INTRODUCTION
Kidney cancer is also called Renal cancer.
This leads to abnormal and uncomfortable growth in kidney cells and tumor formation.
This tumor can be both benign and malignant.
Kidney cancer is mainly not kidney. An excess of both is produced.
the Renal tubule, (Renal cell carcinoma),
The Renal pelvis (transitional cell carcinoma).
If a patient has a renal tumor, he complains of blood in the urine (hematuria) or masses and pain.
Etiology
exact cause is unknown,
cigarette smoking,
obesity,
High blood pressure,
long term dialysis,
occupational exposure to toxic agents,
certain analgesics,
childhood chemotherapy,
previous radiation therapy.
clinical manifestation
Abnormal urin colore like :=dark ,rusty, brown.
back pain,
hydronephrosis (accumulation of fluid in the kidney),
Abdominal mass or lump,
fever,
hypertension,
malaise,
weight loss,
anorexia,
cold intolerance
chronic fatigue
leg and ankle Swelling
Serve at night,
difficulty seeing,
Increased level of calcium in the body (hypercalcemia),
Diagnostic evaluation
history taking and physical examination,
intra venous urography,
Cytological examination,
Renal angiogram,
ultrasonography,
ct scan.
Management
radiation therapy,
chemotherapy,
Hormonal therapy,
surgery, :=
-> Nephrectomy
Simple Nephrectomy: In this only the tumor is removed.
•Partial Nephrectomy:= In this the tumor and some area around it is removed.
•Radical Nephrectomy:= In this kidney, tumor, adrenal gland, lymph node and its surrounding tissue are removed.
Nursing management
Preoperative and post operative Nursing management:=
Pre operative Nursing management:= Providing psychological support to the patient.
Explaining the procedure to the patient and his relative.
Checking the patient’s intake output.
Provide intravenous fluid to the patient.
To provide blood transfusion to the patient.
Provide oxygen to the patient.
Shaving the patient on the operative area.
To provide work and comfortable environment to the patient and his relatives.
Post operative Nursing management := Keeping the patient under close observation after the operation.
To check patient’s vital signs every 15 minutes.
Checking the patient’s blood pressure every 15 minutes.
Provide oxygen to the patient if needed.
Provide intravenous fluid.
Maintain the patient’s nutritional and hydration status.
To provide psychological support to the patient and his family members.
Provide proper antibiotic and analgesic medicine to the patient.
Properly dressing the operation area of the patient.
To clear all the doubts of the patient and his family members.
BLADDER CANCER
INTRODUCTION: =
In bladder cancer, abnormal and uncontrollable growth of the epithelial cells of the bladder leads to the formation of tumors. These tumors are benign and
Can be malignant.
About 90% of urinary system cancers are bladder cancer.
There are types of cancer in the urinary system according to its cells.
urethelial carcinoma (in urethial carcinoma),
squamous cell carcinoma,
Adenocarcinoma (in adenocarcinomas).
Etiology
Age := Mainly seen between 50 to 70 years.
sex := Affects men more than women.
(3 : 1),
cigarette smoking,
chemical exposure,
Diet := Fried meat and animal fats are more common in people who eat them.
Race := White people are more likely to develop bladder cancer.
personal history of bladder cancer,
family history of bladder cancer,
chronic bladder inflammation,
birth defects,
External beam radiation.
treatment of certain drugs.
clinical manifestation
blood in urine (hematuria := blood in urine),
pain during urination,
frequent urination,
pelvic pain,
back pain,
Alteration in voiding.
Diagnostic evaluation
history taking and physical examination
cytoscopy,
Excretory urography (excretory urography),
ct scan,
ultrasonography,
Biannual examination,
tumor biopsy,
Cytological examination
medical management
radiation therapy,
chemotherapy,
Immunotherapy,
surgery: • cystectomy, (bladder removal)
•Partial cystectomy, (in which only the affected portion of the bladder is removed).
pre operative and post operative nursing management:=
This includes checking the patient’s urine output every hour in pre-operative and post-operative management.
Proper hospitalization of the patient and keeping him under close observation of nurses and handling personnel.
Inform the patient and health care personnel immediately if any complications arise.
pre operative:=
Checking the patient’s urine output.
Catheter insertion in the patient.
Properly explain to the patient about the surgery and its complications and its benefits and side effects.
To check the patient’s vital sign. To prepare the patient for surgery.
Obtaining consent for surgery from family members of the patient.
