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.
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):
Risk for Injury
Risk for Injury: Vulnerable for injury as a result of environmental conditions interacting with the individual’s adaptive and defensive resources, which may compromise health.
May be related to
- [not applicable]
Possibly evidenced by
- Amputation of a limb
- Changes in stump incision (redness, irritation, swelling, drainage)
- Improper fit of prosthesis and failure to adapt to it
- Improper positioning and alignment of the stump, psychosocial maladaption to prosthesis
- Child will not experience injury as evidenced by clean and dry stump without redness, odor, or drainage.
|Assess child for type of surgery and|
condition and healing of the stump,
type of bandaging or cast, presence
of drains, type of prosthetic device and fit.
|Provides information about amputation needed to provide specific care of stump and rehabilitation.|
|Observe dressing for bleeding, redness, pain, drainage at stump area every 2 to 4 hours; maintain dressing pressure or wrapping of the stump as adviced; change dressing only if ordered.||Indicates infection or risk of hemorrhage at amputation.|
|Allow expressions about sudden lifestyle changes and permanent disability adjustment difficulties.||Promotes verbalization of feelings and help to adjust with change in image.|
|Provide stump and socket care using mild|
soap and warm water, rinse and pat dry.
|Promotes adaptation to device and prevents infection caused by pathogens transmitted via the prosthetic device.|
|Assist child with range-of-motion exercises daily as recommended by the physical therapist.||Promotes mobility and healing of the stump and prevents contractures.|
|Maintain Trendelenburg and prone|
position as ordered; avoid elevation, external rotation, or abduction of stump.
|Prevents deformities and contractures caused by hip flexion.|
|Instruct child in stump positioning and exercising, ROM of muscles and joints.||Prevents muscle or joint complications and enhances mobility.|
|Teach parents and child in stump|
care, toughening exercises, application of stocking and prosthesis, care of device.
|Promotes adaptation to loss and proper stump and prosthesis care.|
|Stress the importance of performing daily activities and avoiding restrictions as advice.||Promotes mobility and return to former activities within limitation imposed by amputation and use of the prosthetic device.|
|Discuss alteration in clothing and|
instruct in crutch walking and how to move around the environment.
|Enhances body image and return to limited activities.|
|Reassure the child that feelings of anger, denial, and hostility are normal following such a loss.||Promotes acceptance of child while grieving for the loss.|
|Encourage parents and child to continue|
chemotherapy and rehabilitation therapy.
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