CANCER • Comes from a latin word “crab” • The term cancer represents a large group of diseases characterized by a malfunction of the call growth process that cause the uncontrolled growth of abnormal cells NEOPLASM – a cell division malfunction Two types: 1. Benign • Strictly local affairs • Tend to be surrounded by a capsule • Grows slowly and seldom kills their host • Slowly progressing and remain stationary or may regress 2. Malignant • Are nonencapsulated masses that grow more relentlessly and may become killers • Their cells resemble immature cells • They invade their surroundings • Progressive and almost always fatal of untreated Cause of cancer morbidity is through: METASTASIS- refers to the spread of cancer from primary site to the secondary site. Cancer cells can break away, leak, or spill from a primary tumor, enter lymphatic and blood vessels, circulate through the bloodstream, and be deposited within normal tissue elsewhere in the body. Metastasis is one of three hallmarks of malignancy (contrast benign tumors). Most tumors and other neoplasms can metastasize, although in varying degrees (e.g., glioma and basal cell carcinoma rarely metastasize). When tumor cells metastasize, the new tumor is called a secondary or metastatic tumor, and its cells are like those in the original tumor. This means, for example, that, if breast cancer metastasizes to the lungs, the secondary tumor is made up of abnormal breast cells, not of abnormal lung cells. The tumor in the lung is then called metastatic breast cancer, not lung cancer. MAJOR CATEGORIES OF CANCER: classified according to the tissue from which they originate: 1. Carcinoma – cancer arising from epithelial tissue (basal cell carcinoma) 2. Sarcoma – cancer arising from fat, connective tissue, muscle or bone (osteosarcoma) 3. Lymphoma – cancer arising from lymphoid tissue (burkitt’s lymphoma) 4. Leukemia – cancer of the blood- forming cells in the bone marrow (acute lumphocyte leukemnia.
CARCINOGENS: The term carcinogen refers to any substance, radionuclide or radiation that is an agent directly involved in the promotion of cancer or in the increase of its propagation. This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substances are considered carcinogens, but their carcinogenic activity is attributed to the radiation, for example gamma rays and alpha particles, which they emit. Common examples of carcinogens are inhaled asbestos, certain dioxins, and tobacco smoke. CAUSES/RISK FACTORS: 1. CHEMICAL CARCINOGENESIS: • Tobacco and tobacco quids and pipe smoking • Asbestos • Arsenic, chromium and nickel compounds • Vinyl chloride • Radon gas • Diethylstilbestrol • Estrogen 2. PHYSICAL CARCINOGENESIS: • Ultraviloet radiation, ionizing radiation • Precancerous lesions • Acquired disorders • Diet related foods containing high fat • Obesity 3. FAMILIAL CARCINOGENESIS: • Many inherited cancers behave as autosomal dominant traits 4. VIRAL CARCINOGENESIS • Hepatitis B virus and hepatocellular carcinoma • Human T – cell leukemnia virus-1 and adult T-cell leukemnia or lymphoma • Herpes virus (DNA virus) • Herpes simplex type2 and humanpapillomavirus (HPV) SYMPTOMS Symptoms of cancer depend on the type and location of the tumor. For example, lung cancer can cause coughing, shortness of breath, or chest pain. Colon cancer often causes diarrhea, constipation, and blood in the stool. Some cancers may not have any symptoms at all. In certain cancers, such as gallbladder cancer, symptoms often do not start until the disease has reached an advanced stage. The following symptoms can occur with most cancers: • Chills • Fatigue • Fever • Loss of appetite • Malaise • Night sweats • Weight loss
CANCER PROTECTING MECHANISM • HEALTHY DIET • PHYSICAL FITNESS • EXERCISE HOW IS CANCER DIAGNOSED? INDIRECT: xray, UTZ, CT scan, endoscopy, blood exam, CBC Direct- biopsy, like: • FNAB • Core needle biopsy • Breast mass excision biopsy • Breast mass incision biopsy • Cytology – Pap smear Objectives • Cure • Control (advance stage) • Palliation (end stage) • -improve quality of life • -relieve symptoms of pain • -improve function • -prolong life EXAMS AND TEST Like symptoms, the signs of cancer vary based on the type and location of the tumor. Common tests include the following: • Biopsy of the tumor • Blood chemistries • Bone marrow biopsy (for lymphoma or leukemia) • Chest x-ray • Complete blood count (CBC) • CT scan Most cancers are diagnosed by biopsy. Depending on the location of the tumor, the biopsy may be a simple procedure or a serious operation. Most patients with cancer have CT scans to determine the exact location and size of the tumor or tumors. A cancer diagnosis is difficult to cope with. It is important, however, that you discuss the type, size, and location of the cancer with your doctor when you are diagnosed. You also will want to ask about treatment options, along with their benefits and risks. It's a good idea to have someone with you at the doctor's office to help you get through the diagnosis. If you have trouble asking questions after hearing about your diagnosis, the person you bring with you can ask them for you. TREATMENT MODALITIES OF CANCER • Surgery – this procedure is done to remove the tumor or the disease tissue for a cure. Surgery can also be used to diagnose: as a preventive treatment, or for reconstruction. The care of the focus on the body part involved or removed. • Chemotherapy – this is undertaken to destroy cancer cells by interfering with mitosis or by destroying cell wall. • Radiation – localized treatment, used to destroy cancer cells, without destruction of the normal cells. • Immunotherapy – Immunotherapy, though still in the experimental stages , is a promising new approach in the treatment of cancer. Treatment also varies based on the type of cancer and its stage. The stage of a cancer refers to how much it has grown and whether the tumor has spread from its original location. • If the cancer is confined to one location and has not spread, the most common goals for treatment are surgery and cure. This is often the case with skin cancers, as well as cancers of the lung, breast, and colon. • If the tumor has spread to local lymph nodes only, sometimes these can also be removed. • If surgery cannot remove all of the cancer, the options for treatment include radiation, chemotherapy, or both. Some cancers require a combination of surgery, radiation, and chemotherapy. Although treatment for cancer can be difficult, there are many ways to keep up your strength. If you have radiation treatment, know that: • Radiation treatment is painless. • Treatment is usually scheduled every weekday. • You should allow 30 minutes for each treatment session, although the treatment itself usually takes only a few minutes. • You should get plenty of rest and eat a well-balanced diet during the course of your radiation therapy. • Skin in the treated area may become sensitive and easily irritated. • Side effects of radiation treatment are usually temporary. They vary depending on the area of the body that is being treated. If you are going through chemotherapy, you should eat right. Chemotherapy causes your immune system to weaken, so you should avoid people with colds or the flu. You should also get plenty of rest, and don't feel as though you have to accomplish tasks all at once. It will help you to talk with family, friends, or a support group about your feelings. Work with your health care providers throughout your treatment. Helping yourself can make you feel more in control.
