MEDSURG - cancer

Family members often panic and call 911 due to significant changes in a hospice patient's breathing, such as reductions to three times a minute.
Emergency crews may not treat hospice patients as outlined per protocols, leading to complications with emergency response.
Importance of clear communication in end-of-life care to ensure patient comfort.

Observations revealed high doses of pain medications provided to manage patient discomfort; often involve medications like Ativan for pain management.
Staff are trained to ensure patients have a peaceful end of life experience.
Discusses patient agency in end-of-life care, allowing for changes in decisions about treatment.

Cell proliferation refers to the rapid increase in cell numbers within a given space (typically in tumors).
Anaplasia characterized by the loss of normal cell features often points to malignant cells.
- Abnormal cells often proliferate uncontrollably.
- Rapid reproduction typically indicates malignancy, suggesting pathways that may lead to cancer.

Metastasis occurs when cancer cells spread through the bloodstream to other body parts (e.g. lung cancer spreading to kidneys).
Once malignant cells become widespread, survival rates drop significantly.

Explanation of carcinogenesis: a three-step process whereby carcinogens lead to cancer development.
1. Initiation: Mutation of DNA leading to cellular death or changes.
2. Promotion: Abnormal cellular growth after DNA mutation.
3. Progression: Further mutations leading to malignancy and metastasis.
Exposure to carcinogens includes:
- Viruses: (e.g., HBV - hepatitis B).
- Radiation exposure (X-rays, etc.).
- Chemical agents (e.g., asbestos).

Overweight, sedentary lifestyle, poor nutrition elevate risks.
Smoking as a significant risk factor for cancer, including through secondhand smoke.
Hormonal influences (e.g., estrogen, testosterone) can also increase cancer risks.

Primary Prevention: Reducing risks by lifestyle adjustments (e.g., quitting smoking, improved nutrition).
Secondary Prevention: Regular screenings (especially for skin cancers due to sun exposure); includes the ABCDE method for suspected skin cancers.
Tertiary Prevention: Ongoing monitoring and lifestyle adjustments following cancer treatment.

Nutrition plays a crucial role in the healing process and impacts immunity (red and white blood cells).
Addressing appetite loss due to conditions such as anorexia or malabsorption.

The TNM staging system includes:
- T: Size of the tumor.
- N: Involvement of lymph nodes.
- M: Presence of metastasis.
The grading system ranges from 1-4 based on abnormality levels.

Goals of cancer treatment include:
- Cure: Elimination of malignant cells.
- Control: Managing cancer through containment and slowing growth if cure is not feasible.
- Palliation: Relief of symptoms and improving quality of life.

Different types of surgery:
- Excisional, needle, endoscopic biopsies.
- Prophylactic surgeries may be performed in high-risk patients.
Surgical approaches may involve treatments of lymph nodes for detecting malignancy.

Palliative care focuses on symptom management and improving quality of life for those with terminal conditions.
Importance of communication and psychological support for patients and families.

Core chemotherapy drugs often used in treatment.
Chemo's impact on both malignant and healthy cells, leading to side effects:
- Antineoplastic agents targeting various phases of the cell cycle.
- Importance of tailored approaches based on cancer type and progression.
Monitoring for toxicity and effectiveness are critical steps in treatment.

Regular checks for blood counts (white and red blood cells, platelets).
Significance of patient isolation or enhanced precautions when presenting neutropenia.
Management of symptoms related to chemotherapy such as nausea or pain.

Patients encouraged to engage in light exercise, maintain nutrition, and years of follow-up with oncologist post-treatment.
Women often face unique challenges specific to reproductive health during cancer treatments (including potential infertility concerns).

Patients educated on self-examinations for early detection (e.g., breast and testicular self-exams).
Emphasis on regular screenings (e.g. mammograms from age 45, or earlier based on family history of breast cancer).

Focus on pain management, patient mobility after surgery (e.g., mastectomy), and prevention of complications such as lymphedema.
Importance of post-operative education around recovery, nutrition, and follow-up requirements.

Addressing emotional challenges faced by cancer patients (including expected grief and anxiety) while maintaining patient dignity and autonomy.
Discussing supportive cancer networks and therapeutic options for mental health during their journey.

Referral for hospice care indicates focus on quality of remaining life rather than curative efforts.
Discussing psychological insights during end-of-life discussions to prepare for family needs.

Nurses play a key role in establishing trust and maintaining open communication with patients.
Active listening to address fears and support patient choices in care processes.