The document discusses oncology nursing and cancer treatment modalities. It defines the 7 cardinal signs of cancer and differentiates between benign and malignant tumors. The goals of cancer therapy are described as curative, control, or palliative. The major cancer treatment modalities - surgery, radiation therapy, and chemotherapy - are explained along with associated nursing interventions. Toxic effects of treatment are outlined and nursing management of side effects is discussed.
Here are some additional common side effects of chemotherapy:
- Mucositis (inflammation and ulcers in the mouth and gastrointestinal tract)
- Dermatologic effects like rashes, dry skin, nail changes
- Hepatotoxicity and kidney toxicity with some agents
- Cardiotoxicity with agents like doxorubicin
- Secondary cancers and myelodysplasia due to mutagenic effects
- Infertility issues depending on the agents used
It's important for nurses to thoroughly assess for and manage side effects during chemotherapy treatment.
A surgical site infection (SSI) occurs after surgery in the part of the body where surgery took place. SSIs increase morbidity, mortality, length of stay, and costs. There are three levels of SSI: superficial, deep, and organ/space. Risk factors include age, obesity, diabetes, and prolonged preoperative stay. Prevention focuses on minimizing contamination, enhancing defenses, and preventing post-op access to the incision through measures like preop showering, appropriate hair removal, proper attire and hand hygiene for staff, judicious antibiotic use, and maintaining patient homeostasis during and after surgery.
Staging of cancer involves assessing how far a cancer has spread both locally and systemically. It is important for determining prognosis and selecting the most appropriate treatment. There are clinical, pathological, and radiological methods used for staging. Clinically, exam assesses tumor size, mobility, and lymph node involvement. Pathological exam of biopsied tissue confirms cancer diagnosis. Radiological exams like mammography, CT, MRI, PET scans provide additional information on tumor characteristics and metastasis. Together these methods are used to divide cancer into stages to guide management and predict outcomes.
This document outlines core components for infection prevention and control (IPC) programs at both the healthcare facility and national levels. It recommends establishing IPC programs with dedicated staff and resources, developing evidence-based guidelines, providing IPC education and training, conducting HAI surveillance, and implementing multimodal strategies using a combination of interventions to improve IPC practices and reduce healthcare-associated infections and antimicrobial resistance. The core components provide guidance on setting up the organizational structures, key activities, and linkages needed for effective IPC programs.
Safe administration & preparation of cancer chemotherapy by irene weruKesho Conference
This document provides information on safe administration and preparation of cancer chemotherapy. It discusses the hazards of anticancer medicines and outlines various safety considerations for personnel, patients, and the environment. Specific guidelines are presented for reconstitution, administration, storage, spill management, oral drug handling, and waste disposal. The importance of patient safety is emphasized, and factors to consider for individual patients are described. Medication errors can occur at various stages, so communication and information sharing need to be standardized. Overall, strict protocols and protective measures are necessary when working with hazardous chemotherapy drugs.
This document provides guidance on managing spills of cytotoxic drugs. It defines a cytotoxic spill as any uncontrolled release of hazardous chemicals, whether solid, liquid, or gas. The recommended procedure is to notify personnel, isolate the spill area, contain the spill, put on protective equipment, clean up the spill using a 5% decon 90 solution, dispose of all contaminated waste properly, wash hands, and file an incident report. Spill kits should contain protective gowns, masks, gloves, waste bags, cleaning supplies, and instructions for managing cytotoxic spills.
This presentaion will show you in simple steps how to handle spills of hazardous drugs and chemotherapy during preparation or administration without being exposed to their harm,
The document provides information on chemotherapy administration including:
1. Chemotherapy involves using drugs to destroy cancer cells by interfering with cellular functions and reproduction.
2. Personal protective equipment like gloves, gowns, and masks should be worn when handling chemotherapeutic agents.
3. The administration process involves preparing medications, inserting IV lines, monitoring for side effects like extravasation during infusion, and documenting the procedure. Management of extravasation or spills should also be followed.
Here are some additional common side effects of chemotherapy:
- Mucositis (inflammation and ulcers in the mouth and gastrointestinal tract)
- Dermatologic effects like rashes, dry skin, nail changes
- Hepatotoxicity and kidney toxicity with some agents
- Cardiotoxicity with agents like doxorubicin
- Secondary cancers and myelodysplasia due to mutagenic effects
- Infertility issues depending on the agents used
It's important for nurses to thoroughly assess for and manage side effects during chemotherapy treatment.
A surgical site infection (SSI) occurs after surgery in the part of the body where surgery took place. SSIs increase morbidity, mortality, length of stay, and costs. There are three levels of SSI: superficial, deep, and organ/space. Risk factors include age, obesity, diabetes, and prolonged preoperative stay. Prevention focuses on minimizing contamination, enhancing defenses, and preventing post-op access to the incision through measures like preop showering, appropriate hair removal, proper attire and hand hygiene for staff, judicious antibiotic use, and maintaining patient homeostasis during and after surgery.
Staging of cancer involves assessing how far a cancer has spread both locally and systemically. It is important for determining prognosis and selecting the most appropriate treatment. There are clinical, pathological, and radiological methods used for staging. Clinically, exam assesses tumor size, mobility, and lymph node involvement. Pathological exam of biopsied tissue confirms cancer diagnosis. Radiological exams like mammography, CT, MRI, PET scans provide additional information on tumor characteristics and metastasis. Together these methods are used to divide cancer into stages to guide management and predict outcomes.
This document outlines core components for infection prevention and control (IPC) programs at both the healthcare facility and national levels. It recommends establishing IPC programs with dedicated staff and resources, developing evidence-based guidelines, providing IPC education and training, conducting HAI surveillance, and implementing multimodal strategies using a combination of interventions to improve IPC practices and reduce healthcare-associated infections and antimicrobial resistance. The core components provide guidance on setting up the organizational structures, key activities, and linkages needed for effective IPC programs.
Safe administration & preparation of cancer chemotherapy by irene weruKesho Conference
This document provides information on safe administration and preparation of cancer chemotherapy. It discusses the hazards of anticancer medicines and outlines various safety considerations for personnel, patients, and the environment. Specific guidelines are presented for reconstitution, administration, storage, spill management, oral drug handling, and waste disposal. The importance of patient safety is emphasized, and factors to consider for individual patients are described. Medication errors can occur at various stages, so communication and information sharing need to be standardized. Overall, strict protocols and protective measures are necessary when working with hazardous chemotherapy drugs.
This document provides guidance on managing spills of cytotoxic drugs. It defines a cytotoxic spill as any uncontrolled release of hazardous chemicals, whether solid, liquid, or gas. The recommended procedure is to notify personnel, isolate the spill area, contain the spill, put on protective equipment, clean up the spill using a 5% decon 90 solution, dispose of all contaminated waste properly, wash hands, and file an incident report. Spill kits should contain protective gowns, masks, gloves, waste bags, cleaning supplies, and instructions for managing cytotoxic spills.
This presentaion will show you in simple steps how to handle spills of hazardous drugs and chemotherapy during preparation or administration without being exposed to their harm,
The document provides information on chemotherapy administration including:
1. Chemotherapy involves using drugs to destroy cancer cells by interfering with cellular functions and reproduction.
2. Personal protective equipment like gloves, gowns, and masks should be worn when handling chemotherapeutic agents.
3. The administration process involves preparing medications, inserting IV lines, monitoring for side effects like extravasation during infusion, and documenting the procedure. Management of extravasation or spills should also be followed.
Surgical site infections are infections that occur after surgery in the part of the body where surgery took place. They can range from minor superficial infections to more serious deep tissue infections. Surgical site infections account for around 20% of all healthcare-associated infections and at least 5% of patients who undergo surgery will develop a surgical site infection. The risk factors include patient characteristics like age, diabetes, and obesity as well as surgical factors like long duration of surgery, improper skin preparation, and poor aseptic technique. Preventing surgical site infections requires strategies like proper patient skin preparation before surgery, appropriate use of antimicrobial prophylaxis during surgery, and careful wound care after surgery.
Nursing care of clients with mental health disordersangeee2005
This document discusses nursing care for clients with mental health disorders. It defines characteristics of mental health and explains that mental disorders are caused by various genetic, biological, social and environmental factors. The document outlines the five-axis diagnosis system used in psychiatry and describes the role of nurses as part of a multidisciplinary treatment team. Key points covered include the stigma surrounding mental illness, its historical treatment, and advocacy efforts to support the vulnerable mentally ill population.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
Chemotherapy involves the use of antineoplastic drugs to treat cancer by interfering with cell functions and reproduction. The objectives of chemotherapy are to maximize cancer cell death, cure cancer if possible, control tumor growth when cure is not possible, and extend life and improve quality of life. Chemotherapy drugs work through various mechanisms like limiting DNA synthesis and causing DNA damage. Drugs are classified based on cell cycle phase specificity and chemical groups. Safe handling of chemotherapy requires proper preparation, administration, and waste disposal to minimize exposure. Patients receiving chemotherapy require management of side effects like fatigue, nausea, mucositis, and monitoring for infections or other complications.
1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 1. Adverse events: An incident which result in harm to the patient. 2. Near Miss: An incident which could resulted in unwanted harm but did not. 3. No-harm events: An incident that occur and reach to the patient but result in no injury.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
12. 1. Diagnosis and management erro
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Cancer of Prostate- Easy PPT for Nursing StudentsSwatilekha Das
Cancer of Prostate- Easy PPT for Nursing Students
Definition & picture
Risk factors
Clinical manifestations
Assessment & diagnostic methods
Medical management
Surgical Management
-Radical prostatectomy
Radiation therapy
Hormone therapy
Other therapies
Thank you
The document analyzes the spatial patterns of common cancers in Saudi Arabia using spatial autocorrelation statistics to detect nonrandom incidence patterns. It finds that lung cancer in males and breast cancer in females exhibited statistically significant clustering in certain regions. Both global and local regression models also revealed significant spatial associations between certain cancer types in Saudi Arabian cities.
This document discusses surgical site infections (SSIs), including definitions, classifications, risk factors, prevention strategies, and assessment methods. It defines SSIs as infections occurring within 30 days of a surgical procedure (or 1 year for implants) that involve the skin or deeper soft tissues at the surgical site. The document outlines classifications for SSIs and wound infections. It also identifies patient, surgical, and anesthetic risk factors and presents guidelines for prevention, including appropriate antibiotic use, glucose control, and hair removal. Methods for assessing wounds and scoring infection severity are also summarized.
