This document provides an overview of cancer and oncology nursing. It defines cancer as uncontrolled growth and spread of abnormal cells. The nursing process for cancer includes assessment, diagnostic tests, tumor staging and grading, nursing diagnoses, and treatment modalities. Treatment may include surgery, chemotherapy, radiotherapy, and palliative care to cure, control, or relieve symptoms of cancer. The goal is pain relief and maintaining quality of life for as long as possible.

1. UNDERSTANDING CANCER
ONCOLOGY NURSING

2. Essential Concepts of Cancer
– What is Cancer?
– Normal Cell Growth vs.
Cancer Cell Growth
– Etiology and Causative
Factors
– Pathophysiology
– Classification of Tumors
– Effects of Cancer

3. NURSING PROCESS
– Assessment
– Laboratory & Diagnostic Tests
– Tumor Staging and Grading
– Nursing Diagnoses & Planning
– Implementation and Management
• Treatment Modalities
– Chemotherapy
• End-of-life Issues

4. WHAT IS CANCER?
CANCER is a complex of diseases
which occurs when normal cells
mutate into abnormal cells that take
over normal tissue, eventually
harming and destroying the host

5. WHAT IS CANCER
A large group of diseases characterized
by:
– Uncontrolled growth and spread of
abnormal cells
– Proliferation (rapid reproduction by cell
division)
– Metastasis (spread or transfer of cancer
cells from one organ or part to another not
directly connected)

6. ONCOLOGY DEFINED
Branch of medicine
that deals with the
study, detection,
treatment and
management of cancer
and neoplasia

7. “ROOT WORDS”
 Neo- new
 Plasia- growth
 Plasm- substance
 Trophy- size
 +Oma- tumor
 Statis- location

8. “ROOT WORDS”
 A- none
 Ana- lack
 Hyper- excessive
 Meta- change
 Dys- bad, deranged

9. CHARACTERISTICS OF NEOPLASIA
 Uncontrolled growth of Abnormal cells
 1. Benign
 2. Malignant
 3. Borderline

10. CHARACTERISTICS OF NEOPLASIA
BENIGN
 Well-differentiated
 Slow growth
 Encapsulated
 Non-invasive
 Does NOT metastasize

11. CHARACTERISTICS OF NEOPLASIA
MALIGNANT
 Undifferentiated
 Erratic and Uncontrolled Growth
 Expansive and Invasive
 Secretes abnormal proteins
 METASTASIZES

12. LOSS OF NORMAL GROWTH
CONTROL

20. NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
1. Parenchyma, Organ or Cell
 Hepatoma- liver
 Osteoma- bone
 Myoma- muscle

21. NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
2. Pattern and Structure, either GROSS or
MICROSCOPIC
 Fluid-filled CYST
 Glandular ADENO
 Finger-like PAPILLO
 Stalk POLYP

22. NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
3. Embryonic origin
 Ectoderm ( usually gives rise to epithelium)
 Endoderm (usually gives rise to glands)
 Mesoderm (usually gives rise to Connective
tissues)

23. BENIGN TUMORS
 Suffix- “OMA” is used
 Adipose tissue- LipOMA
 Bone- osteOMA
 Muscle- myOMA
 Blood vessels- angiOMA
 Fibrous tissue- fibrOMA

24. MALIGNANT TUMOR
 Named according to embryonic cell origin
1. Ectodermal, Endodermal, Glandular, Epithelial
 Use the suffix- “CARCINOMA”
 Pancreatic AdenoCarcinoma
 Squamos cell Carcinoma

25. MALIGNANT TUMOR
 Named according to embryonic cell origin
2. Mesodermal, connective tissue origin
 Use the suffix “SARCOMA
 FibroSarcoma
 Myosarcoma
 AngioSarcoma

26. “PASAWAY”
1. “OMA” but Malignant
 HepatOMA, lymphOMA, gliOMA, melanOMA
2. THREE germ layers
 “TERATOMA”
3. Non-neoplastic but “OMA”
 Choristoma
 Hamatoma

27. ETIOLOGY/CAUSATIVE FACTORS
• Viruses
• Chemical carcinogens
• Physical stressors
• Hormonal factors
• Genetic factors

29. CANCER NURSING
Etiology of cancer
1. PHYSICAL AGENTS
 Radiation
 Exposure to irritants
 Exposure to sunlight
 Altitude, humidity