-The immune system is composed of many interdependent cell types that collectively protect the body from bacterial, parasitic, fungal, viral infections and from the growth of tumor cells. -Many of these cell types have specialized functions. The cells of the immune system can engulf bacteria, kill parasites or tumor cells, or kill viral-infected cells. -Often, these cells depend on the T helper subset for activation signals in the form of secretions formally known as cytokines, lymphokines, or more specifically interleukins.
==ORGANS OF THE IMMUNE SYSTEM==
1.BONE MARROW-The bone marrow produces B cells, natural killer cells, granulocytes and immature thymocytes, in addition to red blood cells and platelets.
2.THYMUS-The function of the thymus is to produce mature T cells. Immature thymocytes, also known as prothymocytes, leave the bone marrow and migrate into the thymus. The mature T cells are then released into the bloodstream.
3.SPLEEN-The spleen is an immunologic filter of the blood. It is made up of B cells, T cells, macrophages, dendritic cells, natural killer cells and red blood cells. In addition to capturing foreign materials (antigens) from the blood that passes through the spleen, migratory macrophages and dendritic cells bring antigens to the spleen via the bloodstream.
4.LYMPH NODES-The lymph nodes function as an immunologic filter for the bodily fluid known as lymph. Lymph nodes are found throughout the body.
==CELLS OF THE IMMUNE SYSTEM== 1.T CELLS-The main function of the T helper cell is to augment or potentiate immune responses by the secretion of specialized factors that activate other white blood cells to fight off infection.
2.B CELLS-The major function of B lymphocytes is the production of antibodies in response to foreign proteins of bacteria, viruses, and tumor cells.
3.GRANULOCYTES-Granulocytes are composed of three cell types identified as neutrophils, eosinophils and basophils, based on their staining characteristics with certain dyes. These cells are predominantly important in the removal of bacteria and parasites from the body. They engulf these foreign bodies and degrade them using their powerful enzymes.
4.MACROPHAGES-Macrophages are important in the regulation of immune responses. They are often referred to as scavengers or antigen-presenting cells (APC) because they pick up and ingest foreign materials and present these antigens to other cells of the immune system such as T cells and B cells.
5.DENDRITIC CELLS-In fact, the dendritic cells are more efficient apcs than macrophages. These cells are usually found in the structural compartment of the lymphoid organs such as the thymus, lymph nodes and spleen. However, they are also found in the bloodstream and other tissues of the body.
=DIABETES TYPE 1= -Type 1 diabetes is characterized by destruction of the pancreatic beta cells. It is thought that combined genetic, immunologic, and possibly environmental (eg, viral) factors contribute to beta cell destruction. -Although the events that lead to beta cell destruction are not fully understood, it is generally accepted that a genetic susceptibility is a common underlying factor in the development of type 1 diabetes. People do not inherit type 1 diabetes itself; rather, they inherit a genetic predisposition, or tendency, toward developing type 1 diabetes. This genetic tendency has been found in people with certain HLA (human leukocyte antigen) types. -There is also evidence of an autoimmune response in type 1 diabetes. This is an abnormal response in which antibodies are directed against normal tissues of the body, responding to these tissues as if they are foreign. -Autoantibodies against islet cells and against endogenous (internal) insulin have been detected in people at the time of diagnosis and even several years before the development of clinical signs of type 1 diabetes.
==PATHOPHYSIOLOGY== Insulin is secreted by beta cells, which are one of four types of cells in the islets of Langerhans in the pancreas. Insulin is an anabolic, or storage, hormone. When a person eats a meal, insulin secretion increases and moves glucose from the blood into muscle, liver, and fat cells. In those cells, insulin: - Transports and metabolizes glucose for energy - Stimulates storage of glucose in the liver and muscle (in the form of glycogen) - Signals the liver to stop the release of glucose - Enhances storage of dietary fat in adipose tissue - Accelerates transport of amino acids (derived from dietary protein) into cells Insulin also inhibits the breakdown of stored glucose, protein, and fat.
During fasting periods (between meals and overnight), the pancreas continuously releases a small amount of insulin (basal insulin); another pancreatic hormone called glucagon (secreted by the alpha cells of the islets of Langerhans) is released when blood glucose levels decrease and stimulate the liver to release stored glucose. The insulin and the glucagon together maintain a constant level of glucose in the blood by stimulating the release of glucose from the liver.
Initially, the liver produces glucose through the breakdown of glycogen (glycogenolysis). After 8 to 12 hours without food, the liver forms glucose from the breakdown of noncarbohydrate substances, including amino acids (gluconeogenesis).
=CLINICAL MANIFESTATIONS= *Polyuria (increased urination) *polydipsia (increased thirst) occur as a result of the excess loss of fluid associated with osmotic diuresis. *polyphagia (increased appetite) resulting from the catabolic state induced by insulin deficiency and the breakdown of proteins and fats. OTHER SYMPTOMS: -fatigue -weakness -sudden vision changes -tingling or numbness in hands or feet -dry skin -skin lesions or wounds that are slow to heal recurrent infections.
=ASSESSMENT AND DIAGNOSTIC FINDINGS= 1. Symptoms of diabetes plus casual plasma glucose concentration equal to or greater than 200 mg/dL (11.1 mmol/L). Casual is defined as any time of day without regard to time since last meal. The classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss. 2.Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 hours. 3.2-hour postload glucose equal to or greater than 200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test.
=DIABETES MANAGEMENT= -the therapeutic goal for diabetes management is to achieve normal blood glucose levels (euglycemia) without hypoglycemia and without seriously disrupting the patient’s usual lifestyle and activity. There are five components of diabetes management: 1.Nutritional management 2.Exercise 3.Monitoring 4.Pharmacologic therapy 5.Education
=NURSING MANAGEMENT= 1. Education 2. Preventing long term diabetic complication -Foot care -Eye care -General hygiene (eg, skin care, oral hygiene) -Risk factor management (eg, control of blood pressure and blood lipid levels, and normalizing blood glucose levels) 3. Teaching Patients to Self-Administer Insulin 4. Organizing Information - includes such as things to do when their are experiencing either hyperglycemia or hypoglycemia
Gud day mam. here's my report on IMMUNOLOGIC DISORDERS and here it goes,,
ALLERGIC RHINITIS (AR) * DESCRIPTION. Allergic Rhinitis (hay fever) is an allergic reaction characterized by seasonal occurrences. It is the most common form of respiratory allergy. occurs at any age groups.
*ETIOLOGY. AR is induced by airborne droplets. Common seasonal pollens include: 1. tree pollens (oak, maple and birch) in the spring. 2. grass pollens (plantain) in the summer. 3. weed pollens(ragweed) in the fall.
*PATHOPHYSIOLOGY. AR occurs when immunologlobulin (Ig)E antibodies in the nasal mucosa combine with inhaled allergens on the mucosal surface. The nasal mucosa reacts by slowing ciliary action, edema formation adn leukocyte infiltration. Tissue edema is a result of vasodilation and increased capillary permeability.
* ASSESSMENT FINDINGS. 1.Family History of allergies 2. CLINICAL MANIFESTATIONS: a. Itching, burning nasal mucosa. b. Copious mucous secretions causing runny nose. c. Red, burning, tearing eyes. d. Sneezing. e. Pale boggy nasal mucosa. 3. LABORATORY AND DIAGNOSTIC FINDINGS: a. Skin testing identifies the offending allergens.
*NURSING MANAGEMENT 1. ADMINISTER PRESCRIBED MEDICATIONS. (which include antihistamine, decongestant and topical corticosteroids.) 2. ENCOURAGE THE CLIENT TO USESALINE NASAL SPRAYS TO SOOTHE MUCOUS MEMBRANES. Advise the client to blow nose before administering nasal medications. 3. PROVIDE THE CLIENT AND FAMILY HEALTH TEACHINGS.
*DESCRIPTION. Rheumatoid Arthritis is a chronic, progressive disease involving inflammation of synovial joints. The incidence is greater in women than in men. Peak age of onset is between age of 30 and 60, but the disease can develop at any age.
*ETIOLOGY. RA is apparently an autoimmune disorder; its cause is unknown. Exacerbation s may be associated with increased physical or emotional stress.
*PATHOPHYSIOLOGY. Pathologic changes begins as inflammation and progress to destruction of joints, producing deformity and loss of motion. The disease may affect only joints or may extend to body organs and blood vessles.
*ASSESSMENT FINDINGS. 1.CLINICAL MANIFESTATIONS a. Edematous, warm, tender joints. b. Limited Range of Motion in the affected area. c. Fatigue, weakness, and anorexia. d. In later stage, weight loss, fever, anemia, and muscle atrophy.
2. LABORATORY AND DIAGNOSTIC FINDINGS. a. Radiographic studies reveals abnormalities such as progressive joint damage.
*NURSING MANAGEMENT 1. ADMINISTER PRESCRIBED MEDICATIONS. (non-steroidal inflammatory drugs, slow acting anti rheumatic medications, and corticosteroids.) 2. PROVIDE PAIN RELIEF. Provide comfort measures, include massage and position changes . Apply hot or cold therapy to the affected joints according to the clients need. 3. Promote self-care. 4. Promote client and family coping. 5. PROVIDE ADEQUATE REST AND SLEEP. to prevent fatigue;provide comfort measure, including foam mattress and supportive pillows; discuss energy conservation techniques. 6. ENCOURAGE PROPER BODY ALIGNMENT. to prevent contractures. 7. COLLABORATE WITH THE PHYSICAL THERAPIST. to design and provide the client with physical therapy program. Encourage a muscle activity program for self- care. Water exercise are excellent because water promotes buoyancy, which eases joint movements. 8. RECOMMEND A WEIGHT REDUCTION PROGRAM ,if appropriate. 9. COLLABORATE WITH THE OCCCUPATIONAL THERAPIST AND PROMOTE THE USE OF BRACES, SPLINTS, AND ASSISTIVE DEVICES, if appropriate. 10. DISCUSS RELAXATION TECHNIQUES. such as imagery, biofeedback, diversionary activities and distraction for pain management. 11. Discuss maintaining optimal nutritional status.
*DESCRIPTION. GBS is an acute, rapidly progressive form of polyneuritis producing ,muscle weakness and mild sensory disturbances. It can develop at any age but is common between ages 30 and 50. The incidence is equal to men and women.
* ETIOLOGY. GBS is post infectious polyneuritis of unknown origin that commonly follows febrile illness.
* PATHOPHYSIOLOGY. Segmental demyelination of peripheral nerves causes inflammation and degeneration in sensory and motor nerve roots. Most clients experience spontaneous and complete sensory, although mild deficits may persist.
* ASSESSMENT FINDINGS 1. CLINICAL MANIFESTATIONS > Respiratory or GI infections( usually occurs 1 to 4 weeks before the onset of symptoms.) >Ascending paralysis starting in the legs >Motor weakness progressing to involve the entire peripheral nervous system, including respiratory muscles. > Progression may involve total or partial paralysis.
2. LABORATORY AND DIAGNOSTIC FINDINGS. >Lumbar puncture and Cerebrospinal Fluid (CSF) Analysis may reveal elevated levels of CSF proteins.
*NURSING MANAGEMENT. 1. EXPLAIN THE PROCEDURES AND CARE MEASURES TO HELP REDUCE THE CLIENTS ANXIETY. 2. MONITOR RESPIRATORY STATUS IF RESPIRATORY MUSCLES ARE INVOLVED. Mechanical ventilation may be necessary. 3. MAXIMIZE FUNCTIONAL ABILITIES. a. Prevent complications of immobility such as deep vein thrombosis, constipation, contractures, and pressure ulcers. b. Maximize effective communication. The client may need to use blinking eyes when unable to move upper extremities. 4. PROMOTE ADEQUATE NUTRITION TO PREVENT MUSCLE WASTING. a. Encourage soft foods that are easy to swallow. b. If the client is unable to swallow , the client may need nasogastric tube feedings. 5. ASSIST WITH PLASMAPHERESIS, if prescribed.