To remove all the patient’s clothes and jewelry.
The area of the patient’s body that is to be operated should be shaved properly.
Providing psychological support to the patient and his family members.
Providing intravenous fluid to the patient.
Painting the patient’s body area with proper savlon and spirit.
Post operative nursing management:= Keeping the patient under close observation after the operation.
Patient Nadar 15 minutes to check vital signs.
Keeping blood transfusion ready for the patient.
Provide intravenous fluid to the patient.
Properly dressing the operative area of the patient.
Provide proper antibiotic and analgesic medicine to the patient.
Maintain septic technique while handling the patient.
To clear all the doubts of the patient and his family members.
Tell the patient not to do hard activity.
Tell the patient not to take very spicy food and fatty food.
Maintain patient’s intake output chart.
Ask the patient to maintain personal hygiene.
Conduct all blood investigations of the patient.
Providing psychological support to the patient and his family members.
ovarian cancer INTRODUCTION
Ovary is an organ of reproductive system.
Abnormal and controlled growth of its cells in ovary and formation of tumor like structures and it results in malignancy i.e. cancer.
The result of cancer Bloating
Pelvic pain,
Frequent urination.
Etiology
excessive use of birth control pills,
early menarche,
late menopause
Nullipara (A woman who has never conceived a pregnancy) etc.
clinical manifestation
Pelvic pain,
abdominal pain,
constipation,
nausea,
weight loss,
poor appetite,
weakness,
Fatigue.
Diagnostic evaluation:=
history taking and physical examination.
laparotomy,
x ray,
ct scan,
ultrasound,
MRI,
to check Elevated serum protein level
Increase. Ca :=125.
management
radiation therapy,
chemotherapy,
biotherapy,
chemotherapy,
surgical removal of tumor.
nursing management
Perform a head to toe examination of the patient.
To check patient’s vital sign.
Checking the patient’s intake output.
To see what the patient’s pen level is.
Performing a skin integrated check on the patient.
Maintain hygienic condition of patient.
Provide a comfortable position to the patient.
Providing patient-named diversional therapy.
Providing analgesic medicine to the patient.
Maintain hygienic condition of patient.
Provide patient with proper bed sheet and clean closes to wear.
Provide the patient with bedclothes and sponges.
Providing patient neckline and wrinkle free bed sheet.
Advise the patient to maintain oral hygiene.
Checking the turgor and integrity of the patient’s skin.
Tell the patient to drink two to three liters of water throughout the day.
To maintain the nutritional status of the patient.
To provide work and comfortable environment to the patient.
Provide proper position to the patient.
Providing proper psychological support to the patient.
Explain to the patient about the side effects of cancer surgery and its chemotherapy and radiation therapy.
Tell the patient to do some activity every day.
Persuading the patient to do a little exercise every day.
Maintain aseptic technique while handling the patient.
To clear all the doubts of the patient and his family members.
Answer all the questions of the patient and family members. And provide psychological support to him.
INTRODUCTION Cervical cancer involves abnormal and uncontrollable growth of cervical cells and formation of tumor life structures and this tumor can be benign or malignant.
Etiological factors
multiple sex partners,
birth control pills,
Nallipara,
Multiparty,
human papilloma viral infection,
Nutritional deficiency,
Low socio economic factors,
early childbearing,
smoking,
Chronic cervical infection,
Hiv infection,
cigaratte smoking.
clinical manifestation
abnormal vaginal bleeding,
thin vaginal discharge,
Pelvic and low back pain,
painful urination,
edema of lower extremities,
weight loss,
anemia,
Diagnostic evaluation
history taking and physical examination.
pap smear test,
Pelvic examination,
X-rays,
laboratory investigation,
biopsy,
ultrasonography,
MRI.
Clposcopy,
cytography,
barium X Ray studies,
Intravenous urography.
management
1) Cryotherapy:= In this freezing of the tumor is done using liquid nitrogen.
2) (LEEP)LOOP ELECTROCAUTRI EXCISION PROCEDURE :=This procedure is used to remove abnormal cells.
In this, the lesion layer of the cervix is thinly cut using a very thin wire.
3) Conization := In this cone shape portion of cervix is removed.
4) Hysterectomy: The entire uterus is removed.
total hysterectomy,
Remove uterus,
Cervix, and ovaries.
Radical hysterectomy,
Remove uterus,
Cervix, ovaries,
fallopian tube,
Malignant area of vagina affected lymph node.
