1 / 83

Oncology Nursing

Oncology Nursing. NEO 113 JuLy 16, 2011. Oncology defined. Branch of medicine that deals with the study, detection, treatment and management of cancer . “Root words”. Neo- new Plasia- growth Plasm- substance Trophy- size +Oma- tumor Statis- location. “Root words”. A- none Ana- lack

jayden
Download Presentation

Oncology Nursing

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Oncology Nursing NEO 113 JuLy 16, 2011

  2. Oncology defined • Branch of medicine that deals with the study, detection, treatment and management of cancer

  3. “Root words” • Neo- new • Plasia- growth • Plasm- substance • Trophy- size • +Oma- tumor • Statis- location

  4. “Root words” • A- none • Ana- lack • Hyper- excessive • Meta- change • Dys- bad, deranged

  5. CANCER NURSING Etiology of cancer 1. PHYSICAL AGENTS • Radiation • Exposure to irritants • Exposure to sunlight • Altitude, humidity

  6. CANCER NURSING Etiology of cancer 2. CHEMICAL AGENTS • Smoking • Dietary ingredients • Drugs

  7. CANCER NURSING Etiology of cancer • Genetics and Family History • Colon Cancer • Breast cancer

  8. CANCER NURSING Etiology of cancer • Dietary Habits • Low-Fiber • High-fat • Processed foods • alcohol

  9. CANCER NURSING Etiology of cancer • Viruses and Bacteria • DNA viruses- HepaB, Herpes, EBV, CMV, Papilloma Virus • RNA Viruses- HIV, HTCLV • Bacterium- H. pylori

  10. CANCER NURSING Etiology of cancer • Hormonal agents • DES • OCP especially estrogen

  11. CANCER NURSING Etiology of cancer • Immune Disease • AIDS

  12. CANCER NURSING Body Defenses Against TUMOR • 1. T cell System/ Cellular Immunity • Cytotoxic T cells kill tumor cells • 2. B cell System/ Humoral immunity • B cells can produce antibody • 3. Phagocytic cells • Macrophages can engulf cancer cell debris

  13. CANCER NURSING Cancer Diagnosis • 1. BIOPSY • The most definitive • 2. CT, MRI • 3. Tumor Markers

  14. CANCER NURSING Cancer Staging The degree of DIFFERENTIATION • Stage 1- Low grade • Stage 4- high grade

  15. CANCER NURSING GENERAL MEDICAL MANAGEMENT • 1. Surgery- cure, control, palliate • 2. Chemotherapy • 3. Radiation therapy • 4. Immunotherapy • 5. Bone Marrow Transplant

  16. CANCER NURSING GENERAL Pharmacology • 1. antimetabolites • 2. antibiotics • 3. plant alkaloids • 4. antiemetics

  17. CANCER NURSING GENERAL Promotive and Preventive Nursing Management • 1. Lifestyle Modification • 2. Nutritional management • 3. Screening • 4. Early detection

  18. SCREENING • 1. Male and female- Occult Blood, CXR, and DRE • 2. Female- SBE, CBE, Mammography and Pap’s Smear • 3. Male- DRE for prostate, Testicular self-exam

  19. Nursing Assessment Utilize the ACS 7 Warning Signals • CAUTION • C- Change in bowel/bladder habits • A- A sore that does not heal • U- Unusual bleeding • T- Thickening or lump in the breast • I- Indigestion • O- Obvious change in warts • N- Nagging cough and hoarseness

  20. Nursing Assessment • Weight loss • Frequent infection • Skin problems • Pain • Hair Loss • Fatigue • Disturbance in body image/ depression

  21. Nursing Intervention • MAINTAIN TISSUE INTEGRITY • Handle skin gently • Do NOT rub affected area • Lotion may be applied • Wash skin only with SOAP and Water

  22. Nursing Intervention • MANAGEMENT OF STOMATITIS • Use soft-bristled toothbrush • Oral rinses with saline gargles/ tap water • Avoid ALCOHOL-based rinses

  23. Nursing Intervention • MANAGEMENT OF ALOPECIAAlopecia begins within 2 weeks of therapy • Regrowth within 8 weeks of termination • Encourage to acquire wig before hair loss occurs • Encourage use of attractive scarves and hats • Provide information that hair loss is temporary BUT anticipate change in texture and color

  24. Nursing Intervention • PROMOTE NUTRITION • Serve food in ways to make it appealing • Consider patient’s preferences • Provide small frequent meals • Avoids giving fluids while eating • Oral hygiene PRIOR to mealtime • Vitamin supplements

  25. Nursing Intervention • RELIEVE PAIN • Mild pain- NSAIDSModerate pain- Weak opiods • Severe pain- Morphine • Administer analgesics round the clock with additional dose for breakthrough pain