INFECTIOUS DISEASES Also known as communicable diseases Are those illnesses that can be transmitted from person to person, or from other infected medium to a person. Germs are the culprit behind the communicable diseases, though not all germs are harmful. TYPES OF COMMUNICABLE DISEASES I. Sexually transmitted diseases – Like Chlamydia, gonorrhea , HIV/AIDS, and herpes II. Transmitted via contaminated food and drinks – Like cholera, typhoid fever, botulism and other. III. Disease transmitted via mosquito and other vector - Like dengue fever malaria and others. IV. Other notable infected disease- Like rabies, measles, anthrax and others. SIGNS AND SYMPTOMS Fever Sore throat Vomiting Stomach pain General ache Eye irritation Coughing Diarrhea Skin rashes And Runny nose STGES OF INFECTIOUS DISEASE 1. Incubation period – Interval between intrans of pathogen into body and appearance of first symptom 2. Prodromal stage – Interval from onset of nonspecific signs and stmptoms to more specific symptom this time, micro organism grows and multiplies, and client may be more capable of spreading disease to other. 3. Illness stage – Interval when client manifest signs and symptoms specific to type of infection. 4. Convalescence – Interval hen acute symptoms of infection disappear.
CAUSATIVE AGENT Causative agents are pathogens. Pathogens are micro organisms that are capable of causing disease or infection. ENDOGENOUS INFECTION- If micro-organism from a person own body cause an infection EXOGENOUS INFECTION- If micro-organism derived from sources out side a person’s own body causes an infection
RESERVOIR A reservoir is any person, animals, plant, soil or substance in which an infectious agent normally lives and multiplies, on which it depend primarily for survival, and where it reproduce it self in such manner that it can be transmitted to the susceptible host. Animate reservoir- people, insect, birds, and other animal Inanimate reservoir- Soil, water, food, feces, IV fluid and equipment.
PORTAL OF EXIT A portal of exit is the site from where micro-organism leaves the host to enter other host and cause disease. Example: • URT: Saliva from the oral cavity, sneezing, coughing, and talking • GIT: Feces/ diarrhea from the bowel, and vomitus • Blood: Infected blood • Urogenital tract: semen, vaginal secretion, and infected urine • Skin and mucous membranes: Discharge from infected skin lesions and infected wounds
TRANSMISSION DIRECT CONTACT- Is person to person transmission of pathogen through touching, biting, kissing, or sexual intercourse. Micro-organism can expelled from the body by coughing, sneezing, or talking INDIRECT CONTACT- Includes both vehicle-borne and vector- borne contact. PORTAL OF ENTRY A portal of entry is the site through which micro-organism enter the susceptible host and cause disease/infection. Example: • Inhalation (e.g., influenza) • Ingestion (e.g., gastroenteritis) • Needle stick injury (e.g., hepatitis B) • Sexual contact (e.g., Chlamydia) • Open wound or puncture (e.g., stepping on the nail) ulcer SUSCIPTIBLE HOST The host is human body: and who is at risk for infection. Example: • Human Defenses against infection 1st line of defense: - Mechanical barrier - Body secretion- saliva, sweat, tears, gastric juices, bile and mucous -lymphoid tissue -normal flora 2nd line defense: - Inflammatory responses: signs and symptom include: o Localized: redness, heat, swelling, pain, and impaired of the body part o Systemic: fever, malaise, leococytosis, lymph node enlargement, nausea and vomiting. 3rd line of defense: o Antibodies are produce in response to the presence of foreign protein (antigen), not usually present in the body. WAY TO BREAK THE CHAIN Elimination of sources of infection Appropriate handling and disposal of body secretion Appropriate handling of contaminated item, segregation of waste categories and disposal Correct hand washing Single use equipment Cleaning, disinfection and sterilization of reusable instrument and equipment Implementation of aseptic technique Maintenance of aseptic techniques, use of sterile item Maintenance of skin and mucous membrane integrity Immunization against infectious disease Acquired immunity Healthy life style High standard of personal hygiene
NOSOCOMIAL INFECTION Also known as Hospital-acquired infection Is an infection that first appears between 48 hours and four days after a patient is admitted to a hospital Hospital-acquired infection are usually related to a procedure or treatment use to diagnose or treat the patient’s initial illness and injury Hospital-acquired infection can be cause by bacteria, viruses, fungi, or parasites. These microorganism may already be present in the patient’s body or may come from the environment,, contaminated hospital equipment, health care workers or other patient Hospital-acquired infection may develop from the performance of surgical procedures; from the insertion of the catheters (tubes) in to the urinary tract , nose, mouth, or blood vessels; or from material from the nose or mouth that is aspirated (inhaled) into the lungs The most common types of Hospital acquired infection are UTI and ventilator associated pneumonia, and surgical wound. PREVENTION Identify hig-risk procedures and other possible sources of infection Strict adherence to hand-washing rules by health care workers and visitors to avoid passing infectious microorganism to or between hospitalized patient Strict attention to aseptic techniques in the performance pof procedures, including use of sterile gown, gloves, mask, and barriers Sterilization of all reusable equipments such as ventilator, humidifier, and any devise thaqt come in contact with the respiratory tract Frequent changing of dressing for wound and use anti bacterial ointment under dressing Removed NGT (nose to stomach) and ETT (mouth to stomach) as soon as possible And others precaution.
I was once a very timid girl. I learned to socialize, relate, and I realized....We're all the same. Though different abilities make us unique, but we have commonalities---we all have the need to communicate.
MEILEEN FRANCISCO
ReplyDeleteIV – F
7TH ROTATION
CANCER
• Comes from a latin word “crab”
• The term cancer represents a large group of diseases characterized by a malfunction of the call growth process that cause the uncontrolled growth of abnormal cells
NEOPLASM – a cell division malfunction
Two types:
1. Benign
• Strictly local affairs
• Tend to be surrounded by a capsule
• Grows slowly and seldom kills their host
• Slowly progressing and remain stationary or may regress
2. Malignant
• Are nonencapsulated masses that grow more relentlessly and may become killers
• Their cells resemble immature cells
• They invade their surroundings
• Progressive and almost always fatal of untreated
Cause of cancer morbidity is through:
METASTASIS- refers to the spread of cancer from primary site to the secondary site.