30. CANCER NURSING
Etiology of cancer
2. CHEMICAL AGENTS
 Smoking
 Dietary ingredients
 Drugs

31. CANCER NURSING
Etiology of cancer
3. Genetics and Family History
 Colon Cancer
 Premenopausal breast cancer

32. CANCER NURSING
Etiology of cancer
4. Dietary Habits
 Low-Fiber
 High-fat
 Processed foods
 alcohol

33. CANCER NURSING
Etiology of cancer
5. Viruses and Bacteria
 DNA viruses- HepaB, Herpes, EBV, CMV,
Papilloma Virus
 RNA Viruses- HIV, HTCLV
 Bacterium- H. pylori

34. CANCER NURSING
Etiology of cancer
 6. Hormonal agents
 DES
 OCP especially estrogen

35. CANCER NURSING
Etiology of cancer
 7. Immune Disease
 AIDS

40.  BURKITT’S LYMPHOMA - a cancer of the
lymphatic system

48. Classification of Cancer
According to Behavior of Tumor
• Benign - tumors that cannot spread by
invasion or metastasis; hence, they only grow
locally
• Malignant - tumors that are capable of
spreading by invasion and metastasis. By
definition, the term “cancer”

51. Patterns of cell Proliferation
• Hyperplasia
• Dysplasia
• Metaplasia
• Anaplasia
• Neoplasia

55. Patterns of cell Proliferation
•Metaplasia
• conversion of one type of cell in a tissue to
another type not normal for that tissue
•Anaplasia
• change in the DNA cell structure and orientation
to one another, characterized by loss of
differentiation and a return to a more primitive
form.
Neoplasia
• uncontrolled cell growth, either benign or
malignant

56. Metastasis
• Metastasis: 3 stages
– Invasion – neoplastic cells from primary
tumor invade into surrounding tissue with
penetration of blood or lymph.
– Spread – tumor cells spread through lymph
or circulation or by direct expansion
– Establishment and growth – tumor cells are
established and grow in secondary site:
lymph nodes or in organs from venous
circulation

57. CANCER NURSING
Spread of Cancer
 1. LYMPHATIC
 Most common
 2. HEMATOGENOUS
 Blood-borne, commonly to Liver and Lungs
 3. DIRECT SPREAD
 Seeding of tumors

58. CANCER NURSING
Body Defenses Against TUMOR
 1. T cell System/ Cellular Immunity
 Cytotoxic T cells kill tumor cells
 2. B cell System/ Humoral immunity
 B cells can produce antibody
 3. Phagocytic cells
 Macrophages can engulf cancer cell debris

62. Classification of Tumors
• CARCINOMAS: EPITHELIAL TISSUE
– BODY SURFACES, LINING OF BODY CAVITIES
ETC: (ADENOCARCINOMA)
• SARCOMAS: CONNECTIVE TISSUE
– STRIATED MUSCLE, BONE, ETC
(OSTEOSARCOMA)
• LYMPHOMAS AND LEUKEMIAS
– HEMATOPOIETIC SYSTEM
• NERVOUS TISSUE TUMORS
– EX. NERVE CELLS-NEUROBLASTOMA
• MYELOMA
– Develops in the plasma cells of bone marrow

66. Effects of Cancer
• Disruption of Function- can be due to
obstruction or pressure
• Hematologic Alterations: can impair function
of blood cells
• Hemorrhage: tumor erosion, bleeding, severe
anemia
• Anorexia-Cachexia Syndrome: wasted
appearance of client

67. Effects of Cancer
• Paraneoplastic Syndromes: ectopic sites
with excess hormone production
– ↑ Parathyroid hormone→ hypercalcemia
– ↑ secretion of insulin→ hypoglycemia
– ↑ Antidiuretic hormone (ADH) → fluid
retention, HTN & peripheral edema
• ↑ Adrenocorticotropic hormone (ACTH):
cause excessive secretion of cortisone (ie:
fluid retention, ↑ glucose levels)

68. Effects of Cancer
• Pain: major concern of clients and
families associated with cancer
• Physical Stress: body tries to respond and
destroy neoplasm

69. ASSESSMENT
• Nursing History
– Health History – chief complaint and
history of present illness (onset, course,
duration, location, precipitating and
alleviating factors)
– Cancer signs: CAUTION US!

