Adult Health 2- EXAM 1
What are the normal hemoglobin and hematocrit levels? - Hgb: 12-16 female & 14-18 male
Hct: 37-47% female & 42-52% male
What is the normal WBC level? - 5,000-10,000
What is normal platelet, INR, and PTT? - 150,000-400,000
0.8-1.1
25-35 seconds
What are normal BUN and creatinine levels? - BUN- 10-20
Creatinine- 0.5-1.3
What is a normal fasting BG and A1C? - normal <100, prediabetic 100-125, diabetic >126
normal 4.5-5.5%, prediabetic 5.5-6.4%, diabetic >6.5%
What is occurring during cancer? - In normal cell division, cells known when to die (apoptosis) and in
cancer cell division the cell ignores the message to die and continues growing. Neoplasia is any new or
continued cell growth not needed for normal development. Cancer (malignancy) is a type of abnormal
cell growth in which cellular regulation is lost resulting in new tissues that serve no useful function.
,Primary tumors are identified by the tissue from which they arose and in secondary tumors (metastatic)
cancer cells move from primary location by breaking off and establishing remote colonies.
What are the risk factors for developing cancer? - Factors like immunity, age, and genetic risk affect
whether an adult is likely to develop cancer. Adults older than 60 years have reduced immunity and a
higher incidence of cancer compared with that of the general population. Immunity is important for as it
puts patients at risk if they have preexisting condition or if they take steroids (suppresses immune
system) or any other medications to treat conditions/diseases (sickle cell)
What is the acronym to teach older patients to be aware of for signs of cancer? - C: changes in bowel or
bladder habits
A: a sore that does not heal
U: unusual bleeding or discharge
T: thickening or lump in the breast or elsewhere
I: indigestion or difficulty swallowing
O: obvious change in wart or mole
N: nagging cough or hoarseness
What are the three interacting factors that influence cancer development? & what is genetic testing? -
exposure to carcinogens, genetic predisposition, and immunity. Genetic testing for certain cancers is
available to provide risk information or rule out an adult's genetic risk for specific cancer types but DOES
NOT diagnose cancer.
What are carcinogens? - Cancer causing agents or things that can help cause cancer such as radiation
(ionizing x-rays and UV), chemicals pesticides, bacteria (H pylori causes stomach cancer, GERD), genetics
(family hx, BRCA 1 & 2 mutation), viruses, hormones, and lifestyle. Most cancer is related to tobacco
usage (chemical carcinogens). Physical carcinogens are radiation, chronic irritation. Viral carcinogens are
oncoviruses, HPV (cervical, skin cancer), hep B/C (liver cancer), epstein-barr (mono).
What is primary and secondary prevention for cancer? - Primary: includes avoiding all carcinogens and
modifying risk factors to avoid cancer causing agents. It also includes removal of at risk tissue such as
,moles or polyps. Also wearing sun screen, smoking cessation, healthier diet (avoid animal fat, avoid
nitrates, minimize red meat, eat food high in vitamin A/C.), chemoprevention (aspirin, vit D), vaccination
(HPV).
Secondary: not preventing the cancer but checking for it with regular screening. Screenings even if they
come out negative. This is to try and catch cancer early. Secondary prevention may be necessary for
those of old age or family hx of cancer.
What are some of the impacts cancer and treatments with have on a patient? - Impaired immunity and
clotting: decreased production of healthy bone marrow can occur when cancer starts in or invades bone
marrow (bad bc bone marrow makes RBC, WBC, and platelets). When tumor cells metastasize in bone
marrow they reduce the production and function of healthy WBC which impair immunity. Also chemo
reduces neutrophil WBC count.
Altered GI function: patients undergoing chemo are at risk for n/v, diarrhea and constipation. Cachexia
(extreme body wasting and malnutrition) occur during treatment or with advanced cancer. This is why
nutritional support for cancer patients are critical and may include TPN or high protein diet. Tumors in
the GI tract may also alter the ability to absorb nutrients and eliminate wastes.
Altered peripheral nerve function: though tumors in the spine can change peripheral nerve function the
more common cause is chemotherapy. Chemo agents injure peripheral nerves leading to peripheral
neuropathy with reduced sensory perception. These patients report loss of sensation, numbness,
tingling, neuropathic pain and change in gait and balance.
Motor and sensory deficits: occur when cancer invades bone or brain and compresses nerves. Bone
becomes thinner and puts pt at risk for fractures. Bone metastasis causes pain, fractures, spinal cord
compression and hypercalcemia. SCC and hypercalcemiaa are emergencies.
Altered resp and cardiac function: Tumors that grow in the airways cause obstruction. If lung tissue is
involved lung capacity is decreased leading to dyspnea and hypoxemia. Tumors can also press on the
blood and lymph system in the chest which results in airway compression and dyspnea.
