adult health 2

  
Learning Objective #1: Identify the epidemiology and etiology of cancer.
a. What are the top three cancers in men and women?
b. Compare the characteristics of malignant and benign cancer cells.
c. What are the broad categories of cancer-causing agents? Identify examples of each. 
Learning Objective #2: Describe the health promotion, diagnosis, and spread of cancer. 
a. Define primary, secondary, and tertiary prevention.
b. What are primary prevention recommendations for nutrition and physical activity? 
c. What are the cancer screening recommendations for breast, colon, and lung cancer?
d. How is the TNM staging and grading system interpreted?
e. What is metastasis and how does it primarily occur?
Learning Objective #3: Describe the management of patients undergoing of surgery for cancer treatment.
a. What are the types of surgeries in cancer treatment and the goal of each?
b. What are the post-operative concerns, regardless of type?
Learning Objective #4: Describe the management of patients undergoing radiation.
a. What is the difference between external and internal radiation?
b. When do localized, early systemic, and late/chronic systemic effects occur and usually resolve?
c. What are common systemic effects (early and late/chronic) of radiation therapy?
d. What are the most common localized effects, depending on the area of radiation?
e. How do healthcare workers and caregivers protect themselves from the effects of internal radiation therapy?
Learning Objective #5: Describe the management of patients undergoing of chemotherapy.
c. What are the routes of chemotherapy administration and most common side effects?
d. What are the precautions a healthcare worker should take when caring for a patient receiving chemotherapy?
e. Describe the prevention, signs/symptoms, and interventions for chemotherapy extravasation.
f. Describe the types, timing, desensitization procedures, and priority intervention for hypersensitivity reactions.
Learning Objective #6: Identify assessment and nursing management of patients with cancer and with oncologic emergencies. 
a. What are the nursing interventions and rationales for patients with the following nursing diagnoses:
i. Risk for infection r/t myelosuppression
ii. Risk for impaired skin integrity: erythematous and wet desquamation reactions to radiation therapy
iii. Impaired oral mucous membrane r/t stomatitis
iv. Imbalanced nutrition r/t nausea and vomiting
v. Imbalanced nutrition r/t anorexia or malabsorption
vi. Risk for bleeding
b. Explain the patho/causes, signs/symptoms, and interventions for hypercalcemia, tumor lysis syndrome, and superior vena cava syndrome.
  
Lung Cancer, Brunner and Suddarth, Chapters 20 and 23
Reading: 
· Bronchoscopy, pp 505-506
· Chest Tumors (lung cancer only), pp 620-624
Charts/Tables/Figures: None
Learning Objective #7: Describe bronchoscopy and related nursing implications.
Learning Objective #8: Discuss the health assessment and nursing management of patients at risk for or with lung cancer.
a. What are the types of lung cancer, risk factors, and prevention?
b. What are the major clinical manifestations of lung cancer?
c. How do you calculate a pack year history?
d. What are the major nursing interventions for relieving breathing problems?
Colorectal Cancer, Brunner and Suddarth, Chapter 47
Reading: 
· Nursing Management of the Patient Requiring an Ostomy, pp 1336-1342
· Colorectal Neoplasms, pp 1342-1350
Charts/Tables/Figures:
· Chart 47-9, Risk Factors 
· Table 47-6, Potential Complications and Nursing Interventions after Colorectal Surgery 
· Chart 47-7, Patient Undergoing Ostomy Surgery
Learning Objective #9: Identify the responsibilities of the nurse in meeting the needs of the patient with an intestinal diversion. 
Learning Objective #10: Apply the nursing process as a framework for care of the patient with colorectal cancer.
· What are the major risk factors for colon cancer?
· Describe pre-test patient education for fecal occult blood tests and colonoscopy.
· What are the most common signs and symptoms of colorectal cancer? 
· How do colorectal cancer s/s differ by location of the tumor?
· What are the pre-operative interventions for a patient undergoing intestinal diversion?
· What are the post-op nursing assessments and interventions, including identification of the following complications?
o paralytic ileus 
o mechanical obstruction 
o peritonitis
o infection 
o wound dehiscence
· What discharge assessments and teaching with regard to self-care of ostomy, diet, and expected fecal drainage (appearance/timing based on ostomy location)?
Breast Cancer, Brunner and Suddarth, Chapter 58
· Breast Assessment, pp 1720-1727 
· Malignant Conditions of the Breast, pp 1730-1740 
· Nursing Management, pp 1742-1744
Charts/Tables/Figures:
· Chart 58-1, Abnormal Assessment Findings During Inspection
· Chart 58-2, BSE Patient Education
· Table 58-2, Comparisons of Various Breast Masses (focus on difference between benign and malignant)
· Table 58-3, Risk Factors for Breast Cancer
· Chart 58-5, Hand and Arm Care after ALND
· Chart 58-6, Patient Education for Drainage Devices
· Chart 58-7, Patient Education for Arm Exercises
· Table 58-5, Comparing SLNB and ALND
Learning Objective #11: Identify the risk factors and health promotion for breast cancer.
Learning Objective #12: Compare and contrast the characteristics of benign and malignant breast disorders, diagnostic imaging, and surgical biopsy types for breast cancer. 
a. What are the characteristics of benign vs. malignant breast disorders?
b. For what purpose is each diagnostic test used, including
c. What are the pre-op, immediate post-op, and discharge instructions following breast biopsy?
Learning Objective #13: Use the nursing process as a framework for care of the patient undergoing surgery for the treatment of breast cancer. 
a. Differentiate between the three types of mastectomy surgical treatments and the two lymph node dissection methods.
b. What are the assessments needed to identify post-op complications following mastectomy?
c. What are the important patient education points to make for drain care following mastectomy?
d. What precautions should be enforced after surgery and discharge to reduce the risk of lymphedema?
Learning Objective #14: Explain the purpose, mechanism of action, side effects, and administration considerations for common breast cancer medications (pegfilgrastim, filgrastim, neupogen, tamoxifen and aromatase inhibitors).
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