The document provides an overview of cancer biology, including key terminology, epidemiology, etiology, prevention, screening, diagnosis, staging, treatment, and biomarkers. It defines various types of cancers and neoplasms, describes the cellular and genetic events leading to cancer development, and outlines the general principles and goals of cancer treatment, which may include surgery, chemotherapy, radiation therapy, and palliative care.
Nosocomial infections, also known as hospital-acquired infections, can develop in patients admitted to hospitals and transmitted through various routes. The magnitude of nosocomial infections in Tanzania is unknown but believed to occur in 5-10% of admitted patients. Risk factors include impaired immunity, pre-existing diseases, immunosuppressive therapies, and medical devices that bypass body defenses. Prevention strategies include establishing infection control programs, practicing sterilization, aseptic techniques, environmental cleaning and disinfection, protective clothing, isolation, surveillance, and rational antibiotic use.
There are many types of cancer treatment. The types of treatment that patient receive will depend on the type of cancer, stage of cancer and how advanced it is.
Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
Infection control and standard safety precautionsmannparashar
This document discusses infection prevention and standard safety measures. It begins by introducing the topic and defining hospital-associated infections. It then covers the chain of infection, types of infections like nosocomial and iatrogenic, common organisms causing infection, and the nursing process for infection control including assessment, diagnosis, goals, and implementation. It details standard, contact, airborne and droplet precautions. It concludes by discussing the roles and responsibilities of infection control nurses.
This document discusses colorectal cancer. Some key points:
- Colorectal cancer is the second most common cause of cancer deaths in North America. It affects the colon and rectum.
- Risk factors include family history, age over 50, inflammatory bowel disease, poor diet, smoking, and diabetes. Genetic changes like mutations in APC and DNA repair genes contribute to colorectal cancer development.
- Screening tools include fecal occult blood tests, sigmoidoscopy, colonoscopy, and virtual colonoscopy. Screening guidelines vary but generally recommend annual fecal tests, sigmoidoscopy every 5 years, or colonoscopy every 10 years starting at age 50. Family history of colorectal cancer may
Infection Control in Intensive Care Unit: Role of NursesVIKAS MISKIN
This slide contains Infection control, MRSA Infection, Sterilization, Disinfection, infection control team, infection control nurse, nursing process in infection control
The document discusses infection control procedures for healthcare workers. It covers the goals of infection control training which are to educate workers on pathogen transmission in the workplace and apply principles to minimize risks. Standard precautions that should be used with all patients are outlined, including hand hygiene, use of gloves, gowns and masks. Additional contact and airborne precautions are described for patients with certain infections.
Oral Cancer is an uncontrollable growth of cells which invades the vital structure. It can occur anywhere in the mouth. It occurs due to tobacco use, Areca nut, Alcohol, Poor nutrition, HPV virus, Genetic factors, Chronic trauma.
A red and white patches on lips or gum tongue or Buccal Mucosa having symptoms of pain, hoarseness of voices, loosening of teeth, Biopsy, Endoscopy, Imaging Technique are some way of examination.
Treated by Surgery , Radiation Therapy, Chemotherapy, Brachial Therapy.
Habit Cessation and Maintenance of oral hygiene prevents Cancer.
Call us regarding Oral cancer and its Treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Hospital acquired infections (HAIs) are infections patients get while receiving medical treatment for other conditions in a hospital. The document discusses factors that promote HAIs like decreased immunity and invasive medical procedures. It also outlines common types of HAIs like surgical site infections and UTIs. The impacts of HAIs include increased hospital stays, additional costs, and transmission of organisms to the community. Preventing the spread requires proper hand hygiene, environmental cleaning, and disinfection of medical equipment. Hospitals should have infection control committees and programs to conduct surveillance and promote prevention practices.
Sarcomas are rare cancers that develop in connective tissues like bone and soft tissues. There are two main types - bone sarcomas and soft tissue sarcomas. Common soft tissue sarcomas include angiosarcoma, fibrosarcoma, and leiomyosarcoma. The causes are often unknown but can be related to genetic syndromes, radiation exposure, or chemicals. Symptoms depend on the location but may include lumps, swelling, or pain. Diagnosis involves imaging tests, biopsy, and determining if the cancer has spread. Treatment options include surgery, radiation, chemotherapy, targeted therapies, and immunotherapy. Rehabilitation can help cope with effects.
The document summarizes several studies presented at the 2008 Gastrointestinal Cancers Symposium. The PACCE trial found that adding panitumumab to oxaliplatin or irinotecan chemotherapy did not improve outcomes and increased toxicity. The FFCD trial found higher response rates with 5-FU/irinotecan vs 5-FU alone in elderly patients with colorectal cancer. The X-ACT trial showed a trend toward improved survival with capecitabine vs 5-FU/LV as adjuvant therapy. Studies also suggested intermittent oxaliplatin dosing may improve outcomes and that KRAS mutation status predicts response to anti-EGFR antibodies like panitumumab.
What Next? Answering the question of life after chemotherapy at Memorial Sloa...Joseph Gray
A service design concept providing continuity of psychosocial care for chemotherapy patients at Memorial Sloan Kettering Cancer Center. Service Design Seminar, IIT Institute of Design, Chicago. Taught by Mark Jones of IDEO. Team members: Jessica Striebich, Nikhil Mathew, Joe Gray, and Julia Lyoo.
Surgical site infections are infections that occur after surgery in the part of the body where surgery took place. They can range from minor superficial infections to more serious deep tissue infections. Surgical site infections account for around 20% of all healthcare-associated infections and at least 5% of patients who undergo surgery will develop a surgical site infection. The risk factors include patient characteristics like age, diabetes, and obesity as well as surgical factors like long duration of surgery, improper skin preparation, and poor aseptic technique. Preventing surgical site infections requires strategies like proper patient skin preparation before surgery, appropriate use of antimicrobial prophylaxis during surgery, and careful wound care after surgery.
Nursing care of clients with mental health disordersangeee2005
This document discusses nursing care for clients with mental health disorders. It defines characteristics of mental health and explains that mental disorders are caused by various genetic, biological, social and environmental factors. The document outlines the five-axis diagnosis system used in psychiatry and describes the role of nurses as part of a multidisciplinary treatment team. Key points covered include the stigma surrounding mental illness, its historical treatment, and advocacy efforts to support the vulnerable mentally ill population.
This document discusses cancer screening guidelines for several common cancers. It recommends screening for breast cancer with annual mammograms and clinical exams starting at age 40, and beginning earlier or including MRI for those at high risk. Cervical cancer screening should begin at age 21 with Pap tests every 3 years or co-testing with HPV every 5 years. Colorectal cancer screening options include colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal tests. Genetic screening is recommended for those with a family history suggesting inherited cancer risk. Lung cancer screening with low-dose CT is advised for high-risk smokers aged 55-74. Prostate cancer screening involves PSA testing and DRE for men aged 50-69
Chemotherapy involves the use of antineoplastic drugs to treat cancer by interfering with cell functions and reproduction. The objectives of chemotherapy are to maximize cancer cell death, cure cancer if possible, control tumor growth when cure is not possible, and extend life and improve quality of life. Chemotherapy drugs work through various mechanisms like limiting DNA synthesis and causing DNA damage. Drugs are classified based on cell cycle phase specificity and chemical groups. Safe handling of chemotherapy requires proper preparation, administration, and waste disposal to minimize exposure. Patients receiving chemotherapy require management of side effects like fatigue, nausea, mucositis, and monitoring for infections or other complications.
1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 1. Adverse events: An incident which result in harm to the patient. 2. Near Miss: An incident which could resulted in unwanted harm but did not. 3. No-harm events: An incident that occur and reach to the patient but result in no injury.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
12. 1. Diagnosis and management erro
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
Cancer of Prostate- Easy PPT for Nursing StudentsSwatilekha Das
Cancer of Prostate- Easy PPT for Nursing Students
Definition & picture
Risk factors
Clinical manifestations
Assessment & diagnostic methods
Medical management
Surgical Management
-Radical prostatectomy
Radiation therapy
Hormone therapy
Other therapies
Thank you
The document analyzes the spatial patterns of common cancers in Saudi Arabia using spatial autocorrelation statistics to detect nonrandom incidence patterns. It finds that lung cancer in males and breast cancer in females exhibited statistically significant clustering in certain regions. Both global and local regression models also revealed significant spatial associations between certain cancer types in Saudi Arabian cities.
This document discusses surgical site infections (SSIs), including definitions, classifications, risk factors, prevention strategies, and assessment methods. It defines SSIs as infections occurring within 30 days of a surgical procedure (or 1 year for implants) that involve the skin or deeper soft tissues at the surgical site. The document outlines classifications for SSIs and wound infections. It also identifies patient, surgical, and anesthetic risk factors and presents guidelines for prevention, including appropriate antibiotic use, glucose control, and hair removal. Methods for assessing wounds and scoring infection severity are also summarized.
The document provides an overview of cancer biology, including key terminology, epidemiology, etiology, prevention, screening, diagnosis, staging, treatment, and biomarkers. It defines various types of cancers and neoplasms, describes the cellular and genetic events leading to cancer development, and outlines the general principles and goals of cancer treatment, which may include surgery, chemotherapy, radiation therapy, and palliative care.
Nosocomial infections, also known as hospital-acquired infections, can develop in patients admitted to hospitals and transmitted through various routes. The magnitude of nosocomial infections in Tanzania is unknown but believed to occur in 5-10% of admitted patients. Risk factors include impaired immunity, pre-existing diseases, immunosuppressive therapies, and medical devices that bypass body defenses. Prevention strategies include establishing infection control programs, practicing sterilization, aseptic techniques, environmental cleaning and disinfection, protective clothing, isolation, surveillance, and rational antibiotic use.
There are many types of cancer treatment. The types of treatment that patient receive will depend on the type of cancer, stage of cancer and how advanced it is.
Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
Infection control and standard safety precautionsmannparashar
This document discusses infection prevention and standard safety measures. It begins by introducing the topic and defining hospital-associated infections. It then covers the chain of infection, types of infections like nosocomial and iatrogenic, common organisms causing infection, and the nursing process for infection control including assessment, diagnosis, goals, and implementation. It details standard, contact, airborne and droplet precautions. It concludes by discussing the roles and responsibilities of infection control nurses.
This document discusses colorectal cancer. Some key points:
- Colorectal cancer is the second most common cause of cancer deaths in North America. It affects the colon and rectum.
- Risk factors include family history, age over 50, inflammatory bowel disease, poor diet, smoking, and diabetes. Genetic changes like mutations in APC and DNA repair genes contribute to colorectal cancer development.
- Screening tools include fecal occult blood tests, sigmoidoscopy, colonoscopy, and virtual colonoscopy. Screening guidelines vary but generally recommend annual fecal tests, sigmoidoscopy every 5 years, or colonoscopy every 10 years starting at age 50. Family history of colorectal cancer may
Infection Control in Intensive Care Unit: Role of NursesVIKAS MISKIN
This slide contains Infection control, MRSA Infection, Sterilization, Disinfection, infection control team, infection control nurse, nursing process in infection control
The document discusses infection control procedures for healthcare workers. It covers the goals of infection control training which are to educate workers on pathogen transmission in the workplace and apply principles to minimize risks. Standard precautions that should be used with all patients are outlined, including hand hygiene, use of gloves, gowns and masks. Additional contact and airborne precautions are described for patients with certain infections.
Oral Cancer is an uncontrollable growth of cells which invades the vital structure. It can occur anywhere in the mouth. It occurs due to tobacco use, Areca nut, Alcohol, Poor nutrition, HPV virus, Genetic factors, Chronic trauma.
A red and white patches on lips or gum tongue or Buccal Mucosa having symptoms of pain, hoarseness of voices, loosening of teeth, Biopsy, Endoscopy, Imaging Technique are some way of examination.
Treated by Surgery , Radiation Therapy, Chemotherapy, Brachial Therapy.
Habit Cessation and Maintenance of oral hygiene prevents Cancer.
Call us regarding Oral cancer and its Treatment:-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Hospital acquired infections (HAIs) are infections patients get while receiving medical treatment for other conditions in a hospital. The document discusses factors that promote HAIs like decreased immunity and invasive medical procedures. It also outlines common types of HAIs like surgical site infections and UTIs. The impacts of HAIs include increased hospital stays, additional costs, and transmission of organisms to the community. Preventing the spread requires proper hand hygiene, environmental cleaning, and disinfection of medical equipment. Hospitals should have infection control committees and programs to conduct surveillance and promote prevention practices.
Sarcomas are rare cancers that develop in connective tissues like bone and soft tissues. There are two main types - bone sarcomas and soft tissue sarcomas. Common soft tissue sarcomas include angiosarcoma, fibrosarcoma, and leiomyosarcoma. The causes are often unknown but can be related to genetic syndromes, radiation exposure, or chemicals. Symptoms depend on the location but may include lumps, swelling, or pain. Diagnosis involves imaging tests, biopsy, and determining if the cancer has spread. Treatment options include surgery, radiation, chemotherapy, targeted therapies, and immunotherapy. Rehabilitation can help cope with effects.
The document summarizes several studies presented at the 2008 Gastrointestinal Cancers Symposium. The PACCE trial found that adding panitumumab to oxaliplatin or irinotecan chemotherapy did not improve outcomes and increased toxicity. The FFCD trial found higher response rates with 5-FU/irinotecan vs 5-FU alone in elderly patients with colorectal cancer. The X-ACT trial showed a trend toward improved survival with capecitabine vs 5-FU/LV as adjuvant therapy. Studies also suggested intermittent oxaliplatin dosing may improve outcomes and that KRAS mutation status predicts response to anti-EGFR antibodies like panitumumab.
What Next? Answering the question of life after chemotherapy at Memorial Sloa...Joseph Gray
A service design concept providing continuity of psychosocial care for chemotherapy patients at Memorial Sloan Kettering Cancer Center. Service Design Seminar, IIT Institute of Design, Chicago. Taught by Mark Jones of IDEO. Team members: Jessica Striebich, Nikhil Mathew, Joe Gray, and Julia Lyoo.
Christi R. Lanphier has over 15 years of experience in nursing and healthcare. She received her Bachelor's degree in Nursing from Georgia Baptist College of Nursing in 2006. She is currently a Clinical Manager at Northwest Georgia Oncology where she oversees communication between physicians and staff, schedules staff, and leads meetings. Prior to her manager role, she worked as an Infusion Nurse at Northwest Georgia Oncology and in pediatric clinics.
Every crisis offers extra power and an opportunity for something new. A crisis can occur on a personal or societal level and represents a traumatic change and unstable situation, such as in politics, society, economics, or the military. While crises are painful and difficult, recognizing the opportunity within a crisis is important. The Chinese symbol for crisis contains the symbols for both danger and opportunity. Having strong faith during a crisis allows one to convert it into an opportunity and achieve more than one thought possible.
Building electronic chemotherapy order by RabbitChemorabbitchemo
RabbitChemo, a web based chemotherapy order service, is set to launch a beta version soon. We are excited to bring the benefits of internet to medical professional workplace to change how chemotherapy order works today.
This document discusses various aspects of cancer treatment, including:
1. Local and systemic cancer treatments such as surgery, radiotherapy, chemotherapy, hormone therapy, and biological response modifiers. It also discusses different types, mechanisms of action, and targets of chemotherapy drugs.
2. The cell cycle and how different chemotherapy drugs target specific phases of the cell cycle. It provides details on chemotherapy administration, indications, contraindications, and monitoring.
3. Side effects of chemotherapy drugs on different organ systems. It also discusses concepts like drug resistance, dose modification, and the relationship between dose intensity and treatment response.
This document summarizes research on improving adherence to oral chemotherapy through nursing interventions. It describes barriers to adherence such as side effects and costs. It then outlines several studies that tested nursing interventions like education using tools like MOATT, follow-up calls, and oral chemotherapy clinics. These interventions showed improvements in medication knowledge and adherence and reduced side effects and health care costs. The document advocates for standardizing oral chemotherapy education and monitoring to help patients better manage treatment at home.
This document outlines the education and monitoring required for home chemotherapy patients. It discusses providing education to patients regarding possible complications, performing assessments, and tailoring instructions to individual needs. Key points of education include monitoring for signs of infection, diet and oral care, neutropenic precautions, and when to call the nurse. The overall goals are to safely administer chemotherapy at home and improve patients' quality of life.
Nursing care of patients undergoing chemotherapy requires thorough assessment, monitoring for side effects, and communication. Nurses must understand the treatment plan including drugs, dosages, and potential side effects. During chemotherapy, nurses monitor patient responses, document signs and symptoms, and inform the healthcare team. Chemotherapy administration requires careful preparation, administration through appropriate routes like intravenous, and safe disposal of supplies and unused drugs. Nurses must also properly manage any chemotherapy spills.
Chemotherapy safety and handling-Thao's presentationHA VO THI
This document discusses chemotherapy safety and handling guidelines. It outlines the risks of hazardous drug exposure, engineering controls like ventilation requirements, personal protective equipment, safe storage, compounding and administration practices, decontamination procedures, medical surveillance, and future steps for improving safety in Vietnam. The key points are that chemotherapy drugs pose risks and strict protocols are needed to minimize exposure for healthcare workers handling these agents.
Faye Glenn Abdellah was a pioneering nurse who developed a "typology of 21 nursing problems" to identify and classify common patient needs and guide nursing care. Her framework categorized problems into physical, sociological, emotional needs; nurse-patient relationships; and elements of patient care. Abdellah believed this typology would provide a method to evaluate nursing students' experiences and competencies. Some of the 21 problems addressed basic needs like hygiene, activity, and safety, as well as sustaining needs such as nutrition, elimination and regulatory functions, and remedial needs such as communication and spiritual goals. Abdellah's theory stated that nursing involves using problem-solving to address patients' health needs through key nursing
This document discusses the nurse's role in chemotherapy. It covers classification of chemotherapy drugs which target different parts of the cell cycle. It describes targeted therapy drugs that identify specific cancer cells. The indications for chemotherapy include neoadjuvant, induction, consolidation, adjuvant, and maintenance. Preparation of chemotherapy drugs requires special equipment for safety. Routes of administration include oral, subcutaneous, intravenous, intra-thecal, intravesical, and intraperitoneal. Central lines like PICCs and ports are described along with complications and side effects of chemotherapy.
The document summarizes recommendations for nurse follow-up of patients on oral chemotherapy at CCH Paynesville, Specialty Services-Oncology. It provides background information on oral chemotherapy and discusses the importance of patient education and monitoring by nurses. The document recommends that nurses follow-up with patients weekly for the first month, every other week for months two and three, and monthly thereafter. It also provides tips on documenting education and monitoring side effects.
This document provides information about chemotherapy treatment and common side effects to patients at the Lions Gate Hospital Dr. Paul Klimo Medical Oncology Clinic. It discusses how chemotherapy works, potential side effects that can affect normal cells like bone marrow, mouth, nerves, reproductive organs and hair follicles. It also outlines signs of low blood cell counts and provides tips for managing common side effects like nausea, vomiting, diarrhea, constipation and fatigue. Patients are advised to contact the oncology clinic about fever, infections or other concerning symptoms.
This presentation is part of the theoretical and practical training course for oncology nurses of Bugando Medical Centre (Tanzania) that our institute organized in collaboration with Dr Nestory Masalu, Prof Dino Amadori, Dr Patrizia Serra, Dr Carla Masini, Dr Marina Bragagni and Dr Ivana Barlati. It was for all of us an amazing experience sharing with Tanzanian Colleagues these information.
Faye Glenn Abdellah was an influential American nursing theorist and public health scientist. She developed a theory that identified 21 common nursing problems experienced by patients. These problems focused on maintaining physiological needs, sustaining care needs, remedial care needs, and restorative care needs. Abdellah's theory transformed nursing from a disease-centered focus to a patient-centered approach and helped establish nursing diagnosis as a formal step in the nursing process. Her work has significantly influenced nursing education, practice, and research.
cancer of the oral cavity and pharynxnx.pptxRamya569989
This document provides information about cancer of the oral cavity and pharynx. It discusses the incidence, risk factors, clinical manifestations, diagnosis, medical management including surgery and radiation therapy, and nursing management focusing on promoting mouth care, ensuring adequate nutrition, supporting self-image, minimizing pain, and preventing infection. The nursing management aims to help patients cope with treatment side effects and maintain quality of life.
