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NUR 2392 / NUR2392 Exam 1: Multidimensional Care II / MDC 2 Exam 1 Study Guide (2021/2022) Rasmussen
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NUR2392 Multidimensional Care II / MDC 2 Exam 1 Study Guide
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Multidimensional Care II Exam 1 Study GuideCh. 21: Principles of Cancer Development
● Benign vs. Malignant cells
○ Benign:
■ Specific Morphology- they resemble the tissue they originated from (they look
like the host).
■ Small Nuclear to Cytoplasmic Ratio- they have a similar structure inside the cell
to normal cells and small nucleus.
■ Specific Function- they contribute to the body in some way.
■ Tight Adherence- they bind close together.
■ No Migration- they do not move around the body or invade other tissue sites.
■ Orderly Growth-they grow at a normal rate.
■ Euploidy- they have a normal amount of chromosomes per cell.
○ Malignant (Cancer):
■ Anaplasia- loss of appearance of the parent cell.
■ Large Nuclear to Cytoplasmic Ratio- they have a large nucleus and occupy space.
■ Specific Functions are Lost- they serve no purpose to the body.
■ Loose Adherence- loose binding of the cells, causing potential spread into the
blood and body.
■ Migration/Metastasis- spreads and moves easily.
■ Loss of cellular regulation and contact- the cells will crowd, push, and grow on
top of other cells.
■ Rapid Cell Division- the cells will be produced and grow at a faster rate
, ■ Aneuploidy- abnormal number of chromosomes per cell.
● Seven warning signs of cancer
○ “CAUTION”
■ C: changes in bowel or bladder habits
■ A: a sore that does not heal or mouth sources (mucositis)
■ U: unusual bleeding or discharge
■ T: thickening of a lump in a tissue
■ I: indigestion and dysphagia
■ O: obvious change in a wart or mole
■ N: nagging cough
● Cancer development stages of malignancy
○ Initiation: the normal cell becomes damaged which is irreversible and can lead to cancer
developing
○ Promotion: repeat exposures to a damaging stimuli enhances growth- mutations can
cause this
○ Progression: because of repeat exposures, there is an increase in production of
malignant cells
○ Metastasis: movement of the cancer cells
■ Malignant transformation: some cells will divide enough to form a tumor area
on top of tissue.
■ Tumor vascularization: cancer cells secrete tumor angiogenesis factor
stimulating the blood vessels to bud and for channels to grow.
■ Blood Vessel Penetration: cancer cells break off from the main tumor and
enzymes on the surface of the tumor cells make holes in the blood vessels,
allowing the cancer cells to enter blood vessels and travel around the body.
■ Arrest and Invasion: cancer cells clump up in the blood vessel walls and invade
new tissue aera to support continued growth of cancer cells and new tumors.
● Cancer classification: monitor tumor growth, aggression, progression, and to determine
appropriate treatment.
○ Tumor grading: based on cellular aspects of cancer.
■ Based on the aggressiveness of the cancer cell and differentiation from the
normal tissue.
● G0: the grade cannot be determined
● G1: Tumor cells are well differentiated and closely resemble the normal
cells from which they arose.This grade is considered a low grade of
malignant change.These tumors are malignant but are relatively slow
growing.
● G2: Tumor cells are moderately differentiated; they still retain some of
the characteristics of normal cells, but also have more malignant
characteristics than do G1 tumor cells.
● G3: Tumor cells are poorly differentiated, but the tissue of origin can
usually be established.The cells have few normal cell characteristics.
, ● G4: Tumor cells are poorly differentiated and retain no normal cell
characteristics.Determination of the tissue of origin is difficult and
perhaps impossible.
○ Plodiy: based on the number of chromosomes the cell has
■ Cancer cells will have an abnormal number of chromosomes in their cells.
● Euploidy: normal amount of cell chromosomes- 46 with 23 pairs.
● Aneuploidy: abnormal number and formation of chromosomes in cancer
cells.
○ Staging: determines the exact location of the cancer, how large the tumor is, and if it is
spreading.
■ Clinical staging: assesses patient symptoms to determine size and spread.
■ Surgical staging: assesses size, number, sites, and spread by visualization at
surgery.
■ Pathological staging: determining the tumor size, number, sites, and spread by
pathologic examination of tissues obtained at surgery.
○ TNM- tumor, node, metastasis
■ Describes the anatomic extent of cancers. 1-4. 1 is that there is no spreading or
is small and 4 is that there is a large spread and that the tumor is large also.
● Primary tumor (T): how large the tumor is .
○ Tx: primary tumor cannot be assessed
○ T0: no evidence of primary tumor
○ Tis: carcinoma in situ- pre cancer
○ T1, T2, T3, T4: increasing size and/or local extent of primary
tumor
● Regional lymph nodes (N): based on how many nodes the tumor takes
over in the body.
○ Nx: regional lymph nodes cannot be assessed
○ N0: no regional lymph node metastasis
○ N1, N2, N3: increasing involvement of regional lymph nodes
● Distant metastasis (M): if the cancer is moving or not moving.
○ Mx: presence of distant metastasis cannot be assessed
○ M0: no distant metastasis
○ M1: distant metastasis
○ Doubling time: the amount of time it takes for a tumor to double in size. Will help
determine tumor growth.
○ Mitotic index: the percentage of actively dividing cells within a tumor.
○ Cancers are classified by the tissue they originate from. Other ways to classify cancer
include: biologic behavior, anatomic site, and degree of differentiation
■ Adeno = epithelial
■ Chondro = cartilage
■ Fibro = fibrous connective
■ Glio = glial cells (brain)
■ Hemangio = blood vessel
■ Hepato = liver
, ■ Leiomyo = smooth muscle
■ Lipo = fat/adipose
■ Lympho = lymphoid tissue
■ Melano = pigment producing cells
■ Meningioma = meninges
■ Neuro = nerve tissues
■ Osteo = bone
■ Renal = kidney
■ Rhabdo = skeletal muscle
■ Squamous = epithelial layer, mucous membranes, organ lining
● Cancer prevention (primary vs. secondary)
○ Primary
■ Use of sunscreen
■ Stop tobacco use
■ Use PPE in workplace
■ Reduce alcohol consumption
■ Modify diet
■ Limit sexual partners/safe sex practices
■ Remove at-risk tissue: removing polyps, breast tissue, etc
■ Chemoprevention: strategy that uses drugs, chemicals, natural nutrients, or
other substances to disrupt one or more steps important to cancer development
■ Vaccinations: Currently the only vaccines approved for prevention of cancer are
related to prevention of infection from several forms of the human papilloma
virus (HPV)
○ Secondary
■ Routine screenings: annual mammography after 40yrs, colonoscopy at 50yrs and
then every 10, annual fecal occult, digital rectal exam for men after 50yrs
■ Genetic testing for those with genetic predisposition- BRCA gene
● Types of cancers (carcinoma, sarcoma, melanoma, lymphoma, leukemia, blastoma)
○ Carcinoma: cancer of the epithelial tissue (skin, liver, kidney)
○ Melanoma: cancer of the pigment cells, or melanocytes
○ Sarcoma: cancer of the connective tissues
○ Lymphoma: cancer of the lymphatic cells
○ Leukemia: cancer of the bone marrow
○ Blastoma: cancer of the immature, building cells
Ch. 22: Care of Patients with Cancer
● Diagnostic tests and lab values (biopsy, imaging, absolute neutrophil count, RBC/PLT/WBC
ranges)
○ Biopsy: GOLD STANDARD FOR CANCER DIAGNOSIS
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