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  • 11/27/10 A mole that is asymmetric is something to be concerned about
  • 11/27/10
  • When a CA dx is made: Grading of the cancer: how similar or different they look compared to normal cells
  • 11/27/10 Biopsy tells the MD how they can treat the CA. If there is no CA in the lymph nodes, then a breast CA pt might only need to radiation to the one spot where the cancer was found If the lymph nodes are involved, plus the breast then the patient will be on chemotherapy
  • These tests are only done when someone has symptoms.
  • Ex: Lets say someone has lymphoma: we can try to cure it if the grade is I or II maybe III, with aggressive chemo for a long time, maybe some total body radiation, or a bone marrow transplant Control: sometimes there is not a cure (multiple myleoma). Can we give people long expanses of good life? Can we slow down the rate of progression? If we can’t cure or control CA, then Palliation is a acceptable objective for tx: Care of symptoms. Not in anyway trying to cure CA, not even possible to control a CA. We can keep people out of pain, we can stop their muscle spasms, help dry up secretions in their mouth.
  • Radiation can be used for cure, control, or palliation. Watch out for F/E imbalances, diarrhea, eat potassium rich food Pelvic area: diarrhea, cystitis, Skin reactions: sun burn Teach people not to put anything on reddened skin. Aloe from a plant or green aloe gel can be used. Teach people to wear soft, cotton clothing. No polyester, no tight fitting clothing. Water and soap are fine, but don’t rub the area with any soap. Decreased salivia, lose taste ability, metallic taste in mouth
  • Ex: Va
  • Sessions are usually 3 weeks apart Given IV; there are some PO forms (PO is not as strong) Chemo is so strong.. (like Draino) if you have an IV infiltration, if that chemo leaks out and gets in your skin.. It kills your skin!!!! VESICANT!
  • Blood cells are fast growing cells Most common reason for being on an oncology unit: high fever, incredibly low WBC count, and all kinds of infections
  • One of the things on people’s to do list before starting chemo: is to get dental work done or any invasive procedures!
  • Neupogen: bone marrow stimulate; stimulates production of WBC; SQ injection. THIS HURTS!!!!!!!!!!!!!!!!!!! When blood cells start being produced they are produced really really fast!!!!!! --- once WBC count goes above 2000 they are usually allowed to go home!
  • KNOW LAB VALUES!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Normal platelet counts: 150,000-450,000 What if someone has a fib and is taking coumadin and they have cancer? They have to stop coumadin during chemo therapy
  • 11/27/10 No razors, no cutting finger nails
  • Checking the pink of the conjunctiva of the eyes is a good way to check for anemia!!!! Men Hemoglobin: 14-18; Hemtocrit: 42-52% Women Hemoglobin: 12-16 Hemtocrit: 38-48% If hemoglobin is 6; stopping oxygen to the heart, SOB is from overall lack of oxygen Biggest side effect of Epogen, Procrit, Neumega and Neupogen is BONE PAIN!!!!!!!!!!!!!!! GIVE THEM TYLENOL, NARCOTICS
  • Tumor necrotizing factor: makes mouth taste funny, makes anything you eat funny
  • LISTEN TO LECTURE: 01:14:30 (TIME) file name: 11-16-2010 Spinal cord compression: metasisis to the spine -- 1 st sign: loss of bowel/bladder fxn.. Pt says “I just wet the bed.. This has never happened to me before” -- Weakness/tingling in the legs -- CALL MD IN THE MIDDLE OF THE NIGHT -- Radiation -- Might do an emergency laminectomy -- Steroids: decrease inflammation and swelling; take down the size of the tumor to get the pressure off
  • ALWAYS PICK AIRWAY/SUCTIONING ON THE TEST!!!!!!!!!!!!!!!!!!!!!!!!!!!!! As the #1 priority #2 priority is communication
  • Stage I: lymphoma that is in the tissue of the lymph node.. Has not spread! Tx with radiation to the spot Stage II: Lymphoma that is in the tissue of the lymph node and in some of the surrounding area tx: radiation Stage III and IV: In the lymphatic fluid… tx: chemo and maybe radiation
  • Prone to getting atelectasis and pneumonia.. Everytime they take a breath it hurts like hell! Nutritionally they are a wreck: look at serum albumin and protein levels! Pain
  • KNOW YOUR BODY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
  • Most Breast Ca most often occurs in the upper outer quadrant… near lymphnodes
  • 1 st degree risk: mother, sister, maternal aunt.. Considered to be at highest risk !!!!!!!!!!!!!!!!!!!
  • 11/27/10 Clean margins: around the cancer should be healthy tissue
  • Nursing care after surgery: 1) Pain control 2) start moving the arm where the mastectomy was done (1 st 24 hours put pillow under the arm that was used) Reach for recovery: community program run by women who have had breast surgery. 1 on 1 visits… to help with patients and their recovery 2 nd day post op: very gentle, mild exercises (toes touching the wall and then use your fingers to walk up the wall and that will help to raise arm higher)
  • High fevers: cooling blankets
  • Dr has to say “in my best professional opinion his life expectancy is less than 6 mths”