Pelvic trachelectomy:=
In this, only the selected part of the cervix is removed.
And simultaneously the tumor in the cervix is removed.
radiation therapy,
chemotherapy.
pre operative and post operative nursing management:= preoperative nursing management:=
Providing psychological support to the patient.
Explaining the entire procedure of surgery to the patient.
To prepare the patient physically and mentally for surgery.
Maintain the patient’s nutritional status.
Maintain patient’s hydration status.
Catheterizing the patient.
The patient was given an I.v. Setting up the line.
Providing fluid to the patient through the parenteral route.
Perform all laboratory investigations of the patient.
To provide work and comfortable environment to the patient.
Prepare blood transfusion for patient.
The operative area of the patient’s body should be shaved properly.
Painting the operative body parts of the patient with proper savlon and spirit.
Administering the prescribed antibiotic medicine to the patient in a proper manner.
To check patient’s vital sign.
Post operative nursing management
Close observation of the patient after the operation.
Maintain aseptic technique while attending to patients.
To check patient’s vital signs every 15 minutes.
Dressing the patient properly where the operative area is.
Keeping the surgical site under proper observation.
Maintain patient’s intake output chart.
Provide intravenous fluid to the patient.
Provide prescribed analgesic and antibiotic medicine to the patient.
Checking the drainage tube properly.
Observe the patient for any kind of redness, swelling, inflammation on the operative side.
Providing psychological support to the patient and his family members.
Instruct the patient to perform strenuous activity.
Ask the patient to do small and frequent amounts of activity.
uterine cancer
Uterus is an organ of female reproductive system.
Due to the abnormal and uncontrollable growth of the uterus cells in the uterus, the tumor is formed.
Can be benign (noncancerous) or malignant (cancerous).
And this occurs mainly in the endometrium (innermost layer) of the uterus.
Etiological factor
chronic exposure to estrogen.
Endometrium Hyperplasia.(endometrium hyperplasia),
Obesity,
a high fat diet,
Women above 50-60 years.
multiparty,
nallipara,
Hiv infection,
nutritional deficiency.
family history,
exposure to radiation,
race (white women’s are more likely to have uterine cancer).
clinical manifestation
abnormal vaginal bleeding,
abnormal discharge from vaginal canal,
painful and difficulty in urination,
Pelvic pain,
anemia,
fatigue,
weakness,
Diagnostic evaluation
history taking and physical examination,
biopsy,
ultrasound,
x-ray,
ct scan,
MRI,
transabdominal ultrasound,
transvaginal ultrasound,
Management
radiation therapy,
chemotherapy,
hormone therapy.
If the tumor is small, conservative treatment should be provided.
Use of gonadotropin-releasing hormone analogs to lower estrogen hormone levels.
Controlling the obesity level of the patient.
surgical management
hysterectomy,
if large tumor so do myomectomy,
laparoscopic myomectomy,
Hysterectomy
partial hysterectomy,
total hysterectomy.
Preoperative and post operative nursing management:
pre operative nursing management:=
To provide complete information about the treatment and disease to the patient.
Explain all pre-operative and post-operative procedures to the patient.
To check patient’s vital signs.
Providing analgesic and antibiotic medicine to the patient.
Inform the patient about the operation and take consent from the patient’s family member.
To prepare the patient physically and psychologically for the operation.
Setting up two intravenous lines to the patient.
Perform all laboratory investigations of the patient.
Keeping blood ready for patients.
Provide intravenous fluid to the patient.
The body parts of the patient to be operated should be properly shaved.
Clean the patient’s body parts with Savlon and Betadine.
Inserting a urine catheter into the patient.
Maintaining intake output chart of patient.
Maintaining SMT technique while handling the patient.
Administer prescribed energy intake and antibiotic medicine.
Painting the operative area of the patient properly with Savlon and Betadine.
Post operative nursing management
Keeping the patient under close observation after the operation.
To observe the patient for any post-operative complications.
Maintaining intake output chart of patient.
To provide intravenously to the patient.
Administer blood if the patient has lost excessive amount of blood.
Properly dressing the operative parts of the patient.
Maintain aseptic technique while handling the patient.
Provide the prescribed analgesic and antibiotic medicine to the patient.
Changing the patient’s position frequently to prevent bat 16.
To check patient’s vital signs.
Maintain aseptic technique while handling the patient.
Providing psychological support to the patient and his family members.
Instruct the patient and his family members to start the patient on a liquid diet first, followed by a semisolid, and then a solid diet.