70. WARNING SIGNS OF CANCER
CAUTION US!
– Change in bowel or bladder habits
– A sore that does not heal
– Unusual bleeding or discharge
– Thickenings or lumps
– Indigestion or difficulty in swallowing
– Obvious change in a wart or mole
– Nagging or persistent cough or hoarseness
– Unexplained anemia
– Sudden unexplained weight loss

71. Change in bowel or bladder habits
– A person with colon cancer may have
diarrhea or constipation, or he may notice
that the stool has become smaller in
diameter
– A person with bladder or kidney cancer

72. A sore that does not heal
– Small, scaly patches on the skin that
bleed or do not heal may be a sign of skin
cancer
– A sore in the mouth that does not heal can
indicate oral cancer

73. • Unusual bleeding or discharge
– Blood in the stool is often the first sign of
colon cancer
– Similarly, blood in the urine is usually the
first sign of bladder or kidney cancer
– Postmenopausal bleeding (bleeding after
menopause) may be a sign of uterine
cancer

74. • Thickenings or lumps
– Enlargement of the lymph nodes or glands
(such as the thyroid gland) can be an early
sign of cancer
– Breast and testicular cancers may also
present as a lump

75. • Indigestion or difficulty in
swallowing
– Cancers of the digestive system, including
those of the esophagus, stomach, and
pancreas, may cause indigestion,
heartburn, or difficulty swallowing

76. • Obvious change in a wart or mole
– Moles or other skin lesions that change in
shape, size, or color should be reported

77. • Nagging or persistent cough or
hoarseness
– Cancers of the respiratory tract, including
lung cancer and laryngeal cancer, may
cause a cough that does not go away or a
hoarse (rough) voice

78. • Unexplained anemia
• Sudden unexplained weight loss

79. PHYSICAL ASSESSMENT
• Inspection – skin and mucus membranes for
lesions, bleeding, petechiae, and irritation
– Assess stools, urine, sputum, vomitus for acute or
occult bleeding
– Scalp noting hair texture and hair loss
• Palpation
– Abdomen for any masses, bulges or abnormalities
– Lymph nodes for enlargement
• Auscultation – of lung sounds, heart sounds
and bowel sounds

80. Laboratory & Diagnostic
Tests • Cancer detection examination
• Laboratory tests
– Complete blood cell count (CBC)
– Tumor markers – identify substance (specific
proteins) in the blood that are made by the tumor
• PSA (Prostatic-specific antigen): prostate cancer
• CEA (Carcinoembryonic antigen): colon cancer
• Alkaline Phosphatase: bone metastasis
– Biopsy

81. Diagnostic Tests
• Determine location of cancer:
– X-rays
– Computed tomography
– Ultrasounds
– Magnetic resonance imaging
– Nuclear imaging
– Angiography

82. • Diagnosis of cell type:
– ▪Tissue samples: from biopsies, shedded cells (e.g.
Papanicolaou (PAP) smear), & washings
– ▪ Cytologic Examination: tissue examined under
microscope

83. • Direct Visualization:
– ▪ Sigmoidoscopy
– ▪ Cystoscopy
– ▪ Endoscopy
– ▪ Bronchoscopy
– ▪ Exploratory surgery; lymph node biopsies to
determine metastases

92. Tumor Staging and Grading
• Staging determines size of tumor and existence of
metastasis
• Grading classifies tumor cells by type of tissue
• The TNM system is based on the extent of the tumor
(T), the extent of spread to the lymph nodes (N),
and the presence of metastasis (M).

93. Primary Tumor (T)
TX - Primary tumor cannot be evaluated
T0 - No evidence of primary tumor
Tis - Carcinoma in situ (early cancer that has not spread to neighboring
tissue)
T1, T2, T3, T4 - Size and/or extent of the primary tumor
Regional Lymph Nodes (N)
NX - Regional lymph nodes cannot be evaluated
N0 - No regional lymph node involvement (no cancer found in the
lymph nodes)
N1, N2, N3 - Involvement of regional lymph nodes (number and/or
extent of spread)
Distant Metastasis (M)
MX - Distant metastasis cannot be evaluated
M0 - No distant metastasis (cancer has not spread to other parts of the
body)
M1 - Distant metastasis (cancer has spread to distant parts of the body)

94. NURSING DIAGNOSES
• Acute or chronic pain
• Impaired skin integrity
• Impaired oral mucous membrane
• Risk for injury
• Risk for infection
• Fatigue
• Imbalanced nutrition: less than body requirements

