Nursing Concepts 4 - Abnormal Celluar Growth

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What are UTERINE FIBROIDS & what are they related to?: Benign tumors in the uterine corpus that may appear on the broad ligament or cervix. They may be related to levels of estrogen and HGH
What are the signs & symptoms of UTERINE FIBROIDS: hypermenorrhea, (dysmenorrhea or leukorrhea may occur) pain, backache, constipation, urinary frequency or urgency or intestinal obstruction
What are dx test for UTERINE FIBROIDS?: blood tests, palpation of the tumor, laparoscopy or D & C
What are treatments for UTERINE FIBROIDS?: - observation, blood transfusion or hysterectomy
What is GESTATIONAL TROPHOBLASTIC DISEASE (hydatiform mole): Developmental anomaly of the placenta. The chorionic villi convert into a mass of clear vesicles. (chorionic tumor)
What are signs/symptoms Gestational Throphoblastic Disease (hydatiform mole): rapid growth of the uterus, vaginal bleeding and cramping
What are Gestational Throphoblastic Disease (hydatiform mole) dx?: HCG levels are extremely high for early pregnancy

US fails to reveal a fetal skeleton
Whtat are Gestational Throphoblastic Disease (hydatiform mole) Tx?: D & C, weekly monitoring of HCG until they remain normal for 3 consecutive weeks. Periodic follow-up for 1 to 2 years because of increased risk of neoplasm
What is the drug of choice for choriocarcinoma. Emphasize contraception a patient following removal of a gestational trophoblastic neoplasm until HCG is normal (may take as long as 2 years).: Methotrexate prophylactically
What is Fibrocystic Disease of the breast ?: Overgrowths of fibrous tissue in the area of the ducts forming small cysts that develop and disappear quickly. Common between ages of 30-50. Cysts have no malignant potential however breasts that have cysts are more prone to develop cancer
What is tx for Fibrocystic Disease of the breast ?: aspiration of fluid, medication (Danocrine), analgesics for pain
What is Pyloric Stenosis?: hyperplasia and hypertrophy of the circular muscle at the pylorus narrows the pyloric canal. Defect is common in male infants between ages 1-6 months
What are the signs & symptoms of Pyloric Stenosis: projectile vomiting, visible reverse peristaltic waves, weight loss, constipation and a hypertrophied sphincter, the size of an olive can be felt in the abdomen. Dehydration is common and metabolic alkalosis will occur without rapid intervention
What is tx for Pyloric Stenosis?: surgical intervention (pyloromyotomy performed by laparoscopy).
What is prostatic hyperplasia considered?: Normal result of aging
What are the symptoms and signs of prostatic hyperplasia: reduced stream force and claiber of urine, a feeling of not emptying the bladder, urinary retention
What are dx for prostatic hyperplasia?: Rectal digital exam of the prostate, intravenous pyelograpy, elevated BUN and creatinine levels, UA and urine culture
What are tx for prostatic hyperplasia: prostate massage, sluid restriction, sitz baths, regular sexual intercourse to relieve prostatic congestion, TURP (transuretheral resection of the prostate).
What should be noted about malignant abnormal cell growth?: (Most common LUNG CANCER, 2nd most common PROSTATE CANCER, 3rd most common COLON/RECTAL CANCER)
SKIN CANCER
Basal cell epithelioma is most common in?: adults after age 40 in blond, fair-skinned, caucasian males
What is a risk factor for Basal cell epithelioma ?: Prolonged sun exposure is the largest risk factor
What should be noted about Basal cell epithelioma lessions?: They are small, smooth, pink, translucent papules that progress to firm raised bordered lesions with depressed centers. usually occur on the face
Superficial basal cell epithelioma are commonly found where?: on the chest and back
Describe Superficial basal cell epithelioma lesions?: - It is an oval or irregular shaped lesion, slightly elevated and lightly pigmented. The lesion appears scaly and may resemble eczema or psoriasis.
What are risk factors for Superficial basal cell epithelioma-: Arsenic ingestion
What is the tx for Superficial basal cell epithelioma ?: chemotherapy (5-fluororacil), surgical excision, radiation or chemosurgery
What are nursing interventions for Superficial basal cell epithelioma ?: Interventions include high protein diet, avoid sun exposure and tender skin care to prevent bleeding
Squamous cell carcinoma occurs in ?: occurs in caucasian males. over age 60 from sun exposure
