Cancer Warning Signs (CAUTION)
- Change in Bowel or Bladder Habits
- A Sore That Does Not Heal
- Unusual Bleeding or Discharge
- Thickening or Lump in the Breast or Elsewhere
- Dyspepsia (Indigestion)
- Obvious Change to Warts or Moles
- Nagging Cough
Leukemia Assessment
- Immature WBCs
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- May Have Normal or High WBC Count
Leukemia Interventions
- Bone Marrow Aspiration
- X-Rays
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
Hodgkin's Lymphoma Assessment
- Lymph Node Cancer
- Contiguous Spread
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Bimodal Age Distribution
- Reed-Sternberg Cells
Hodgkin's Lymphoma Interventions
- Biopsy
- Staging
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Secondary Cancer Screening
Testicular Carcinoma Assessment
- Seminoma Germ Cells
- Non-Seminoma Germ Cells
- Painless Scrotal Mass
- Testicular Swelling
- Acute Pain Rare
- Elevated Serum Tumor Markers
- Males Between 15-35 Years Old
- Cryptorchidism
- Testicular Self Exam
Cervical Cancer Screening
- Women Aged 21-65 Years
- Pap Smear Every 3 Years
- Women Aged 30-65 Years
- Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
- Identify Lesions
- Cryotherapy
- Loop Excision
- Cold Knife Conization
Cervical Cancer Assessment
- Human Papillomavirus (HPV)
- Metrorrhagia
- Leukorrhea
- Pain
- Abnormal Pap Test
- May Be Asymptomatic
- HPV Vaccine
Breast Cancer Diagnosis
- Mammography
- Ultrasound
- MRI for High Risk Patients
- Confirmed with Biopsy
- Lymph Node Involvement
- Receptor Positivity
- Estrogen and Progesterone Receptors
- HER-2
Breast Cancer Interventions
- Radiation or Chemotherapy
- Hormonal Therapy
- Tamoxifen
- Lumpectomy
- Mastectomy
- Avoid BP and Injections Affected Arm
- Hand Exercises
- Grief Related to Body Image
- Prosthetics
- Reconstruction
- Lymphedema
Esophageal Adenocarcinoma Characteristics and Presentation
- Most Common Esophageal Cancer in USA
- Lower 1/3 of Esophagus
- Gastroesophageal Reflux Disease (GERD)
- Barrett's Esophagus
- Achalasia
- Obesity
- Smoking
- Weight Loss
- Progressive Dysphagia
- Anemia
Lung Cancer Assessment
- 2nd Most Common Cancer
- Chronic Cough
- Hoarseness
- Abnormal Breath Sounds
- Hemoptysis
- Chest Pain
- Anorexia or Weight Loss
- Symptoms Appear Late in Disease
Prostate Cancer Assessment
- Most Common Cancer in Men
- Mimics BPH
- Metastasis to Back
- Low Back Pain
- Fatigue
- Prostate Specific Antigen (PSA)
- Digital Rectal Examination (DRE)
- Transrectal Ultrasound (TRUS)
- Biopsy
Prostate Adenocarcinoma Characteristics and Presentation
- Most Common Cancer in Men
- Screening Test if Suspicious
- Prostate Specific Antigen (PSA)
- Peripheral Zone
- African American
- Advanced Age
- Usually Asymptomatic
- Terminal Hematuria
- Urinary Retention or Incontinence
- Lower Back Pain
Disseminated Intravascular Coagulation (DIC) Assessment
- Improper Initiation of Clotting Cascade
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
Disseminated Intravascular Coagulation (DIC) Interventions
- Risk for Shock
- Renal Failure
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
Sepsis Assessment
- Systemic Infectious Process
- Fever
- Hypotension
- Change in LOC
- Increased WBC
- Shift to the Left
- Tachycardia
- Tachypnea
- Hyperglycemia
- Edema
Severe Sepsis and Septic Shock Assessment
- Microthrombi
- DIC
- Decreased Oxygen Saturation
- Decreased WBC
- Oliguria
- High Output Heart Failure
- Multiple Organ Failure
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
- Monitor Serum and Urine Osmolality
- IandOs with Daily Weights
- Restrict Fluid Intake
- Monitor Cardiovascular and Neurological Status
- Seizure Precautions
Hypercalcemia
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Increased Risk for Renal Calculi
- Increase Fluids
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
Hypercalcemia Treatments
- Treat Underlying Disorder
- Hydration
- Dialysis
- Calcium Restriction
- Bisphosphonates
- Calcitonin
- Cinacalcet
- Glucocorticosteroids
- Denosumab
Iron Deficiency Anemia
- Malnutrition/Malabsorption
- Hemorrhage
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor