Transcript Psychosocial Status

Caring for Individuals Experiencing
Cancer
NURS 2016
Cancer
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A disease process
Abnormal cell is transformed by a
genetic mutation of the cellular DNA
Abnormal cell forms a clone and
proliferates abnormally
Chronic disease with acute
exacerbations
Proliferative Patterns
Benign
 Cells well differentiated
 Encapsulated
 Slow growth rate
 Non-metastasizing
 Little tissue damage
 Not usually fatal
Malignant
 Cells poorly
differentiated
 Infiltrate surrounding
tissue
 Growth rate fast
 Metastasizing
 Extensive tissue
damage
 Usually fatal if
proliferation not
controlled
Metastatic Mechanisms
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Lymphatic
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Hematogenous
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Angiogenesis
Categories/Factors
in Carcinogenesis
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Viruses and Bacteria
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Physical agents
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Genetic and Familial
factors
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Dietary factors
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Hormonal factors
Chemical agents
Primary Prevention
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Facilitate participation in cancer
prevention programs
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Promote healthful living
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Engage in political action to enhance
healthy community initiatives
Secondary Prevention
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Detection and screening to achieve
early diagnosis and prompt intervention
Screening usually involves cancers with
highest incidence and survival rates
Many factors influence knowledge,
attitudes and beliefs about cancer and
the health promoting behaviours they
practice.
Diagnostic Testing
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Determine the presence and extent of a
tumor
Identify possible metastatic activity
Evaluate the function of involved body
systems
Obtain tissue for analysis
Management of Cancer
Surgery
 Diagnostic
 Primary treatment
 Prophylactic
 Palliative
 Reconstructive
Nursing Care in Ca Surgery
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Consider patient’s age, organ
impairment, nutritional deficits,
coagulation disorders, altered immunity.
Provide support and presence as
patient and family consider possible
changes and outcomes of surgery.
Monitor possible complications of
surgery
Peri-operative care
Management of Cancer
Radiation Therapy
 Used to interrupt cell
growth.
 External or Internal
delivery
 toxicity
Nursing Care in Ca Radiation
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Protecting skin and
oral mucosa
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Protecting
caregivers
Management of Cancer
Chemotherapy
 Antineoplastic agents used to interfer
with cellular functions and reproduction.
 Systemic rather than local.
 Administered via oral, topical, IM, IV,
SC, arterial, intracavity, and intrathecal.
Considerations with Chemo-x
Extravasation
Toxicity
 GI system
 Hematopoietic system
 Renal system
 Cardio pulmonary system
 Reproductive system
Nursing Care in Cancer
Chemotherapy
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Assessing fluid and electrolyte status
Modifying risk for infection & bleeding
Administering chemotherapy: an
advanced and specialty skill.
Safety of patient and caregivers
Other Cancer Management
Strategies
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Bone marrow transplant
Hyperthermia
Biological Response Modifiers
Photodynamic therapy
Gene therapy
Unconventional therapies
Nursing Assessment of Individuals
Living with and Battling Cancer
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Infection
Bleeding
Skin Problems
Hair Loss
Nutritional Concerns
Pain
Fatigue
Psychosocial Status
Body Image
Assessment
Infection
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Sites: pharynx, skin,
perianal area, urinary
and respiratory tracts.
Signs: increased WBC,
pyrexia, swelling,
redness, drainage, pain
Sepsis
Bleeding
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Sites: skin mucous
membranes,intestinal,
urinary, respiratory
tracts, and brain.
Melena, hematuria,
hemoptysis and
hematemesis
Ecchymosis, petechiae,
oozing at injection sites.
Assessment
Skin Problems
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Predisposing factors
Nutritional deficit
Bowel and bladder
incontinence
Immobility
Immunosuppression
Age
Alopecia
 Location
extensiveness
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Impact on selfimage
Assessment
Nutritional Concerns
 Monitor wt and
caloric intake daily
 Obtain diet hx,
anorexia, meds,
chewing and
swallowing, N&V,
diarrhea.
 Clinical and lab data
Pain
 Identify causative
factors
 Identify factors the
increase perception
of pain.
 Pain assessment
Assessment
Fatigue
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May serve a protective
function
Weariness, weakness,
lack of energy, lack of
motivation, difficulty
concentrating.
Less verbal, pale
Phys and psych
stressors
Psychosocial Status
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Psychological and
mental status
Mood and emotional
response to results of
dx testing and
prognosis
Family/significant other
support
Assessment
Body Image
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Depersonalization
Reality of illness,
possible disability and
death
Threats to image:
surgery, hair loss,
cachexia, skin changes,
altered comm. patterns,
sexual dysfunction