Prevention and early detection of cancer p307 • Primary prevention p 307 • Secondary prevention p 307 • Tertiary prevention p 307 Warning signs for cancer p 308 • Adults 7 warning signs p 308 • Children Wong / Brunner library • In various organs Preventative measures / safeguards education

2. Patient history
subjective data- pg. 300
• Age
• Habits
• Bodily changes
• Diet
• Present/previous occupation
• Lifestyle
• Environmental history
• Patient & his/her family’s health history
• Presenting complaints
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3. Patient history
objective data- pg. 300
• Physical exam:
• Inspection
• CHANGES IN SKIN COLOUR, MOLES, WARTS OR DEFORMITY
• Palpation
• LUMPS & PAINFUL AREAS
• Auscultation
• TO DETECT ANY ABNORMAL SOUNDS
• Percussion
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4. General clinical
signs & symptoms- pg. 301
• Anaemia
• May result from unusual bleeding from any bodily orifice, ulcers or lesions
or erosion of blood vessels
• Infection
• Worn out or damaged erythrocytes that are not replaced due to bone
metastases or deficient leukocytes and thrombocyte production with bone
marrow involvement resulting in decreased resistance to infection
• Bone marrow depression due to chemotherapy or radiation resulting in
infection
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5. General clinical
signs & symptoms- pg. 301
• Ulceration
• Due to poor blood supply and inadequate nutrition to the lesion and/or surrounding
tissue
• Infection
• Due to increased efficiency of immunological responses and defense mechanisms
• Pain
• Occurrence depends on the organ or system involved
• May appear early if the growth is near or along a sensory nerve or if it is within bine
tissue, and associated with pressure, obstruction or destruction of a vital organ
• Becomes more severe as cancer progresses.
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6. General clinical
signs & symptoms- pg. 301
• Collection of fluid in body spaces
• Presence of fluid in pleural cavity is an indication of metastasis
• Loss of weight and strength
• Due to poor health and malnutrition as the rapidly growing cancer cells compete
with normal cells for nutrients, resulting in disturbances of normal metabolic and
physiological processes throughout the body.
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7. General clinical
signs & symptoms- pg. 301
• Change in appearance
• Due to disfigurement caused by destruction or removal of body organs/tissues
• Emotional disturbances
• Anxiety, pain, concern, depression, withdrawal, restlessness, insomnia and loss of hope
and interest in life
• Anger and resentfulness
• Cachexia
• A general state of ill health involving marked weight loss and muscle loss.
• Wasting syndrome is often a sign of disease, such as cancer, AIDS, heart failure or
advanced chronic obstructive pulmonary disease (COPD).
• Symptoms include weight loss, muscle loss, a lack of appetite, fatigue and decreased
strength.
• Treatment includes nutritional counselling, medication to stimulate appetite and weight
gain and treating the underlying disease.
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8. Prevention and early detection of CA- pg. 307
• PRIMARY PREVENTION
• Educate
• Warning signs
• Benefits of early detection, prevention and treatment options
• Risk factors
• Avoidance of exposure to carcinogenic agents
• Measures by government to control air and water pollution, protection of
workers, radiographers and other professionals
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9. Example: smoking laws South Africa
• Cigarette Laws
• If you are under 18, you are banned from buying cigarettes. This includes buying flavoured tobacco products used for hookah smoking. You are
also not allowed to enter into smoking areas if you are under 18.
• Smoking in banned places like restaurants, offices and malls where there is no isolated, sealed off smoking room is illegal.
• No smoking in a car (even if it’s your own car) when one of the passengers is under 12 years. This is because children are negatively affected by
tobacco smoking because their lungs are either still developing or too weak to handle that kind of environmental pollution.
• Smoking in partly closed public areas such as balconies, pavements and parking areas is not allowed.
• Smoking in locations used for commercial childcare activities, for schools or teaching/tutoring such as crèches is banned.
• Tobacco companies aren’t allowed to advertise, hold parties or use marketing to target the youth.
• Those sugar cigarettes in cute packaging which some of us have been exposed to have now been banned. Children learn by example and if they
buy sweets and toys that look similar to cigarettes they are more likely to start smoking because of curiosity.
• No smoking is allowed in cinemas, on domestic flights in the country and all public transport.
• Some hotels have also banned smoking inside the building.
• Only up to 25% of a public place, such as a building or public transport can be allocated a smoking area. This area needs to be physically isolated
from the rest of the interior. In other words, this smoking area needs to be enclosed and can only be used as a smoking area where the smoke
can escape to the outside.
• Cigarettes are not be sold individually or ‘loose’.