Post-operative care involves monitoring the patient's ABCDEs and vital signs. Oxygen therapy is usually provided until the anaesthetic dissipates. Specific considerations depend on the surgery and may involve drain monitoring, stoma care, or extensive physiotherapy. Pain assessment and management is fundamental, using tools like scales and working with a multi-disciplinary team using medication, positioning, and early mobilization. Mobility should begin within 24 hours to prevent complications while monitoring the patient's condition and risks.
Importance of taking medical history prior to implant placement/ dental crown...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This document provides information about breast cancer including its definition, anatomy, risk factors, etiological factors, pathophysiology, clinical manifestations, stages, diagnostic tests, treatment, management, and nursing care. It discusses how breast cancer begins in the ductal or lobular cells and can spread through the lymphatic system and bloodstream. Risk factors include family history, obesity, lack of breastfeeding. Treatment may involve surgery, radiation, chemotherapy, hormone therapy and pain management. Nursing care focuses on education, managing anxiety and pain, and promoting healthy coping.
The document contains information about various nursing theories, models, concepts and their originators. It discusses theories such as Maslow's hierarchy of needs, Roy's adaptation model, Orlando's nursing process theory, Levine's conservation principles, Johnson's behavioral systems model, Orem's self-care deficit theory, Peplau's interpersonal theory, King's goal attainment theory, Newman's theory of health as expanding consciousness, Neuman's systems model, Parse's theory of human becoming, Watson's theory of human caring, Henderson's 14 basic needs, Abdellah's 21 nursing problems, Erikson, Tomlin and Swain's modeling and role-modeling theory, and Weidenbach's view on the nurse's individual
The nursing care plan assessed a client with easy bruising and weakness, diagnosed a risk for infection due to low blood counts, and planned short-term goals of stabilizing vital signs and long-term goals of healing wounds and increasing nutrition through dietary changes and medication.
Module 02 - Multidimensional Care StrategiesNursing Care.docxaudeleypearl
Module 02 - Multidimensional Care Strategies
Nursing Care
Nursing care of the patient experiencing reproductive disorders requires a collaborative approach. Nursing care is dependent on the type of disorder and treatment. A multidimensional care approach encompasses the physical, developmental, emotional, cultural, intellectual, and spiritual aspects of nursing care to ensure that all needs of the patient are being met. Patient and family education is ongoing throughout the patient’s stay to improve overall health following discharge.
Nursing care of a patient experiencing male reproductive disorders, as well as sexually transmitted infections, includes general nursing care interventions such:
Monitoring vital signs.
System focused assessment.
Monitoring laboratory/other diagnostic study results and reporting abnormalities and providing prescribed treatment.
Monitoring intake and output.
Assessing for signs and symptoms of complications and adverse effects of treatment.
Administration of prescribed medication, including chemotherapy.
Specialized care must be taken when administering chemotherapy; chemotherapy precautions must be implemented to protect the patient, family, and staff. Specialized handling of chemotherapy agents is included in these precautions.
Multidimensional patient care needs can be met by conducting the appropriate psychosocial, nutritional, spiritual, and cultural assessment. Based on the assessment findings, patient care can be tailored to meet the patient’s needs. Male reproductive disorders and sexually transmitted infections can result in emotional stress as well as anxiety. Early identification of these stressors will help to identify coping strategies for the patient and family.
Patient and family education play a vital role in the care of a patient. Identification of knowledge deficits and providing education on the disease process and treatment options will enable the patient and family to deal with the diagnosis and decide on an appropriate plan that meets their needs.
Some male reproductive disorders may require surgical interventions; nursing care includes preparing the patient for the surgical procedure as well as post-operative monitoring. Post-operative monitoring to reduce the incidence of complications includes encouraging coughing and deep breathing to prevent respiratory complications. Interventions such as early ambulation and venous thromboembolism (pharmacological or mechanical) prophylaxis can assist in the prevention of deep venous thrombosis. Pain assessment and management must be performed to ensure the pain is controlled to promote early ambulation, and coughing and deep breathing to prevent post-operative complications.
Benign Prostatic Hyperplasia
Nursing care of a patient diagnosed with benign prostatic hyperplasia includes conducting a focused assessment regarding urinary elimination, providing privacy and emotional support to the patient, preparing the patient .
Oral Ca-introduction and nursing responsibilitiesssuser002e70
This document discusses various treatment options for oral cancer including hormonal therapy, targeted therapy, immunotherapy, and palliation. It provides details on the mechanisms of action, administration methods, goals, and potential side effects of each treatment type. The role of nurses is also summarized which includes properly educating and supporting patients throughout treatment, managing side effects, and providing psychological and physical comfort during palliative care.
Moniliasis, or candidiasis, is a common fungal infection caused by Candida that usually infects moist areas of the body like the vagina. It is more common in those with diabetes, obesity, pregnancy, or those using antibiotics or hormonal contraceptives. Symptoms include burning, itching, and thick white discharge. Diagnosis involves examination and testing. Treatment consists of antifungal creams or suppositories used for 1-2 weeks. Nursing focuses on pain management, health education to prevent further infections, and monitoring for complications.
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
This 2 minute learning presentation will make you more aware about cancer and how to manage this disease. To cover yourself against critical illness' like cancer, visit us at - http://www.bajajallianz.com/Corp/health/critical-Illness.jsp
CARE OF PATIENTS WITH CANCER BY BHUMIKA.G.THAKORBhumikaThakor1
Nurses play an important role in caring for patients with cancer through all stages of the disease. This includes providing:
1) Education on prevention, screening, and treatment side effects.
2) Symptom management for issues like pain, nutrition problems, fatigue, infection risks, and psychosocial concerns during diagnostic testing, chemotherapy, radiation, and surgery.
3) Tertiary care focusing on palliative care, hospice, and supporting patients' emotional needs and end of life decisions.
The document provides an overview and agenda for a presentation on nutritional care in oncology. It discusses the importance of eating a healthy diet and planning ahead of cancer treatment. It outlines common side effects of various chemotherapy drugs and recommendations for nutritional and personal management of the side effects. The presentation emphasizes the importance of maintaining a positive attitude during treatment.
This document discusses head and neck squamous cell carcinoma (HNSCC), including risk factors such as age and gender, types such as oral cavity cancer and oropharyngeal cancer, clinical manifestations like leukoplakia and erythroplakia, diagnostic studies including biopsy and imaging, and management with surgery, chemotherapy, and radiation therapy. Nursing care focuses on pain management, nutrition, and helping patients cope with changes from treatment.
The document discusses the importance of nutrition during and after radiation therapy for cancer patients. It notes that malnutrition can result from both the cancer itself and side effects of radiation like mucositis and dysphagia. The European Society on Clinical Nutrition and Metabolism guidelines provide recommendations on energy requirements and interventions. A poem then outlines steps for nutrition management during radiation, including maintaining weight, a high-protein diet, and addressing issues like oral candidiasis and electrolyte imbalances. It emphasizes the importance of nutrition surveillance post-radiation to correct fluid-electrolyte problems and address late effects.
ROJoson PEP Talk: CANCER CURABILITY & SURVIVORSHIPReynaldo Joson
The document discusses cancer curability and survivorship. It begins by defining cancer as uncontrolled cell growth that can spread to other tissues. It then notes that while there is no true cure for cancer currently, some cancers may be considered cured if they do not recur within a certain time period, such as 10 years, based on the typical recurrence timelines for different cancer types. The document also discusses how physicians use the term "remission" if cancer is undetectable, but do not guarantee it will not return. It defines a cancer survivor as anyone diagnosed with cancer and notes the speaker's registry of over 150 survivors who have been in remission for 10+ years.
Esophageal Cancer Causes, Symptoms, Diagnosis, and TreatmentChestsurgeryindia
Esophageal Cancer Overview: Causes, Symptoms, Diagnosis, and Treatment
Causes:
Esophageal cancer develops when cells in the esophagus undergo genetic mutations, leading to uncontrolled growth. Risk factors include smoking, excessive alcohol consumption, chronic acid reflux (GERD), obesity, and certain pre-existing conditions like Barrett's esophagus.
Symptoms:
Common symptoms include difficulty swallowing (dysphagia), unintentional weight loss, chest pain or discomfort, indigestion, chronic cough, and hoarseness. Early detection is crucial, as symptoms may not manifest until the cancer is advanced.
Diagnosis:
Diagnostic procedures include endoscopy, where a flexible tube with a camera is inserted to examine the esophagus. Biopsies may be taken for further analysis. Imaging tests like CT scans, PET scans, and endoscopic ultrasound help determine the cancer's extent and staging.
Treatment:
Treatment approaches depend on the cancer's stage. Options include surgery to remove the tumor, chemotherapy, radiation therapy, or a combination. In some cases, targeted therapies and immunotherapy may be employed. Palliative care helps manage symptoms and improve the patient's quality of life.
Early detection and personalized treatment plans are crucial in improving outcomes for esophageal cancer patients. Regular screenings are recommended for individuals with risk factors or persistent symptoms.
cervical cancer is the most common type of cancer in females and death by its meglancy, there are many female who are unaware of this cancer and its treatment, early detection and its treatment can help females in good prognosis and speedly recovery and can be refer by all nursing student for their knowledge, study, improving skills and application in their clinical practices
2. OBJECTIVES:OBJECTIVES:
By the end of this presentation, learnersBy the end of this presentation, learners
will be able to:will be able to:
Define 7 cardinal signs of cancer.Define 7 cardinal signs of cancer.
Differentiate between benign andDifferentiate between benign and
malignant tumor.malignant tumor.
Discuss goals of cancer therapy.Discuss goals of cancer therapy.
Explain in detail about the surgery,Explain in detail about the surgery,
radiation therapy and chemotherapyradiation therapy and chemotherapy
along with there nursing interventions.along with there nursing interventions.