Tell the patient not to do any kind of hard work.
Ask the patient to move a little.
Giving education to the patient or taking bed rest of the property.
Ask the patient and his family members to follow up properly.
colorectal cancer
INTRODUCTION
COLON is an organ of the gastro-intestinal system.
Abnormal and uncontrollable growth occurs in the cells of the colon and forms a tumor and this tumor can be both benign and malignant.
In colorectal cancer, cancerous growths occur in the colon, rectum, and appendix and affect the digestion of food.
etiology
age :=above 50 years old age,
diet,
Genetic disorders,
Family history,
personal history of polyps,
history of inflammatory bowel disease,
obesity,
viral,
smocking,
alcohol,
excessive one of fatty and spicy food,
male are more affected than female,
excessive use of fat.
clinical manifestation
feel tired,
weakness,
difficulty breathing,
Changes in bowel habit.
small-caliber or ribbon-like stool,
Diarrhea,
constitution (constipation),
red and dark blood in stool,
nausea,
vomiting,
weight loss,
rectal pain,
abdominal pain,
distension,
Cramp
Bloating
Diagnostic evaluation:=
history taking and physical examination,
stool test,
fecal occult blood test,
colonoscopy,
Genetic testing,
Management
radiation therapy,
chemotherapy,
biotherapy,
gene therapy,
immuno therapy.
surgery
Surgery is the choice for colorectal cancer.
Radical bowel resection,
partial colostomy,
hemicolectomy,
laparoscopic surgery.
prevention
regular screening,
Genetic counselling,
lifestyle and nutrition,
quit smoking,
pre operative and
Post operative nursing management:=
pre operative nursing management
Explaining the procedure to the patient and his family members.
Perform all laboratory tests of the patient.
Preparing the patient for the operation.
Setting up an IV line to the patient.
Keep the patient on Nbm (nill per oral).
Catheterizing the patient.
Maintaining patient no intake output chart.
Shaving the operative body parts of the patient in a proper manner.
Clean the operative body parts of the patient with Savlon and spirit.
Provide IV fluid to the patient.
Give the patient total parantrol nutrition.
Keeping the patient’s nutritional status and food balance normal.
Provide the prescribed Analgesic and Antibiotic medicine to the patient.
Obtaining consent of the patient and his family members.
Post operative nursing management
Keeping the patient comfortable and under close observation after operation.
To provide work and comfortable environment to the patient.
Ask the patient to do deep breathing exercises.
Keep the patient’s fluid balance normal.
Maintain aseptic technique to the patient.
To maintain the nutritional status of the patient.
Maintain patient’s intake output chart.
Properly dressing the operative area of the patient.
Checking the operative area of the patient for any kind of infection or inflammation.
Seeing if the fashion has any weekne s painting or nosia and vomiting.
To check patient’s vital signs.
The patient’s I.v. Provide fluids.
Changing the patient’s dressing every twenty-four hours.
Provide the patient with prescribed analgesic and antibiotic medicine.
Maintain hygienic condition of patient.
Change the patient’s position every two hours to prevent bed sores.
Ask the patient to walk slowly.
Do not ask the patient to do any kind of hard activity.
Ask the patient to rest properly.
Providing Mind Diversional Renal Therapy to the patient.
Provide liquid semi-solid food to the patient first and then solid food.
Keeping the patient’s head elevated to prevent any heart burn.
Providing psychological support to the patient and his family members.
INTRODUCTION
Abnormal and uncontrollable growth of the best cell occurs in breast cancer.
And it results in tumor and R tumor can be malignant.
It is called breast cancer. This breast cancer can occur anywhere in the breast, but it is mainly found in the upper outer parts of the breast.
Where there is excess tissue.
Breast cancer originates from the cells of the lobule of the breast, which is known as the milk production gland or duct.
Etiology
age := in women over 60 years old age.
Gender :=most in female,
personal history of breast cancer,
family history,
certain breast change,
reproductive and menstrual history,
radiation therapy to change,
atypical Hyperplacia (a typical hyperplasia),
Hormonal replacement therapy (estrogen and progesterone),
oral contraceptive use,
overweight and obesity,
lack of physical activity,
drinking alcohol.
clinical manifestation
a lump or thickening in or near the breast or in the underarm area.
There is a change in the size and shape of the breast.
The skin of breast areola and nipple becomes red, swollen and scaly.
Skin irritation and dimpling.