What are risk factors for Squamous cell carcinoma: x-ray therapy, arsenic ingestion (think gardener using herbicides), carcinogen exposure (tar, oil), and chronic skin inflammation and irritation
What should be noted about lesions of the Squamous cell carcinoma: Lesions of the lower lip and ears have a poor prognosis but others have a good prognosis
What are dz for Squamous cell carcinoma ?: by biopsy
What are tx for Squamous cell carcinoma?: chemosurgery, radiation, electrodesiccation and curettage and excision.
Malignant melanoma is common in who?: common in women than men, ages 50-70. Very rare in children
what are risk factors for Malignant melanoma: . Risk factors include sun exposure, fair skin type, pregnancy (hormones increase both growth and incidence), family history
What are common locations for Malignant melanoma: Common locations are the head, neck, legs, and back.
What should be noted about Malignant melanoma as they relate to moles?: All moles (nevi) that change in color, size, texture, have drainage or bleed should be investigated
What are the dx & tx for Malignant melanoma: Dx- biopsy. Tx- surgical tumor removal with wide resection, lymphadenectomy, chemotherapy and radiation.
Cancer of the lip- occurs most often in ___: men
What are risk factors for cancer of the lip?: smoking, sun and wind exposure
What is the prognosis for cancer of the lip?: Prognosis is good if the lesion is localized and totally excised.
Cancer of the mouth usually occurs in ?: middle-aged adults
What is the drug of choice for cancer of the mouth and what does it affect?: Excision is tx of choice. It affects speech, nutrition, facial features, and swallowing.
Cancer of the tongue is commonly related to?: persistent irritation caused by tobacco use, food, chronic alcoholism, or poorly aligned teeth
what is tx for Cancer of the tongue?: radiation and surgical removal of the lesion (may include removal of part or all of the tongue).
What is stomach cancer caused by and who is more likely to have it and due to what?: degenerative changes in gastric ulcers. Men 2x more likely than women. Middle-aged adults in the low socioeconomic group are common because of a diet high in starch, with few fresh vegetables and fruits
What is used to dx stomach cancer?: x-ray exam, gastric analysis and biopsy via gastroscopy
What is the prognosis of stomach cancer and where is the largest incidence ?: Poor prognososis. Increased incidence of stomach cancer in Japanese.
What is cancer of the esphagus called and who is generally affected: epidermoid carcinoma is rare and affects people over the age of 60.
Intestine cancer generally occurs in ___: middle-aged adults, with low-residue diets of refined carbohydrates and fats. History of ulcerative colitis, diverticulitis and polyps have been implicated in malignant changes.
What is dx for intestine cancer?: guaiac stool tests, digital rectal exam and sigmoidoscopy. CEA antigen (unreliable, can be elevated in inflammation and other diseases) A CEA titer less than 5 ng is considered normal. A CEA greater than 10 ng must be investigated
What are the treatments for intestine cancer ?: Radiation and chemotherapy
What are risk factors for liver cancer and who is it commonly found in?: risk factors include cirrhosis. Commonly found in middle-aged to older males
What are dx for liver cancer?: liver function studies, biopsy and scan of liver
What are treatments for liver cancer?: surgical removal of the liver. (Up to 90% of the wliver can be removed with no loss of function, the liver can regenerate.)
What are symptoms & signs of prostate cancer?: usually asymptomatic, urinary retention, dribbling, difficulty starting the stream and cystitis are late symptoms
Bone metastis is common with what cancer: prostate caner
What are dx for prostate cancer: biopsy
What are treatments for prrostate cancer?: surgical intervention, chemotherapy, and radiation.
Explain breast cancer: most common malignancy of women, usually occurs after age 35. Risk factors include family history, long menstrual cycles, early menses, late menopause, constant stress, first pregnancy after age 35. Commonly metastases to lung, liver, bone, kidneys, brain and adrenal glands
What are signs and symptoms of breast cancer?: lump or mass, change in breast size or symmetry, thickening, dimpling of skin, unusual nipple discharge