3. 7 WARNING SIGNS OF7 WARNING SIGNS OF
CANCERCANCER
C=C= change in bowel / bladder habitschange in bowel / bladder habits
A=A= a sore throat that does not heala sore throat that does not heal
U=U= unusual bleedingunusual bleeding
T=T= thickening or lump in breastthickening or lump in breast
I=I= indigestion / difficulty in swallowingindigestion / difficulty in swallowing
O=O= obvious change in warts or molesobvious change in warts or moles
NN= nagging, cough and hoarseness= nagging, cough and hoarseness
4. Malignant tumorMalignant tumor
Rapid growthRapid growth
Invasive growthInvasive growth
PoorlyPoorly
demarcateddemarcated
InvasionInvasion
MetastasisMetastasis
Life threateningLife threatening
DIFFERENCE BETWEEN BENIGN AND
MALIGNANT TUMORS
Benign tumorBenign tumor
Slow growthSlow growth
Expansive growthExpansive growth
Well demarcatedWell demarcated
No invasionNo invasion
No metastasisNo metastasis
Rarely a life threatRarely a life threat
5.
6. GOAL OF CANCER THERAPYGOAL OF CANCER THERAPY
Treatment goals may includeTreatment goals may include
the followingthe following
CURATIVE:CURATIVE: treatment shouldtreatment should
completely eradicate thecompletely eradicate the
malignant disease.malignant disease.
CONTROL:CONTROL: managementmanagement
should prolong patient survivalshould prolong patient survival
and inhibition of cancer cellsand inhibition of cancer cells
growth.growth.
PALLIATION:PALLIATION: effectiveeffective
symptomatic treatment shouldsymptomatic treatment should
be given to the patients.be given to the patients.
7. Cont.Cont.
Our main goal for cancer therapyOur main goal for cancer therapy
is to improveis to improve ““QUALITY OFQUALITY OF
LIFE”LIFE” of patients.of patients.
10. Cont.Cont.
Nursing care of the patient undergoingNursing care of the patient undergoing
surgery for cancer includes fosteringsurgery for cancer includes fostering
the patient's understanding of thethe patient's understanding of the
specific procedure and expectedspecific procedure and expected
outcome, preparing the patientoutcome, preparing the patient
physically and psychologically for thephysically and psychologically for the
surgery, reducing anxiety, supportingsurgery, reducing anxiety, supporting
the patient's postoperative physiologicthe patient's postoperative physiologic
stability, relieving pain, preventingstability, relieving pain, preventing
complications, and promotingcomplications, and promoting
compliance with postoperativecompliance with postoperative
instructions.instructions.
11. Cont.Cont.
Cancer patients who areCancer patients who are
undergoing surgery requireundergoing surgery require
general perioperative nursinggeneral perioperative nursing
care.care.
When surgery is used with otherWhen surgery is used with other
treatment methods liketreatment methods like
chemotherapy and radiationchemotherapy and radiation
therapy then postoperativetherapy then postoperative
complications like infection,complications like infection,
impaired wound healing, DVT,impaired wound healing, DVT,
altered renal and pulmonaryaltered renal and pulmonary
functions can be expected.functions can be expected.
12. Cont.Cont.
Nurse should provide educationNurse should provide education
and emotional support to patientand emotional support to patient
and their family by assessingand their family by assessing
the needs.the needs.
Nurse should discuss their fearsNurse should discuss their fears
and coping mechanisms withand coping mechanisms with
them.them.
Nurse should encourage patientNurse should encourage patient
and family to participate activelyand family to participate actively
in decision making process.in decision making process.
13. Cont.Cont.
When patient or family ask about
the results of diagnostic testing and
surgical procedures then nurse’s
response is guided by the
information which physician has
previously conveyed to the patient
and family.
Nurse should frequently
communicate with other health
care team members to be certain
that the information provided is
consistent.
14. Cont.Cont.
After surgery nurse should assessAfter surgery nurse should assess
patient’s response to surgery andpatient’s response to surgery and
monitor patient for possiblemonitor patient for possible
complications like hemorrhage, fluidcomplications like hemorrhage, fluid
electrolyte imbalance,electrolyte imbalance,
thrombophlebitis, homodynamicthrombophlebitis, homodynamic
instability and organ dysfunction.instability and organ dysfunction.
Postoperative teachings regardingPostoperative teachings regarding
self care, nutrition, wound care andself care, nutrition, wound care and
medications should be addressedmedications should be addressed
properly.properly.
15. Cont.Cont.
Nurses have a responsibility toNurses have a responsibility to
coordinate early dischargecoordinate early discharge
planning and home care, asplanning and home care, as
indicated, to ensure continuity ofindicated, to ensure continuity of
care.care.
Referrals must be sent toReferrals must be sent to
appropriate professionals andappropriate professionals and
community support services.community support services.
16. BASIC FACTORS INBASIC FACTORS IN
RADIATION PROTECTIONRADIATION PROTECTION
DISTANCE:DISTANCE: greater distancegreater distance
from source, less exposure tofrom source, less exposure to
radiation.radiation.
TIME:TIME: try to spend less time withtry to spend less time with
in close contact with patient.in close contact with patient.
SHIELDING:SHIELDING: use appropriateuse appropriate
material to absorb radiationmaterial to absorb radiation
energy like lead aprons, glass orenergy like lead aprons, glass or
aluminum shields or rubberaluminum shields or rubber
gloves.gloves.
17. TOXIC EFFECTS OFTOXIC EFFECTS OF
RADIATION & NURSINGRADIATION & NURSING
MANAGEMENTMANAGEMENT
MAINTAIN TISSUE INTEGRITY:MAINTAIN TISSUE INTEGRITY:
Handle skin gently.Handle skin gently.
Inspect skin for integrity and doInspect skin for integrity and do
frequent reassessmentsfrequent reassessments
Do NOT rub affected areaDo NOT rub affected area
Avoid using ointments, powders orAvoid using ointments, powders or
lotion.lotion.
Wash skin only with moisturizing soapWash skin only with moisturizing soap
and waterand water
Protect skin from exposure to sunlight,
chlorinated swimming pools, extreme
temperature.
18. Cont.Cont.
ALOPECIA:ALOPECIA:
Alopecia begins within 2 weeks ofAlopecia begins within 2 weeks of
therapytherapy
Regrowth within 8 weeks ofRegrowth within 8 weeks of
terminationtermination
Encourage to acquire wig before hairEncourage to acquire wig before hair
loss occursloss occurs
Encourage use of attractive scarvesEncourage use of attractive scarves
and hatsand hats
Provide information that hair loss isProvide information that hair loss is
temporary BUT anticipate change intemporary BUT anticipate change in
texture and colortexture and color
19. Cont.Cont.
STOMATITIS:STOMATITIS:
Use soft-bristled toothbrushUse soft-bristled toothbrush
Gentle oral hygiene is essential toGentle oral hygiene is essential to
remove debris, prevent irritation andremove debris, prevent irritation and
promote healing.promote healing.
Oral rinses with saline gargles/ tapOral rinses with saline gargles/ tap
waterwater
Avoid ALCOHOL-based rinsesAvoid ALCOHOL-based rinses
Frequent reassurance thatFrequent reassurance that
symptoms are a result of treatmentsymptoms are a result of treatment
and do not represent deterioration ofand do not represent deterioration of
disease.disease.
20. Cont.Cont.
PROMOTE NUTRITION:PROMOTE NUTRITION:
Serve food in ways to make itServe food in ways to make it
appealingappealing
Consider patient’s preferencesConsider patient’s preferences
Provide small frequent mealsProvide small frequent meals
Avoids giving fluids while eatingAvoids giving fluids while eating
Oral hygiene PRIOR toOral hygiene PRIOR to
mealtimemealtime
Vitamin supplementsVitamin supplements
21. Cont.Cont.
RELIEVE PAIN:RELIEVE PAIN:
Mild pain- NSAIDSMild pain- NSAIDS
Moderate pain- Weak opioidsModerate pain- Weak opioids
Severe pain- MorphineSevere pain- Morphine
Administer analgesics round theAdminister analgesics round the
clock with additional dose forclock with additional dose for
breakthrough painbreakthrough pain
22. Cont.Cont.
DECREASE FATIGUE:DECREASE FATIGUE:
Plan daily activities to allowPlan daily activities to allow
alternating rest periodsalternating rest periods
Light exercise is encouragedLight exercise is encouraged
Small frequent mealsSmall frequent meals
23. Cont.Cont.
RADIATION SICKNESS:RADIATION SICKNESS:
Bed restBed rest
Small frequent feedingsSmall frequent feedings
Increased calories, increasedIncreased calories, increased
protein dietprotein diet
Adequate fluid intakeAdequate fluid intake
Administer vitamins, sedatives,Administer vitamins, sedatives,
antihistamine, antiemeticsantihistamine, antiemetics
Monitor intake and outputMonitor intake and output
24. Cont.Cont.
BONE MARROW DEPRESSION:BONE MARROW DEPRESSION:
Vital signs especially temperatureVital signs especially temperature
CBC monitoringCBC monitoring
Observe signs and symptoms ofObserve signs and symptoms of
infectioninfection
Good oral hygiene-prevent gumGood oral hygiene-prevent gum
bleeding; use soft-bristle toothbrushbleeding; use soft-bristle toothbrush
or non-sting mouthwash.or non-sting mouthwash.
25. Cont.Cont.
IMPROVE BODY IMAGE:IMPROVE BODY IMAGE:
Therapeutic communication isTherapeutic communication is
essentialessential
Encourage independence inEncourage independence in
self-care and decision makingself-care and decision making
Offer cosmetic material likeOffer cosmetic material like
make-up and wigsmake-up and wigs
26. Cont.Cont.
ASSIST IN GRIEVINGASSIST IN GRIEVING
PROCESS:PROCESS:
Some cancers are curableSome cancers are curable
Grieving can be due to loss ofGrieving can be due to loss of
health, income, sexuality, andhealth, income, sexuality, and
body imagebody image
Answer and clarify informationAnswer and clarify information
about cancer and treatmentabout cancer and treatment
optionsoptions
Identify resource peopleIdentify resource people
Refer to support groupsRefer to support groups
27.
