Download PERAWATAN KANKER

PERAWATAN KANKER
DEFINISI
• penyakit yang menyerang proses dasar kehidupan sel,
mengubah genom sel (komplemen genetik total sel)
dan menyebabkan penyebaran liar dan pertumbuhan
sel-sel.
• sebuah penyakit yang ditandai dengan pembagian sel
yang tidak teratur dan kemampuan sel-sel ini untuk
menyerang jaringan biologis lainnya, baik dengan
pertumbuhan langsung di jaringan yang bersebelahan
(invasi) atau dengan migrasi sel ke tempat yang jauh
(metastasis). Pertumbuhan yang tidak teratur ini
menyebabkan kerusakan DNA, menyebabkan mutasi di
gen vital yang mengontrol pembagian sel, dan fungsi
lainnya
“Akar Kata”
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Neo- raru
Plasia-pertumbuhan
Plasm- substance
Trophy- ukuran
+Oma- tumor/benjolan
Statis- lokasi/regio
“Akar Kata”
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A- tidak/tidak ada
Ana- kekurangan/ketiadaan
Hyper- berlebihan/terlalu banyak
Meta- perubahan/penyebaran
Dys- kekurangan, kesakitan/nyeri
Karakteristik Neoplasia
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Pertumbuhan Sel Abnormal tidak Terkontrol
1. Benign  tumor jinak
2. Malignant  tumor ganas
3. Borderline  tumor jinak mengarah
keganasan
Characteristics of Neoplasia
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BENIGN
Well-differentiated
Slow growth
Encapsulated
Non-invasive
Does NOT metastasize
Characteristics of Neoplasia
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MALIGNANT
Undifferentiated
Erratic and Uncontrolled Growth
Expansive and Invasive
Secretes abnormal proteins
METASTASIZES
Nomenclature of Neoplasia
Tumor is named according to:
1. Parenchyma, Organ or Cell
• Hepatoma- liver
• Osteoma- bone
• Myoma- muscle
Nomenclature of Neoplasia
Tumor is named according to:
2. Pattern and Structure, either GROSS or
MICROSCOPIC
• Fluid-filled CYST
• Glandular ADENO
• Finger-like PAPILLO
• Stalk POLYP
Nomenclature of Neoplasia
Tumor is named according to:
3. Embryonic origin
• Ectoderm ( usually gives rise to epithelium)
• Endoderm (usually gives rise to glands)
• Mesoderm (usually gives rise to Connective
tissues)
BENIGN TUMORS
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Suffix- “OMA” is used
Adipose tissue- LipOMA
Bone- osteOMA
Muscle- myOMA
Blood vessels- angiOMA
Fibrous tissue- fibrOMA
MALIGNANT TUMOR
• Named according to embryonic cell origin
1. Ectodermal, Endodermal, Glandular, Epithelial
• Use the suffix- “CARCINOMA”
• Pancreatic AdenoCarcinoma
• Squamos cell Carcinoma
MALIGNANT TUMOR
• Named according to embryonic cell origin
2. Mesodermal, connective tissue origin
• Use the suffix “SARCOMA
• FibroSarcoma
• Myosarcoma
• AngioSarcoma
“PASAWAY”
1. “OMA” but Malignant
– HepatOMA, lymphOMA, gliOMA, melanOMA
2. THREE germ layers
– “TERATOMA”
3. Non-neoplastic but “OMA”
– Choristoma
– Hamatoma
Etiology of cancer
1. PHYSICAL AGENTS
• Radiation
• Exposure to irritants
• Exposure to sunlight
• Altitude, humidity
2. CHEMICAL AGENTS
• Smoking
• Dietary ingredients
• Drugs
3. Genetics and Family History
• Colon Cancer
• Premenopausal breast cancer
4. Dietary Habits
• Low-Fiber
• High-fat
• Processed foods
• Alcohol
5. Viruses and Bacteria
• DNA viruses- HepaB, Herpes, EBV, CMV,
Papilloma Virus
• RNA Viruses- HIV, HTCLV
• Bacterium- H. pylori
6. Hormonal agents
• Pada beberapa penelitian diketahui bahwa
pemberian hormon tertentu secara berlebihan
dapat menyebabkan peningkatan terjadinya
beberapa jenis kanker seperti payudara,
rahim, indung telur dan prostat (kelenjar
kelamin pria)
7. Immune Disease
• AIDS
Spread of Cancer
• 1. LYMPHATIC
• Most common
• 2. HEMATOGENOUS
– Blood-borne, commonly to Liver and Lungs
• 3. DIRECT SPREAD
– Seeding of tumors
PRTAHANAN TUBUH MELAWAN
TUMOR
• 1. T cell System/ Cellular Immunity
– Cytotoxic T cells kill tumor cells
• 2. B cell System/ Humoral immunity
– B cells can produce antibody
• 3. Phagocytic cells
– Macrophages can engulf cancer cell debris
DIAGNOSTIC
1. BIOPSY
– The most definitive
2. CT, MRI
3. Tumor Markers
GRADING
The degree of DIFFERENTIATION
• Grade 1- Low grade
• Grade 4- high grade
Cancer Staging
1. Uses the T-N-M staging system
• T- tumor
• N- Node
• M- Metastasis
2. Stage 1 to Stage 4
• Stage 0: A small group of cancerous cells have been found in
one location in the lung.