What are treaments for breast cancer: based on stage of disease. Lumpectomy, modified radical mastectomy, radical mastectomy, chemotherapy and radiation. TNM staging system: Tumor size, Nodal involvement, Metastatic Progress.
Uterus cancer is common with for: postmenopausal women aged 50-60.
What are signs of uterus cancer?: abnormal uterine bleeding, anovulation obesity, hypertension, and familial tendency.
What are risk factors for uterus cancer?: Increased risk in a history of uterine polyps or endometriosis
What should be noted about dx as it relates to uterus cancer?: Can NOT be dx from PAP smear
What are dx for uterus cancer?: Biopsy of endometrial endocervical or cervical tissue. Schillerâ€™s test: (staining of the vagina with iodine, health tissue turns brown, malignant tissue can not absorb the stain. This is a definitive test for uterine cancer
what are treatments for uterus cancer: surgical intervention ranging from hysterectomy to pelvic exenteration, chemotherapy, radiation and hormonal therapy
Explain lung cancer: more common in men, has a poor prognosis and is largely preventable. Types include squamous, oat-cell, adeno and large-cell (anaplastic) carcinoma
What are signs and symptoms of lung cancer: smokerâ€™s cough, wheezing, hemoptysis, dyspnea, and chest pain.
What are dx of lung cancer: Dx- chest x-ray, sputum for cytology, bronchoscopy, needle biopsy of the lungs, tissue biopsy and thoracentesis
What are tx for lung cancer?: pneumonectomy, lobectomy, or wedge resection, radiation and chemotherapy.
Explain bladder canncer as it relates to commonly affected: more common in men, than in women. Occurs after age 50. Increased risk linked to occupations like cable workers, petroleum workers, hairdressers, weavers, aniline dye workers, rubber workers, spray painters, and leather finishers
What are signs and symptoms are bladder cancer?: intermittent hematuria, clots in the urine, pain after voiding, bladder irritability, nocturia, dribbling and urinary frequency
What are dx of bladder cancer: cystoscopy and biopsy
What are tx of bladder cancer?: cystoscope resection if the tumor is well localized, radical cystectomy and urethrectomy with permanent ileal conduit (male impotence and permanent sterility)
Explain the correlation of pancrease cancer: positive correlation between alcoholism and cancer of the pancreas Most common in older males
What are signs and symptoms of pancrease cancer: - weight loss, anorexia, weakness, nausea, jaundice and a palpable abdominal mass. Recent onset of diabetes mellitus
What are dx of pancrease cancer: - liver function studies, x-rays, scans, biopsy and elevated fasting blood sugar
What is a treatment for pancrease cancer: â€œWhipple procedure
what is the â€œWhipple procedure": Surgical removal of the head of the pancreas, the common bile duct, the distal part of the stomach, and duodenum. Long, extensive surgery with risks associated with long anesthesia time and long exposure of the internal viscera.
What is WILMâ€™S TUMOR?: childhood tumor of the kidney with a good prognosis if treated. Familial link
what are signs of WILMâ€™S TUMOR: palpable firm, smooth mass in the abdomen, hypertension, vomiting
What are dx of WILMâ€™S TUMOR: urine collection of catecholamines, presence r/o tumor
What are treatments for WILMâ€™S TUMOR: radical nephrectomy, radiation, chemotherapy
WHy is palpation contraindicated with Wilm tumor?: could cause rupture and seeding, dissemination of the tumor.
What is LEUKEMIA?: malignant proliferation of blast cells (pre-WBC
ALL - (Acute lymphoblastic leukemia) is common in? What is the prognosis?: children, reasonably good prognosis
AML (acute myeloblastic leukemia) is common in ?: in all ages.
CML ( chronic myelogenous leukemia) is common in ?: uncommon before age 20
What are the signs and symptoms of leukemia?: high fever, abnormal bleeding, chills, pallor, recurrent infection, prolonged weakness
What dx test are performed for leukemia?: bone marrow aspirate with a large component of immature WBCâ€™s
What is the tx for leukemia?: chemotherapy, bone marrow transplant.
Briefly explain Sarcomas: malignant tumor of bone more common in males, most frequently children and adolescents.
What are signs and symptoms for Sarcomas: rapid growth (tall for age
what are dx test for Sarcomas?: biopsy, bone scans and x-rays
What are the tx for sarcomas and nsg interventions?: amputation and radiation. Chemotherapy, immunotherapy and bone transplants may also be combined

