Nurseslabs » cancer

Chemotherapy: Risk For Infection RT Leukopenia

NursesLabs — Tue, 24 Jan 2012 17:32:50 +0000

Nursing Diagnosis: Risk for Infection RT Leukopenia Secondary to Chemotherapy

Outcomes: Infection Severity, Immune Status (NOC). Client will remain free of infection as evidenced by temperature remaining within normal limits. Client will verbalize interventions that prevent infection.

Interventions	NIC	Rationales
Monitor vital signs to check for infection	Infection Protection	An elevated temperature is frequently the initial sign or manifestation
Practice proper hand-washing and use aseptic technique when providing care	Infection Protection	Hand washing is the single most effective intervention to decrease the risk of infection. Aseptic technique minimizes risk of nosocomial infections.
Keep neutropenic clients separate from others	Infection Protection	Neutropenic clients are at greatest risk for infection
Monitor laboratory results, especially complete blood count, white blood cell count (WBC), differential and absolute neutrophils	Infection Protection	Abnormal results provide data that provide a basis for early detection of infection
Monitor respiratory, urinary, mucosal and skin systems	Infection Protection	Changes in these systems are often a basis for early detection of infection. Neupogen decreases infection risk by increasing WBCs in clients receiving chemotherapy who develop neutropenia
Teach manifestations of infection and those to report immediately	Infection Protection	Infection in neutropenic clients is life threatening
Teach measures for prevention of infection, such as avoiding crows and not cleaning fish tanks or litter boxes	Infection Protection	These are high-risk sources of infection

Evaluation: The client will remain free of infection or seek treatment promptly if manifestations of infection appear. The client will verbalize methods that minimize this condition from occurring.

Sources: Black, J. M. (2009). Medical Surgical Nursing: Clinical Management and Positive Outcomes. Singapore: Elsevier.

Chemotherapy: Risk For Infection RT Leukopenia Original source at: Nurseslabs

14 Mastectomy Nursing Care Plans

NursesLabs — Tue, 24 Jan 2012 17:32:47 +0000

Mastectomy is the surgical removal of the breast which is usually a surgical management for patients with breast cancer. This is done to prevent the metastasize of the cancer cells. Breast cancer is the most common malignancy experienced by women. Breast cancer is the uncontrolled growth of breast cells.

The nursing goal for a patient who underwent mastectomy can be: pain management, counseling due to disturbed body image, and preventing infection due to surgical incision.

This post contains 14 nursing care plans for patients who underwent mastectomy.

1. Risk for Injury

Areas involving the neck are considered to be the most vascularized parts of a person’s body. We all know that the most common complication of a surgery is excessive bleeding or hemorrhage, this was brought about by excessive blood loss intra or post operatively.

Assessment

Diagnosis

Objectives

Nursing Interventions

Rationale

Desired Outcomes

S: ØO:The patient may manifest:>edema>muscle weakness>aleter mobility>sensory and perceptual disturbances due to anesthesia>Apprehension, restlessness

>thirst; cold , moist, pale skin

>increase in pulse rate, respiration rate

>drop in temperature

>decrease in urinary output

Risk for Injury related to change in center of gravity secondary to extensive removal of chest tissue

Short term:After 3-4 hours of nurse-patient interaction, the patient will verbalize understanding of individual factors that contribute to possibility of injury and take steps to correct situations.Long Term:After 3-4 days of nurse-patient interaction, the patient will demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.

>Establish pt. Rapport> Monitor vital signs frequently.> Access mood, coping abilities and personality styles>Identify interventions and safety devices

> Encourage participation in self-help programs, such as assertiveness training, positive self image

> Provide bibliotherapyand written resources

> Assist client during periods of ambulation

> Walk lient’s unaffected side

> Instruct the client to keep the shoulders level and the muscle relaxed when walking

>To gain trust and cooperation of the pt.> VS could indicate possible bleeding> That may result in carelessness and increased risk-taking without consequences.> To promte safe physical environment and individual safety> To enhance self-esteem and sense of self-worth

> For later review and self-pced learning

> The nurse supports the client when or if client loose balance

> The lient is more likely to drift toward the side of the body that is heavier

> Clients tend to accommodate for the change in the center of gravity by leaning to the side

Short term:The patient shall verbalize understanding of individual factors that contribute to possibility of injury and take steps to correct situations.Long Term:The patient shall demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.

14 Mastectomy Nursing Care Plans Original source at: Nurseslabs

How to: Perform Nursing Assessment Effectively

NursesLabs — Wed, 21 Dec 2011 17:08:07 +0000

They say that “the best nurses are excellent at assessment”, this is true because if we would look at the nursing process, assessment is the first step. If you have a weak foundation in assessment, the rest follows. This is a post to help you perform Nursing Assessment.

So, here are a list of keywords, assessment mnemonics which you can use to quickly and accurately assess a variety of patients.

