NURSING CARE OF PATIENT WITH CANCER
MRS.MAMTA TOPPO
ASSOCIATE PROFESSOR
R.I.M.S.C.O.N
Patient with suspected cancer undergo extensive testing
to:
1- determine the present and extent of tumor .
2- identify possible spread(metastasis)of disease or
invasion of other body tissue.
3- evaluate the function of involved and uninvolved
body systems and organs.
4- obtain tissue and cells for analysis, including
evaluation of tumor stage and grade.
Nursing care of patients with cancer
Nursing diagnosis: Risk for infection related to inadequate defenses related to
mylosuppresion secondary to radiation of antineoplastic agents
Goal: prevention of infection
Nursing intervention:
1.Assess patient for evidence of infection.
2-Report fever, chills, diaphrosis, swelling, heat, pain, erythema, exudates on any body
surface. Also report changes in respiratory or mental status. Urinary frequency or
burning, rash, or diarrhea.
3-obtain culture sensitivities as indicated before initiation of antimicrobial treatment
wound exudates, sputum, urine, stool, blood).
4-initiate measures to minimize infection.
5-assess intravenous sites every day for evidence of infection.
6-avoid intramuscular injection.
7-avoid insertion of urinary catheter.
8-advice patient to avoid exposure to animal excreta.
Nursing diagnosis: Impaired skin integrity: erythematous and wet desquamation
reaction to radiation therapy.
Nursing interventions
1-In erythematous areas:
a: avoid the use soaps, cosmetics, performs, powders, lotions and ointments
deodorants.
B: use only lukewarm water to bath the area.
C: avoid rubbing or scratching the area.
D: avoid shaving the area with a straight- edged razor.
E : avoid applying hot water bottles, heating pads, ice, and adhesive tape to the area.
F: avoid exposing the area to sunlight or cold weather.
G: avoid tight clothing in the area. Use cotton clothing.
H: apply vitamin A and D ointment to the area.
2- if wet desquamation occurs:
A: do not disrupt any blisters that have formed.
B: avoid frequent washing of the area.
C: report any blistering.
D: use prescribed creams or ointments.
E: if area weeps, apply a nonadhesive absorbent dressing.
F: if the area is with out drainage, use moisture and vapor- permeable dressings such as
hydrocolloids and hydrogeis on noninfected areas.
G: consult with enterostomal therapist if eschar forms.
Nursing care of patients with cancer
Nursing diagnosis: Impaired skin integrity: alopecia
Goal: maintenance of tissue integrity; coping with hair loss.
Nursing interventions
1- Discuss potential hair loss and regrowth with patient and family; advice that hair
loss occur on body parts than the head.
2- explore potential impact of hair loss on self-image, interpersonal relation ships.
3- prevent trauma to scalp .
4- encourage patient to wear own clothes and return social contacts.
5- explain that hair growth usually begins again once therapy is completed.
Nursing diagnosis: Impaired oral mucous membrane: stomatitis.
Goal: maintenance of intact oral mucous membrane.
Nursing interventions
A: Assess oral cavity daily
B: instruct patient to report oral burning, pain, areas of redness, open lesions on the
lips, pain associated with swallowing.
C: encourage and assist in oral hygiene.
related to nausea and vomiting.
Goal: patient experiences less nausea and vomiting associated with
chemotherapy; weight loss is minimized
Nursing interventions
1-assess patient previous experiences and expectations of nausea and vomiting, including
causes and interventions used.
2- adjust diet before and after drug administration according to patient preference and
tolerance.
2- prevent unpleasant sights, odors, and sounds in the environment.
4- use distraction, music therapy, biofeedback, self-hypnosis, relaxation techniques, and
guided imagery before, during, and after chemotherapy.
5- administer prescribed antiemetics, sedation, and corticosteroids before chemotherapy
and afterward as needed.
6- ensure adequate fluid hydration before, during, and after drug administration; assess
intake and output.
7- encourage frequent oral hygiene.
8- provide pain relief measure, if necessary.
9- consult with dietician as needed.
10- assess and address other contributed factors to nausea and vomiting such as other
symptoms, constipation, gastrointestinal irritation, electrolyte imbalance, radiation therapy,
medications, and central nervous system metastasis.
Nursing care of patients with cancer
Nursing diagnosis: fatigue
Goal: increased activity
Nursing interventions
1- Encourage rest periods during the day, especially before and after physical
exertion.
2- at minimum, promote patient normal sleep habits.
3- rearrange daily schedule and organize activities to conserve energy expenditure.
4- encourage patient to ask for others assistance with necessary choers, such as
housework, child care, shopping, cooking.
5- encourage reduced job workload, if necessary and possible, by reducing number of
hours worked per week.
6- encourage adequate protein and calorie intake.
7- encourage use of relaxation techniques, mental imaging.
8- encourage participation in planned exercise program.
9- administer blood products as prescribed for collaborative management.
10- assess for fluid and electrolyte disturbances.
11- assess for sources of discomfort.
12- provide strategies to facilitate mobility.
Nursing care of patients with cancer
Nursing diagnosis: chronic pain
Goal: relief of pain and discomfort
Nursing interventions
1-Use pain scale to assess pain and discomfort characteristics: location, quality,
frequency, duration, etc.
2- assess other factors contributing to patients pain: fear, fatigue, anger, etc.
3- administer analgesics to promote optimum pain relief within limits of physicians
prescription.
4- assess patient behavioral responses to pain and pain experience.
5- collaborate with patient, physician, and other health care team members when
changes in pain management are necessary.
6- encourage strategies of pain relief that patient has used successfully in previous
pain experience.
7- teach patient new strategies to relieve pain and discomfort distraction, imaging,
relaxation, cutaneous stimulation, etc.