95. NURSING DIAGNOSES
• Risk for imbalanced fluid volume
• Anxiety
• Disturbed body image
• Deficient knowledge
• Ineffective coping
• Social isolation

96. OUTCOME IDENTIFICATION
1. Pain relief
2. Integrity of skin and oral mucosa
3. Absence of injury and infection
4. Fatigue relief
5. Maintenance of nutritional intake and fluid and
electrolyte balance
6. Improved body image
7. Absence of complications

97. OUTCOME IDENTIFICATION
1. Knowledge of prevention and cancer treatment
2. Effective coping through recovery and grieving
process
3. Optimal social interaction

98. IMPLEMENTATION/MANAGE MENT
• Prevention and detection
– Primary Prevention
• Reducing modifiable risk factors in the external
and internal environment
– Secondary Prevention
• Recognizing early signs and symptoms and
seeking prompt treatment
• Prompt intervention to halt cancerous process

106. SOME CARCINOGENS IN THE
WORKPLACE

108. TREATMENT MODALITIES
• Aimed towards:
– CURE - free of disease after treatment → normal
life
– Control - Goal for chronic cancers
– Palliative Care: Quality of life maintained at
highest level for the longest possible time

109. • Surgery – surgical removal of tumors; most commonly
used treatment
• Preventive or prophylactic
• Diagnostic surgery
• Curative surgery
• Reconstructive surgery
• Palliative surgery
• Chemotherapy – use of antineoplastic drugs to
promote tumor cell death, by interfering with
cellular functions and reproduction

110. • Radiotherapy – directing high-energy ionizing
radiation to destroy malignant tumor cells
without harming surrounding tissues
Types:
– Teletherapy (external): radiation delivered in
uniform dose to tumor; Teletherapy is external
beam irradiation and uses a device located at a
distance from the patient. It produces X-rays of
varying energies and is administered by
machines a distance from the body 31½ to 39
inches (80 to 100 cm).

111. – Brachytherapy: delivers high dose to tumor and
less to other tissues; radiation source is placed in
tumor or next to it; In brachytherapy, the
radiation device is placed within or close to the
target tissue. Radiation is delivered in a high
dose to a small tissue volume with less radiation
to adjacent normal tissue, but requires direct
tumor access.

113. • Immunotherapy – use of chemical or microbial
agents to induce mobilization of immune
defenses.
• Biologic response modifiers (BRMs) – use of
agents that alters immunologic relationship
between tumor and host in a beneficial way

114. • Bone marrow peripheral stem cell
transplantation – aspirating bone marrow cells
from compatible donor and infusing them into
the recipient
• Gene therapy – transfer of genetic materials into
the client’s DNA

115. NURSING MANAGEMENT
1. Promote measures that relieve pain and discomfort.
• Pharmacologic and non-pharmacologic interventions
2. Promote measures to maintain intact skin integrity
3. Promote measures that maintain oral mucosa
4. Promote measures to prevent injury from abnormal
bleeding
• Monitor platelet count; avoid aspiring products, etc

116. NURSING MANAGEMENT
1. Promote measures that identify and prevent infection
• Monitor WBC count; encourage frequent handwashing
and overall cleanliness
2. Help decrease the client’s fatigue and increase his
activity level
3. Promote measures that ensure adequate nutritional
intake
• High protein, high calorie diet
4. Ensure adequate fluid and electrolyte balance

117. NURSING MANAGEMENT
1. Promote measures to enhance body image.
• Take an honest gentle, caring approach; encourage
client to express and verbalize feelings
2. Promote measures that address preventing
complications of cancer therapy
3. Instruct client and family about the disease process
and treatments; provide necessary information for self-
care.
4. Help client and family cope effectively
5. Promote measures to reduce social isolation.