Nursing interventions include teaching about phantom pain, psychological support for alteration in body image, proper body alignment and positioning
In one sentence what is lymphomas?: - abnormal cellular growth that originates in the lymph glands and lymphatic tissue
What are the signs and symptoms of lympomas?: swelling of the lymph glands, tonsils, adenoids, and nodes in the cervical area
What dx test is used for lyphomas?: biopsied tissue
What tx are used for lymphomas?: Tx- BACOP protocol (bleomycin, adriamycin, cytoxan, vincristin (Oncovin), and prednisone. It has been effective in producing a prolonged remission
Define: Hypertrophy: enlargement of an organ or part due to increase in the size or number of cells
Define: Atrophy: normal in aging. Decrease in size or number of cells
Define: Hyperplasia: increase in new cells that results from a stimulus, reversible once the stimulus is removed.
Define: Neoplasia: Malignant growth of new cells that doesnâ€™t remove when the stimulus is removed.
Define: Metaplasia: conversion of a cell from highly specialized to less specialized.
Define: Dysplasia: bizarre cell growth that causes cells to be different in shape, size or arrangement than cells from the same type of tissue. May be reversible.
Explain incidence rate as it relates to breast, bladder, prostate and colon cancer?: increase with age
What are actions are likely to reduce the incidence rate for breast, bladder, prostate and colon cancer?: high-residue diet, increased intake of cruciferous vegetables, vitamins A, D, and E, carotene.
What are Alternative/complementary tx forbreast, bladder, prostate and colon cancer ?: treatments include hypnosis, acupressure, acupuncture, Reiki therapy, guided imager, therapeutic touch, homeopathy, vitamins A, E, and B complex.
According the American Cancer what are the seven warning signs of cancer?: Changes in bladder or bowel habits
A sore that does not heal
Unusual discharge or bleeding
Thickening or lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in a mole or wart
Nagging cough or hoarseness
What do Alkylating agents do?: react with DNA to inhibit cell division/growth
Busulfan is an example of what chemotherapeutic agent?: Alkylating agents
carboplatin is an example of what chemotherapeutic agent?: Alkylating agents
cisplatin is an example of what chemotherapeutic agent?: Alkylating agents
cyclophosphamide is an example of what chemotherapeutic agent?: Alkylating agents
ifosfamide is an example of what chemotherapuetic agent?: Alkylating agents
melphalan is an example of what chemotherapuetic agent?: Alkylating agents
nitrogen mustard is an example of what chemotherapuetic agent?: Alkylating agents
thiotepais an example of what chemotherapuetic agent?: Alkylating agents
What are side effects of Alkylating agents?: renal toxicity.
What does Nitrosoureas do?: : cross blood-brain barrier to react with DNA to inhibit cell division/growth. BCNU (carmustine), CCNU (lomustine
How do Nitrosoureas act?: cross blood-brain barrier to react with DNA to inhibit cell division/growth
BCNU (carmustine) is an example of: Nitrosoureas
CCNU (lomustine)is an example of: Nitrosoureas
methyl CCNU (semustine) is an example of: Nitrosoureas
streptozocin is an example of: Nitrosoureas
What are the side effects of nitrosoureas ?: myelosuppression, especially thrombocytopenia.
How do Antimetabolites act?: compete with metabolites during nucleic acid production which prevents cell growth.
thioguanine cytarabine is an example of: Antimetabolites
fluorouracil is an example of _____: Antimetabolites
azactadine is an example of _____: Antimetabolites
Antimetabolites is an example of _____: mercaptopurine
What are the side effects of Antimetabolites: renal toxicity, hepatotoxicity, proctitis, mucositis, ulcerations and stomatitis.
How do Antitumor antibiotics act?: interfere with DNA-dependent RNA synthesis and bind with DNA to block cell growth
Andriamycin is an example of ____: Antitumor antibiotics
bleomycin is an example of ____: Antitumor antibiotics
dactinomycin is an example of ____: Antitumor antibiotics
mithramycin is an example of _____: Antitumor antibiotics
mitomycinis an example of _____: Antitumor antibiotics
mitoxantroneis an example of _____: Antitumor antibiotics
What are the side effects of Antitumor antibiotics ?: cardiac toxicity.
How do Hormonal agents act?: change the chemical environment by binding to hormone receptor sites which prohibits the growth of tumors susceptible to hormones
Tamoxifen is an example of ______: Hormonal agents
androgens is an example of ______: Hormonal agents
anti-estrogens is an example of ______: Hormonal agents
estrogens is an example of ______: Hormonal agents
progesterone is an example of _____: Hormonal agents
steroids are an example of _____: Hormonal agents
What are distinctive side effects of Busulfan: Black, tarry stools;