• Some restaurants allow families with young children to sit in the smoking area of a restaurant because there might be adults in the family who
want to smoke. By law, the manager of the restaurant must make sure that no one under 18 is present in that smoking section.
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10. Prevention and early detection of CA- pg. 307
• SECONDARY PREVENTION
• Early diagnosis and prompt intervention
• Regular physical examinations should be encouraged
• BSE
• Screening
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11. Prevention and early detection of CA- pg. 307
• TERTIARY PREVENTION
• Cured disease, stabilised and now is irreversible
• Restore and rehabilitate individual to optimal level
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12. 7 WARNING SIGNS OF CANCER- pg.308
CAUTION
Change in bowel
or bladder
habits
A sore throat
that does not
heal
Unusual
bleeding or
discharge from
an orifice
Thickening or a
lump in the
breast or
elsewhere
Indigestion that
is chronic or
difficulty
swallowing
Obvious change
in wart or mole
Nagging cough
or hoarseness
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13. CA warning signs in the
bladder/kidney - pg.308
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14. CA warning signs in the Breast- pg.308
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15. CA warning signs in cervix and uterus cancer-
pg.308
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16. CA warning signs in the GIT- pg.308
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17. CA warning signs in the mouth & throat-
pg.308
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18. CA warning signs of the larynx- pg.308
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19. CA warning signs of the lungs- pg.308
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20. CA warning signs of the circulatory system-
pg.308
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21. CA warning signs of the lymphatic system-
pg.308
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22. Safeguards against cancer- Table 17.6- pg.308
• Breast
• BSE
• Colon and rectum
• Regular screening
• Prostatic exam
• Lung
• Stop smoking
• Annual chest x ray
• Skin
• Avoid unnecessary exposure to sunlight
• Cervix
• Females: at least x3 during their adult life
• Annual screening is recommended
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23. General nursing care for patients with disorders of
the haematological system- pg. 684
• PROBLEM: Fatigue: A overwhelming, sustained sense of exhaustion and
decreased capacity for physical and mental work at usual level.
• May be related to: Decreased hemoglobin and diminished oxygen-carrying
capacity of the blood.
• Possibly evidenced by: Exertional discomfort or dyspnea, Inability to maintain
usual level of physical activity, Increased rest requirements & Report of fatigue
and lack of energy.
• Desired Outcomes: Client will verbalize use of energy conservation principles
and verbalize reduction of fatigue, as evidenced by reports of increased energy
and ability to perform desired activities.
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24. General nursing care for patients with disorders of
the haematological system- pg. 684
Nursing Interventions Rationale
Assess the specific cause of fatigue.
The specific cause of fatigue is due to tissue hypoxia
from normocytic anemia; Other related medical
problems can also compromise activity tolerance.
Assess the client’s ability to perform activities of
daily living (ADLs), and the demands of daily living,
Fatigue can limit the client’s ability to participate in
self-care and perform his or her role responsibilities
in family and society, such as working outside the
home.
Assist the client in planning and prioritizing activities
of daily living (ADL).
This will allow the client to maximize his/her time
for accomplishing important activities. Not all self-
care and hygiene activities need to be completed i
the morning. Likewise, not all housework needs to be
completed in one day.
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25. General nursing care for patients with disorders of
the haematological system- pg. 684
Nursing Interventions Rationale
Assist the client in developing a schedule for daily
activity and rest. Stress the importance of frequent rest
periods.
Energy reserves may be depleted unless the client
respects the body’s need for increased rest. A plan that
balances periods of activity with periods of rest can help
the client complete desired activities without adding
levels to fatigue.
Monitor hemoglobin, hematocrit, RBC counts, and
reticulocyte counts.
Decreased RBC indexes are associated with decreased
oxygen-carrying capacity of the blood. It is critical to
compare serial laboratory values to evaluate progression
or deterioration in the client and to identify changes
before they become potentially life-threatening.
Educate energy-conservation techniques.
Clients and caregivers may need to learn skills for
delegating task to others, setting priorities, and
clustering care to use available energy to complete
desired activities. Organization and time management
can help the client conserve energy and reduce fatigue.
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26. General nursing care for patients with disorders of
the haematological system- pg. 684
Nursing Interventions Rationale
Instruct the client about medications that may stimulate
RBC production in the bone marrow.
Recombinant human erythropoietin, a hematological
growth factor, increases hemoglobin and decreases the
need for RBC transfusions.
Provide supplemental oxygen therapy, as needed. Oxygen saturation should be kept at 90% or greater.
Anticipate the need for the transfusion of packed RBCs.