Cancer cells can break away, leak, or spill from a primary tumor, enter lymphatic and blood vessels, circulate through the bloodstream, and be deposited within normal tissue elsewhere in the body. Metastasis is one of three hallmarks of malignancy (contrast benign tumors). Most tumors and other neoplasms can metastasize, although in varying degrees (e.g., glioma and basal cell carcinoma rarely metastasize).
When tumor cells metastasize, the new tumor is called a secondary or metastatic tumor, and its cells are like those in the original tumor. This means, for example, that, if breast cancer metastasizes to the lungs, the secondary tumor is made up of abnormal breast cells, not of abnormal lung cells. The tumor in the lung is then called metastatic breast cancer, not lung cancer.
MAJOR CATEGORIES OF CANCER: classified according to the tissue from which they originate:
1. Carcinoma – cancer arising from epithelial tissue (basal cell carcinoma)
2. Sarcoma – cancer arising from fat, connective tissue, muscle or bone (osteosarcoma)
3. Lymphoma – cancer arising from lymphoid tissue (burkitt’s lymphoma)
4. Leukemia – cancer of the blood- forming cells in the bone marrow (acute lumphocyte leukemnia.
CARCINOGENS: The term carcinogen refers to any substance, radionuclide or radiation that is an agent directly involved in the promotion of cancer or in the increase of its propagation. This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substances are considered carcinogens, but their carcinogenic activity is attributed to the radiation, for example gamma rays and alpha particles, which they emit. Common examples of carcinogens are inhaled asbestos, certain dioxins, and tobacco smoke.
ReplyDeleteCAUSES/RISK FACTORS:
1. CHEMICAL CARCINOGENESIS:
• Tobacco and tobacco quids and pipe smoking
• Asbestos
• Arsenic, chromium and nickel compounds
• Vinyl chloride
• Radon gas
• Diethylstilbestrol
• Estrogen
2. PHYSICAL CARCINOGENESIS:
• Ultraviloet radiation, ionizing radiation
• Precancerous lesions
• Acquired disorders
• Diet related foods containing high fat
• Obesity
3. FAMILIAL CARCINOGENESIS:
• Many inherited cancers behave as autosomal dominant traits
4. VIRAL CARCINOGENESIS
• Hepatitis B virus and hepatocellular carcinoma
• Human T – cell leukemnia virus-1 and adult T-cell leukemnia or lymphoma
• Herpes virus (DNA virus)
• Herpes simplex type2 and humanpapillomavirus (HPV)
SYMPTOMS
Symptoms of cancer depend on the type and location of the tumor. For example, lung cancer can cause coughing, shortness of breath, or chest pain. Colon cancer often causes diarrhea, constipation, and blood in the stool.
Some cancers may not have any symptoms at all. In certain cancers, such as gallbladder cancer, symptoms often do not start until the disease has reached an advanced stage.
The following symptoms can occur with most cancers:
• Chills
• Fatigue
• Fever
• Loss of appetite
• Malaise
• Night sweats
• Weight loss
CANCER PROTECTING MECHANISM
ReplyDelete• HEALTHY DIET
• PHYSICAL FITNESS
• EXERCISE
HOW IS CANCER DIAGNOSED?
INDIRECT: xray, UTZ, CT scan, endoscopy, blood exam, CBC
Direct- biopsy, like:
• FNAB
• Core needle biopsy
• Breast mass excision biopsy
• Breast mass incision biopsy
• Cytology – Pap smear
Objectives
• Cure
• Control (advance stage)
• Palliation (end stage)
• -improve quality of life
• -relieve symptoms of pain
• -improve function
• -prolong life
EXAMS AND TEST
Like symptoms, the signs of cancer vary based on the type and location of the tumor. Common tests include the following:
• Biopsy of the tumor
• Blood chemistries
• Bone marrow biopsy (for lymphoma or leukemia)
• Chest x-ray
• Complete blood count (CBC)
• CT scan
Most cancers are diagnosed by biopsy. Depending on the location of the tumor, the biopsy may be a simple procedure or a serious operation. Most patients with cancer have CT scans to determine the exact location and size of the tumor or tumors.
A cancer diagnosis is difficult to cope with. It is important, however, that you discuss the type, size, and location of the cancer with your doctor when you are diagnosed. You also will want to ask about treatment options, along with their benefits and risks.
It's a good idea to have someone with you at the doctor's office to help you get through the diagnosis. If you have trouble asking questions after hearing about your diagnosis, the person you bring with you can ask them for you.
TREATMENT MODALITIES OF CANCER
• Surgery – this procedure is done to remove the tumor or the disease tissue for a cure. Surgery can also be used to diagnose: as a preventive treatment, or for reconstruction. The care of the focus on the body part involved or removed.
• Chemotherapy – this is undertaken to destroy cancer cells by interfering with mitosis or by destroying cell wall.
• Radiation – localized treatment, used to destroy cancer cells, without destruction of the normal cells.
• Immunotherapy – Immunotherapy, though still in the experimental stages , is a promising new approach in the treatment of cancer.
Treatment also varies based on the type of cancer and its stage. The stage of a cancer refers to how much it has grown and whether the tumor has spread from its original location.
• If the cancer is confined to one location and has not spread, the most common goals for treatment are surgery and cure. This is often the case with skin cancers, as well as cancers of the lung, breast, and colon.
• If the tumor has spread to local lymph nodes only, sometimes these can also be removed.
• If surgery cannot remove all of the cancer, the options for treatment include radiation, chemotherapy, or both. Some cancers require a combination of surgery, radiation, and chemotherapy.
Although treatment for cancer can be difficult, there are many ways to keep up your strength.
If you have radiation treatment, know that:
• Radiation treatment is painless.
• Treatment is usually scheduled every weekday.
• You should allow 30 minutes for each treatment session, although the treatment itself usually takes only a few minutes.
• You should get plenty of rest and eat a well-balanced diet during the course of your radiation therapy.
• Skin in the treated area may become sensitive and easily irritated.
• Side effects of radiation treatment are usually temporary. They vary depending on the area of the body that is being treated.
If you are going through chemotherapy, you should eat right. Chemotherapy causes your immune system to weaken, so you should avoid people with colds or the flu. You should also get plenty of rest, and don't feel as though you have to accomplish tasks all at once.
