Tiêu đề COMPRE - HANDOUTS - ONCO (Ms. Rojas) ✅

TOP RANK REVIEW ACADEMY, INC. Page 3 | Chemotherapeutic agents CELL CYCLE SPECIFIC (S PHASE) • TOPOISOMERASE I INHIBITOR: Irinotecan, Topotecan • TOPOISOMERASE II INHIBITOR: Etoposide, Teniposide • ANTIMETABOLITES: Cytarabine, 5-fluorouracil, Hydroxyurea, Methotrexate • CELL CYCLE SPECIFIC (M PHASE) MITOTIC SPINDLE INHIBITORS • PLANT ALKALOIDS: Vinblastine, Vincristine, Vinorelbine • TAXANE: Paclitaxel, Docetaxel CELL CYCLE NON-SPECIFIC • ALKYLATING AGENT • Busulfan, Carboplatin, Cisplatin, Cyclophosphamide, Nitrogen mustard, Thiotepa • NITROSUREAS • Carmustine, Lomustine  • ANTITUMOR ANTIBIOTICS • Bleomycin, Dactinomycin, Daunorubicin, Doxorubicin, Epirubicin, Idarubicin • HORMONAL AGENTS • Tamoxifen, Fulvestrant, Goserelin Side effects: • Nausea and vomiting • Stomatitis • Anemia, leukemia, thrombocytopenia • Kidney injury • Cardiac toxicity • Infertility • Peripheral neuropathy • Cognitive impairment • Fatigue NURSING CARE FOR PATIENTS WITH CANCER RISK FOR INFECTION • Place patient in a private room • Inform patient to avoid contact with people who have known or recent infection • Instruct staff in careful hand hygiene before and after entering room • Avoid rectal or vaginal procedures, IM injections, insertion of urinary catheters • Encourage patient to ambulate in room unless contraindicated. • Assess IV sites for evidence of infection RISK FOR IMPAIRED SKIN INTEGRITY • Avoid the use of soaps, cosmetics, perfumes, lotions, powder in erythematous areas • Avoid rubbing or scratching skin • Avoid applying hot water bottles, heating pads • Avoid exposing the area to sunlight or cold weather • Avoid tight clothing; Use cotton clothing IMPAIRED ORAL MUCOUS MEMBRANE INTEGRITY • Assess oral cavity daily using the same assessment criteria or rating scale. • Instruct patient to report oral burning, pain, areas of redness, open lesions on oropharyngeal mucosa and lips, pain associated with swallowing, or decreased tolerance to temperature extremes of food. • Encourage and assist as needed in oral hygiene. • Advise patient to avoid irritants such as commercial mouthwashes, alcoholic beverages, and tobacco. • Avoid irritating foods (acidic, hot, rough, and spicy); • Use water-based moisturizers to protect lips. IMPAIRED TISSUE INTEGRITY: ALOPECIA • Discuss potential hair loss and regrowth with patient and family; advise that hair loss may occur on body parts other than the head. • Explore potential impact of hair loss on self- image, interpersonal relationships, and sexuality. • Explain that hair growth usually begins again once therapy is completed. Prevent or minimize hair loss through the following: • Use mild shampoo and conditioner, gently pat dry, and avoid excessive shampooing • Avoid excessive combing or brushing; use wide-toothed comb. Suggest ways to assist in coping with hair loss. • Purchase wig or hairpiece before hair loss. • Begin to wear wig before hair loss.
TOP RANK REVIEW ACADEMY, INC. Page 4 | IMPAIRED NUTRITIONAL STATUS (ANOREXIA, CACHEXIA, MALABSORPTION) • Assess and address factors that interfere with oral intake or are associated with increased risk of decreased nutritional status. • Initiate appropriate referrals for interdisciplinary collaboration to manage factors that interfere with oral intake. • Suggest smaller, more frequent meals. • Educate patient to avoid unpleasant sights, odors, and sounds in the environment during mealtime. • If patient desires, serve alcoholic beverages at mealtime with foods. • Consider cold foods, if desired. IMPAIRED NUTRITIONAL STATUS (NAUSEA AND VOMITING) • Assess the patient’s previous experiences and expectations of nausea and vomiting, including causes and interventions used. • Adjust diet before and after drug administration according to patient preference and tolerance. • Prevent unpleasant sights, odors, and sounds in the environment. • Administer prescribed antiemetics, sedatives, and corticosteroids before chemotherapy and afterward as needed. • Ensure adequate fluid hydration before, during, and after drug administration; assess intake and output • Encourage frequent oral hygiene. FATIGUE • Encourage balance of rest and exercise; avoiding extended periods of inactivity. At minimum, promote patient’s normal sleep habits. • Encourage protein, fat, and calorie intake at least equal to that recommended for the general public. • Encourage participation in planned exercise programs involving aerobic, resistance, and flexibility training based on individual limitations and safety measures. • Encourage the use of relaxation techniques and guided imagery. CHRONIC PAIN • Use pain scale to assess pain and discomfort characteristics: location, quality, frequency, duration, etc., at baseline and on an ongoing basis. • Assure patient that you know the pain is real and will assist them in reducing it. • Address myths or misconceptions and lack of knowledge about the use of opioid analgesics. • Collaborate with patient, primary provider, and other health care team members when changes in pain management are necessary. • Explore nonpharmacologic and complementary strategies to relieve pain and discomfort: distraction, imagery, relaxation, cutaneous stimulation, acupuncture, etc. GRIEF • Encourage verbalization of fears, concerns, and questions regarding disease, treatment, and future implications. • Explore previous successful coping strategies. • Encourage ventilation of negative feelings, including projected anger and hostility, within acceptable limits. • Involve spiritual advisor as desired by the patient and family. • Allow for progression through the grieving process at the individual pace of the patient and family. DISTURBED BODY IMAGE • Identify threats to patient’s self-esteem (e.g., altered appearance, decreased sexual function, hair loss, decreased energy, role changes). Validate concerns with patient. • Encourage continued participation in activities and decision making. • Encourage patient to verbalize concerns. • Assist patient in self-care when fatigue, lethargy, nausea, vomiting, and other symptoms prevent independence. • Assist patient in selecting and using cosmetics, scarves, hair pieces, hats, and clothing that increase their sense of attractiveness. BREAST CANCER Risk factors: • Age, family history • Early menarche and late menopause • Previous cancer of the breast, uterus, or ovaries • Nulliparity, late first birth • Obesity • High-dose radiation exposure to chest Interventions: Radiation therapy, chemotherapy; Hormonal manipulation; Surgery Post operative interventions: Monitor vital signs. Position patient semi-fowler’s, affected arm elevated above the level of the heart Encourage deep breathing exercises Assess for infection, color changes, bleeding in surgical site Maintain FE balance, diuretics and low salt diet for severe lymphedema. LUNG CANCER Risk factors: Cigarette smoking; Secondhand smoking; Environmental and occupational pollutants Assessment: