Quiz #4 Terms: Chapter 57: Caring for Patients w/ Cancer
Absolute neutrophil count (ANC): The absolute count of neutrophils typical done with the total WBC
count.

Interventions/ Relevance:
o ANC <500 = severe risk for infection
o Neutropenia can occur even though total WBC is within normal range therefore,
knowing ANC is more precise assessment of neutrophil status.
Allogenic Bone marrow: comes from a histocompatible donor (identical twins, relative, and unrelated
donors)

Interventions/ Significance:
o Nurse should understand the indications for a transplant which include the type and
stage of disease, patient’s age and performance status, and donor availability.
o Monitor patient frequently and be able to adjust quickly and competently to the
patient’s potential condition changes.
o Nurse should encourage donors to express concerns r/t success or failure of the
transplant and provide support as needed.
o Nursing care for this specific donor includes routine postop care
 Monitor REEDA, respiratory status, pain, etc.
Anaplasia: Irreversible change in the structure of an adult cell that deteriorates to a more immature
level. This type of cellular change is the classic finding of cancer. Anaplastic cells no longer have the
ability to implement their unique functions and overall are chaotic in their nature.
 Interventions/ significance:
o The nurse can assess cancer growth patterns via nonneoplastic and neoplastic growth
patterns (benign vs. malignant)
o The nurse should encourage the patient to go through screening regularly because they
may precede the development of cancer
Anorexia: loss of appetite that can be due to the cancer or to the treatment.

Interventions:
o Encourage eating to the patient while explaining the need to maintain adequate
nutrition.
o Provide appetite-enhancing drugs such as antiemetics or antihistamines (THCderivatives)
o Monitor accurate I&O and record.
o Inquire about food preferences (personal and cultural)
o Assess Patterns and behaviors r/t to eating.
o Monitor serum albumin, prealbumin, glucose, magnesium, sodium, and iron.
o Assess for signs of malnutrition.
o Consult nutritionist to determine appropriate needs for individual.
o Provide meticulous oral care (prevents infection and promotes appetite)
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Encourage small frequent meals that are high in calories and protein.
Encourage adequate fluid intake, while limiting during meal times so patient doesn’t
replace fluids for food.
Increase activity level as tolerated.
Provide suitable eating environment.
Monitor tube feedings.
Administer cytoprotectives as ordered.
Provide discharge teaching to patient and family regarding nutritional needs.
Autologous BMT: transplanted bone marrow that comes from the recipient when the patient’s bone
marrow has adequate and functioning stem cells.

Interventions/ Significance:
o Nurse should understand the indications for a transplant with include the type and stage
of disease, patient’s age and performance status, and donor availability.
o Monitor patient frequently and be able to adjust quickly and competently to the
patient’s potential condition changes.
o Nurse should follow hospital policy/procedures and protocol when handling bone
marrow transplants and frozen bone marrow transplants.
Benign:
Biopsy: A procedure in which a portion of tissue is examined for the presence of abnormal cells

Intervention/significance:
o Nurse should be able to assist the physician when obtaining the biopsy sample using
sterile technique.
Biotherapy: treatment with agents whose origin is from biological sources and/or agents that affect
biologic responses.

Intervention/ Significance:
o Nurse should understand the immune system so that they can comprehend the
rationale for the unique treatment,
o Nurse should be familiar with the specific agent given and the side effects associated
with that agent.
o Nurse should safely handle and administer the drug.
o The nurse should know the common SE
 Severe inflammatory reactions
 Peripheral neuropathy
 Skin rashes
Bone marrow harvesting: obtaining bone marrow for transplantation.

Interventions/significance:
o Nurse should inform donor that they may expect pain at donor sites for 1 week and
remedied with nonnarcotic analgesics.
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Nurses should encourage donors to express concerns related to transplant and provide
support.
Nurses should be aware of graft failure and GVHD for patients undergoing
transplantation. Engraftment is the establishment of new bone marrow.
Bone Marrow Transplantation (BMT): the transfer of hematopoietic cells from the bone marrow.