It will help you to talk with family, friends, or a support group about your feelings. Work with your health care providers throughout your treatment. Helping yourself can make you feel more in control.
==IMMUNE SYSTEM==
ReplyDelete-The immune system is composed of many interdependent cell types that collectively protect the body from bacterial, parasitic, fungal, viral infections and from the growth of tumor cells.
-Many of these cell types have specialized functions. The cells of the immune system can engulf bacteria, kill parasites or tumor cells, or kill viral-infected cells.
-Often, these cells depend on the T helper subset for activation signals in the form of secretions formally known as cytokines, lymphokines, or more specifically interleukins.
==ORGANS OF THE IMMUNE SYSTEM==
1.BONE MARROW-The bone marrow produces B cells, natural killer cells, granulocytes and immature thymocytes, in addition to red blood cells and platelets.
2.THYMUS-The function of the thymus is to produce mature T cells. Immature thymocytes, also known as prothymocytes, leave the bone marrow and migrate into the thymus. The mature T cells are then released into the bloodstream.
3.SPLEEN-The spleen is an immunologic filter of the blood. It is made up of B cells, T cells, macrophages, dendritic cells, natural killer cells and red blood cells. In addition to capturing foreign materials (antigens) from the blood that passes through the spleen, migratory macrophages and dendritic cells bring antigens to the spleen via the bloodstream.
4.LYMPH NODES-The lymph nodes function as an immunologic filter for the bodily fluid known as lymph. Lymph nodes are found throughout the body.
==CELLS OF THE IMMUNE SYSTEM==
1.T CELLS-The main function of the T helper cell is to augment or potentiate immune responses by the secretion of specialized factors that activate other white blood cells to fight off infection.
2.B CELLS-The major function of B lymphocytes is the production of antibodies in response to foreign proteins of bacteria, viruses, and tumor cells.
3.GRANULOCYTES-Granulocytes are composed of three cell types identified as neutrophils, eosinophils and basophils, based on their staining characteristics with certain dyes. These cells are predominantly important in the removal of bacteria and parasites from the body. They engulf these foreign bodies and degrade them using their powerful enzymes.
4.MACROPHAGES-Macrophages are important in the regulation of immune responses. They are often referred to as scavengers or antigen-presenting cells (APC) because they pick up and ingest foreign materials and present these antigens to other cells of the immune system such as T cells and B cells.
5.DENDRITIC CELLS-In fact, the dendritic cells are more efficient apcs than macrophages. These cells are usually found in the structural compartment of the lymphoid organs such as the thymus, lymph nodes and spleen. However, they are also found in the bloodstream and other tissues of the body.
=DIABETES TYPE 1=
ReplyDelete-Type 1 diabetes is characterized by destruction of the pancreatic beta cells. It is thought that combined genetic, immunologic, and possibly environmental (eg, viral) factors contribute to beta cell destruction.
-Although the events that lead to beta cell destruction are not fully understood, it is generally accepted that a genetic susceptibility is a common underlying factor in the development of type 1 diabetes. People do not inherit type 1 diabetes itself; rather, they inherit a genetic predisposition, or tendency, toward developing type 1 diabetes. This genetic tendency has been found in people with certain HLA (human leukocyte antigen) types.
-There is also evidence of an autoimmune response in type 1 diabetes. This is an abnormal response in which antibodies are directed against normal tissues of the body, responding to these tissues as if they are foreign.
-Autoantibodies against islet cells and
against endogenous (internal) insulin have been detected in people at the time of diagnosis and even several years before the
development of clinical signs of type 1 diabetes.
==PATHOPHYSIOLOGY==
Insulin is secreted by beta cells, which are one of four types of cells in the islets of Langerhans in the pancreas. Insulin is an anabolic, or storage, hormone. When a person eats a meal, insulin secretion increases and moves glucose from the blood into muscle,
liver, and fat cells. In those cells, insulin:
- Transports and metabolizes glucose for energy
- Stimulates storage of glucose in the liver and muscle (in the
form of glycogen)
- Signals the liver to stop the release of glucose
- Enhances storage of dietary fat in adipose tissue
- Accelerates transport of amino acids (derived from dietary protein) into cells
Insulin also inhibits the breakdown of stored glucose, protein, and fat.
During fasting periods (between meals and overnight), the pancreas continuously releases a small amount of insulin (basal insulin); another pancreatic hormone called glucagon (secreted by the alpha cells of the islets of Langerhans) is released when
blood glucose levels decrease and stimulate the liver to release stored glucose. The insulin and the glucagon together maintain a
constant level of glucose in the blood by stimulating the release of glucose from the liver.
Initially, the liver produces glucose through the breakdown of glycogen (glycogenolysis). After 8 to 12 hours without food, the
liver forms glucose from the breakdown of noncarbohydrate substances,
including amino acids (gluconeogenesis).
=CLINICAL MANIFESTATIONS=
*Polyuria (increased urination)
*polydipsia (increased thirst) occur as a result of the excess loss of fluid associated with osmotic diuresis.
*polyphagia (increased appetite) resulting from the catabolic state induced by insulin deficiency and the breakdown of proteins and fats.
OTHER SYMPTOMS:
-fatigue
-weakness
-sudden vision changes
-tingling or numbness in hands or feet
-dry skin
-skin lesions or wounds that are slow to heal
recurrent infections.
=ASSESSMENT AND DIAGNOSTIC FINDINGS=
1. Symptoms of diabetes plus casual plasma glucose concentration equal to or greater than 200 mg/dL (11.1 mmol/L). Casual is defined as any time of day without regard to time since last meal. The classic symptoms of diabetes include polyuria, polydipsia, and unexplained weight loss.
2.Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least
8 hours.
3.2-hour postload glucose equal to or greater than 200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test.
=DIABETES MANAGEMENT=
-the therapeutic goal for diabetes management is to achieve normal blood glucose levels (euglycemia) without hypoglycemia and without seriously disrupting the patient’s usual
lifestyle and activity. There are five components of diabetes management:
1.Nutritional management
2.Exercise
3.Monitoring
4.Pharmacologic therapy
5.Education
Cont.
