NURS 2207 Introduction To The Care Of The Adult
Health Client Increasingly Complex Hematologic
Disorders And Cancer: Qs & As
PATHO OF CANCER Right Ans - •Uncontrolled and unregulated growth of
cells-
**** proliferation and differentiation
the nursing care for the different patient goals Right Ans - •Curative: tries
to go back to normal life.
•Control: control cancer, size, reduce symptoms. Decrease risk of
reoccurrence
•Palliative: comfort measures until end of life. Die with dignity
normal differentiation Right Ans - •Stem Cell Divides and produces a
mature cell of whatever type it replicated.
•Contact inhibition: abrupt arrest of the cell cycle in fully differentiated
tissues and organs
•Generation time of cell - Tissues have some predetermined stem cells. The
time it takes for these cells to divide.
target tissues of chemotherapy Right Ans - Gi tract, bone marrow, and hair
follicles
- targets rapidly dividing cells
neoplasm Right Ans - (or tumor) is a mass of new tissue that grows
independently of its surrounding structures and has no physiologic purpose.
ex.) benign and malignant
benign neoplasm Right Ans - - Localized
- Solid mass
- Well-defined borders
- Frequently encapsulated
- Grow slowly & usually stop when they reach the boundaries of another
tissue, however, can be destructive
- Easily removed
- Usually do not reoccur
,Malignant Neoplasms Right Ans - •Grow aggressively
•Irregularly shaped
•Cut through surrounding tissues as they grow causing bleeding,
inflammation, necrosis
•Malignant cells travel from the primary tumor through the blood or lymph
system to invade other tissues and form a secondary tumor(s) (metastasis)
•Can reoccur
•Rob body of energy and nutrition as they grow
•The degree of anaplastic cells is a consideration in the classification and
staging
biology of cancer Right Ans - - Two major dysfunctions in the process of
cancer development:
- Defective cell proliferation (growth)
- Defective cell differentiation (maturation)
*** cell loses normal function
hyperplasia Right Ans - an increase in the number or density of normal
cells
metaplasia Right Ans - an adaptation of a cell due to a stressor in the
environment; normal for it's type but has developed in an abnormal location;
is a protective manner & is reversible when stressor ceases: changes shape of
form
- change from one cell to another
dysplasia Right Ans - loss of DNA control over differentiation occurring in
response to adverse conditions
- Reversible changes in size, shape and organization of mature cells
anaplasia Right Ans - regression of a cell to an immature or
undifferentiated cell type; not under DNA control: malignant
initiation stage of development Right Ans - •mutation in cell's genetic
structure
•Avoids apoptosis
•Irreversible
,promotion stage of development Right Ans - •Influenced by repeated
exposure to carcinogens.
•Reversible
•1 to 40 years often pass between exposure to external factors & detectable
cancers.
•Critical Mass
•1 cm = 1 Billion Cells
progression stage of development Right Ans - •Increased growth rate and
now act like malignant cells.
•Now can be invasiveness and stimulate angiogenesis. (can create own blood
supply and blood vessels- will steal blood including o2 and nutrients)
•Metastasis
- Not reversible
risk factors for cancer Right Ans - •Infectious
•Heredity: Familial predisposition
•Age: 80% occur after age 55
•Gender
•Socioeconomics: Low income are higher risk
•Stress: Continuous unmanaged stress (epinephrine & cortisol at high levels);
depressed immune system
•Diet: High fat, low fiber
•Occupational
•Tobacco: Dec. risk if quit before middle age
•Alcohol use
•Recreational Drug Use: Suppresses immune system; marijuana worse than
tobacco
•Obesity: BMI >30
•Lack of physical activity
•Sun Exposure
•Hep b, Epstein barr, herpes, HPV can cause cancer
•Hydrogenated oils and nitrates are direct links to cancers
•Tumor Associated Antigens (TAAs) Right Ans - - the altered cell surface
antigens found on cancer cells.- how the immune system knows to destroy
them
*** EXAMPLES: these are the immune cells responsible for seeking and
destroying cancer cells in the body
, •Cytotoxic T cells
•NK (natural killer) cells
•Monocytes and macrophages
•B lymphocytes
Immunologic Escape Right Ans - The process by which cancer cells evade
the immune system
•Produce weak surface antigens (TAA)
•Secrete immune system suppressing factors
•Immune system becomes ineffective
oncofetal antigens Right Ans - Type of tumor antigen that are found on
both the surfaces and the inside of cancer and fetal cells. Means the cell has
shifted to an immature metabolic pathway.
Ca-125 Right Ans - ovarian cancer
PSA Right Ans - prostate-specific antigen
CEA Right Ans - GI cancer, should disappear in third trimester
AFP Right Ans - marker for liver cancer
tumor suppressor genes Right Ans - A gene whose protein product inhibits
cell division, thereby preventing the uncontrolled cell growth that contributes
to cancer.
protooncogenes Right Ans - - Normal cellular genes that regulate cell
proliferation and differentiation that can become oncogenes.
- can turn on cell division. Can cause this to accelerate
diagnosis of cancer Right Ans - •HEMATOLOGY STUDIES
•CBC (HgB, HCT, WBC)
•CMP
•PT/INR
•URINE STUDIES
•AMYLASE
•BILIRUBIN
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