There is pain in the breast.
There is pain and tenderness in the nipple.
The nipple is an invitation to the breast.
Discharge from the nipple.
Axillary and supraclavicular lymph nodes are enlarged.
Diagnostic evaluation
history tacking and physical examination #
biopsy,
X Ray,
ct scan,
mri,
mammography,
management
radiation therapy,
chemotherapy,
biotherapy,
gene therapy,
surgery
Mastectomy,
partial mastectomy,
Radical Mastectomy,
lymph node dissection,
cryotherapy,
breast reconstructive surgery.
nursing management pre operative nursing management
Close observation of the patient to see if there are any adverse effects of radiation therapy such as fatigue, sore throat, cough, nausea, loss of appetite.
To see if the patient has any side effects of chemo therapy such as bone marrow suppression, hair loss, weight loss, fatigue, depression, anxiety.
To provide psychological support to women.
Involving women in treatment.
Explain all the procedures to the woman.
Provide antiemetic medicine to the patient.
Setting up an IV line to the patient.
Provide IV fluid to the patient.
Catheterizing the patient.
Maintaining intake output chart of patient.
Proper preparation of the body part of the patient to be operated.
To carry out all laboratory investigations of the patient.
Consent of patient and his family member should be taken.
Post operative nursing management
Keeping women in confinement after operation.
To check patient’s vital sign every 15 minutes.
Checking blood pressure every 15 minutes.
Provide psychological support to the patient.
To provide work and comfortable environment to Dushyant.
Provide eye fluid to the patient.
Maintain patient’s intake output chart.
Properly dressing the operative body parts of the patient.
To provide work and comfortable environment to the patient.
Look at the body part of the patient where the surgery has been done to see if there is any kind of redness, swelling, inflammation or not.
Providing antibiotic and analgesic medicine to the patient.
Maintain the patient’s nutritional and hydration status.
Provide Ana JC and antibiotic medicine to the patient.
Ask the patient to do a little exercise.
Providing psychological support to the patient and his family members.
Ask the patient to maintain hygienic condition.
Prostate cancer INTRODUCTION
Prostate cancer occurs in the prostate gland.
Abnormal and uncontrollable growth of prostate gland cells in the prostate gland leads to tumor formation.
And this tumor results in a cancerous tumor and causes cancer.
Prostate cancer can also spread to surrounding tissue.
And this cancer can spread to all parts of the body like liver bone lungs etc.
Etiology
advance age
hereditary,
Hormonal influence,
environment factor,
cigarette smoking,
toxins, chemicals.
industrial products.
diet high in saturated fat,
increase age
clinical manifestation
burning or pain during urination,
inability to urinate,
a sensation of incomplete emptying of the bladder even after passing urination,
frequent nocturnal urination
weak or interrupted flow of urine,
blood in urine,
blood in seven, (hematospermia),
Pelvic pain,
back or hip pain,
abdominal pain,
chest pain,
weight loss.
Diagnostic evaluation
history taking and physical examination
biopsy,
blood test,
urine test,
X Ray,
ct scan,
MRI,
Management
radiation therapy,
chemotherapy,
biotherapy,
gene therapy,
immunotherapy,
Hormonal therapy,
cryotherapy,
Nursing management assessment
Perform a head to toe examination of the patient.
To check patient’s vital sign.
Maintaining intake output chart of patient. Assess the patient’s pain level.
Assess patient skin integrity.
Assess the patient’s bowel and bladder habits.
Maintain patient’s oral hygiene.
To see if the patient has hair loss or any side effects due to chemotherapy and radiation therapy.
Nursing diagnosis
1) Pain related to disease condition
Nursing interventions:=
Reliving pain level:=
Assess the patient’s pain level.
Position the patient comfortably.
Providing Mind Diversional Therapy to the patient.
Provide the patient with his/her essential medicines.
To provide work and comfortable environment to the patient.
2) Self care deficit related to disease condition.
Nursing interventions
provide hygiene conditions to the patient
Provide very clean clothes and bed sheet to the patient.
Provide bed bath and sponge bath to the patient.
Provide clean and wrinkle free bed sheet to the patient.
Maintain oral care of the patient.
Ask the patient to practice proper hand washing.
3) Impaired skin integrity related to cancerous condition.
Nursing interventions:=
maintain skin integrity.
Assess the patient’s skin integrity.
Checking the patient’s skin turgor.
To see if any type of bleeding occurs from the patient’s body.