Packed RBCs increase oxygen-carrying capacity of the
blood.
Refer the client and family to an occupational therapist.
The occupational therapist can teach the client about
using assistive devices. The therapist also can help the
client and family evaluate the need for additional
energy-conservation measures in the home setting.
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27. General nursing care for patients with disorders of
the haematological system- pg. 684
• PROBLEM: Deficient Knowledge
• May be related to: Complexity of treatment, Lack of recall, Lack of
resources, New condition or treatment, Unfamiliarity with the disease
condition.
• Possibly evidenced by: Inaccurate follow-through of instructions,
Questioning members of health care team & Verbalized inaccurate
information.
• Desired Outcomes: Client will verbalize understanding of own disease and
treatment plan.
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28. General nursing care for patients with disorders of
the haematological system- pg. 684
Nursing Interventions Rationale
Assess current knowledge of the diagnosis, disease
process, possible causative factors, and treatment.
Determining the client’s current knowledge and
perceptions will facilitate the planning of individualized
teaching. Clients may have a general understanding
of anemiarelated to iron deficiency but limited
knowledge of other types of anemia.
Assess the client’s and family’s understanding of the new
medical vocabulary.
Usually, people have a limited understanding of medical
vocabulary, hence are not exposed to the language being
used by the health care professionals.
Explain the importance of the diagnostic procedures
(such as complete blood count), bone
marrow aspiration and a possible referral to a
hematologist.
Diagnosing a type of anemia will be based on the changes
in the RBC indexes and the findings in the bone
marrow aspiration.
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29. General nursing care for patients with disorders of
the haematological system- pg. 684
Nursing Interventions Rationale
Explain the hematological vocabulary and the functions
of blood elements, such as white blood cells, red blood
cells, and platelets.
Clients usually have a basic knowledge of the
hematological system.
Instruct client to avoid known risk factors.
Causative factors such alcoholism, exposure to toxic
chemicals, dietary deficiencies, and the use of some
medications can affect red blood cell production and
lead to anemia.
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30. Acute transfusions reactions- pg. 687
REACTION TYPE AETIOLOGY ASSESSMENT FINDINGS
Haemolytic Transfusion of incompatible
blood
Fever and chills
Flushing
Low back pain
Hypotension
Tachypnea
Haemoglobinuria
Haemoglobinaemia
Vascular collapse
Shock, renal failure and
cardiac arrest
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31. Acute transfusions reactions- pg. 687
REACTION TYPE AETIOLOGY ASSESSMENT FINDINGS
Allergic
Anaphylaxis
Reaction to certain proteins
in the blood
Giving IgA proteins to people
who have developed these
antibodies
Flushing, urticarial, pruritus
Urticaria, wheezing,
cyanosis, shock and cardiac
arrest
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32. Acute transfusions reactions- pg. 687
REACTION TYPE AETIOLOGY ASSESSMENT FINDINGS
Reaction due to circulatory
overload
Infection/septicemia
Rapid transfusion of blood
Transfusion of contaminated
blood
Pulmonary congestion
Fever, chills, hypotension,
shock
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33. Nursing responsibilities regarding blood
transfusions- pg. 687
• Explain the procedure to the patient
• Establish if the patient accepts the transfusion
• Check the doctor’s prescription regarding blood or blood
component
• Assist the doctor with establishing venous access
• Follow unit protocols regarding collection of blood from blood
bank, identification of the patient, putting up the first unit
• Obtain and record history of allergies
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34. Nursing responsibilities for blood
transfusions- pg. 687
• Baseline vital signs
• 2-4 hourly observations
• Witness- checking of blood and identifying patient
• Ensure that blood is administered at room temperature
• And warmed according to unit protocol
• Observe blood for any irregularities before commencing transfusion
• Calculate rate of flow etc.
• Ensure that equipment is disposed safely
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35. Management of blood transfusions reactions-
pg. 688
• Stop the transfusion
• Keep the IV line open
• Notify the doctor
• Check all info
• Monitor vital signs
• Monitor urinary output
• Follow prescription in managing the symptoms
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36. Management of blood transfusions reactions-
pg. 688
• Save the blood bag and tubing and send to blood bank
• Complete the transfusion reaction report as per protocol
• Collect urine and blood samples in line with hospital policy
• Keep record
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37. Reference list
• https://za.pinterest.com/pin/320529698460438290/?lp=true
• http://www.cancerspecialistpune.com/cervical-cancer/
• https://tslnigeria.tv/early-warning-signs-of-blood-cancer/
• https://nurseslabs.com/4-anemia-nursing-care-plans/3/
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