4 Osteogenic Sarcoma (Osteosarcoma) Nursing Care Plans

February 8, 2018

Osteogenic sarcoma (Osteosarcoma) is a primary bone malignancy that usually affects the metaphysics of the long bones (femur, humerus, and tibia). The most common symptoms of osteosarcoma are dull aching pain and swelling in the bone or joint around the tumor. The disease most commonly occurs in children, teenagers, and young adults between the ages of 10 and 20 and it is prevalent in males than females.

Management consists of a combination of treatment that includes amputation of the limb with chemotherapy before and/or following surgery, or a bone and joint prosthesis in selected children to restore the limb with chemotherapy prior the surgery.

Nursing Care Plans

Care plan for a child with osteosarcoma includes prevention of injury, improved condition of oral mucous membranes, relief from anxiety and absence of complications.

Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for osteogenic sarcoma (Osteosarcoma):

Ineffective Protection

Ineffective Protection: Decrease in the ability to guard self from internal or external threats such as illness or injury.

May be related to

Antineoplastic medication
Abnormal blood profile (leukopenia, thrombocytopenia, anemia, coagulation)

Possibly evidenced by

Altered blood coagulation
Bone marrow suppression
Impaired immunity against infection
Hematoma, petechiae, hematochezia, hematemesis, bleeding from nose or gums.

Desired Outcome

Child will not experience bleeding episode.
Child’s temperature will remain <100° F
Child’s breath sounds will be clear bilaterally.

Nursing Interventions	Rationale
Monitor for any signs of bleeding and febrile episodes; Note laboratory findings: WBC, platelet count, Hct, and absolute neutrophil count.	Provides knowledge on any obvious, visible presence of bleeding or abnormal blood profile that predispose to bleeding due to bone marrow suppression and immunosuppression resulting from chemotherapy.
Inform parents and child to avoid exposure to people with upper respiratory infection or any illness.	Prevents a highly susceptible child to acquire an infection.
Encourage parents and child to avoid contact play or sports, straining at defecation, forcefully blowing nose.	Prevents injury that may possibly result in bleeding.
Inform parents to notify health care provider for signs of increased temperature, changes in behavior, headache, dizziness, fatigue, pallor, bleeding episode, exposure to a communicable disease.	Signifies a complication related to an abnormal blood profile.
Teach handwashing technique before providing care, using of protective gear such as mask and gown when appropriate, providing a private room, monitor for any signs and symptoms of infections.	Prevents transmission of a microorganism to a compromised immune system during chemotherapy if neutrophil count is less than 1,000/cu mm.
Discourage the use of hard toothbrush, obtaining rectal temperatures, undergoing unnecessary invasive procedures.	Prevents the occurrence of bleeding caused by during chemotherapy which alters platelet and clotting factors.
Teach and demonstrate on how to get urine and stool sample using dipstick and hematest.	Determines the presence of bleeding in the gastrointestinal or urinary tract.