ASSESSMENT FOR ALERTNESS

Description		Adult Behavior	Pediatric Behavior
A	Alert	Client’s eyes open spontaneously; appears aware of and responsive to the environment; follows commands eyes tract peoples and objects.	Child is active and responds appropriately to parents and other external stimuli.
V	Response to Verbal Stimuli	Patient’s eyes do not open spontaneously but open to verbal stimuli. Patient is able to response in some meaningful way when spoken to.	Response only when his or her name is called by parents.
P	Response to Pain	Patient does not response to questions but moves or cries out in response to a painful stimulus such as pinching the skin or earlobe.	Response only when painful stimulus is received, such as pinching the nail bed.
U	Unresponsive	Patient does not response to any stimuli.	No response at all.

SAMPLE HISTORY ASSESSMENT

Description
S	Symptoms	“What’s wrong?” “What brings you to the hospital?”	Patient’s chief complaints
A	Allergy	“Are you allergic to anything?” “What happens to you when you use something that you’re allergic to?”	Seeking to know what type of allergic reaction they experience
M	Medications	“Are you taking any medications?” “What are you taking the medications for?” “When did you last take your medications?”	Prescribed, Over the counter, herbal meds and etc are asked.
P	Past Medical History	“Have you had this problem before?” “Do you have other medical problems?”	Seeking to know the previous state of health, and previous illnesses.
L	Last Oral Intake	“When did you last eat or drink anything?” “What was it that you last ate?”	Seeking what are the last oral intakes of the client.
E	Events leading up to the illness or injury	Injury: “How did you get hurt?” Illness: “What led to this problem?”	Seeking to know how his present status happened.

DCAP-BTLS Rapid Assessment

D	Deformities
C	Contusions
A	Abrasions (Consider bony prominences for pressure sores)
P	Punctures or Penetrations
B	Burns
T	Tenderness
L	Lacerations
S	Swelling

CAGE: Diagnostic Tool for Alcohol Problems

Description		Sample Question
C	Concern by the person that there is a problem	Have you ever felt that you should Cut down on your drinking?
A	Apparent to others that there is a problem	Have you ever become Annoyed by criticisms of your drinking?
G	Grave consequences	Have you ever felt Guilty about your drining?
E	Evidence of dependence or tolerance	Have you ever had a morning Eye opener to get rid of a hangover?

ABCDEFGHI TRAUMA ASSESSMENT

Description
A	Airway
B	Breathing
C	Circulation
D	Disability (neurologic status)
E	Expose (remove clothing, keep the patient warm)
F	Full set of vital signs
G	Give comfort measures
H	History/Head-to-Toe assessment
I	Inspect posterior surfaces

CAUTION: SEVEN WARNING SIGNS OF CANCER

Description
C	Change in bowel or bladder habits
A	A sore throat that does not heal
U	Unusual bleeding or discharge
T	Thickening or lump in breast or elsewhere
I	Indigestion or dysphagia
O	Obvious change in wart or mole
N	Nagging cough or hoarseness

Sources:

Adapted from Clinical Nursing Pocket Guide

How to: Perform Nursing Assessment Effectively Original source at: Nurseslabs

Green Tea Does Not Protect Against Breast Cancer

NursesLabs — Fri, 16 Dec 2011 02:18:37 +0000

A report published last October 28 in an online journal of Breast Cancer Research found out that Iwasaki’s team, after collecting green tea usage data on 53,793 women who were surveyed between 1995 and 1998 have no changes in the risk for developing breast cancer.

This is an evidence that just by drinking green tea doesn’t have much cancer-fighting agents to make a difference.

[via USA Today ]

Green Tea Does Not Protect Against Breast Cancer Original source at: Nurseslabs

Rectal Adenocarcinoma Nursing Care Plans

NursesLabs — Sat, 12 Nov 2011 12:37:26 +0000

Adenocarcinoma of the rectum arises as an intramucosal epithelial lesion, usually in an adenomatous polyp or gland. As cancers grow, they invade the muscularis mucosa, lymphatic structures, and vascular structures and involve regional lymph nodes, adjacent structures, and distant sites, especially the liver.

Nursing goal for a patient with Rectal CA can be towards managing pain, managing symptoms, and patient education.

Acute Pain

The patient has colorectal cancer and one of its symptoms is abdominal pain. The pain is a subjective unpleasant sensation resulting from stimulation of sensory nerve endings by injury, or other harmful factors. Pain is activated when a pt’s pain threshold is reached. Pain threshold is the point at which a stimulus activates pain receptors to produce a feeling of pain. Pain usually accompanies inflammation. It results from the synthesis of prostaglandins, which are hormones produced during the inflammatory process.

