NUR314 Exam 2 Oncology Case Study Short questions and answers. Guaranteed for Excellence

What is commonly Involved in a biopsy? •The surgeon will excise tissue (nevi + margins) to place under microscope to identify type of cell involved (benign or malignant) or type of cancer involved (basal, squamous, melanoma). •Local anesthetic used to numb area. Stitches to close incision. •May take up to a week for results. Why are Multiple Biopsies Ordered for some patients? Specifically Jim in the case study. To determine if lung mass/lymph node tissue are of the same origin as the original biopsy (melanoma) or if it would be secondary cancer. Brainpower What is the importance of biopsies and other diagnostics? Helps determine modality of treatment (surgery, chemo, radiation), sequence of treatment, and length of time/timeline of treatment What factors affect prognosis and treatment for cancer? •Size of tumor, depth (TNM) •Tumor size (0-4), # of Node Involvement (0-3), presence of Metastasis (0 or 1) •Staging (evidence of invasiveness) •Histology (well differentiated vs not differentiated at all) •Grading: Lower grade=less aggressive cancer vs Higher grade=very aggressive cancer •Presence of co-morbid conditions •Psychological status •Personal desire Mr. Hendrix asks what chemotherapy is. Using simple terms, how would explain chemotherapy and how it works to him? Chemotherapy is a medication that targets and destroys these abnormal melanocytes. Chemotherapy can help shrink and decrease tumor burden and control further growth of the abnormal melanocytes leading to future remission or cure. Mr. Hendrix tells you he heard chemotherapy makes you really sick. What teaching is important to conduct with him regarding side effects or complications of his chemotherapy? Chemotherapy works on active cells. Active cells are cells that are growing and dividing into more of the same type of cell. Cancer cells are active, but so are some healthy cells. These include cells in your blood, mouth, digestive system, and hair follicles. Side effects happen when chemotherapy damages these healthy cells. You are reviewing how to manage alopecia with Mr. Hendricks. You determine further teaching is needed after he says: A."The chemotherapy may cause me to lose all my body hair" B."Wearing a scarf or hat when outside will help to protect me." C."My hair should begin to return 2 months or so after treatment ends." D."I can prevent hair loss if I wash every other day with a gentle shampoo." D."I can prevent hair loss if I wash every other day with a gentle shampoo." 3 multiple choice options Mr. Hendrix is admitted to the hospital for his first round of chemotherapy. What chemotherapy precautions would you implement? •Place biohazard sign on the patient's door. •PPE (2 pairs of gloves or chemo gloves), gown, mask, and shield used to handle patient effluent (e.g. urine, feces) •Place chux over toilet, double flush when flushing the toilet •Special trash can and sharps container (yellow) to handle waste and sharps •Special laundry bag to handle sheets/blankets/gown used by patient •Equishield is a special device used with chemotherapy tubing. It prevents the nurses from getting the fluid on themselves during administration. How long are Chemo precautions kept in place? 48 hours after last dose of chemotherapy What precautions should be in place once a patient goes home? •Precautions still in place 48 hours after chemotherapy •Close lid of toilet when flushing (men should sit to void to prevent splash) •Wear two pairs of gloves when handling linens/clothes/etc. •Use separate toilet if able. If not, wash hands well if they were to come into contact with effluent •Wash soiled clothes/linens in separate load (use mild detergents) •Use condoms during sex, avoid open mouth kissing/sharing of saliva In an effort to limit Mr. Hendricks risk for infection, which of the following nursing