Interventions/ Significance:
o Nurse should understand the indications for a transplant with include the type and stage
of disease, patient’s age and performance status, and donor availability.
o Monitor patient frequently and be able to adjust quickly and competently to the
patient’s potential condition changes.
o Nurse should encourage donors to express concerns r/t success or failure of the
transplant and provide support as needed.
Cachexia: altered absorption and changes in metabolism, such as protein, fat, and carbohydrates,

Interventions/ significance:
o Nurse should remember that patient’s with adequate caloric and protein intake may still
be cachexic from not be absorbing the necessary nutrients.
o Nurse should ensure that the patient’s nutritional needs are being made.
o Monitor for early s/s of cachexia: n/v, anorexia, weight loss, muscle and adipose tissue
wasting, hyperlipidemia, and other metabolic derangements.
o Collaborate with a nutritionist to perform an effective nutritional screening evaluation
by determining food intake, presence of symptoms, determining patient’s functional
status, weight, assessment data, and lab data.
Carcinogens: chemical, biological, or physical agent that has the potential of changing the molecular
structure of the DNA of a cell.

Intervention:
o Educate patient about anticarcinogens that interfere with agents and prevent cancerous
growths.
 Educate patient about cancer prevention: life style changes, eliminate
enivornmental pollutants.
 Anticarcinogens include: vitamin C, A, and E and Selenium which can be found in
most diets.
Carcinogenesis: The process of tumor development. Normal cells are altered = development of
cancerous cells
 Interventions/ significance:
o The nurse should encourage the patient to go through screening for early detection so
that treatment is more successful with small tumors and before spreading.
Carcinoma in situ: preinvasive epithelial tumors with glandular or squamous cell origins.

Interventions/ significance:
o

Nurse should assess the surrounding tissues periodically to ensure that they are not
affected by malignant cells.
Interventions/ significance:
o For patient’s under radiation therapy for malignant tumor:
 Consider time, distance and shielding
 Teach accurate objective facts to help client cope.
 Do not remove markings.
 Administer skin care.
 Do not use lotions or ointments.
 Avoid direct exposure of the skin to the sun.
 Care for xerostomia (dry mouth).
 Bone exposed to radiation is more vulnerable to fracture.
o For patient’s under chemotherapy:
 Interventions:
 Administration of chemotherapy
o Verification of agent, dose, schedule, route (IV, regional, PO)
o Dose calculations
o Safe preparation, handling and disposal
 Monitor pt for common side effects of chemo: myelosuppression, n/v,
mucositis in GI tract, diarrhea/ constipation, fatigue, alopecia, fertility
problems
 Assess patient’s immune status, pain control, hemodynamic stability,
and emotional coping.
Chemotherapy: systemic administration of cytotoxic drugs to treat cancer.


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Interventions:
o Administration of chemotherapy
 Verification of agent, dose, schedule, route (IV, regional, PO)
 Dose calculations
 Safe preparation, handling and disposal
Monitor pt for common side effects of chemo: myelosuppression, n/v, mucositis in GI tract,
diarrhea/ constipation, fatigue, alopecia, fertility problems
Assess patient’s immune status, pain control, hemodynamic stability, and emotional coping.
Cytokines: regulatory proteins that have an appetite-suppressing effect that are released in the
beginning of treatment and peaks at 4 weeks.

Interventions:
o Educate patient about the presence of cytokines and their effect on the appetite.
o Encourage eating to the patient while explaining the need to maintain adequate
nutrition.
o Provide appetite-enhancing drugs such as antiemetics or antihistamines (THCderivatives)
Cytoreductive therapy: surgery used to remove a large tumor burden, which will reduce the quantity of
cancer cells.