[ipaper id=27051342]

Constipation

Due to decrease physical activity of patient, the movement of feces through the large intestine is slow, thus, the patient manifest difficulty or decreased frequency in defecation. And also there is a presence of blockage in the intestines forming bulk and therefore the stool cannot pass through. (Ed notes: also there is painful and straining-like passage of stool)

[ipaper id=27051346]

Impaired Bed Mobility

Abdominal cramping because of colorectal cancer there is a blockage of stool and formation of masse It starts from the synthesis of prostaglandins, which are hormones produced during the inflammatory process. The pain is triggered when the patient is moving so the response of the patient he/she will not move to prevent initiation of pain.

[ipaper id=27051349]

Activity Intolerance

Activity intolerance is brought about by the weakness. Weakness is caused by cancer, cancer cells get the nutrients that normal cell needs. In this situation normal cell lack nutrients so they cannot perform their functions. There will energy that the body can use so instead of doing daily activities the patient will just take rest.

[ipaper id=27051339]

Self-Care Deficit

Restriction on the physical mobility of the client has resulted to a decreased ability for selfcare. Specifically for this client, he has been unable to perform activities like bathing (and other measures of grooming), dressing up and attend to toileting needs by herself, thus, there is selfcare deficit. Weakness that is brought by cancer normal cells are lacking in nutrients. That the body needs in order to perform activities of daily living.

[ipaper id=27051358]

Knowledge Deficit

They cannot understand diagnostic procedures that’s why doctors and nurses must explain medical procedures to the patient level of understanding. And also they lack knowledge about the surgery. The affected colon must be remove as what the doctor decides.

[ipaper id=27051352]

Risk for Impaired Skin Integrity

Prolonged physical immobilization may cause pressure ulcers. Pressure ulcers may be caused by inadequate blood supply and as a result of reperfusion injury when blood reenters tissue. A simple example of a mild pressure sore may be experienced by healthy individuals while sitting in the same position for extended periods of time: the dull ache experienced is indicative of impeded blood flow to affected areas

[ipaper id=27051354]

Conclusion

You guys know what’s written here right? Subscribe and comment!

Source:

eMedicine: Rectal Adenocarcinoma

Rectal Adenocarcinoma Nursing Care Plans Original source at: Nurseslabs

Avoiding Quackery and Fraud

NursesLabs — Mon, 25 Jul 2011 21:44:34 +0000

A lot of people believe TV advertisements, testimonials and other advertising campaigns about a certain drug or therapy that provides “cure”. These adverts often claim (in an indirect way) that they have the cure for chronic problems like cancer, diabetes, impotence, heart diseases, and other more.

These advertisements usually target those people who are ready to try anything to cure their illnesses. Sadly, these claims rarely help and most of the time causes side-effects.

As nurses, we should be the first person to be aware of these modus and warn clients about them also. These claims can be ineffective and worst, can be dangerous to your health!

Here are some tips on how to be a better health consumer and avoid fraud and quackery:

Advertisements Through Testimonials

We often see advertisements like an (iridology commercial) on TV with people giving their testimonials about a certain drug or therapy that helped cure them. We often believe these shit, but little we do know that we have different reactions to a certain medical therapy. So, (most of the time) there is no absolute therapy for a certain disease a person have since all of us are unique.

A very good example are those "iridology" centers wherein they claim to diagnose a variety of problems with just the iris as the basis

Claims to Have a Secret Ingredient

This is a no, no in pharmacology. Consumers must know what they are taking.

Drugs That Are Not Evaluated

Drugs should be evaluated in prominent medical journals.

Claims Benefits That Seems Too Good To Be True

How about I advertise this slimming drug that cuts about 2 pounds per week, increases your immunity, gives you stable heart conditions, detoxifies, and is also a potent anti-cancer drug all in one single pill you have to take once? Be suspicious of those kind of drugs.

Treatments That Are Unethical and Illegal

Unethical means contrary to conscience or morality and professional standards. There are some faith-healers here in the Philippines that have unethical way of ‘treating’ their patients.

Are Available Only Through Mail or Home Delivery

Sometimes there are people who go house-to-house to promote a certain drug product. Be suspicious when that happens.

Ask Questions

The best way to protect yourself against fraud is to ask questions and be observant. You have the right to refuse a treatment.You have the right to be informed about your condition in terms you understand. Do not take the risk and agree on anything without asking “why” first.

Trust Your Common Sense

Medicines doesn’t work like magic. If someone takes the time to explain a problem or a treatment to us (which is your right as a health consumer), we usually make a pretty good decision on what is best for us.

Do Your Own Research

If you have a complicated problem, or want to know more about your options:

Start by asking your doctor for any books or any written information you could borrow and read.
Access the Internet and surf for legitimate websites about health (health.com, mayoclinic.com, webmd.com).
If you find something interesting about your condition, make a copy for your doctor and discuss it at your next visit.

Conclusion

Overall, what needed here most to avoid fraud is to be knowledgeable, suspicious, and trust your common sense. Do not risk your health to alternative treatment which are unapproved and untrustworthy. As nurses, we should be able to suppress some believes of the client which are unhealthful. This makes health education important.

Image sources: 1, 2, 3

Avoiding Quackery and Fraud Original source at: Nurseslabs