Oncology NCLEX Clinical Study Booklet · 10 cards
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Cancer Basics. General What is Cancer?
Uncontrolled growth of abnormal cells Can invade tissues and metastasize (spread) Benign (localized) vs malignant (invasive) Warning Signs (CAUTION)
Change in bowel/bladder; A sore that won't heal Unusual bleeding/discharge; Thickening or lump Indigestion/dysphagia; Obvious change in wart/mole; Nagging cough/hoarseness Risk & Prevention
Tobacco, alcohol, UV, diet, obesity, viruses (HPV, HBV) Screening: mammogram, colonoscopy, Pap, PSA Sun protection; vaccines (HPV, HBV) NCLEX Tip Know the 7 warning signs (CAUTION). Early detection through screening (mammogram, colonoscopy, Pap) dramatically improves outcomes.
Chemotherapy. Treatment What is Chemotherapy?
Systemic drugs that kill rapidly dividing cells. Also harms normal fast-growing cells (marrow, GI, hair). What are the Causes / Risk Factors?
Used to treat, control, or cure many cancers Given in cycles What are the Symptoms?
Bone marrow suppression (↓WBC, RBC, platelets) Nausea / vomiting Alopecia Mucositis, diarrhea Fatigue How is it Diagnosed?
Monitor CBC (nadir) Assess for toxicity What is the Treatment?
NEUTROPENIC precautions (infection risk) Antiemetics; oral / skin care for mucositis Handle & administer safely (hazardous drug) Monitor CBC; report fever immediately NCLEX Tip Chemo causes bone marrow suppression — a fever in a neutropenic patient is an EMERGENCY. Teach infection precautions and to report fever immediately.
Radiation Therapy. Treatment What is Radiation Therapy?
Localized high-energy radiation destroys cancer cells. External beam or internal (brachytherapy). What are the Causes / Risk Factors?
Local tumor treatment or palliation What are the Symptoms?
Skin changes (redness, dryness) at the site Fatigue Site-specific effects (mucositis, diarrhea) How is it Diagnosed?
Assess skin & site-specific effects What is the Treatment?
Skin care: do NOT wash off site markings; mild soap, pat dry No lotions / powders / heat / cold on the site unless approved Loose cotton clothing; protect from sun Brachytherapy: time, distance, shielding NCLEX Tip Protect irradiated skin: don't remove the markings, avoid lotions/heat/sun, wear loose cotton. For internal radiation, apply time-distance-shielding.
Neutropenia. Complication What is Neutropenia?
Abnormally low neutrophils (ANC) → high infection risk. Common with chemo (nadir). What are the Causes / Risk Factors?
Chemotherapy, radiation Bone marrow disorders ANC <500 = severe risk What are the Symptoms?
FEVER may be the ONLY sign (blunted immune response) Signs of infection may be subtle Fatigue How is it Diagnosed?
CBC with differential; calculate ANC Cultures if febrile What is the Treatment?
Neutropenic precautions: private room, strict hand hygiene, no fresh flowers / raw produce Avoid sick visitors; no rectal temps / suppositories Fever = emergency → cultures + broad-spectrum antibiotics ASAP Growth factors (filgrastim) NCLEX Tip In neutropenia, fever may be the only sign of infection — treat it as an emergency with cultures and antibiotics. No fresh flowers, raw produce, or rectal procedures.
Breast Cancer. Solid Tumor What is Breast Cancer?
Malignancy of breast tissue. The most common cancer in women. What are the Causes / Risk Factors?
Female, age BRCA1/BRCA2 mutations, family history Early menarche / late menopause Hormone therapy, obesity What are the Symptoms?
Painless breast lump (often upper outer) Skin dimpling (peau d'orange) Nipple retraction / discharge Axillary lymph nodes How is it Diagnosed?
Mammogram, ultrasound Biopsy (definitive) Hormone receptor / HER2 testing What is the Treatment?
Surgery (lumpectomy / mastectomy) Chemo, radiation, hormone therapy (tamoxifen), targeted (trastuzumab) Post-mastectomy: no BP / blood draws on the affected arm; arm exercises Teach breast self-awareness; screening NCLEX Tip After a mastectomy with lymph node removal, avoid BP, injections, and blood draws in the affected arm to prevent lymphedema.