Interventions:
o Proper wound care
o Monitor for regrowth of tumor after debulking.
o Nurse can be patient advocate to physician if current pain meds are not sufficient
enough for the patient.
o Nurse’s care should focus on increasing quality of life of patient.
Dysplasia: alterations in normal mature cells

Interventions/significance:
o Nurse should monitor and assess for any external stimuli that can cause the cell
alterations such as radiation, inflammation, toxic chemicals, or chronic irritation.
o Educate patient about wearing sunscreen when going outside and staying away from
toxic chemicals
o The nurse should encourage the patient to go through screening regularly because they
may precede the development of cancer
Engraftment: establishment of new bone marrow.

Interventions/ significance:
o Nurse should carefully monitor patient for potential complications associated the
pancytopenia (reduced WBC and RBC) and immunosuppression experienced
immediately after the transplant.
o Monitor for post-transplant s/s of infection and bleeding.
o Nurse should be aware of the signs of graft failure and GVHD (graft-versus-host disease)
Hyperplasia: increase in tissue mass due to reversible increase in the number of cells of a certain tissue
type. Abnormal when cells produced > demand.

Interventions
o assess the increase in tissue mass. When did it occur? Does it reduce your abilities?
Cause any pain?
Hypertrophy: increase in cell’s size which is caused by (increased workload, stimulation by hormones,
compensation for tissue loss)

Interventions:
o May need hormone therapy
Malignant:

Interventions/ significance:
o For patient’s under radiation therapy for malignant tumor:
 Consider time, distance and shielding
o
 Teach accurate objective facts to help client cope.
 Do not remove markings.
 Administer skin care.
 Do not use lotions or ointments.
 Avoid direct exposure of the skin to the sun.
 Care for xerostomia (dry mouth).
 Bone exposed to radiation is more vulnerable to fracture.
For patient’s under chemotherapy:
 Interventions:
 Administration of chemotherapy
o Verification of agent, dose, schedule, route (IV, regional, PO)
o Dose calculations
o Safe preparation, handling and disposal
 Monitor pt for common side effects of chemo: myelosuppression, n/v,
mucositis in GI tract, diarrhea/ constipation, fatigue, alopecia, fertility
problems
 Assess patient’s immune status, pain control, hemodynamic stability,
and emotional coping.
Metaplasia: occurs when one mature cell type is substituted for another type not typically found in the
involved tissue.

Interventions:
o Assess for cause of metaplasia which could be: inflammation, vitamin deficiencies,
irritation, and chemical agents.
o Must find the cause while it is reversible.
o Encourage use of vitamin supplements and to stay away from carcinogens.
o The nurse should encourage the patient to go through screening regularly because they
may precede the development of cancer
Metastasis: spread of cancerous cells from a primary site of origin to a distant site.

Interventions:
o Nurse should be able to recognize the cancer s/s of the site that it metastasized to.
 Nurse should also know the treatment of these types of cancers as well.
o Nurse should understand the process of metastasis in which the tumor cells only form
temporary attachments to other cells and ECM components.
o Encourage the pt. to have regular screening because early detection of cancer allows for
diagnosis at an early stage of tumor development, which may lead to a more positive
outcome for the patient.
o The nurse can use the TNM system to describe the presence and extent of local,
regional, and distant.
 T – tumor size
 N – absence or presence of regional lymph nodes
 M – absence of presence of distant metastases
Nadir: points at which the lowest blood count is reached.

Interventions/ significance:
o Nurse should now that the nadir occurs approx. 7-10 days after treatment, which is also
when they are at highest risk for infection.
o Provide patient education about s/s of infection and when to report to the physician.
Neoplasm: “New growth;” inherent in this definition is the understanding that there is an abnormal
tissue mass that goes beyond the normal cell boundaries and results in the cells inability to perform its
normal function. Neoplasms can be destructive to the host because they occupy space and they battle
for nutrients crucial to maintain the host’s life. Two types: benign and malignant
 Interventions/ significance:
o The nurse can teach the patient about the difference between benign and malignant
o Teaching about self-inspection and differentiation of the two types of neoplasm
Neutropenia: reductioin in the number of circulating neutrophils, whereas leukopenia is defined as a
reduction in the number of circulating WBC’s.

