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Transcript 
Nursing Management: Cancer
What is it?
Definition: A group of more than
200 diseases  uncontrolled and
unregulated cell growth
 2nd leading cause of death
 Disparities

Pathophysiology
Cellular dysfunction
1. Differentiation
2. Proliferation
By Cancer Research UK, CC BY-SA 4.0, via Wikimedia Commons
Development of Cancer
Initiation
Carcinogens:
 Chemicals
 Viruses
 Radiation
Promotion
Reversible
proliferation of
altered cells
Progression
 growth rate
 Invasiveness
 Metastasis

Initiation
Promotion
Progression
Clinical Manifestations: General

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Unexplained weight loss
Fatigue
Skin changes
Thickening or lumps
Unusual bleeding or discharge
Sores that do not heal
National Cancer Institute, Public Domain
Assessment: Subjective
History of present illness: Symptoms
Past Medical History: Viral infections, cancer,
immunizations
Social History: Tobacco use, UV exposure,
environmental or occupational toxins
Family History: Hereditary cancer syndromes
Assessment: Objective
General: VS, appearance
Review of Systems
Focused Physical Exam
Assessment: Labs
Labs: CBC, CMP
Cancer gene mutation
ex. BRCA1 and BRCA2
Tumor Markers
ex. PSA, Alpha-fetoprotein
Tissue Biopsy
Bone Marrow Harvest, By Photographer’s Mate 2nd Class Chad McNeeley (Navy News Service, 021204-N-0696M-180)
[Public domain], via Wikimedia Commons
Assessment: Imaging
Imaging:





X-ray
CT
MRI
Nuclear (PET, SPECT)
Ultrasound
Physiological: ABCD
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Acute pain
Imbalanced nutrition: less than body requirements
Activity intolerance
Self-care deficit
Risk for infection
Psychological

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Fear
Death anxiety
Ineffective role performance
Spiritual distress
Disturbed body image
Interventions
Administer:



Chemotherapy
Biologic Therapy
Supportive medications
Assist/Prep:


Surgical procedures
Radiation Therapy
National Cancer Institute, Public Domain
Neoadjuvant
Adjuvant
Chemotherapy
Purpose
 Mechanism(s) of action
 Complications

Induction
Consolidation
Salvage
Conditioning
(HSCT)
Immunosuppression
Disorder vs. secondary
immunosuppression
 Neutropenia



Mild: ANC<1500 cells/microL
Severe: ANC<500 cells/microL
Risk for infection
 Neutropenic precautions

Scanning electron micrograph image of a human
neutrophil ingesting MRSA. National Institute of Allergy
and Infectious Diseases (NIAID). Public Domain
Interventions
Monitor & Support: Side effects,
risk for infection, central lines,
psychosocial needs
Educate: Neutropenic precautions,
genetic counseling, therapy,
end-of-life planning, coping
strategies & survivorship
By Cancer Research UK [CC BY-SA 4.0] via Wikimedia Commons
Complications
Infection
 Acute/chronic adverse effects
 Psychological distress
 Secondary cancer diagnoses or
recurrence of primary cancer

Evaluation: Desired Outcomes

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Pain control
Optimal level of activity and functioning (ADLs)
Balanced nutritional intake
Free of infection
Healthy coping strategies and psychosocial stability
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