Specific and non specific effects

skin reactions

1600

faint erythema

2-3000

erythema

3-4000

dry desquamation

4000

moist desquamation

6000

epilation/alopecia

2000

mouth changes: stomatitis, xerostomia, mucositis, taste alterations

2-3000

pharyngitis

2-3000

laryngitis

4000

esophagitis

2-3000

nausea and vomiting

1-2000

diarrhea/colic

2-5000

cystitis

3-4000

nonspecific effects

skin pallor, weight loss, fatigue, sleep

neurologic changes

headaches, vision changes, gait and mobility changes, significant changes in temperament, changes in mental status

pain

assess location and intensity; instruct importance of taking meds regularly

reflective listening

reflecting content or implied feelings of the patients nonverbal observations or communication the pt feels had been omitted/emphasized; involves responding wit empathy

empathy

identifying feelings, thought, or experiences of another person

2/3’s of communication is…

nonverbal

cognitive

facts and words contained in message

affective

feelings, attitudes, behaviors

10 most common verbal responses

minimal verbal response, reflecting, paraphrasing, probing, clarifying, interpreting, checking out, informing, confronting, summarizing

general assessment

health data, baseline for care planning

physical assessment

signs, symptoms, nutrition, pain, biochemical balance

nutritional assessment

monitors diet and weight

cachexia

loss of muscle with or without loss of fat mass

MST (malnutrition)

quick screening; used by any staff

PG-SGA

gold standard; evaluates weight change, food intake, eating symptoms, functional capacity

6 dimensions of cancer pain

1- physiologic- cause

2- sensory- intensity

3- affective- anxiety

4- sociocultural- family/culture

5- behavioral- meds

6- cognitive- beliefs

physiologic/sensory dimensions

pain severity, loccation, duration, quality

acute pain

new, short term; may follow procedure, must be treated immediately

chronic pain

duration of 3+ months; often from tumor invasion

radiation and chemotherapy can cause…

myelosuppression (bone marrow suppression)

anemia

low RBC’s; fatigue, weakness, pallor

leukopenia

low WBC’s; risk infection

thrombocytopenia

low platelets; bleeding risk

pancytopenia

reduction in RBC’s, WBC’s, and platelets

domains of quality of life

physical- loss of function, symptoms, fatigue

psychosocial- anxiety, depression

social- support network, relationships

anxiety

individual’s response to real or perceived threat

A-state

how patient feels “right now“

A-trait

long term predisposition to anxiety

depression

perceived loss of self esteem

cancer rehabilitation

max restoration of functions within limits imposed by malignancy and its treatments

National cancer act of 1971

created to lead fight against cancer; includes rehab initiatives

interprofessional rehab

needs assesment; dynamic and ongoing

cultural assessment

systemic appraisal of elements; respect/acceptance of differences=key to care

Children assessment should cover…

physical- function/mobility

psychological- anxiety

relational- family support

social- education

Adolescent assessment must cover…

sensory/cognitive

baseline behaviors

complete health/med history

Palliative care

relieve symptoms, side effects, improve QOL

End-of-life care

focuses on comfort and quality of life when treatments no longer work