Ask the patient to drink two to three liters of water.
Ask the patient to apply body lotion.
Tell the patient not to rub and scratch the skin.
Ask the patient to wear cotton clothes.
Refraining the patient from wearing tight clothing.
4) Impaired nutrition status of patient less than body requirement related to diarrhea and vomiting.
Nursing interventions:=
improve nutritional status:=
Assess the nutritional status of the patient.
Providing a comfortable environment to the patient.
Ask the patient to wash hands while eating.
Providing an appetizer to the patient.
Remove any bed-order items around the patient while he is eating.
Keeping the patient and emotional and non-emotional things in mind.
Give food to the patient in little intervals.
Give the patient as much food as he likes.
Keeping the patient’s environment absolutely clean while eating.
5) Disturbed body image (hair loss) related to radiotherapy and chemotherapy.
Nursing interventions:=
improve body image* of patient:=
Maintain good interpersonal relationships with patients.
Maintain good rapport with patients.
Telling the patient that hair loss is temporary.
Tell the patient that weight loss is normal when undergoing chemo therapy and radiation therapy.
Providing psychological support to the patient.
6) Activity intolerance related to the weakness.
Nursing interventions:=
improve the activities of the client.
Assessing the patient’s activity level.
Maintain good interpersonal relationship with patients.
Ask the patient to do daily routine activities in moderation.
Tell the patient to take some rest between activities.
Tell the patient to do proper exercise and yoga.
7) High risk of infection related to *hospitalizations.
Nursing interventions
reduce the risk of infection:=
Assess the patient’s infection side.
Maintain aseptic technique while handling the patient.
Maintain aseptic technique while dressing the patient’s body parts.
To provide proper clean and hygienic condition to the patient.
Giving the patient McLean cloth to wear.
Giving the patient high protein rich food that helps the patient to fight infection.
Providing proper antibiotic medicine to the patient.
8) Depression and fear related to treatment of cancer.
Nursing interventions:=
Reduce the fear level of the client.
To check the patient’s anxiety and fear level.
To maintain good interpersonal relationship with patients.
Helping the patient to solve his doubts and problems.
Listening to the patient and his family members properly.
To answer all the questions of the patient.
Providing psychological support to the patient.
To provide coping abilities on how the patient can deal with the situation in such a bad situation.
INTRODUCTION
Bone cancer can occur in any part of the body.
But mainly bone cancer affects long bones like bones of arms and legs.
If the cancer originates from the bone, it is called primary bone cancer.
And if the bone cancer has spread from another part of the body and has spread to the bone, then it is called secondary bone cancer.
type of bone cancer
1) Benign bone tumor:=
Benign bone tumor include:=
osteomas (osteo mass),
osteoblastomas (osteoblastomas),
osteoidosteoma (in osteoid osteoma),
osteochondromas (osteochondromas),
enchondroma (in enchondro),
2) Malignant bone tumor:=
The most common bone tumor
osteosarcoma (in osteosarcoma),
chondrosarcoma (chondrosarcoma),
fibrosarcoma (fibrosarcoma),
chordoma (whiplash),
3) Metastasis bone cancer :=
Almost all types of cancer spread to bone, but mainly
bone,
breast,
Lungs,
Kindly,
Thyroid,
And prostate
This is the main organ from which cancer is transmitted to bone.
Etiology
occure at 10-25year age,
exposure to radiation,
inherited genetic disorder,
some drugs,
chemotherapy.
clinical manifestation
pain,
mass or lump felt in the bone,
weak bone,
fever,
chills,
night sweats,
anemia,
anorexia,
fatigue,
Tenderness,
weight loss,
Neurological symptoms may present with nerve root compression.
Swelling,
limited motion,
increase skin temperature over mass,
Diagnostic evaluation
history taking and physical examination,
bone scan,
X Ray,
ct scane,
mri,
myelography,
arteriography,
biopsy,
Elevated serum alkaline phosphate.
Management
radiation therapy,
chemotherapy,
biotherapy,
bone marrow transplantation,
immunotherapy,
gene therapy,
surgical management
limb sparing surgery,
amputation,
lymph node dissection,
Reconstructive surgery,
tumor curettage,
bone grafting,
limb salving procedures,
nursing management
To check patient’s vital signs.
To see how much blood the patient has lost.
To see if the patient has any complications like deep vein thrombosis,
Pulmonary embolism, Infection,
Etc.
Administering analgesic medication to the patient.
Provide intravenous fluid to the patient.