28. CHEMOTHERAPYCHEMOTHERAPY
Use of antineoplastic agents toUse of antineoplastic agents to
cure or palliative cancer in ancure or palliative cancer in an
attempt to destroying tumorattempt to destroying tumor
cells by interfering with cellularcells by interfering with cellular
functions.functions.
It is used primarily to treatIt is used primarily to treat
systemic disease rather thansystemic disease rather than
localized treatment. or as anlocalized treatment. or as an
adjuvant therapyadjuvant therapy to reduce
tumor size preoperatively, to
destroy any remaining tumor
cells postoperatively,
29. ADMINISTRATION OFADMINISTRATION OF
CHEMOTHERAPEUTIC AGENTSCHEMOTHERAPEUTIC AGENTS
ROUTES:ROUTES:
TopicalTopical
OralOral
IntravenousIntravenous
IntramuscularIntramuscular
SubcutaneousSubcutaneous
ArterialArterial
IntracavitaryIntracavitary
IntrathecalIntrathecal
Dosage:Dosage:
Based on theBased on the
total bodytotal body
surface areasurface area
PreviousPrevious
response toresponse to
chemotherapychemotherapy
or radiationor radiation
therapytherapy
Functions ofFunctions of
major organmajor organ
system.system.
30. Cont.Cont.
Extravasations is a seriousExtravasations is a serious
problem and has to beproblem and has to be
monitored carefully whilemonitored carefully while
administration ofadministration of vesicantsvesicants
(agents that deposited into(agents that deposited into
subcutaneous tissue and causesubcutaneous tissue and cause
tissue necrosis and damage totissue necrosis and damage to
underlying tendons, nerves andunderlying tendons, nerves and
blood vessels).blood vessels).
31.
32. Cont.Cont.
Indications for extravasations are asIndications for extravasations are as
followfollow
Absence of blood return fromAbsence of blood return from
intravenous catheter.intravenous catheter.
Resistance to blood flow ofResistance to blood flow of
intravenous fluid.intravenous fluid.
Swelling, pain or redness at the site.Swelling, pain or redness at the site.
If it is suspected then medicationIf it is suspected then medication
administration should beadministration should be STOP
immediately, ice should be applied, ice should be applied
and we have to notify physician as heand we have to notify physician as he
has to aspirate the infiltratedhas to aspirate the infiltrated
medication.medication.
33. TOXIC EFFECTS OFTOXIC EFFECTS OF
CHEMOTHERAPEUTIC AGENTSCHEMOTHERAPEUTIC AGENTS
Gastrointestinal system:Gastrointestinal system: nausea /nausea /
vomiting, stomatitis, anorexia,vomiting, stomatitis, anorexia,
mucositis of GI tract, diarrhea.mucositis of GI tract, diarrhea.
Hematopoietic system:Hematopoietic system: bone marrowbone marrow
depression leading to leukemiadepression leading to leukemia
(WBC) , anemia (RBC) and(WBC) , anemia (RBC) and
thrombocytopenia (platelets).thrombocytopenia (platelets).
Renal system:Renal system: damage to kidney,damage to kidney,
hyperkalemia, hyperphosphatemia,hyperkalemia, hyperphosphatemia,
hypocalcemia so have to monitorhypocalcemia so have to monitor
serum electrolytes.serum electrolytes.
34. Cont.Cont.
Cardiopulmonary system:Cardiopulmonary system: irreversibleirreversible
cardiac toxicities, so have to closelycardiac toxicities, so have to closely
monitor ejection fraction (volume of bloodmonitor ejection fraction (volume of blood
with each heart beat) and signs of heartwith each heart beat) and signs of heart
failure.failure.
Reproductive system:Reproductive system: testicular andtesticular and
ovarian functions are affected.ovarian functions are affected.
Reproductive cell are damaged resulting iReproductive cell are damaged resulting i
chromosomal abnormalities in offsprings.chromosomal abnormalities in offsprings.
Integumentary system:Integumentary system: alopecia, localalopecia, local
skin irritation.skin irritation.
35. Cont.Cont.
Neurologic system:Neurologic system: neurologicneurologic
damage can occur withdamage can occur with
repeated doses. Peripheralrepeated doses. Peripheral
neuropathies, loss of DT,neuropathies, loss of DT,
hearing losshearing loss and paralytic ileusand paralytic ileus
may occur.may occur.
Miscellaneous:Miscellaneous: Fatigue whichFatigue which
can affect quality of life.can affect quality of life.
36. NURSING MANAGEMENT INNURSING MANAGEMENT IN
CHEMOTHERAPYCHEMOTHERAPY
The goal of nursing interventions isThe goal of nursing interventions is
to prevent or minimize side effectsto prevent or minimize side effects
caused by cancer treatments.caused by cancer treatments.
Providing nursing care to patientsProviding nursing care to patients
receiving chemotherapy presentsreceiving chemotherapy presents
many challenges.many challenges.
Antineoplastic drugs have systemicAntineoplastic drugs have systemic
effects on normal cells as well aseffects on normal cells as well as
on malignant cells, thereforeon malignant cells, therefore
chemotherapy usually affect manychemotherapy usually affect many
body systems.body systems.
37. Cont.Cont.
The nurse must have knowledge ofThe nurse must have knowledge of
the pharmacology of antineoplasticthe pharmacology of antineoplastic
agents, proper techniques of drugagents, proper techniques of drug
preparation and administration, drugpreparation and administration, drug
interactions, and possible adverseinteractions, and possible adverse
effects of individual agents.effects of individual agents.
The nurse must be skilled in theThe nurse must be skilled in the
technique of venipuncture and thetechnique of venipuncture and the
management of various types ofmanagement of various types of
venous access devices and drugvenous access devices and drug
administration systems.administration systems.
38. Cont.Cont.
Nurses should prepare patients andNurses should prepare patients and
families to manage anticipated sidefamilies to manage anticipated side
effects of chemotherapy and to reporteffects of chemotherapy and to report
symptoms of potentially serious sidesymptoms of potentially serious side
effects early to avoid seriouseffects early to avoid serious
consequences.consequences.
An important responsibility of nursesAn important responsibility of nurses
involved in the delivery of chemotherapyinvolved in the delivery of chemotherapy
is to ensure that the correct dose of theis to ensure that the correct dose of the
correct drug is administered by thecorrect drug is administered by the
correct route to the right patient.correct route to the right patient.
39. Cont.Cont.
Nurses frequently triage patientNurses frequently triage patient
problems and assist in theproblems and assist in the
evaluation of symptoms andevaluation of symptoms and
initiation of interventionsinitiation of interventions
Subjective and objective data,Subjective and objective data,
including information about theincluding information about the
last chemotherapy treatmentlast chemotherapy treatment
and knowledge of the patient'sand knowledge of the patient's
history, guide the nurse inhistory, guide the nurse in
determining the patient'sdetermining the patient's
disposition and treatment.disposition and treatment.
40. Cont.Cont.
Patient education is facilitatedPatient education is facilitated
when side effects are classified aswhen side effects are classified as
immediate, early, delayed, andimmediate, early, delayed, and
late.late.
Immediate side effects, such asImmediate side effects, such as
hypersensitivity reactions, occurhypersensitivity reactions, occur
within the first 24 hours.within the first 24 hours.
41. Cont.Cont.
Diarrhea and alopecia have anDiarrhea and alopecia have an
onset of days to weeks and areonset of days to weeks and are
considered early side effects.considered early side effects.
Delayed effects, such asDelayed effects, such as
anemia or pulmonary fibrosis,anemia or pulmonary fibrosis,
occur within weeks to months,occur within weeks to months,
and late effects, such as secondand late effects, such as second
malignancies, may not appearmalignancies, may not appear
for months or years.for months or years.
42. NURSING DIAGNOSISNURSING DIAGNOSIS
Fear/anxietyFear/anxiety
situational crisissituational crisis
Threat to/change in health/socio-Threat to/change in health/socio-
economic status, role functioning,economic status, role functioning,
interaction patterninteraction pattern
Threat of deathThreat of death
Separation from familySeparation from family
Grieving, anticipatoryGrieving, anticipatory
Loss of physiologic well being (loss ofLoss of physiologic well being (loss of
body part, change in body functionbody part, change in body function
Perceived potential deathPerceived potential death
43. NURSING DIAGNOSISNURSING DIAGNOSIS
Situational low self-esteemSituational low self-esteem
BiophysicalBiophysical
PsychosocialPsychosocial
Acute/Chronic PainAcute/Chronic Pain
Disease processDisease process
Side-effects of therapeutic agentsSide-effects of therapeutic agents
Altered nutrition, less than bodyAltered nutrition, less than body
requirementsrequirements
Hypermetabolic state, consequencesHypermetabolic state, consequences
of chemo, radiation, surgery,of chemo, radiation, surgery,
emotional distress, fatigue, poor painemotional distress, fatigue, poor pain
controlcontrol
44. NURSING DIAGNOSISNURSING DIAGNOSIS
Risk for fluid volume deficitRisk for fluid volume deficit
FatigueFatigue
Risk for infectionRisk for infection
Risk for altered mucousRisk for altered mucous
membranemembrane
Risk for skin/tissue integrityRisk for skin/tissue integrity
Risk for Constipation / diarrheaRisk for Constipation / diarrhea
Risk for Altered sexualityRisk for Altered sexuality
patternspatterns
46. PATIENT EDUCATIONPATIENT EDUCATION
• THROMBOCYTOPENIA
• Use soft toothbrush to avoid bleedingUse soft toothbrush to avoid bleeding
gumsgums
• When shaving, use electric razorWhen shaving, use electric razor
• Avoid constipation, enemas, rectal tempsAvoid constipation, enemas, rectal temps
• Do not use products that contain aspirin,Do not use products that contain aspirin,
NSAIDNSAID
• Avoid IM or sc injectionAvoid IM or sc injection
• Notify MD/RN if petechiae, bruising, frankNotify MD/RN if petechiae, bruising, frank
or tarry stools, change in colour of urine –or tarry stools, change in colour of urine –
frank blood, dark amber, bleeding fromfrank blood, dark amber, bleeding from
any part of body such as nosebleedany part of body such as nosebleed
47. Cont.
• MINIMIZE SIDE EFFECTS OF
NAUSEA AND VOMITING:
• Avoid offensive odorsAvoid offensive odors
• Small frequent feedings rather thanSmall frequent feedings rather than
3 big meals3 big meals
• Adjust oral and fluid intakeAdjust oral and fluid intake
• Relaxation exercises, mindRelaxation exercises, mind
diversional therapies, etc.diversional therapies, etc.
