MANAGEMENT IN CANCER PATIENTS

NURSING INTERVENTIONS FOR CHEMOTHERAPY SIDE EFFECTS

1. GI System Nausea and Vomiting, diarrhea, constipation Administer antiemetic to relieve nausea and vomiting Replace fluid electrolyte losses, low-fiber diet to relieve diarrhea Increase fluid intake and fibers in diet to prevent/relieve constipation 2. Integumentary System Pruritus, urticaria, and systemic signs Provide good skin care Stomatitis Provide good oral care Avoid hot and spicy food

Alopecia Reassure that it is temporary Encourage to wear wigs, hats, or head scarf Skin Pigmentation Inform that it is temporary Nail Changes Reassure that nails may grow normally after chemotherapy 3. Hematopoietic System Anemia Provide frequent rest periods Neutropenia Protect from infection Avoid people with infection Thrombocytopenia Protect from trauma Avoid ASA

4. Genito Urinary System

Hemorrhagic Cystitis Provide 2 3 L of fluids per day

Urine color changes

Reassure that it is harmless

5. Reproductive System
Premature menopause or amenorrhea Reassure that menstruation resumes after chemotherapy

ANTIEMETIC TO RELIEVE NAUSEA AND VOMITING RELATED TO CHEMOTHERAPY

Dronabinol (Marinol) Ondnsetron (Zofran) Granisetron (Kytril) Alprazolam (Zanax) Lorazepam (Ativan) Haloperidol (Haldol) Prochlorperazine (Compazine)

RADIATION THERAPY
Role in cancer Intervention
Primary curative role Adjunct to other therapy Palliation

Sources of Radiation Therapy

External Radiation Therapy (Teletherapy) . Administered through an x-ray medicine Internal Radiation Therapy. Administered within or near the tumor

Types
Sealed Source (Brachytherapy) Unsealed Source (Oral, IV)

1. Skin Reactions Erythema, dry/moist desquamation Atrophy, telangiectasia, depigmentation, necrotic/ulcerative lesions
Observe for early signs of skin reaction and report Keep area dry Wash area with water, no soap and pat dry (do not rub) Do not apply ointments, powders or lotion on the area Don not apply heat, avoid direct sunshine or cold Use soft cotton fabrics for clothing Do not erase markings on the skin. These serve s guide for area iirradiation

2. Infection Due to bone marrow suppression

Monitor blood counts weekly Good personal hygiene, nutrition, adequate rest Teach signs of infection to report to physician

3. Hemorrhage Platelets are vulnerable to radiation

Monitor platelet count Avoid physical trauma or use of aspirin Teach signs of hemorrhage Monitor stool and skin for signs of hemorrhage Use direct pressure over injection sites until bleeding stops

4. Fatigue

Results of high metabolic demands for tissue repair and toxic waste removal
Provide rest and good nutrition

5. Weight Loss
Anorexia, pain, and effect of CA 6. Stomatitis Ulceration of oral mucous membrane Administer analgesics before meals Bland diet, no smoking/alcohol Good oral hygiene/saline rinses q2h Sugarless lemon drops or mint to increase salivation

7. Diarrhea 8. Nausea and Vomiting 9. Headache 10. Alopecia 11. Cystitis 12. Social Isolation