Provide support by pillows to the affected extremity.
Provide a splint to the patient for additional protection.
Ask the patient and his family members to ask his fears and all his questions.
Providing psychological support to the patient.
To prepare the patient beforehand for the patient’s body image to change.
Anchoring the patient to perform his daily routine activities
To provide complete information to the patient and his family members about the disease and its treatment.
Maintaining the patient’s nutritional and hydration status.
To work and provide a comfortable environment to improve the patient’s sleep pattern.
Asking the patient to move the part of the extremities.
Providing support to the patient’s joint.
Be careful that the patient does not fall.
Creating a hazard free environment for patients.
Providing a supportive environment to the patient.
Providing psychological support to the patient.
To answer all questions of the patient.
To provide psychological support to the patient so that the coping ability of the patient improves.
oncological emergency:=
This is a life threatening condition that requires immediate management.
1) superior vena cava syndrome,
2) hypercalcemia,
3) Spinal cord compression,
4) pericardial effusion,
5) Intra vascular *Coagulopathy,
6) tumor lysis syndrome,
7) Inappropriate antidiuretic hormone.
Diagnostic evaluation
history taking and physical examination,
bone scan,
X Ray,
ct scane,
mri,
myelography,
arteriography,
biopsy,
Elevated serum alkaline phosphate.
Management
radiation therapy,
chemotherapy,
biotherapy,
bone marrow transplantation,
immunotherapy,
gene therapy,
surgical management
limb sparing surgery,
amputation,
lymph node dissection,
Reconstructive surgery,
tumor curettage,
bone grafting,
limb salving procedures,
nursing management
To check patient’s vital signs.
To see how much blood the patient has lost.
To see if the patient has any complications like deep vein thrombosis,
Pulmonary embolism, Infection,
Etc.
Administering analgesic medication to the patient.
Provide intravenous fluid to the patient.
Provide support by pillows to the affected extremity.
Provide a splint to the patient for additional protection.
Ask the patient and his family members to ask his fears and all his questions.
Providing psychological support to the patient.
To prepare the patient beforehand for the patient’s body image to change.
Anchoring the patient to perform his daily routine activities
To provide complete information to the patient and his family members about the disease and its treatment.
Maintaining the patient’s nutritional and hydration status.
To work and provide a comfortable environment to improve the patient’s sleep pattern.
Asking the patient to move the part of the extremities.
Providing support to the patient’s joint.
Be careful that the patient does not fall.
Creating a hazard free environment for patients.
Providing a supportive environment to the patient.
Providing psychological support to the patient.
To answer all questions of the patient.
To provide psychological support to the patient so that the coping ability of the patient improves.
oncological emergency:=
This is a life threatening condition that requires immediate management.
1) superior vena cava syndrome,
2) hypercalcemia,
3) Spinal cord compression,
4) pericardial effusion,
5) Intra vascular *Coagulopathy,
6) tumor lysis syndrome,
7) Inappropriate antidiuretic hormone.
1) superior vena cava syndrome (superior vena cava syndrome)
:= In superior vena cava syndrome, the superior vena cava is obstructed. And it is mainly seen in Caesarean patients.
It can cause partial or complete obstruction due to obstruction of blood coming from the head, neck, and upper limbs through the superior cava to the right atrium.
In this the superior vena cava is compressed.
Due to any cancerous tumor, due to enlargement of lymph node, there is compression in Superior vena cava.
And due to this, venous circulation or drainage of the head, neck, arm, and thorax (thorax) is reduced.
Etiology
cigarette smoking,
tobacco use,
occupation carcinogens,
Nutritional deficiency,
non neoplastic diseases such as tuberculosis,
chronic bronchitis,
Emphysema.
clinical manifestation
Cough,
Difficulty breathing,
chest pain,
Excessive expectoration,
Blood in the phlegm,
Fever,
vomiting and diarrhea,
weight loss,
feel tired,
Loss of appetite, persistence pneumonitis.
Diagnostic evaluation
history taking and physical examination,
x-ray,
ct scane,
pet (Prozitron Emosine Tomography),
Cytological examination,
Bronchoscopy,
lymph node biopsy,
pft(Pulmonary function test :=
pulmonary function test),
management
radiation therapy,
chemotherapy,
biotherapy,
bone marrow therapy,
immunotherapy,
bronchoscopy learning therapy,
photo therapy,
Airway stunting,
surgical resection.
complications
Superior vena cava syndrome,
hypocalcemia,
syndrome of inappropriate antidiuretic hormone,
Brain Metastasis,
spinal cord compression,
pulmonary scarring,
Nursing management
Nursing assessment :=
To assess the patient’s respiratory rate and vital signs.
