ORAL REVALIDA
NCM 417
Question #1: Differentiate benign and malignant neoplasm.
CHARACTERISTICS BENIGN MALIGNANT
Cell characteristics Well- differentiated cells that Cells are undifferentiated
resemble normal cells of the and often bear little
tissue from w hich the tumor resemblance to the normal
originated. cells of the tissue from which
they arose.
Mo de o f gro w th Tumor grows by expansion Grow s at the periphery and
and do es not infiltrate the sends out processes that
surrounding tissues; usually infiltrate and destro y the
encapsulated. surrounding tissues.
Rate o f gro wth Rate of grow th is usually Rate of growth is variable
slow. and depends on level of
differentiation; the more
anaplastic the tumor, the
faster its grow th.
Metastasis Does not spread by Gains access to the blood
metastasis. and lymphatic channels and
metastizes to the other areas
of the body.
General effects Is usually a localized O ften causes generalized
phenomenon that does not effects, such as anemia,
cause generalized effects w eakness, and weight lo ss.
unless its lo cation interferes
with vital functions.
Tissue destruction Does not usually cause tissue O ften causes extensive tissue
damage unless its location damage as the tumor
interferes with blood flow. outgrow s its blood supply or
encroaches on blood flow to
the area; may also produce
substances that causes cell
damage.
Ability to cause death Does not usually cause death Usually causes death unless
unless its lo cation interferes growth can be controlled.
with vital functions.
Question #2: Explain the Theories of Cancer Causation.
Theories of Cancer Causation
Failure of the Immune Response Theory
All individuals possess cancer cells.
However, cancer cells are recognized by the
immune response system
Theories of Cancer Causation
Cellular Transformation and
Derangement Theory
The normal cells maybe transformed
into cancer cells due to exposure to some
etiologic agents
Question #3: Discuss the systemic effects of cancer.
Clinical Manifestations of Cancer
Cancer Cell Proliferation
Pain - general mechanisms that cause pain
associated with cancer:
- pressure on nerve endings
- obstruction
- invasion of a sensitive structure
- stretching of visceral surfaces
- tissue destruction
- inflammation
- a late sign of cancer
Clinical Manifestations of Cancer
Pressure – due to increase in size of
neoplastic growth
Obstruction – as tumor continues to grow,
hollow organs and vessels
become compressed and
obstructed
Clinical Manifestations of Cancer
Effusion – when lymphatic flow is obstructed
Ulceration and necrosis – result as the
tumor erodes blood vessels and
pressure on tissue
Vascular thrombosis, embolism,
thrombophlebitis – tend to
produce abnormal coagulation
factors
Clinical Manifestations of Cancer
Paraneoplastic Syndrome – malignant
cells produce enzymes,
hormones, and other substances
Clinical Manifestations of Cancer
Anorexia – Cachexia Syndrome
- the final outcome of unrestrained cancer
cell growth
- malignant neoplasms deprive normal
cells of nutrition
- taste sensation diminishes or becomes
altered and the individual may have
aversion to eating
Question #4: Discuss the roles of the nurse in cancer care.
Responsibilities of the Nurse
in CANCER care
• Support the idea that cancer is a chronic illness
that has acute exacerbations rather than one
that is synonymous with DEATH and
SUFFERING
• Assess own level of knowledge relative to the
pathophysiology of the disease process
• Make use of current research findings and
practices in the care of the client with cancer and
his or her family
• Identify patients at high risk for cancer
Responsibilities of the Nurse
in CANCER care
• Participate in PRIMARY and SECONDARY
prevention efforts
• Assess the nursing care needs of the patient
with cancer
• Assess the learning needs, desires, and
capabilities of the patient with cancer
• Identify nursing problems of the patient and the
family
• Assess the social support networks available to
the patient
Responsibilities of the Nurse
in CANCER care
• Plan appropriate interventions with the patient
and the family
• Assist the patient to identify strengths and
limitations
• Assist the patient to design short-term and long-
term goals for care
• Implement NCPs that interfaces with the medical
regimen and that is consistent with the
established goals
• Collaborate with the members of a
multidisciplinary team to foster continuity of care
Responsibilities of the Nurse
in CANCER care
• Evaluate the goals and resultant outcomes
of care with the patient, family, and
members of the multidisciplinary team
• Reassess and redesign the direction of
care as determined by the evaluation
Question #5: Explain the steps in malignant transformation.
Three Steps of Carcinogenesis
(Malignant Transformation)
• Initiation
• Initiators (carcinogens) escape normal enzymatic mechanisms
and alter the genetic structure of the cellular DNA where
permanent mutation occurs.
• Pro motion
• Repeated exposure to promoting agents (co -carcinogens) causes
the expression of abnormal or mutant genetic mutation even
after long latency periods.
• Pro gression
• Cellular changes formed during initiation and promotion now
exhibit increased malignant behaviour.
• These cells now show a propensity to invade adjacent tissues
and to metastasize.
Question #6: Describe 2nd degree burns.
Second-degree burns
epidermis and part of dermis
symptoms
blisters
deep redness
wet and shiny
very painful to touch
no scars
example –Êcontact with hot objects or flame
Question #7: What are the complications of burns?
Complications
infection
peripheral vascular resistance and hypovolemia
acute tubular necrosis
cardiac arrhythmias
cardiac arrest
Question #8: Discuss the Rule of Nines in calculating the Total Body Surface Area (TBSA) of burned
patient.
RU LE OF N IN ES
H ea d & Neck = 9%
E a ch u pper ext rem it y (Ar m s) = 9%
E a ch lower ext r em it y (Legs) = 18%
An t er ior t r u n k= 18%
P ost er ior t r u n k = 18%
Gen it a lia (per in eu m ) = 1%
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Question #9: What is Curling’s Ulcer?
CU RLIN G’S U LCER
Acu t e u lcer a t ive ga st r o du oden a l disea se
Occu r wit h in 24 h ou r s a ft er bu rn
Du e t o r edu ced GI blood flow a n d m u cosa l
da m a ge
Tr ea t clien t s wit h H 2 blocker s, m u coprot ect a n t s,
a n d ea r ly en t er a l n u t r it ion
Wa t ch for su dden dr op in h em oglobin
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Question #10: Identify three nursing diagnoses applicable in the emergent phase of burn injury.
CU RLIN G’S U LCER
Acu t e u lcer a t ive ga st r o du oden a l disea se
Occu r wit h in 24 h ou r s a ft er bu rn
Du e t o r edu ced GI blood flow a n d m u cosa l
da m a ge
Tr ea t clien t s wit h H 2 blocker s, m u coprot ect a n t s,
a n d ea r ly en t er a l n u t r it ion
Wa t ch for su dden dr op in h em oglobin
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