Nursing Implications : Cancer

Nursing Implications : Cancer 150 150 Tony Guo

Nursing Implications

  • Bone marrow suppression
    • Myelosuppression: most common side effect of chemotherapy
    • Treatment-induced reductions in RBCs and WBCs can result in
      • Infection
      • Hemorrhage
      • Overwhelming fatigue
  • Fatigue
    • Encourage conservation strategies
      • Rest before activity
      • Get assistance with activity
      • Remain active during periods of time patients feel better
    • Maintain nutritional and hydration status
    • Assess for reversible causes of fatigue
  • Gastrointestinal (GI) effects
    • Prophylactic administration of antiemetics
    • Assess for signs and symptoms of
      • Alkalosis, dehydration, and I and O
    • Nonirritating, low-fiber, high-calorie, high-protein diet
    • Antidiarrheal, antimotility, and antispasmodic medications
    • Anorexia
      • Monitor carefully to avoid weight loss
        • Weigh twice weekly
      • Recommend small, frequent, high-protein, high-calorie meals
      • Involve dietitian before treatment begins
  • Skin reactions
    • Occur in radiation treatment field
    • Acute or chronic
      • Develop 1 to 24 hours after treatment
      • Generally progressive as treatment dose accumulates
    • Dry desquamation
      • Erythema is an acute response followed by dry desquamation.
      • Dry reactions are uncomfortable and result in pruritus. Lubricate the dry skin with a nonirritating lotion emollient (such as aloe vera) that contains no metal, alcohol, perfume, or additives that can be irritating to the skin.
    • Wet desquamation
      • If the rate of cell sloughing is faster than the ability of the new epidermal cells to replace dead cells, a wet desquamation occurs with exposure of the dermis and weeping of serous fluid.
      • Wet reaction must be kept clean and protected from further damage.
      • Wet desquamation of tissues generally produces pain, drainage, and increased risk of infection.
    • Prevent infection
    • Facilitate wound healing
    • Protect irritated skin temperature extremes
    • Avoid constricting garments, harsh chemicals, and deodorants
    • Help patients deal with hair loss (alopecia)
  • Reproductive effects
    • Inform patient of expected sexual side effects
    • Use appropriate shielding
    • Encourage discussion of issues related to reproduction and sexuality
    • Refer to counseling if needed

Leave a Reply

Your email address will not be published.