ReplyDelete=PHARMACOLOGIC THERAPY=
-Insulin
types of insulin includes:
1.insulin pumps
2.insulin pens
3.jet injectors
-Sulfonylareas
-Biguanides
-Alpha glucosidase inhibitors
=NURSING MANAGEMENT=
1. Education
2. Preventing long term diabetic complication
-Foot care
-Eye care
-General hygiene (eg, skin care, oral
hygiene)
-Risk factor management (eg, control of
blood pressure and blood lipid levels,
and normalizing blood glucose levels)
3. Teaching Patients to Self-Administer Insulin
4. Organizing Information - includes such as things to do when their are experiencing either hyperglycemia or hypoglycemia
Gud day mam. here's my report on
ReplyDeleteIMMUNOLOGIC DISORDERS and here it goes,,
ALLERGIC RHINITIS (AR)
* DESCRIPTION. Allergic Rhinitis (hay fever) is an allergic reaction characterized by seasonal occurrences. It is the most common form of respiratory allergy. occurs at any age groups.
*ETIOLOGY. AR is induced by airborne droplets. Common seasonal pollens include:
1. tree pollens (oak, maple and birch) in the spring.
2. grass pollens (plantain) in the summer.
3. weed pollens(ragweed) in the fall.
*PATHOPHYSIOLOGY. AR occurs when immunologlobulin (Ig)E antibodies in the nasal mucosa combine with inhaled allergens on the mucosal surface. The nasal mucosa reacts by slowing ciliary action, edema formation adn leukocyte infiltration. Tissue edema is a result of vasodilation and increased capillary permeability.
* ASSESSMENT FINDINGS.
1.Family History of allergies
2. CLINICAL MANIFESTATIONS:
a. Itching, burning nasal mucosa.
b. Copious mucous secretions causing runny nose.
c. Red, burning, tearing eyes.
d. Sneezing.
e. Pale boggy nasal mucosa.
3. LABORATORY AND DIAGNOSTIC FINDINGS:
a. Skin testing identifies the offending allergens.
*NURSING MANAGEMENT
1. ADMINISTER PRESCRIBED MEDICATIONS. (which include antihistamine, decongestant and topical corticosteroids.)
2. ENCOURAGE THE CLIENT TO USESALINE NASAL SPRAYS TO SOOTHE MUCOUS MEMBRANES. Advise the client to blow nose before administering nasal medications.
3. PROVIDE THE CLIENT AND FAMILY HEALTH TEACHINGS.
RHEUMATOID ARTHRITIS (RA)
ReplyDelete*DESCRIPTION. Rheumatoid Arthritis is a chronic, progressive disease involving inflammation of synovial joints. The incidence is greater in women than in men. Peak age of onset is between age of 30 and 60, but the disease can develop at any age.
*ETIOLOGY. RA is apparently an autoimmune disorder; its cause is unknown. Exacerbation s may be associated with increased physical or emotional stress.
*PATHOPHYSIOLOGY. Pathologic changes begins as inflammation and progress to destruction of joints, producing deformity and loss of motion. The disease may affect only joints or may extend to body organs and blood vessles.
*ASSESSMENT FINDINGS.
1.CLINICAL MANIFESTATIONS
a. Edematous, warm, tender joints.
b. Limited Range of Motion in the affected
area.
c. Fatigue, weakness, and anorexia.
d. In later stage, weight loss, fever, anemia, and muscle atrophy.
2. LABORATORY AND DIAGNOSTIC FINDINGS.
a. Radiographic studies reveals abnormalities such as progressive joint damage.
*NURSING MANAGEMENT
1. ADMINISTER PRESCRIBED MEDICATIONS. (non-steroidal inflammatory drugs, slow acting anti rheumatic medications, and corticosteroids.)
2. PROVIDE PAIN RELIEF. Provide comfort measures, include massage and position changes . Apply hot or cold therapy to the affected joints according to the clients need.
3. Promote self-care.
4. Promote client and family coping.
5. PROVIDE ADEQUATE REST AND SLEEP. to prevent fatigue;provide comfort measure, including foam mattress and supportive pillows; discuss energy conservation techniques.
6. ENCOURAGE PROPER BODY ALIGNMENT. to prevent contractures.
7. COLLABORATE WITH THE PHYSICAL THERAPIST. to design and provide the client with physical therapy program. Encourage a muscle activity program for self- care. Water exercise are excellent because water promotes buoyancy, which eases joint movements.
8. RECOMMEND A WEIGHT REDUCTION PROGRAM ,if appropriate.
9. COLLABORATE WITH THE OCCCUPATIONAL THERAPIST AND PROMOTE THE USE OF BRACES, SPLINTS, AND ASSISTIVE DEVICES, if appropriate.
10. DISCUSS RELAXATION TECHNIQUES. such as imagery, biofeedback, diversionary activities and distraction for pain management.
11. Discuss maintaining optimal nutritional status.
GUILLAIN- BARRE SYNDROME (GBS)
ReplyDelete*DESCRIPTION. GBS is an acute, rapidly progressive form of polyneuritis producing ,muscle weakness and mild sensory disturbances. It can develop at any age but is common between ages 30 and 50. The incidence is equal to men and women.
* ETIOLOGY. GBS is post infectious polyneuritis of unknown origin that commonly follows febrile illness.
* PATHOPHYSIOLOGY.
Segmental demyelination of peripheral nerves causes inflammation and degeneration in sensory and motor nerve roots.
Most clients experience spontaneous and complete sensory, although mild deficits may persist.
* ASSESSMENT FINDINGS
1. CLINICAL MANIFESTATIONS
> Respiratory or GI infections( usually occurs 1 to 4 weeks before the onset of symptoms.)
>Ascending paralysis starting in the legs
>Motor weakness progressing to involve the entire peripheral nervous system, including respiratory muscles.
> Progression may involve total or partial paralysis.
2. LABORATORY AND DIAGNOSTIC FINDINGS.
>Lumbar puncture and Cerebrospinal Fluid (CSF) Analysis may reveal elevated levels of CSF proteins.
*NURSING MANAGEMENT.
1. EXPLAIN THE PROCEDURES AND CARE MEASURES TO HELP REDUCE THE CLIENTS ANXIETY.
2. MONITOR RESPIRATORY STATUS IF RESPIRATORY MUSCLES ARE INVOLVED. Mechanical ventilation may be necessary.
3. MAXIMIZE FUNCTIONAL ABILITIES.
a. Prevent complications of immobility such as deep vein thrombosis, constipation, contractures, and pressure ulcers.
b. Maximize effective communication. The client may need to use blinking eyes when unable to move upper extremities.