48. SPECIAL CONCERNS
BleedingBleeding
Skin problemsSkin problems
Hair lossHair loss
NutritionNutrition
PainPain
FatigueFatigue
PsychosocialPsychosocial
statusstatus
Body imageBody image
StomatitisStomatitis
AnorexiaAnorexia
MalabsorptionMalabsorption
Cachexia (lossCachexia (loss
of body weight,of body weight,
adipose,visceradipose,viscer
al proteins,andal proteins,and
skeletalskeletal
muscle)muscle)
49. SAFE HANDLINGSAFE HANDLING
Essential to reduce risks toEssential to reduce risks to
involved personnel.involved personnel.
Cytotoxic drugs are carcinogenic,Cytotoxic drugs are carcinogenic,
mutagenic and teratogenic.mutagenic and teratogenic.
50. SAFE HANDLING cont’dSAFE HANDLING cont’d
Potential exposure to staff occursPotential exposure to staff occurs
during:during:
Preparation of medicationPreparation of medication
Administration and changing linesAdministration and changing lines
etcetc
Handling of body fluids e.g. urineHandling of body fluids e.g. urine
Handling of chemo waste productsHandling of chemo waste products
e.g. lines, medication bottlese.g. lines, medication bottles
Spillage / leakage of chemotherapySpillage / leakage of chemotherapy
TransportationTransportation
51. PRIOR TO CHEMOTHERAPYPRIOR TO CHEMOTHERAPY
ADMINISTRATIONADMINISTRATION
1.1.Review- The chemotherapy drugsReview- The chemotherapy drugs
prescription which should haveprescription which should have
-Name of anti - neoplastic agent.-Name of anti - neoplastic agent.
-Dosage-Dosage
-Route of administration-Route of administration
-Date and time that each agent to be-Date and time that each agent to be
administered.administered.
2.2. Accurately identify the clientAccurately identify the client
3.3.Medications to be administered inMedications to be administered in
conjunction with the chemotherapy e.gconjunction with the chemotherapy e.g
antiemetics, sedatives etc should also beantiemetics, sedatives etc should also be
prepare prior.prepare prior.
ROLE OF A NURSEROLE OF A NURSE
52. 4.4. Assess the clients condition includingAssess the clients condition including
- Most recent report of blood counts- Most recent report of blood counts
including hemoglobin ,hematocrit, whiteincluding hemoglobin ,hematocrit, white
blood cells and platelets.blood cells and platelets.
-Presence of any complicating condition-Presence of any complicating condition
which could contraindicatewhich could contraindicate
chemotherapeutic agent administration i.e.chemotherapeutic agent administration i.e.
infection, extravasations, severe stomatitisinfection, extravasations, severe stomatitis
, decreased deep tendon reflexes, or, decreased deep tendon reflexes, or
bleeding .bleeding .
-Physical status-Physical status
-Level of anxiety-Level of anxiety
-Psychological status.-Psychological status.
53. 5.5.Prepare for potential complicationsPrepare for potential complications
6.6.Assure accurate preparation of theAssure accurate preparation of the
agentagent
-Accuracy of dosage calculation-Accuracy of dosage calculation
- Check expiry date of the drug.- Check expiry date of the drug.
-Recommended administration route-Recommended administration route
7.7.Assess patients understanding of theAssess patients understanding of the
chemotherapeutic agents andchemotherapeutic agents and
administration procedures.administration procedures.
54. CALCULATION OF DRUG DOSAGECALCULATION OF DRUG DOSAGE
It is calculated based on body surfaceIt is calculated based on body surface
area.area.
DRUG PREPARATION-DRUG PREPARATION-
Pharmacy staff should reconstitute allPharmacy staff should reconstitute all
drugs pre-prime the intravenous tubingdrugs pre-prime the intravenous tubing
under a class II biologic safety cabinetunder a class II biologic safety cabinet
(BSC) which provide personnel,(BSC) which provide personnel,
environmental and product safety. Inenvironmental and product safety. In
certain conditions nurses may be requiredcertain conditions nurses may be required
to reconstitute medications. Whento reconstitute medications. When
preparing and reconstituting safe handlingpreparing and reconstituting safe handling
guidelines to be followed.guidelines to be followed.
55. -All chemotherapeutic drug should be-All chemotherapeutic drug should be
prepared according class II BSC.prepared according class II BSC.
-Aseptic technique should be followed.-Aseptic technique should be followed.
-Personal protective equipment includes-Personal protective equipment includes
disposable surgical gloves, long sleevesdisposable surgical gloves, long sleeves
gown and elastic or knit cuffs.gown and elastic or knit cuffs.
-Protective goggles if no BSC-Protective goggles if no BSC
-Wash hands before and after drug-Wash hands before and after drug
handling.handling.
-Limit access to drug preparation area-Limit access to drug preparation area
56. -Keep labeled drug spill kit near-Keep labeled drug spill kit near
preparation area.preparation area.
-Apply gloves before drug handling.-Apply gloves before drug handling.
-Open drug vials/ ampoules away from-Open drug vials/ ampoules away from
body.body.
-Place absorbent pad on work surface.-Place absorbent pad on work surface.
-Wrap alcohol wipe around neck of-Wrap alcohol wipe around neck of
ampoule before opening.ampoule before opening.
-Label all chemotherapeutic drugs.-Label all chemotherapeutic drugs.
- Clean up any spill immediately- Clean up any spill immediately
57. IV.IV. Drug administrationDrug administration
1. Route-1. Route-
i)Oral - Emphasize the importance of compliance by thei)Oral - Emphasize the importance of compliance by the
patient with prescribed schedule.Drugs with emeticpatient with prescribed schedule.Drugs with emetic
potential should be taken with meals.potential should be taken with meals.
Assure that chemotherapeutic agents are stored asAssure that chemotherapeutic agents are stored as
directed by the manufacturer(refrigerate, avoid exposure todirected by the manufacturer(refrigerate, avoid exposure to
direct light,etc).direct light,etc).
ii) Intramuscular and subcutaenous – Chemotherapeuticii) Intramuscular and subcutaenous – Chemotherapeutic
agents that can be administered I/M or subcutaneously areagents that can be administered I/M or subcutaneously are
few in number. Non-vesicants like L- asperaginase,few in number. Non-vesicants like L- asperaginase,
bleomycin, cyclophosphamide, methotraxate. Cyta arabinebleomycin, cyclophosphamide, methotraxate. Cyta arabine
and some hormonal agents are given I/M & /Orand some hormonal agents are given I/M & /Or
subcutaneously.subcutaneously.
58. --Use the smallest gauge needle possible for theUse the smallest gauge needle possible for the
viscosity of the medication.viscosity of the medication.
-Change the needle after withdrawing the-Change the needle after withdrawing the
agent from a vial or ampoule.agent from a vial or ampoule.
-Select a site with adequate muscle and/or SC-Select a site with adequate muscle and/or SC
tissue.tissue.
iii) Intravenous – It is the most common methodiii) Intravenous – It is the most common method
of administration of cancer chemotherapy. Mayof administration of cancer chemotherapy. May
be given through central venous catheters orbe given through central venous catheters or
peripheral access. Absorption is more reliable.peripheral access. Absorption is more reliable.
This route is required for administration ofThis route is required for administration of
vesicants and it also reduces the need ofvesicants and it also reduces the need of
repeated injection. Because the I/V providesrepeated injection. Because the I/V provides
direct access to the circulatory system, thedirect access to the circulatory system, the
potential for infection and life threatening sepsis ispotential for infection and life threatening sepsis is
a serious complication of I/V chemotherapy.a serious complication of I/V chemotherapy.
59. The following guidelines to be kept in mind:The following guidelines to be kept in mind:
-Inspect the solution, container and tubing for-Inspect the solution, container and tubing for
signs of contamination including particles,signs of contamination including particles,
discoloration, cloudiness, and cracks or tears indiscoloration, cloudiness, and cracks or tears in
bottle or bagbottle or bag
-Aseptic technique to be followed-Aseptic technique to be followed
-Prepare medicines according to manufacturer’s-Prepare medicines according to manufacturer’s
directionsdirections
-Select a suitable vein-Select a suitable vein
-Large veins on the forearm are the preferred site.-Large veins on the forearm are the preferred site.
-Use distal veins first, and choose a vein above-Use distal veins first, and choose a vein above
areas of flexion.areas of flexion.
-For non-vesicant drugs, use the distal veins of the-For non-vesicant drugs, use the distal veins of the
hands (metacarpal veins): then the veins of thehands (metacarpal veins): then the veins of the
forearms(basilic and cephalic veins)forearms(basilic and cephalic veins)
60. -For vesicants, use only the veins of the forearms.-For vesicants, use only the veins of the forearms.
Avoid using the metacarpal and radial areas.Avoid using the metacarpal and radial areas.
-Avoid the antecubital fossa and the wrist-Avoid the antecubital fossa and the wrist
because an extravasation in these areas canbecause an extravasation in these areas can
destroy nerves and tendons, resulting in loss ofdestroy nerves and tendons, resulting in loss of
function.function.
-Peripheral sites should be changed daily before-Peripheral sites should be changed daily before
administration of vesicantsadministration of vesicants
-Avoid the use of small lumen veins to prevent-Avoid the use of small lumen veins to prevent
damage due to friction and the decreased abilitydamage due to friction and the decreased ability
to dilute acidic drugs and solutions. Select theto dilute acidic drugs and solutions. Select the
shortest catheter with the smallest gaugeshortest catheter with the smallest gauge
appropriate for the type and duration of theappropriate for the type and duration of the
infusion (21g to 25g for I/V medications and 19 ginfusion (21g to 25g for I/V medications and 19 g
for blood products).for blood products).
61. --Avoid a vein which has been used forAvoid a vein which has been used for
venous access within the past 24 hrs tovenous access within the past 24 hrs to
prevent leakage from a prior puncture site.prevent leakage from a prior puncture site.
Prevent trauma and infection at thePrevent trauma and infection at the
insertion site.insertion site.