• Stage I: The cancer is only in the lung and has not spread
anywhere else.
• Stage II: The cancer has spread to nearby lymph nodes.
• Stage III: The cancer has spread to more distant lymph nodes,
and/or other parts of the chest like the diaphragm.
• Stage IV: The cancer has spread to other parts of the body
(distant metastasis).
CANCER NURSING
GENERAL MEDICAL MANAGEMENT
• 1. Surgery- cure, control, palliate
• 2. Chemotherapy
• 3. Radiation therapy
• 4. Immunotherapy
• 5. Bone Marrow Transplant
CANCER NURSING
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GENERAL Promotive and Preventive Nursing
Management
1. Lifestyle Modification
2. Nutritional management
3. Screening
4. Early detection
SCREENING
• 1. Male and female- Occult Blood, CXR, and
DRE
• 2. Female- SBE, CBE, Mammography and Pap’s
Smear
• 3. Male- DRE for prostate, Testicular self-exam
Nursing Assessment
Utilize the ACS 7 Warning Signals
• CAUTION
• C- Change in bowel/bladder habits
• A- A sore that does not heal
• U- Unusual bleeding
• T- Thickening or lump in the breast
• I- Indigestion
• O- Obvious change in warts
• N- Nagging cough and hoarseness
Nursing Assessment
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Weight loss
Frequent infection
Skin problems
Pain
Hair Loss
Fatigue
Disturbance in body image/ depression
Nursing Intervention
MAINTAIN TISSUE INTEGRITY
• Handle skin gently
• Do NOT rub affected area
• Lotion may be applied
• Wash skin only with SOAP and Water
Nursing Intervention
MANAGEMENT OF STOMATITIS
• Use soft-bristled toothbrush
• Oral rinses with saline gargles/ tap water
• Avoid ALCOHOL-based rinses
Nursing Intervention
MANAGEMENT OF ALOPECIA
Alopecia begins within 2 weeks of therapy
 Regrowth within 8 weeks of termination
 Encourage to acquire wig before hair loss occurs
 Encourage use of attractive scarves and hats
 Provide information that hair loss is temporary
BUT anticipate change in texture and color
Nursing Intervention
PROMOTE NUTRITION
Serve food in ways to make it appealing
Consider patient’s preferences
Provide small frequent meals
Avoids giving fluids while eating
Oral hygiene PRIOR to mealtime
Vitamin supplements
Nursing Intervention
RELIEVE PAIN
Mild pain- NSAIDS
Moderate pain- Weak opiods
Severe pain- Morphine
Administer analgesics round the clock with
additional dose for breakthrough pain
Nursing Intervention
DECREASE FATIGUE
Plan daily activities to allow alternating rest
periods
Light exercise is encouraged
Small frequent meals
Nursing Intervention
IMPROVE BODY IMAGE
Therapeutic communication is essential
Encourage independence in self-care and
decision making
Offer cosmetic material like make-up and
wigs
Nursing Intervention
ASSIST IN THE GRIEVING PROCESS
Some cancers are curable
Grieving can be due to loss of health,
income, sexuality, and body image
Answer and clarify information about
cancer and treatment options
Identify resource people
Refer to support groups
Nursing Intervention
MANAGE COMPLICATION: INFECTION
 Fever is the most important sign (38.3)
 Administer prescribed antibiotics X 2weeks
 Maintain aseptic technique
 Avoid exposure to crowds
 Avoid giving fresh fruits and veggie
 Handwashing
 Avoid frequent invasive procedures
Nursing Intervention
MANAGE COMPLICATION: Septic shock
Monitor VS, BP, temp
Administer IV antibiotics
Administer supplemental O2