4 Osteogenic Sarcoma (Osteosarcoma) Nursing Care Plans

By
Paul Martin, BSN, R.N.
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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):

  1. Ineffective Protection
  2. Impaired Oral Mucous Membrane
  3. Anxiety
  4. Risk for Injury
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Anxiety

Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.

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May be related to

  • Change in health status
  • Threat of death
  • Threat to self-concept.

Possibly evidenced by

  • Increased apprehension and fear of diagnosis
  • Expressed concern and worry about preoperative procedures and preparation, postoperative effects of therapy on physical and emotional status, possible metastasis of disease, loss of limb and use of a prosthesis.

Desired Outcomes

  • Parent and child will express sentiments about the illness.
Nursing InterventionsRationale
Assess parent’s and child’s level of anxiety and how it is manifested; the necessity for information that will relieve anxiety.Provides information about source and level of anxiety and need for interventions to relieve it; sources for the child may be
procedures, fear of mutilation or death,  unfamiliar hospital environment and may be manifested by restlessness, inability to play, sleep, or eat.
Assess possible need for special counseling services for the child.Supports the child’s ability to deal with illness and promotes adjustment to lifestyle changes.
Encourage parents to stay with child; Leave a telephone number in case of a need for more information.Enhances care and promotes emotional comfort to the child.
Communicate with the child based on developmental age level and answer questions calmly and honestly; use pictures, models, and drawings for explanations.Allows better understanding and promotes trust.
Allow open expression of concerns about
illness, procedures, management, and possible consequences of surgery.		Provides an opportunity to vent feelings and fears to reduce anxiety.
Provide child with structure and input in decisions about care and routines as
possible.		Empower the child and promotes independence.
Provide consistent care nurse assignment with the same personnel.Promotes trust and comfort and familiarity with staff giving care.
Orient child to surgical and ICU unit, equipment, noises, and staff.Lessens the anxiety incident brought about by the fear of unknown.
Teach parents and child about the
disease process, surgical procedure, what to expect preoperatively and postoperatively including chemotherapy and its benefits and side effects (nausea,
vomiting, diarrhea, stomatitis, alopecia, and others are possibilities but are temporary; phantom pain).		Provides information to promote understanding that will relieve fear and anxiety; understanding of preoperative and postoperative treatments and effect on body image.
Explain all procedures and care in simple, direct, honest terms and repeat as often as necessary; reinforce physician information if needed and provide specific information as requested.Supplies information about all diagnostic procedures and tests such as CBC, platelets with chemotherapy and scans, and X-rays for diagnosis.
Inform parents and child of the extent of surgery planned with the removal of a limb (that a temporary prosthesis will be fitted immediately following surgery, and a
permanent one will be fitted in 6 to 8 weeks; that recreational and physical therapy will be undertaken following amputation).		Reduces anxiety when knowledge and  support is given, and child and parents will not feel betrayed by inadequate preparation of procedures and treatments.
Introduce the child to another who has same disease and amputation.Provides information and support from a peer with the same condition and who would have empathy.
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See Also

You may also like the following posts and care plans:

Pediatric Nursing Care Plans

Nursing care plans for pediatric conditions and diseases: 

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