-Apply a small amount of iodine-Apply a small amount of iodine
based antiseptic ointment over thebased antiseptic ointment over the
insertion site & cover the area with sterileinsertion site & cover the area with sterile
gauze.gauze.
Intravenous Chemotherapy Via CentralIntravenous Chemotherapy Via Central
Vein Infusion (Vein Infusion (Hickman CatheterHickman Catheter))
62. A Hickman catheter is a flexible polymericA Hickman catheter is a flexible polymeric
silicon rubber catheter which is threadedsilicon rubber catheter which is threaded
through the cephalic vein and into thethrough the cephalic vein and into the
superior vena cava or through thesuperior vena cava or through the
venacava and into the right atrium of thevenacava and into the right atrium of the
heart. Placement in a large vein permitsheart. Placement in a large vein permits
the use of a catheter large enough forthe use of a catheter large enough for
infusion of chemotherapy, hyper osmolarinfusion of chemotherapy, hyper osmolar
fluids for nutrition purposes, bloodfluids for nutrition purposes, blood
products and other needed intravenousproducts and other needed intravenous
fluids.fluids.
63. The silicon rubber material of catheter isThe silicon rubber material of catheter is
chemically inert to prevent decompositionchemically inert to prevent decomposition
and it is anti-thrombogenicand it is anti-thrombogenic
A felt cuff near the exit site anchors theA felt cuff near the exit site anchors the
catheter on the patient’s chest and acts ascatheter on the patient’s chest and acts as
an anatomic barrier to prevent entry ofan anatomic barrier to prevent entry of
infection causing agents.infection causing agents.
It is either single lumen or double-lumen.It is either single lumen or double-lumen.
IV) Intra-arterialIV) Intra-arterial
VV))Intra-peritonealIntra-peritoneal
64. VIVI))Intrathecal- Infusion of medication can be givenIntrathecal- Infusion of medication can be given
through an Ommaya reservoir, implantablethrough an Ommaya reservoir, implantable
pump and /or usually through lumbar puncture.pump and /or usually through lumbar puncture.
aa))Wear protective equipment (gloves,Wear protective equipment (gloves,
gown andgown and eyewear).eyewear).
bb))Inform the patient that chemotherapeuticInform the patient that chemotherapeutic
drugsdrugs are harmful to normal cells and thatare harmful to normal cells and that
protectiveprotective measures used by personnelmeasures used by personnel
minimize their exposureminimize their exposure to these drugs.to these drugs.
cc))Administer drugs in a safe and unhurriedAdminister drugs in a safe and unhurried
environment.environment.
65. dd))Place a plastic backed absorbent pad underPlace a plastic backed absorbent pad under
thethe tubing during administration to catch anytubing during administration to catch any
leakage.leakage.
Do not dispose of any supplies or unusedDo not dispose of any supplies or unused
drugs indrugs in patient care areas.patient care areas.
V.V. DocumentationDocumentation
RecordRecord
-chemotherapeutic drugs, dose, route ,and time-chemotherapeutic drugs, dose, route ,and time
-Premedications, postmedications, prehydration-Premedications, postmedications, prehydration
and other infusions and supplies used forand other infusions and supplies used for
chemotherapy regimen.chemotherapy regimen.
-Any complaints by the patient of discomfort and-Any complaints by the patient of discomfort and
symptoms experienced before, during, and aftersymptoms experienced before, during, and after
chemotherapeutic infusion.chemotherapeutic infusion.
66. VI.VI. Disposal of supplies and unused drugsDisposal of supplies and unused drugs
aa))Do not clip or recap needles or breakDo not clip or recap needles or break
syringes.syringes.
bb))Place all supplies used intact in a leakPlace all supplies used intact in a leak
proof ,puncture proof, appropriate labeledproof ,puncture proof, appropriate labeled
container.container.
cc))Place all unused drugs in containers in aPlace all unused drugs in containers in a
leakleak proof, puncture proof, appropriately labeledproof, puncture proof, appropriately labeled
container.container.
dd))Dispose of containers filled withDispose of containers filled with
chemotherapeutic supplies andchemotherapeutic supplies and
unusedunused drugs indrugs in accordance withaccordance with
regulations of hazardous wastes.regulations of hazardous wastes.
67. VII.VII. Management ofManagement of
chemotherapeutic spillschemotherapeutic spills
Chemotherapy spills should be cleanedChemotherapy spills should be cleaned
up immediately by properly protectedup immediately by properly protected
personnel trained in the appropriatepersonnel trained in the appropriate
procedure. A spill should be identified withprocedure. A spill should be identified with
a warning sign so that other person willa warning sign so that other person will
not be contaminated.not be contaminated.
68. Supplies RequiredSupplies Required
Chemotherapy spill kit containsChemotherapy spill kit contains
Respirator mask for air borne powderRespirator mask for air borne powder
spillsspills
Plastic safety glasses or gogglesPlastic safety glasses or goggles
Heavy duty rubber glovesHeavy duty rubber gloves
Absorbent pads to contain liquid spillsAbsorbent pads to contain liquid spills
Absorbent towels for clean up after spillsAbsorbent towels for clean up after spills
Small scoop to collect glass fragmentsSmall scoop to collect glass fragments
Two large waste disposal bagsTwo large waste disposal bags
69. Protective disposable gownProtective disposable gown
Containers of detergent solution and clear tapContainers of detergent solution and clear tap
water for post spill clean up.water for post spill clean up.
Puncture proof and leak proof container approvedPuncture proof and leak proof container approved
for chemotherapy waste disposalfor chemotherapy waste disposal
Approved, specially labeled, impervious laundryApproved, specially labeled, impervious laundry
bag.bag.
Spill on hard surfaceSpill on hard surface
Restrict area of spillRestrict area of spill
Obtain drug spill kitObtain drug spill kit
Put on protective gown, gloves, gogglesPut on protective gown, gloves, goggles
Open waste disposal bagsOpen waste disposal bags
Place absorbent pads gently on the spill; bePlace absorbent pads gently on the spill; be
careful not to touch spill.careful not to touch spill.
70. Spill on hard surfaceSpill on hard surface
Restrict area of spillRestrict area of spill
Obtain drug spill kitObtain drug spill kit
Put on protective gown, gloves, gogglesPut on protective gown, gloves, goggles
Open waste disposal bagsOpen waste disposal bags
Place absorbent pads gently on the spill;Place absorbent pads gently on the spill;
be careful not to touch spill.be careful not to touch spill.
71. Place absorbent pad in waste bagPlace absorbent pad in waste bag
Cleanse surface with absorbent towelsCleanse surface with absorbent towels
using detergent solution and wipe cleanusing detergent solution and wipe clean
with clean tap water.with clean tap water.
Place all contaminated materials in thePlace all contaminated materials in the
bag.bag.
Wash hands thoroughly with soap andWash hands thoroughly with soap and
water.water.
72. Spill on personnel or patientSpill on personnel or patient
Restrict area of spillRestrict area of spill
Obtain drug spill kitObtain drug spill kit
Immediately remove contaminatedImmediately remove contaminated
protective garments or linenprotective garments or linen
Wash affected skin area with soap andWash affected skin area with soap and
waterwater
If eye exposure-immediately flood theIf eye exposure-immediately flood the
affected eye with water for at least 5 mts;affected eye with water for at least 5 mts;
obtain medical attention promptlyobtain medical attention promptly
Notify the physician if drug spills onNotify the physician if drug spills on
patient.patient.
Documentation- Document the spill.Documentation- Document the spill.
73. Chemotherapy offersChemotherapy offers
patients with cancer apatients with cancer a
great deal of hope for agreat deal of hope for a
cure or a means of controlcure or a means of control
cancer for a long period ofcancer for a long period of
time. Hope and optimismtime. Hope and optimism
are vital ingredients in careare vital ingredients in care
plan.plan.
74. END OF LIFE CAREEND OF LIFE CARE
End of LifeEnd of Life is considered to beis considered to be
the period of time marked bythe period of time marked by
disability or disease that isdisability or disease that is
progressively worse until death.progressively worse until death.
End of Life CareEnd of Life Care is the careis the care
provided to a person in theirprovided to a person in their
final stages of life.final stages of life.
It is also known as hospice care,It is also known as hospice care,
comfort care, supportive care,comfort care, supportive care,
palliative care or simplypalliative care or simply
symptom management.symptom management.
76. NURSING DIAGNOSISNURSING DIAGNOSIS
Risk for Infection related toRisk for Infection related to
impaired or deficient leukocytesimpaired or deficient leukocytes
Risk for Injury related toRisk for Injury related to
thrombocytopenia and bleeding.thrombocytopenia and bleeding.
Risk for Ineffective TissueRisk for Ineffective Tissue
Perfusion due to reducedPerfusion due to reduced
erythrocytes, or vascularerythrocytes, or vascular
disruption by tumordisruption by tumor
77. CONT.CONT.
Potential for Impaired Gas ExchangePotential for Impaired Gas Exchange
due to cancer involvement of thedue to cancer involvement of the
lungs or alterations in fluid statuslungs or alterations in fluid status
Potential for Impaired SensorimotorPotential for Impaired Sensorimotor
Function due to spinal cordFunction due to spinal cord
compressioncompression
Potential for Imbalanced FluidPotential for Imbalanced Fluid
Volume due to disease or treatmentVolume due to disease or treatment
Potential for Fatigue due toPotential for Fatigue due to
malignant illness or its treatmentmalignant illness or its treatment
78. CONT.CONT.
Potential for Impaired MobilityPotential for Impaired Mobility
due to disease complicationsdue to disease complications
Anxiety related to fear ofAnxiety related to fear of
disease or treatmentdisease or treatment
Deficient Knowledge related toDeficient Knowledge related to
disease, or anticancer therapiesdisease, or anticancer therapies
Potential for Ineffective CopingPotential for Ineffective Coping
related to severity of illness orrelated to severity of illness or
prognosisprognosis
Potential for Role Conflict due toPotential for Role Conflict due to
chronic serious illnesschronic serious illness
79. SUMMARYSUMMARY
The potential benefit to theThe potential benefit to the
patient of treatment as anpatient of treatment as an
option must always outweighoption must always outweigh
the toxic effects.the toxic effects.