118. Care of Clients Receiving Chemotherapy
• Classes of Chemotherapy Drugs:
• Alkylating agents:
– Action: create defects in tumor DNA
– Ex: Nitrogen Mustard, Cisplatin
– Toxic Effects: reversible renal tubular necrosis

119. Classes of Chemotherapy Drugs
• Antimetabolites:
– Action: phase specific
– Ex: Methotrexate; 5 fluorouracil
– Toxic Effects: nausea, vomiting, stomatitis,
diarrhea, alopecia, leukopenia

120. Classes of Chemotherapy Drugs
• Antitumor Antibiotics:
– Action: non- phase specific; interfere with DNA
– Ex: Actinomycin D, Bleomycin, adriamycin
(doxorubicin)
– Toxic Effect: damage to cardiac muscle

121. Classes of Chemotherapy Drugs
• Miotic inhibitors:
– Action: Prevent cell division during M phase of
cell division
– Ex: Vincristine, Vinblastine
– Toxic Effects: affects neurotransmission,
alopecia, bone marrow depression

122. Classes of Chemotherapy Drugs
• Hormones:
– Action: stage specific G1
– Ex: Corticosteroids
• Hormone Antagonist:
– Action: block hormones on hormone- binding tumors ie:
breast, prostate, endometrium; cause tumor regression
– Ex: Tamoxifen (breast); Flutamide (prostate)
– Toxic Effects: altered secondary sex characteristics

124. Effects of Chemotherapy
• Tissues: (fast growing) frequently affected
• Examples: mucous membranes, hair cells, bone
marrow, specific organs with specific agents,
reproductive organs (all are fetal toxic; impair
ability to reproduce)

125. Chemotherapy Administration
• Routes of administration:
– Oral
– Body cavity (intraperitoneal or intrapleural)
– Intravenous
• Use of vascular access devices because of threat
of extravasation (leakage into tissues) & long term
therapy

126. Chemotherapy Administration
• Types of vascular access devices:
– PICC lines: (peripherally inserted central
catheters)
– Tunneled catheters: (Hickman, Groshong)
– Surgically implanted ports: (accessed with 90o
angle needle- Huber needles)

127. Nursing care of clients receiving chemotherapy
• Assess and manage:
– Toxic effects of drugs (report to physician)
– Side effects of drugs: manage nausea and vomiting,
inflammation and ulceration of mucous membranes,
hair loss, anorexia, nausea and vomiting with specific
nursing and medical interventions

128. Nursing care of clientsreceiving chemotherapy
• Monitor lab results (drugs withheld if blood
counts seriously low); blood and blood product
administration
• Assess for dehydration, oncologic emergencies
• Teach regarding fatigue, immunosuppression
precautions
• Provide emotional and spiritual support to clients
and families

129. COLON CANCER

130. COLON CANCER
Risk factors
1. Increasing age
2. Family history
3. Previous colon CA or polyps
4. History of IBD
5. High fat, High protein, LOW fiber
6. Breast Ca and Genital Ca

131. COLON CANCER
 Sigmoid colon is the most common site
 Predominantly adenocarcinoma
 If early 90% survival
 34 % diagnosed early
 66% late diagnosis

132. COLON CANCER
PATHOPHYSIOLOGY
 Benign neoplasm DNA alteration malignant
transformation malignant neoplasm  cancer
growth and invasion  metastasis (liver)

133. COLON CANCER
 ASSESSMENT FINDINGS
1. Change in bowel habits- Most
common
2. Blood in the stool
3. Anemia
4. Anorexia and weight loss
5. Fatigue
6. Rectal lesions- tenesmus, alternating D
and C

134. COLON CANCER
 Diagnostic findings
1. Fecal occult blood
2. Sigmoidoscopy and colonoscopy
3. BIOPSY
4. CEA- carcino-embryonic antigen

135. COLON CANCER
 Complications of colorectal CA
1. Obstruction
2. Hemorrhage
3. Peritonitis
4. Sepsis

136. COLON CANCER
 MEDICAL MANAGEMENT
1. Chemotherapy- 5-FU
2. Radiation therapy

137. COLON CANCER
 SURGICAL MANAGEMENT
Surgery is the primary treatment
Based on location and tumor size
Resection, anastomosis, and colostomy (temporary
or permanent)

139. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Colostomy begins to function 3-6 days after
surgery
 The drainage maybe soft/mushy or semi-solid
depending on the site

140. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 BEST time to do skin care is after shower
 Apply tape to the sides of the pouch before
shower
 Assume a sitting or standing position in changing
the pouch

141. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Instruct to GENTLY push the skin down and the
pouch pulling UP
 Wash the peri-stomal area with soap and water
 Cover the stoma while washing the peri-stomal
area

142. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Lightly pat dry the area and NEVER rub
 Lightly dust the peri-stomal area with nystatin
powder

143. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Measure the stomal opening
 The pouch opening is about 0.3 cm larger than
the stomal opening
 Apply adhesive surface over the stoma and press
for 30 seconds

144. COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Empty the pouch or change the pouch when
 1/3 to ¼ full (Brunner)
 ½ to 1/3 full (Kozier)

145. BREAST CANCER
 The most common cancer in FEMALES
 Numerous etiologies implicated

146. BREAST CANCER
RISK FACTORS
1. Genetics
2. Increasing age ( > 50 yo)
3. Family History of breast cancer
4. Early menarche and late menopause
5. Nulliparity
6. Late age at pregnancy

147. BREAST CANCER
RISK FACTORS
7. Obesity
8. Hormonal replacement
9. Alcohol
10. Exposure to radiation

148. BREAST CANCER
PROTECTIVE FACTORS
1. Exercise
2. Breast feeding
3. Pregnancy before 30 yo

150. BREAST CANCER
ASSESSMENT FINDINGS
1. MASS- the most common location is the upper
outer quadrant
2. Mass is NON-tender. Fixed, hard with irregular
borders
3. Skin dimpling
4. Nipple retraction
5. Peau d’ orange

151. BREAST CANCER
LABORATORY FINDINGS
1. Biopsy procedures
2. Mammography

152. BREAST CANCER
Breast cancer Staging
 I - < 2cm
 II - 2 to 5 cm, (+) LN
 III - > 5 cm, (+) LN
 IV- metastasis

153. BREAST CANCER
MEDICAL MANAGEMENT
 1. Chemotherapy
 2. Tamoxifen therapy
 3. Radiation therapy

154. BREAST CANCER
 SURGICAL MANAGEMENT
1. Radical mastectomy
2. Modified radical mastectomy
3. Lumpectomy
4. Quadrantectomy

156. LUMPECTOMY

157. QUADRANTECTOMY

158. BREAST CANCER
NURSING INTERVENTION : PRE-OP
1. Explain breast cancer and treatment
options
2. Reduce fear and anxiety and
improve coping abilities
3. Promote decision making abilities
4. Provide routine pre-op care:
 Consent, NPO, Meds, Teaching about
breathing exercise

159. BREAST CANCER
NURSING INTERVENTION : Post-OP
1. Position patient:
 Supine
 Affected extremity elevated to reduce
edema

160. BREAST CANCER
NURSING INTERVENTION : Post-OP
2. Relieve pain and discomfort
 Moderate elevation of extremity
 IM/IV injection of pain meds
 Warm shower on 2nd
day post-op

161. BREAST CANCER
NURSING INTERVENTION : Post-OP
3. Maintain skin integrity
 Immediate post-op: snug dressing with drainage
 Maintain patency of drain (JP)
 Monitor for hematoma w/in 12H and apply
bandage and ice, refer to surgeon

162. BREAST CANCER
NURSING INTERVENTION : Post-OP
3. Maintain skin integrity
 Drainage is removed when the discharge is
less than 30 ml in 24 H
 Lotions, Creams are applied ONLY when
the incision is healed in 4-6 weeks

163. BREAST CANCER
NURSING INTERVENTION : Post-OP
Promote activity
 Support operative site when moving
 Hand, shoulder exercise done on 2nd
day
 Post-op mastectomy exercise 20 mins TID
 NO BP or IV procedure on operative site

164. BREAST CANCER
NURSING INTERVENTION : Post-OP
Promote activity
 Heavy lifting is avoided
 Elevate the arm at the level of the heart
 On a pillow for 45 minutes TID to relieve
transient edema

165. BREAST CANCER
NURSING INTERVENTION : Post-OP
MANAGE COMPLICATIONS
 Lymphedema
 10-20% of patients
 Elevate arms, elbow above shoulder
and hand above elbow
 Hand exercise while elevated
 Refer to surgeon and physical
therapist

166. BREAST CANCER
NURSING INTERVENTION : Post-OP
MANAGE COMPLICATIONS
 Hematoma
 Notify the surgeon
 Apply bandage wrap (Ace wrap) and ICE pack

167. BREAST CANCER
NURSING INTERVENTION : Post-OP
MANAGE COMPLICATIONS
Infection
 Monitor temperature, redness, swelling and
foul-odor
 IV antibiotics
 No procedure on affected extremity

168. BREAST CANCER
NURSING INTERVENTION : Post-OP
TEACH FOLLOW-UP care
 Regular check-up
 Monthly BSE on the other breast
 Annual mammography

169. THE ENDLUALHATI M. FLORANDA RN MAN