Stop IV immediately Notify HCP o May inject other drugs o Hot pack or cold pack may be added - Mono antibodies o Targeted therapies – antibodies are taking up receptor sites and not allowing the tumor cells to divide and grow – prevent cell division - Hormonal therapy o Cancers are sensitive to hormones o Designed to disrupt ability of cells to thrive on hormones o In women may cause: Chin hair – acne – irregular periods o In men: Gynecomastia Atrophy of the penis + scrotum ↓ sex drive – fluid retention ↑ in DVT - Tumorlysis syndrome o Oncological emergency o Therapies cause a massive destruction of cells – disintegrating – spill their contents into the bloodstream ↑ serum levels of K+ ↓ phosphorus leads to other problems Peaked T waves Fluid retention Metabolic abnormalities - Noncancerous conditions
o Fibrocystic changes Lumps in breasts One side may be bigger than other Painful – tender – aggravated w/ caffeine Tx: Eliminate caffeine Wear supportive bra Medication Diagnosis: Needle aspiration to determine dx - Breast cancer o Early detection is important o Metastasizes to lungs – lymph nodes – bone – brain o Noninvasive: Tx w/ surgical procedure – mastectomy + chemotherapy Easier to tx o Invasive More common Infiltrating – metastasizing – aggressive Can cause system damage o Inflammatory breast cancer Aggressive cancer Orange skin – dimple like o less than 1% of men get cancer o risk factors hx of breast cancer no children obesity – weight alcohol consumption early menstruation – late menopause – estrogen containing smoking cigarettes o Education: Screen every year – mammogram Ask provider for CBE – clinical Notify if any new lamps are felt BSE – self exam to establish familiarity o Concern New lumps Rash on nipple Nipple discharge
Dimpling – inverted nipple o Diagnosis Biopsy – definitive dx Surgical excisional biopsy o Diagnostic + tx o Remove lesion + skin around it o Requires: Analgesic Informed consent Anesthesia Monitor for bleeding + infection One day surgery Mammogram every year Start early in high risk pt Bone scan – liver scan to determine mets Braca testing MRIs o Mastectomy Place patient in high fowlers Measure the Jackson pratt drainage and assess color and odor Chemotherapy ACT therapy Done several times a week for 3-6 months Post op Skin – dry and intact No shower until stapes are removed + drains come out Restriction n activities for 6 weeks Self-image issues + impact on ADLs Monitor for infection Exercises: - start a day after surgery o Squeeze with left hand using soft round object Lymphedema Swelling of arms – due to fluid retention in lymphatic system Irreversible – tough to tx Prevention is key o Keep arm elevated o Apply pressure to the arm – BP cuff – lymph sleeve o Know signs and symptoms of lymphedema to tx immediately o Chemotherapy
Adjuvant therapy May be done before surgery to help shrink the tumor Causes pancytopenia Can have many cycles of chemotherapy AZT – adromycin: cardiac SE Cytoxin – toxic to bladder – hematuria + ↑ risk for bladder cancer Taxall – acute allergic response – give antihistamine - Gynecological cancers o
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- Spring '14
- Hematology, Bone marrow, Anemia