  26. Nursing Intervention • DECREASE FATIGUE • Plan daily activities to allow alternating rest periods • Light exercise is encouraged • Small frequent meals

  27. Nursing Intervention • IMPROVE BODY IMAGE • Therapeutic communication is essential • Encourage independence in self-care and decision making • Offer cosmetic material like make-up and wigs

  28. Nursing Intervention • ASSIST IN THE GRIEVING PROCESS • Some cancers are curable • Grieving can be due to loss of health, income, sexuality, and body image • Answer and clarify information about cancer and treatment options • Identify resource people • Refer to support groups

  29. Nursing Intervention • MANAGE COMPLICATION: INFECTION • Fever is the most important sign (38.3) • Administer prescribed antibiotics X 2weeks • Maintain aseptic technique • Avoid exposure to crowds • Avoid giving fresh fruits and veggie • Handwashing • Avoid frequent invasive procedures

  30. Nursing Intervention • MANAGE COMPLICATION: Septic shock • Monitor VS, BP, temp • Administer IV antibiotics • Administer supplemental O2

  31. Nursing Intervention • MANAGE COMPLICATION: Bleeding • Thrombocytopenia (<100,000) is the most common cause • <20, 000 spontaneous bleeding • Use soft toothbrush • Use electric razor • Avoid frequent IM, IV, rectal and catheterization • Soft foods and stool softeners

  32. Colon cancer

  33. COLON CANCER • Risk factors • 1. Increasing age • 2. Family history • 3. Previous colon CA or polyps • 4. History of IBD • 5. High fat, High protein, LOW fiber • 6. Breast Ca and Genital Ca

  34. COLON CANCER • Sigmoid colon is the most common site • Predominantly adenocarcinoma • If early 90% survival • 34 % diagnosed early • 66% late diagnosis

  35. COLON CANCER • PATHOPHYSIOLOGY • Benign neoplasm DNA alteration malignant transformation malignant neoplasm  cancer growth and invasion  metastasis (liver)

  36. COLON CANCER • ASSESSMENT FINDINGS1. Change in bowel habits- Most common • 2. Blood in the stool • 3. Anemia • 4. Anorexia and weight loss • 5. Fatigue • 6. Rectal lesions- tenesmus, alternating D and C

  37. Colon cancer • Diagnostic findings • 1. Fecal occult blood • 2. Sigmoidoscopy and colonoscopy • 3. BIOPSY • 4. CEA- carcino-embryonic antigen

  38. Colon cancer • Complications of colorectal CA • 1. Obstruction • 2. Hemorrhage • 3. Peritonitis • 4. Sepsis

  39. Colon cancer • MEDICAL MANAGEMENT • 1. Chemotherapy- 5-FU • 2. Radiation therapy

  40. Colon cancer • SURGICAL MANAGEMENT • Surgery is the primary treatment • Based on location and tumor size • Resection, anastomosis, and colostomy (temporary or permanent)

  41. Colon cancer NURSING INTERVENTION Pre-Operative care • 1. Provide HIGH protein, HIGH calorie and LOW residue diet • 2.Provide information about post-op care and stoma care • 3. Administer antibiotics 1 day prior

  42. Colon cancer NURSING INTERVENTION Pre-Operative care • 4. Enema or colonic irrigation the evening and the morning of surgery • 5. NGT is inserted to prevent distention • 6. Monitor UO, F and E, Abdomen PE

  43. Colon cancer NURSING INTERVENTION Post-Operative care • 1. Monitor for complications • Leakage from the site, prolapse of stoma, skin irritation and pulmo complication • 2. Assess the abdomen for return of peristalsis

  44. Colon cancer NURSING INTERVENTION Post-Operative care • 3. Assess wound dressing for bleeding • 4. Assist patient in ambulation after 24H • 5.provide nutritional teaching • Limit foods that cause gas-formation and odor • Cabbage, beans, eggs, fish, peanuts • Low-fiber diet in the early stage of recovery

  45. Colon cancer NURSING INTERVENTION Post-Operative care • 6. Instruct to splint the incision and administer pain meds before exercise • 7. The stoma is PINKISH to cherry red, Slightly edematous with minimal pinkish drainage • 8. Manage post-operative complication

  46. Colon cancer • NURSING INTERVENTION: COLOSTOMY CARE • Colostomy begins to function 3-6 days after surgery • The drainage maybe soft/mushy or semi-solid depending on the site

  47. Colon cancer • NURSING INTERVENTION: COLOSTOMY CARE • BEST time to do skin care is after shower • Apply tape to the sides of the pouch before shower • Assume a sitting or standing position in changing the pouch

More Related