
- Monitor labs and treat
-Monitor vital signs
-provide patient education
-Provide emotional and spiritual support to the patient and family
Hormone Therapy: Goal of Therapy - ANS-Control cancers that are sensitive to hormone
production
- Slows the growth of cancer cells
Hormone Therapy: Nursing Care - ANS- Monitor for side effects of therapy
-Provide patient education
-Provide emotional support and spiritual support to patient and family
stem cell transplant: TYPES - ANSAutologous transplant: Cells are harvested from the
patient's bone marrow before the start of chemotherapy and transfused following treatment
Allogenic transplant: Cells are from a donor that closely matches the patient
stem cell transplant: Nursing Care - ANS- Monitor patient for signs and symptoms of
rejection
-Administer medication as prescribed
-Monitor patient for signs and symptoms of infection
- emotional/ spiritual support
Principles of Cancer Development (Carcinogenesis and oncogenesis) - ANSCancer is an
abnormal growth of cells as a result of exposure to chemicals, substances, behavior choices,
age, and genetics due to loss of cellular regulation. Once the cell growth and function is
altered and the abnormal cells continue to multiply the cells are maintained in the
surrounding tissue. As time progresses the cancer cells often invade nearby tissues. This
abnormal growth of cells is called a tumor. Tumors can be classified as cancerous or
noncancerous.
The basic function of cellular regulation is to create fuel for the body, produce proteins,
transport materials, and dispose of waste. Cellular regulation maintains homeostasis in
response to extracellular signals by promoting cell growth and reproduction. Cancer
develops from a disruption of the normal cell regulation leading to continuous cell division
with genetic defects.
Steps of Cellular Regulation for Cancer Cells:
Initiation - ANSnormal cells become damaged which is irreversible and leads to cancer
development
ONE
Cancer Treatment - ANSCancer treatment is dependent on the type of cancer and how far
the cancer has progressed.
Common problems associated with cancer treatment include infections, bleeding, pain,
malnutrition, fatigue, and psycho social issues.
curative surgery - ANSRemoval of the cancerous tumor when confined to a specific body
location
palliative surgery - ANSIs performed to treat the problems that the cancer or treatment of
cancer has created.
prophylatic surgery - ANSIs performed to remove tissues that are not cancerous but can
become cancerous.
diagnostic surgery - ANSIs performed in order to determine if cancer cells are present
Reconstruction/Restorative surgery - ANSIs performed following treatment to restore the
patients body function such as breast reconstruction following a mastectomy.
Pre-operative care - ANSEnsure necessary test are performed such as blood work, EKG
and chest x ray and ensure the patient has remained NPO for the required time frame
Education - ANSPatient education regarding the type of procedure, post-operative,
management to include any restrictions, wound care, signs and symptoms of infection,
medication, follow up treatment, and follow up appointments
Nutrition - ANSEnsure the patient has a consult for the dietitian to assess nutritional and
cultural needs
Pain Control - ANSEnsure adequate pain control by assessing a patients' pain level
frequently and administering the prescribed medications.
Post-op complications - ANSAssess for post operative complications such as bleeding,
infection, respiratory problems such as acute respiratory distress, pneumonia, and deep vein
thrombosis/ pulmonary embolism. Encourage coughing and deep breathing using IS, ensure
the patient has DVT/PE prophylaxis ordered either pharmacological or mechanical
internal radiation therapy - ANSRadiation treatment in which the radiation is placed inside
the body in a solid or liquid form.
,External Radiation therapy - ANSRadiation treatment that is site specific to the area of
cancer. The treatment is administered via an external machine. Ensure treatment targets
specific area by marking the sites.
Assure adequate rest - ANSFatigue is a common side effect of radiation therapy. Be sure the
patient has adequate rest periods by grouping periods of activities to allow more time for
rest.
Skin care - ANSperform frequent skin assessment and implement measures to maintain and
manage skin breakdown
Radiation implants - ANSPlace patient in a private room, maintain bed rest, never touch
implants should they become dislodged, utilize contact precautions when handling linens
and body fluids. Care providers should NOT be pregnant.
radiation enteritis - ANSCommon side effect of radiation therapy. Ensure the patient is
consuming a low fat diet and administer medication to treat nausea and diarrhea.
Emotional support - ANSProvide emotional and spiritual support to the patient and family by
providing education.
Alkylating agents (Chemo types) - ANSKeeps cells from duplicating damaged DNA
Antimetabolites (chemo type) - ANSInterfere with DNA and RNA growth
Anti-tumor antibiotics (chemo type) - ANSChange the DNA to keep it from multiplying
Topoisomerase inhibitors (chemo type) - ANSSeperates the strands of DNA to enable them
to be copied.
Mitotic Inhibitors (chemo type) - ANSStop cells from dividing
Goals of Chemotherapy Include: - ANS- Cure: goal is to destroy cancer
-Control: goal is to shrink or prevent further growth of the tumor
-Palliation: goal is to relieve the symptoms of the cancer, the hope for a cure or control is
dismal
Chemotherapy: Nursing Care - ANS-Ensure the patient maintains adequate intake. Consult
the dietitian to assess nutritional and cultural needs. Administer anti emetics as prescribed.
- Pain control
- Assure adequate rest
- Skin care
-Emotional support
-Chemotherapy precautions
- Monitor for side effects and treat accordingly
Immunotherapy/ Targeted Therapy - ANS- Boost the body's immune system to help fight
cancer
, - Stops or slows cancer cell growth
- Stops the spread of cancer cells
Immunotherapy/ Targeted Therapy: Nursing Care - ANS-Monitor for side effects and treat
accordingly
- Practice safe drug handling to avoid harm to patient and self
- Monitor labs and treat
-Monitor vital signs
-provide patient education
-Provide emotional and spiritual support to the patient and family
Hormone Therapy: Goal of Therapy - ANS-Control cancers that are sensitive to hormone
production
- Slows the growth of cancer cells
Hormone Therapy: Nursing Care - ANS- Monitor for side effects of therapy
-Provide patient education
-Provide emotional support and spiritual support to patient and family
stem cell transplant: TYPES - ANSAutologous transplant: Cells are harvested from the
patient's bone marrow before the start of chemotherapy and transfused following treatment
Allogenic transplant: Cells are from a donor that closely matches the patient
stem cell transplant: Nursing Care - ANS- Monitor patient for signs and symptoms of
rejection
-Administer medication as prescribed
-Monitor patient for signs and symptoms of infection
- emotional/ spiritual support
Principles of Cancer Development (Carcinogenesis and oncogenesis) - ANSCancer is an
abnormal growth of cells as a result of exposure to chemicals, substances, behavior choices,
age, and genetics due to loss of cellular regulation. Once the cell growth and function is
altered and the abnormal cells continue to multiply the cells are maintained in the
surrounding tissue. As time progresses the cancer cells often invade nearby tissues. This
abnormal growth of cells is called a tumor. Tumors can be classified as cancerous or
noncancerous.
The basic function of cellular regulation is to create fuel for the body, produce proteins,
transport materials, and dispose of waste. Cellular regulation maintains homeostasis in
response to extracellular signals by promoting cell growth and reproduction. Cancer
develops from a disruption of the normal cell regulation leading to continuous cell division
with genetic defects.
Steps of Cellular Regulation for Cancer Cells:
Initiation - ANSnormal cells become damaged which is irreversible and leads to cancer
development