4. PROMOTE ADEQUATE NUTRITION TO PREVENT MUSCLE WASTING.
a. Encourage soft foods that are easy to swallow.
b. If the client is unable to swallow , the client may need nasogastric tube feedings.
5. ASSIST WITH PLASMAPHERESIS, if prescribed.
-----========+FIN+======----------
thank you and God Bless...
hi' mam
ReplyDeleteHAYAD, RABIA M.
ReplyDeleteBSN IV-D
7th ROTATION
INFECTIOUS DISEASES
Also known as communicable diseases
Are those illnesses that can be transmitted from person to person, or from other infected medium to a person.
Germs are the culprit behind the communicable diseases, though not all germs are harmful.
TYPES OF COMMUNICABLE DISEASES
I. Sexually transmitted diseases – Like Chlamydia, gonorrhea , HIV/AIDS, and herpes
II. Transmitted via contaminated food and drinks – Like cholera, typhoid fever, botulism and other.
III. Disease transmitted via mosquito and other vector - Like dengue fever malaria and others.
IV. Other notable infected disease- Like rabies, measles, anthrax and others.
SIGNS AND SYMPTOMS
Fever
Sore throat
Vomiting
Stomach pain
General ache
Eye irritation
Coughing
Diarrhea
Skin rashes
And Runny nose
STGES OF INFECTIOUS DISEASE
1. Incubation period – Interval between intrans of pathogen into body and appearance of first symptom
2. Prodromal stage – Interval from onset of nonspecific signs and stmptoms to more specific symptom this time, micro organism grows and multiplies, and client may be more capable of spreading disease to other.
3. Illness stage – Interval when client manifest signs and symptoms specific to type of infection.
4. Convalescence – Interval hen acute symptoms of infection disappear.
CAUSATIVE AGENT
Causative agents are pathogens.
Pathogens are micro organisms that are capable of causing disease or infection.
ENDOGENOUS INFECTION- If micro-organism from a person own body cause an infection
EXOGENOUS INFECTION- If micro-organism derived from sources out side a person’s own body causes an infection
RESERVOIR
A reservoir is any person, animals, plant, soil or substance in which an infectious agent normally lives and multiplies, on which it depend primarily for survival, and where it reproduce it self in such manner that it can be transmitted to the susceptible host.
Animate reservoir- people, insect, birds, and other animal
Inanimate reservoir- Soil, water, food, feces, IV fluid and equipment.
PORTAL OF EXIT
A portal of exit is the site from where micro-organism leaves the host to enter other host and cause disease.
Example:
• URT: Saliva from the oral cavity, sneezing, coughing, and talking
• GIT: Feces/ diarrhea from the bowel, and vomitus
• Blood: Infected blood
• Urogenital tract: semen, vaginal secretion, and infected urine
• Skin and mucous membranes: Discharge from infected skin lesions and infected wounds
TRANSMISSION
ReplyDeleteDIRECT CONTACT- Is person to person transmission of pathogen through touching, biting, kissing, or sexual intercourse. Micro-organism can expelled from the body by coughing, sneezing, or talking
INDIRECT CONTACT- Includes both vehicle-borne and vector- borne contact.
PORTAL OF ENTRY
A portal of entry is the site through which micro-organism enter the susceptible host and cause disease/infection.
Example:
• Inhalation (e.g., influenza)
• Ingestion (e.g., gastroenteritis)
• Needle stick injury (e.g., hepatitis B)
• Sexual contact (e.g., Chlamydia)
• Open wound or puncture (e.g., stepping on the nail) ulcer
SUSCIPTIBLE HOST
The host is human body: and who is at risk for infection.
Example:
• Human Defenses against infection
1st line of defense:
- Mechanical barrier
- Body secretion- saliva, sweat, tears, gastric juices, bile and mucous
-lymphoid tissue
-normal flora
2nd line defense:
- Inflammatory responses: signs and symptom include:
o Localized: redness, heat, swelling, pain, and impaired of the body part
o Systemic: fever, malaise, leococytosis, lymph node enlargement, nausea and vomiting.
3rd line of defense:
o Antibodies are produce in response to the presence of foreign protein (antigen), not usually present in the body.
WAY TO BREAK THE CHAIN
Elimination of sources of infection
Appropriate handling and disposal of body secretion
Appropriate handling of contaminated item, segregation of waste categories and disposal
Correct hand washing
Single use equipment
Cleaning, disinfection and sterilization of reusable instrument and equipment
Implementation of aseptic technique
Maintenance of aseptic techniques, use of sterile item
Maintenance of skin and mucous membrane integrity
Immunization against infectious disease
Acquired immunity
Healthy life style High standard of personal hygiene
NOSOCOMIAL INFECTION
Also known as Hospital-acquired infection
Is an infection that first appears between 48 hours and four days after a patient is admitted to a hospital
Hospital-acquired infection are usually related to a procedure or treatment use to diagnose or treat the patient’s initial illness and injury
Hospital-acquired infection can be cause by bacteria, viruses, fungi, or parasites. These microorganism may already be present in the patient’s body or may come from the environment,, contaminated hospital equipment, health care workers or other patient
Hospital-acquired infection may develop from the performance of surgical procedures; from the insertion of the catheters (tubes) in to the urinary tract , nose, mouth, or blood vessels; or from material from the nose or mouth that is aspirated (inhaled) into the lungs
The most common types of Hospital acquired infection are UTI and ventilator associated pneumonia, and surgical wound.
PREVENTION
Identify hig-risk procedures and other possible sources of infection
Strict adherence to hand-washing rules by health care workers and visitors to avoid passing infectious microorganism to or between hospitalized patient
Strict attention to aseptic techniques in the performance pof procedures, including use of sterile gown, gloves, mask, and barriers
Sterilization of all reusable equipments such as ventilator, humidifier, and any devise thaqt come in contact with the respiratory tract
Frequent changing of dressing for wound and use anti bacterial ointment under dressing
Removed NGT (nose to stomach) and ETT (mouth to stomach) as soon as possible
And others precaution.
good evening mam thanks a lot... sorry mam ngayon lang ako nka post, hindi po kz ako marunong,, but ngayon okey na,,, thanks talaga
ReplyDelete