Cancer

Cancer  

Information: uncontrolled cell growth leading to potentially serious health problems.

Presenting symptoms:  sores/wounds that don’t heal, indigestion, hoarseness, obvious changes in wart/mole, lump in breast, unusual bleeding  

Diagnostic tests:  mammogram, pap smear, rectal exam, colonoscopy, Skin inspection, Biopsy (definitive means of diagnosing cancer (surgical incision made in tissue and examined under a microscope)  

Treatment:  chemotherapy (kills or inhibits reproduction or neoplastic cells and also kills normal cells (skin, hair, GI lining most affected)

Radiation: destroys cancer cells with minimal exposure to normal cells, effective only for tissue in direct path of radiation beam. Wash irradiated area with soap and water daily to (do NOT – remove radiation marking, use powders, lotions, creams on skin at radiation site, avoid clothing or binding that will rub the skin too much at site and avoid exposure to the sun.  

Complications: infection is a main cause of death, metastasis  

Chemotherapy  

Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body it can be used for cancer, bone marrow diseases and immune system disorders. It can be used by its self or alongside other treatments. It can be used after surgery to kill any cancers left behind, to shirk a tumour so that other treatments such as radiation are possible, to ease signs and symptoms.

Risks: side effects can be significant; each drug is different and has different side effects. Common ones include nausea, vomiting, diarrhoea, loss of appetite, hair loss, fatigue, fever, mouth sores (because these tissues normally divide rapdly and are damaged by chemotherapy agents), pain, constipation, easy bruising, bleeding

Long last side effects: Damage to lung tissue, heart problems, infertility, kidney problems, nerve damage, risk of second cancer.  

How to prepare: Have a catheter, port or pump installed into the vein for long term use, blood tests to check kidney, liver functions and heart tests to check for heart health to see if the body is ready for chemotherapy, check for dental infections for reduce the risk of complications during chemotherapy, plan ahead for side effects (such as infertility, egg freezing)

Forms: Infusions, pills, shots, creams, directly at the tumour during surgery.  

When working with chemotherapy agents it is important to remember that they can be harmful to you and therefore it is essential to stay protected when working with them. It can cause reproductive problems.  Always wear the appropriate PPE this includes gowns, gloves, goggles and face shields. For 48 hours post treatment the patient will secrete hazardous drug metabolite within their sputum, tears, semen, vaginal secretions, urine and stool.  

Breast cancer  

Risk factors: female, over 50, 1st degree relative with history, BRCA1 and BRCA2 mutations, menopause after 50, smoker, alcohol consumption, high fat diet, sedentary life, hormone therapy post menopause.  when is best time to do breast examination? – self breast exams monthly 3-5 days after period and the same time each month

Post-operative: The patient should be encouraged to regularly exercise her arm and shoulder through a rage of movements to maintain a full range of motion in their shoulder and arm. If lymphoedema occurs the patient should be educated on compression bandaging, exercises and minimising arm trauma  

Post-Operative Care

Post Anaesthetic Care unit  

Immediate assessment: ABC (airway, breathing, circulation), Levels of consciousness, wounds, drain, IV, pain  

Aim: Maintain Air way, measurement of Vital signs in immediate post-operative period, continuous cardio-respiratory monitoring and pulse oximetry monitoring, links the patient for escalation of care in response to abnormal physiological observations, pain relief, monitor haemodynamic.  

Process: Administer oxygen as ordered, continuously monitor ECG, pulse and Blood pressure, assess surgical site, check patency of catheters, drains and tubes, provide warm blankets and prevent hypothermia, check lab results.  

Discharge requirements: conscious and orientates, easy noiseless breathing, protective reflexes are active, vital signs have been stable, intake and urinary output is adequate.  

Post-operative Ward

Aim: Restore homeostasis and prevent complications, maintain adequate respiratory and cardiovascular function, maintain adequate fluid and electrolyte balance, nutrition and elimination, promote comfort – pain management, promote wound healing – activity and mobility, provide psychological support, hygiene needs.  

Post-operative exercises: Deep breathing and coughing to prevent pneumonia, leg exercises to prevent DVT, calf pumping to prevent DVT, foot circles, leg lifts, repositioning/turning to prevent pressure sores, preventing wound dehiscence, promote fibre-rich diet to prevent constipation  

Vitamins

Vitamin D

Vit D is important for good bones

Young children that don’t get enough vit D can develop rickets which causes bowed legs and knock knees Adults that don’t get enough can develop bone weakness and increase the risk of fracture.  

How do we get Vitamin D? most people get it through their skin whenever we get the sun on our skin. However, because of the risk of skin cancer you must be careful. Vitamin D in foods (oily fish, milk, eggs, liver, plant-based substitutes, liquid meal replacements)

Vitamin K  

A single vitamin K injection at birth is the most effective way of preventing a serious bleeding disorder called vitamin k deficiency bleeding or VKDB.  

Vitamin K helps blood to clot and prevents serious bleeding,all babies need vitamin K to produce clotting factors. This is because all babies have low levels of vitamin K at birth and without vitamin K babies are at risk of getting VKDB or HDN (haemorrhagic disease of the new-born), VKDB can cause brain damage or death.  In Adults Vitamin K is naturally present in the body and is made in the intestine from food.