Interventions:
o Monitoring the neutrophils is important to understand the patient’s ability to protect
themselves from bacterial invasion.
o Nurse should know that although total WBC may be WDL, neutropenia can still occur.
Requires ANC to accurately assess.
Oncogene: A slightly altered form of a normal gene that is responsible for cell growth and repair and has
been associated with the development of cancer when activated
 Interventions/ significance:
o The nurse should encourage the patient to go through screening for early detection so
that treatment is more successful with small tumors and before spreading.
Palliative surgery/care: useful therapy or patients with advanced cancer which serves the purpose to
reduce or prevent disease or treatment-related symptoms to alleviate suffering.

Interventions:
o Nurse should follow-up on palliative procedures with their own palliative care such
proper administration of analgesics to control the patient’s pain.
o Nurse can be patient advocate to physician if current pain meds are not sufficient
enough for the patient.
o Nurse’s care should focus on increasing quality of life of patient.
o Nurse should implement appropriate relief measures
o Nurse should prioritize symptoms
Peripheral blood stem cell transplantation: transplantation of a patient’s blood cells through a machine
that removes the stem cells from the blood and then returns the blood back to the patient.

Interventions/ Significance:
o
o
o
Nurse should understand the indications for a transplant with include the type and stage
of disease, patient’s age and performance status, and donor availability.
Monitor patient frequently and be able to adjust quickly and competently to the
patient’s potential condition changes.
Nurse should educate and instruct the donor of PBSC to go to follow up doctor
appointments since platelet counts can fall dramatically and put them at a risk for
bleeding.
Radiation: waves and particles of energy

Interventions/ significance:
o Nurse should recognize that radiation is known to cause cancer and that it can be a
complete carcinogen.
o Consider time, distance and shielding
o Teach accurate objective facts to help client cope.
o Do not remove markings.
o Administer skin care.
o Do not use lotions or ointments.
o Avoid direct exposure of the skin to the sun.
o Care for xerostomia (dry mouth).
o Bone exposed to radiation is more vulnerable to fracture.
Radiation therapy: Ionizing rays to treat cancer and destroys ability of cancer cells to multiply.

Interventions/ significance:
 Consider time distance, and shielding
 Teach accurate objective facts to help client cope.
 Do not remove markings
 Administer skin care
 Do not use lotions or ointments
 Avoid direct exposure of the skin to the sun
 Care for dry mouth
 Bone exposed to radiation is more vulnerable to fracture.
External Radiation Therapy: Used alone or with surgery to enhance survival. Pre-op radiation decreases
tumor mass, which aids the removal of entire mass and a nurse should pay attention to wound healing.
Post-op radiation eliminates residual tumor and nurse should wait until healing is finished.

Intervention/ significance:
o Treatment planning phase- nurse should educate pt that planning takes several hours
and encourages pain medication for comfort.
Photodynamic Therapy: Light sensitive molecules that form oxygen radicals after exposure to light. These
radicals destroy DNA, cytoplasm and cell membrane causing cell death.

Intervention/ significance:
o Nurse must educate pt and family about extreme photosensitivity and precautions
necessary to prevent skin damage from examination lights and sun.
Internal Radiation Therapy: Implants placed on tumor for a higher concentration of radiation to be
delivered to a specific site in a short period of time.

Intervention/ significance:
o Nurse should educate the patients and families about the implant including process,
effects and strategies to manage its effects. Also teach about symptom management,
activity restrictions while implant is in place, what causes certain symptoms and how the
implant could change those symptoms.
Staging: describes the extent of the tumor and evidence of metastasis throughout the body.

Interventions:
o Use of the TNM system to describe presence and extent of local, regional, and distant
disease.
 T – tumor size
 N – absence or presence of regional lymph nodes
 M – absence of presence of distant metastases
o Cancer staging helps standardize diagnosis and treatment prognosis