, What is internal and external radiation therapy? - Radiation uses high energy to kill cancer cells with the
goal of minimal damaging effects on surrounding normal tissue. External beam radiation is delivered
outside the patient, so the patient is not radioactive. The exact tumor location is found and marked.
Internal radiation or brachytherapy uses radiation seeds, ribbons, or capsules that come into direct
contact with the tumor. This method provides a higher dose of radiation in the tumor. Brachytherapy
can include inserting catheter into tumor bed or ingestion of radiation like iodine 131.
What are the side effects of radiation? - The most common side effect of radiation is radiation dermatitis
which can range from redness/hyperpigmentation and rash to skin desquamation. Other SE include
altered taste, fatigue, bone marrow suppression. Late effects may include alterations to CNS, head and
neck, lung, heart, pericarditis, breast and chest wall.
What is patient teaching for external and internal radiaiton? - External: teaching about skin care needs is
a priority intervention. Instruct patient not to remove temporary ink markings until radiation therapy is
completed. Also teach to avoid skin irritation and friction from clothing. However, it is still important for
good skin hygiene. Tell patients to use only powders, lotion and creams that are okayed by their HCP,
wear soft clothing, avoid belts/buckles/straps, avoid exposure to sun, and avoid heat exposure
Internal: assign patient to private room with private bath, keep door shut as much as possible, wear
dosimeter film badge at all times that measures amount of radiation exposure, wear lead apron when
providing care.
What is chemotherapy? - Chemo are drugs that are used to kill cancer cells and disrupt their cellular
regulation. Chemo can be used alone, before or after treatment or in combination. Unlike surgery or
radiation, cytotoxic chemotherapy kills both normal and cancer cells. · Neoadjuvant chemo is used to
shrink tumor before surgery or radiation and adjuvant chemo is used to kill remaining cancer cells
following radiation or surgery. Chemo puts patient at high risk for infection, immunosuppression, and
complications.
What are some safety tips for chemo and chemo treatment issues? - Safety: chemo can be absorbed
through the skin and mucous membranes. PPE such as eye protection, mask, double gloving (nitrile),
and non permeable gown should be used. Use caution when handling bodily fluids from a patient that
has received chemo within 48 hours—this also applies to chemo pills/IV do not cut or crush without
gloves as they are BIOHAZARDROUS.
What are the normal hemoglobin and hematocrit levels? - Hgb: 12-16 female & 14-18 male
Hct: 37-47% female & 42-52% male
What is the normal WBC level? - 5,000-10,000
What is normal platelet, INR, and PTT? - 150,000-400,000
0.8-1.1
25-35 seconds
What are normal BUN and creatinine levels? - BUN- 10-20
Creatinine- 0.5-1.3
What is a normal fasting BG and A1C? - normal <100, prediabetic 100-125, diabetic >126
normal 4.5-5.5%, prediabetic 5.5-6.4%, diabetic >6.5%
What is occurring during cancer? - In normal cell division, cells known when to die (apoptosis) and in
cancer cell division the cell ignores the message to die and continues growing. Neoplasia is any new or
continued cell growth not needed for normal development. Cancer (malignancy) is a type of abnormal
cell growth in which cellular regulation is lost resulting in new tissues that serve no useful function.
,Primary tumors are identified by the tissue from which they arose and in secondary tumors (metastatic)
cancer cells move from primary location by breaking off and establishing remote colonies.
What are the risk factors for developing cancer? - Factors like immunity, age, and genetic risk affect
whether an adult is likely to develop cancer. Adults older than 60 years have reduced immunity and a
higher incidence of cancer compared with that of the general population. Immunity is important for as it
puts patients at risk if they have preexisting condition or if they take steroids (suppresses immune
system) or any other medications to treat conditions/diseases (sickle cell)
What is the acronym to teach older patients to be aware of for signs of cancer? - C: changes in bowel or
bladder habits
A: a sore that does not heal
U: unusual bleeding or discharge
T: thickening or lump in the breast or elsewhere
I: indigestion or difficulty swallowing
O: obvious change in wart or mole
N: nagging cough or hoarseness
What are the three interacting factors that influence cancer development? & what is genetic testing? -
exposure to carcinogens, genetic predisposition, and immunity. Genetic testing for certain cancers is
available to provide risk information or rule out an adult's genetic risk for specific cancer types but DOES
NOT diagnose cancer.
What are carcinogens? - Cancer causing agents or things that can help cause cancer such as radiation
(ionizing x-rays and UV), chemicals pesticides, bacteria (H pylori causes stomach cancer, GERD), genetics
(family hx, BRCA 1 & 2 mutation), viruses, hormones, and lifestyle. Most cancer is related to tobacco
usage (chemical carcinogens). Physical carcinogens are radiation, chronic irritation. Viral carcinogens are
oncoviruses, HPV (cervical, skin cancer), hep B/C (liver cancer), epstein-barr (mono).
