NURS 5031 Study Guide: Cancer

Cancer: 

• Identify emergency complications of cancer and cancer treatment

• 3 types of cancer complications:

• 1) Obstructive

• Tumor obstruction of an organ or blood vessel
• Examples include:

• Superior vena cava syndrome (blood in vena cava slows down due to tumor obstruction), spinal cord compression syndrome, third space syndrome

• 2) Metabolic

• Production of ectopic hormones from the tumor or are secondary to metabolic alterations
• Examples include:

• SIADH, hypercalcemia, TLS, septic shock, and DIC (disseminated intravascular coagulation)

• 3) Infiltrative

• Malignant tumors infiltrate major organs or secondary to cancer therapy
• Examples:

• Cardiac tamponade
• Carotid artery rupture

• Understand the nurses role in providing and prioritizing care the care of patients undergoing cancer treatment

• Generalized Nursing Interventions to manage side effects

• Education

• About the treatment regimen
• Supportive care options (antiemetics, antidiarrheals etc)
• What to expect during treatment

• Interventions

• Utilize interventions to counter the negative effects of cancer treatment

• Prevention and Detection

• Patient education on how to reduce risks, screen for cancer early, self-exams, and the 7 warning signs of cancer
• 7 Warning Signs of cancer (Mnemonic: CAUTION)

• C: Change in bowel or bladder habits
• A: A sore that doesn’t heal
• U: Unusual bleeding or discharge
• T: Thickening or lump in breast or elsewhere
• I: Indigestion or dysphagia
• O: Obvious change in wart or mole
• N: Nagging cough or hoarseness

• Malnutrition and Dysgeusia

• Malnutrition: Provide nutrition education and consult with dietitian if 5% weight loss noted
• Altered taste: Avoid disliked foods, change spices to mask changes

• Fatigue

• Encourage conservation of energy
• Maintain nutrition
• Assess for reversible causes of fatigue

• Pain Mgmt

• Treat & Assess!

• Bone Marrow Suppression

• Infection

• Monitor, educate, and treat with antibiotics

• Hemorrhage

• No IM injections
• Transfusions & growth factors if needed
• Monitor for bleeding (including hypotension and anemia)

• Myelosuppression is the most common side effect of chemo

• GI Side-effects

• I/Os, prophylactic antiemetics and antidiarrheals
• Nutrition education, dietitian consult, monitor weight loss
• Vomiting is common within 1 hr of chemo, or a few hours after radiation

• Skin reactions

• Wound consults
• Educations about signs of infection
• Emotional support for skin and hair changes

• Cognitive effects

• Educate about “chemo” brain (brain fog lasting for months or years after treatment)
• Memory games and limited distractions to reduce memory loss

• Reproductive effects

• Inform patient about expected sexual side effects
• Encourage discussion and refer to counseling if needed