blood in urine or stools;

inflammation of the mouth;
lower back or side pain; painful or difficult urination;

pinpoint red spots on skin; unusual bleeding or bruising
What are distinctive side effects of Cisplatin: numbness or tingling in the fingertips and toes
What are distinctive side effects of Cyclophosphamide: missing menstrual periods
What are distinctive side effects of ifosfamide: darkened and thickened skin
carmustine sides effects are ____: convulsions (seizures); inability to move legs or arms ; lower back or side pain
streptozocin sides effects are ____: Swelling of feet or lower legs; unusual decrease in urination
Azacitidine (Systemic) sides effects are ____: pinpoint red spots on skin

troubled breathing with exertion

voice changes
Tamoxifen sides effects are ____: loss of sexual desire or ability (in men)
What are side effects for women taking androgens: For females only
Acne or oily skin; decreased breast size; irregular menstrual cycles; hoarseness or deepening of voice; increase in size of female genitals; increase in unnatural hair growth or male pattern baldness
What are side effects for men taking androgens: Blistering of skin under patch (especially when the nonscrotal patch is applied to bony areas of the skin); breast soreness or enlargement; frequent or continuing erection of penis lasting up to 4 hours or painful penile erections lasting longer than 4 hours
What are side effects for prepubertal boys taking androgens: early growth of pubic hair; enlargement of penis; frequent or continuing erections
What are side effects for Progesterone: excessive worrying
Alkylating drugs: kill cancer cells by directly attacking DNA, the genetic material of the gene
Antimetabolites: interfere with the production of DNA and keep cells from growing and multiplying
Antitumor antibiotics: are made from natural substances such as fungi in the soil. They interfere with important cell functions, including production of DNA and cell protein
Plant alkaloids: prevent cells from dividing normally
Steroid hormones: low the growth of some cancers that depend on hormones
Special considerations for Cyclophosphamide are: may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men

rink plenty of fluids because this drug can irritate your kidneys and bladder

do not have any vaccinations
5-fluorouracil (5-FU) common s/e: weakness or achiness

drying or darkening of the skin or nails

tingling in the hands or feet
Doxorubicin s/s are: difficulty swallowing

darkening of fingernails or toenails

severe heart damage
Vinblastine s/s are: may harm the fetus

jaw pain, headache, or other aches

exposed areas of the skin may become easily sunburned
Cyclophosphamide s/s are: decrease in the number of blood cellsthinned or brittle hair most common

darkened and thickened skin

blistering skin or acne
Cyclophosphamide is what Types of chemotherapy drugs: Alkylating
5-fluorouracil (5-FU). is what Types of chemotherapy drugs: Antimetabolites
Doxorubicin is what Type of chemotherapy drugs: Antitumor antibiotics
bleomycinis what Type of chemotherapy drugs: Antitumor antibiotics
Vinblastine is what Type of chemotherapy drugs: Plant alkaloids
vincristine is what Type of chemotherapy drugs: Plant alkaloid
tamoxifen is what Type of chemotherapy drugs: Steroid hormones

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