NUR 2392 Multidimensional Care II Exam 1 (V1) Study Guide

NUR 2392 Multidimensional Care II Exam 1 (V1) Study Guide Multidimensional Care II Exam 1 Study Guide *The exam questions are not limited to only what is listed on this guide, please refer to your chapter readings and module materials Ch. 21: Principles of Cancer Development ● Benign vs. Malignant cells ○ Benign: ■ Specific Morphology- they resemble the tissue they originated from (they look like the host). ■ Small Nuclear to Cytoplasmic Ratio- they have a similar structure inside the cell to normal cells and small nucleus. ■ Specific Function- they contribute to the body in some way. ■ Tight Adherence- they bind close together. ■ No Migration- they do not move around the body or invade other tissue sites. ■ Orderly Growth-they grow at a normal rate. ■ Euploidy- they have a normal amount of chromosomes per cell. ○ Malignant (Cancer): ■ Anaplasia- loss of appearance of the parent cell. ■ Large Nuclear to Cytoplasmic Ratio- they have a large nucleus and occupy space. ■ Specific Functions are Lost- they serve no purpose to the body. ■ Loose Adherence- loose binding of the cells, causing potential spread into the blood and body. ■ Migration/Metastasis- spreads and moves easily. ■ Loss of cellular regulation and contact- the cells will crowd, push, and grow on top of other cells. ■ Rapid Cell Division- the cells will be produced and grow at a faster rate ■ Aneuploidy- abnormal number of chromosomes per cell. ● Seven warning signs of cancer ○ “CAUTION” ■ C: changes in bowel or bladder habits ■ A: a sore that does not heal or mouth sources (mucositis) ■ U: unusual bleeding or discharge ■ T: thickening of a lump in a tissue ■ I: indigestion and dysphagia ■ O: obvious change in a wart or mole ■ N: nagging cough ● Cancer development stages of malignancy ○ Initiation: the normal cell becomes damaged which is irreversible and can lead to cancer developing ○ Promotion: repeat exposures to a damaging stimuli enhances growth- mutations can cause this ○ Progression: because of repeat exposures, there is an increase in production of malignant cells ○ Metastasis: movement of the cancer cells ■ Malignant transformation: some cells will divide enough to form a tumor area on top of tissue. ■ Tumor vascularization: cancer cells secrete tumor angiogenesis factor stimulating the blood vessels to bud and for channels to grow. ■ Blood Vessel Penetration: cancer cells break off from the main tumor and enzymes on the surface of the tumor cells make holes in the blood vessels, allowing the cancer cells to enter blood vessels and travel around the body. ■ Arrest and Invasion: cancer cells clump up in the blood vessel walls and invade new tissue aera to support continued growth of cancer cells and new tumors. ● Cancer classification: monitor tumor growth, aggression, progression, and to determine appropriate treatment. ○ Tumor grading: based on cellular aspects of cancer. ■ Based on the aggressiveness of the cancer cell and differentiation from the normal tissue. ● G0: the grade cannot be determined ● G1: Tumor cells are well differentiated and closely resemble the normal cells from which they arose.This grade is considered a low grade of malignant change.These tumors are malignant but are relatively slow growing. ● G2: Tumor cells are moderately differentiated; they still retain some of the characteristics of normal cells, but also have more malignant characteristics than do G1 tumor cells. ● G3: Tumor cells are poorly differentiated, but the tissue of origin can usually be established.The cells have few normal cell characteristics. ● G4: Tumor cells are poorly differentiated and retain no normal cell characteristics.Determination of the tissue of origin is difficult and perhaps impossible. ○ Plodiy: based on the number of chromosomes the cell has ■ Cancer cells will have an abnormal number of chromosomes in their cells. ● Euploidy: normal amount of cell chromosomes- 46 with 23 pairs. ● Aneuploidy: abnormal number and formation of chromosomes in cancer cells. ○ Staging: determines the exact location of the cancer, how large the tumor is, and if it is spreading. ■ Clinical staging: assesses patient symptoms to determine size and spread. ■ Surgical staging: assesses size, number, sites, and spread by visualization at surgery. ■ Pathological staging: determining the tumor size, number, sites, and spread by pathologic examination of tissues obtained at surgery. ○ TNM- tumor, node, metastasis ■ Describes the anatomic extent of cancers. 1-4. 1 is that there is no spreading or is small and 4 is that there is a large spread and that the tumor is large also. ● Primary tumor (T): how large the tumor is . ○ Tx: primary tumor cannot be assessed ○ T0: no evidence of primary tumor ○ Tis: carcinoma in situ- pre cancer ○ T1, T2, T3, T4: increasing size and/or local extent of primary tumor ● Regional lymph nodes (N): based on how many nodes the tumor takes over in the body. ○ Nx: regional lymph nodes cannot be assessed ○ N0: no regional lymph node metastasis ○ N1, N2, N3: increasing involvement of regional lymph nodes ● Distant metastasis (M): if the cancer is moving or not moving. ○ Mx: presence of distant metastasis cannot be assessed ○ M0: no distant metastasis ○ M1: distant metastasis ○ Doubling time: the amount of time it takes for a tumor to double in size. Will help determine tumor growth. ○ Mitotic index: the percentage of actively dividing cells within a tumor. ○ Cancers are classified by the tissue they originate from. Other ways to classify cancer include: biologic behavior, anatomic site, and degree of differentiation ■ Adeno = epithelial ■ Chondro = cartilage ■ Fibro = fibrous connective ■ Glio = glial cells (brain) ■ Hemangio = blood vessel ■ Hepato = liver