What is primary and secondary prevention for cancer? - Primary: includes avoiding all carcinogens and
modifying risk factors to avoid cancer causing agents. It also includes removal of at risk tissue such as
,moles or polyps. Also wearing sun screen, smoking cessation, healthier diet (avoid animal fat, avoid
nitrates, minimize red meat, eat food high in vitamin A/C.), chemoprevention (aspirin, vit D), vaccination
(HPV).
Secondary: not preventing the cancer but checking for it with regular screening. Screenings even if they
come out negative. This is to try and catch cancer early. Secondary prevention may be necessary for
those of old age or family hx of cancer.
What are some of the impacts cancer and treatments with have on a patient? - Impaired immunity and
clotting: decreased production of healthy bone marrow can occur when cancer starts in or invades bone
marrow (bad bc bone marrow makes RBC, WBC, and platelets). When tumor cells metastasize in bone
marrow they reduce the production and function of healthy WBC which impair immunity. Also chemo
reduces neutrophil WBC count.
Altered GI function: patients undergoing chemo are at risk for n/v, diarrhea and constipation. Cachexia
(extreme body wasting and malnutrition) occur during treatment or with advanced cancer. This is why
nutritional support for cancer patients are critical and may include TPN or high protein diet. Tumors in
the GI tract may also alter the ability to absorb nutrients and eliminate wastes.
Altered peripheral nerve function: though tumors in the spine can change peripheral nerve function the
more common cause is chemotherapy. Chemo agents injure peripheral nerves leading to peripheral
neuropathy with reduced sensory perception. These patients report loss of sensation, numbness,
tingling, neuropathic pain and change in gait and balance.
Motor and sensory deficits: occur when cancer invades bone or brain and compresses nerves. Bone
becomes thinner and puts pt at risk for fractures. Bone metastasis causes pain, fractures, spinal cord
compression and hypercalcemia. SCC and hypercalcemiaa are emergencies.
Altered resp and cardiac function: Tumors that grow in the airways cause obstruction. If lung tissue is
involved lung capacity is decreased leading to dyspnea and hypoxemia. Tumors can also press on the
blood and lymph system in the chest which results in airway compression and dyspnea.
, What is internal and external radiation therapy? - Radiation uses high energy to kill cancer cells with the
goal of minimal damaging effects on surrounding normal tissue. External beam radiation is delivered
outside the patient, so the patient is not radioactive. The exact tumor location is found and marked.
Internal radiation or brachytherapy uses radiation seeds, ribbons, or capsules that come into direct
contact with the tumor. This method provides a higher dose of radiation in the tumor. Brachytherapy
can include inserting catheter into tumor bed or ingestion of radiation like iodine 131.
What are the side effects of radiation? - The most common side effect of radiation is radiation dermatitis
which can range from redness/hyperpigmentation and rash to skin desquamation. Other SE include
altered taste, fatigue, bone marrow suppression. Late effects may include alterations to CNS, head and
neck, lung, heart, pericarditis, breast and chest wall.
What is patient teaching for external and internal radiaiton? - External: teaching about skin care needs is
a priority intervention. Instruct patient not to remove temporary ink markings until radiation therapy is
completed. Also teach to avoid skin irritation and friction from clothing. However, it is still important for
good skin hygiene. Tell patients to use only powders, lotion and creams that are okayed by their HCP,
wear soft clothing, avoid belts/buckles/straps, avoid exposure to sun, and avoid heat exposure
Internal: assign patient to private room with private bath, keep door shut as much as possible, wear
dosimeter film badge at all times that measures amount of radiation exposure, wear lead apron when
providing care.
What is chemotherapy? - Chemo are drugs that are used to kill cancer cells and disrupt their cellular
regulation. Chemo can be used alone, before or after treatment or in combination. Unlike surgery or
radiation, cytotoxic chemotherapy kills both normal and cancer cells. · Neoadjuvant chemo is used to
shrink tumor before surgery or radiation and adjuvant chemo is used to kill remaining cancer cells
following radiation or surgery. Chemo puts patient at high risk for infection, immunosuppression, and
complications.
What are some safety tips for chemo and chemo treatment issues? - Safety: chemo can be absorbed
through the skin and mucous membranes. PPE such as eye protection, mask, double gloving (nitrile),
and non permeable gown should be used. Use caution when handling bodily fluids from a patient that
has received chemo within 48 hours—this also applies to chemo pills/IV do not cut or crush without
gloves as they are BIOHAZARDROUS.