Lung Cancer. Solid Tumor What is Lung Cancer?
Malignancy of lung tissue. The leading cause of cancer death. What are the Causes / Risk Factors?
Smoking (primary) Secondhand smoke, radon, asbestos Air pollution What are the Symptoms?
Persistent cough, hemoptysis Dyspnea, chest pain Hoarseness Weight loss, fatigue Recurrent infections How is it Diagnosed?
Chest CT, X-ray Biopsy / bronchoscopy Sputum cytology What is the Treatment?
Surgery, chemo, radiation, immunotherapy Smoking cessation O₂, symptom / pain management Support; often palliative NCLEX Tip Smoking is the leading cause of lung cancer. A persistent cough or hemoptysis in a smoker warrants prompt evaluation.
Colorectal Cancer. Solid Tumor What is Colorectal Cancer?
Malignancy of the colon or rectum. Often develops from polyps. What are the Causes / Risk Factors?
Age >50 Family history, polyps, IBD Low-fiber / high-fat diet Obesity, smoking, alcohol What are the Symptoms?
Change in bowel habits Blood in stool (bright or dark) Abdominal pain, cramping Unexplained weight loss, anemia Narrow (pencil) stools How is it Diagnosed?
COLONOSCOPY (screening & biopsy) Fecal occult blood test CEA tumor marker What is the Treatment?
Surgical resection (± colostomy) Chemo, radiation High-fiber diet (prevention); screening at 45–50 Ostomy care / teaching if applicable NCLEX Tip Screening colonoscopy starting at age 45–50 prevents colorectal cancer by removing polyps. Report any change in bowel habits or blood in stool.
Prostate Cancer. Solid Tumor What is Prostate Cancer?
Malignancy of the prostate gland. Common in older men; usually slow-growing. What are the Causes / Risk Factors?
Age >50 Family history African American men (higher risk) Diet What are the Symptoms?
Often asymptomatic early Urinary symptoms (like BPH): hesitancy, weak stream, nocturia Hematuria Bone pain (metastasis) How is it Diagnosed?
Digital rectal exam PSA (elevated) Biopsy (confirms) What is the Treatment?
Active surveillance (slow-growing) Surgery (prostatectomy), radiation Hormone therapy (androgen deprivation) Post-op: monitor continence; Kegels NCLEX Tip Prostate cancer is often slow-growing — 'active surveillance' may be appropriate. PSA and digital rectal exam are used for screening.
Oncologic Emergencies. Complication Tumor Lysis Syndrome
Rapid cell death releases K⁺, phosphate, uric acid ↑K⁺, ↑phosphate, ↓calcium, ↑uric acid → renal failure / dysrhythmias Hydration, allopurinol / rasburicase SVC Syndrome & Cord Compression
SVC: facial/arm swelling, dyspnea, distended neck veins Cord compression: back pain, weakness, bowel/bladder changes — emergency Both need urgent radiation / steroids Hypercalcemia
From bone metastasis Confusion, weakness, ↓reflexes, dysrhythmias Hydration + bisphosphonates NCLEX Tip Tumor lysis syndrome (high K⁺, phosphate, uric acid; low calcium) occurs after rapid tumor cell death — prevent with hydration and allopurinol.
Cancer Pain Management. Supportive What is Cancer Pain Management?
Pain is common in cancer and often undertreated. Use the WHO analgesic ladder. What are the Causes / Risk Factors?
Tumor invasion, treatment effects Bone metastasis, nerve involvement What are the Symptoms?
Self-reported pain (most reliable) Impact on function, sleep, mood How is it Diagnosed?
Regular pain assessment (self-report) Reassess after interventions What is the Treatment?
WHO ladder: non-opioids → weak → strong opioids Around-the-clock dosing for chronic pain Anticipate & manage constipation (opioids) Adjuvants (antidepressants, steroids); no ceiling on opioids for cancer pain NCLEX Tip Cancer pain: give analgesics around-the-clock (not just PRN), follow the WHO ladder, and always start a bowel regimen with opioids.
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