To assess the patient’s urine output.
Assessing the patient’s pain level.
Assessing the patient’s eating pattern.
Assess the patient’s anxiety level and coping skills.
To assess the patient’s blood investigation.
Observing the patient’s signs and symptoms and performing a physical examination.
Nursing diagnosis
1) Impaired breathing pattern related to compromised respiration.
Nursing interventions
improve breathing pattern
Raising the patient’s head so that breathing can be done properly.
Ask the patient to do breathing exercises.
Administer prescribed treatment to the patient and administer antimicrobial agent and nebulization.
Adequate oxygenation to the patient.
Place the patient on a chair and position him in such a way that he can breathe properly.
2) Impaired nutrition pattern less than body requirement related to nausea and vomiting.
Nursing interventions
improve nutritional status
Tell the patient to take some high calorie and high protein food.
For the patient to get enough protein such as milk, eggs, chicken, fish, cheese etc.
To give the patient adequate vitamins.
Give food to the patient.
To provide total parental nutrition to the patient.
3) Pain related to abnormal cell growth.
Nursing interventions
controlling pain
Assessing the patient’s pain level.
Administering analgesic drugs to the patient.
Providing Mind Diversional Therapy to Nishant.
Providing reinsurance to the tenant.
4) Anxiety, fear related to therapeutic regimen and prognosis.
Nursing interventions
minimizing anxiety
Assess the patient’s anxiety level.
Ask the patient to explain his feelings.
Tell the patient that all types of pain are due to cancer.
Providing nsaid (non steroidal anti inflammatory drugs) drugs to the patient.
Explaining the procedure to the patient.
Maintain good communication with the patient.
Spinal cord compression
Introduction
Spinal cord compression causes compression of spinal cord due to enlargement of lift node and formation of tumor.
And because of that the nervous system is affected.
Abnormality of nervous system occurs.
This abnormality leads to morbidity and mortality.
Etiology
tumor,
lymphomas,
intervertebral collapse,
Metastasis cancer (Breast, lung, myeloma Lymphoma.).
clinical manifestation
local inflammation,
swelling,
venous stasis,
Impaired blood supply,
pain,
neurological dysfunction,
weakness,
bladder and bowel Dysfunction.
Diagnostic evaluation
history taking and physical examination.
Percussion Tenderness at the level of compression.
abnormal reflexes,
sensory and motor abnormality,
X Ray,
ct scan,
mri.
management
radiation therapy,
chemotherapy,
surgery,
biotherapy,
bone marrow therapy,
gene therapy,
biotherapy,
Nursing management
Proper assessment of the patient.
Perform a neurological assessment of the patient.
Control the pain level.
To prevent patient complications.
Ask the patient to exercise.
Checking Bowel and Bladder Habits of Passion.
Reassure the patient.
Ask the patient and his family members for coping skills.
To provide psychological support to the patient and his family members.
hypercalcemia
INTRODUCTION
In hypercalcemia, the level of calcium in the body is higher than the normal level.
The level of calcium in the body increases due to kidney cancer.
Due to kidney cancer, the kidney does not work properly and due to this the calcium level of the body increases and due to this the level of calcium in the body increases.
And it results in hypercalcemia.
Etiology
bone destruction by tumor cells,
excessive use of calcium,
Inadequate absorption of calcium in the body.
Diagnostic evaluation
serum calcium level exceeding 11mg/dl.
management
Provide proper fluids to the patient.
Provide diuretic medicine to the patient.
Using calcitonin to lower calcium levels.
Identifying patients who are likely to develop hypercalcemic conditions.
Providing education to patients and family members.
Explain to the patient whether to use dietary and pharmacological interventions such as using school softeners and laxatives.
Tell the patient to maintain his nutritional status.
If the patient has nausea and vomiting, provide antiemetic medicine.
Ask the patient to move slightly.
pericardial effusion
INTRODUCTION
In this pericardial (the uppermost membrane of the heart) there is a collection of fluid due to lung and oeophagial cancer.
Etiology
cancerous tumor,
tumor of lung and esophagus,
breast cancer,
clinical manifestation
In this the neck is distended.
Distant heart sound,
compensatory tachycardia,
increased vascular pressure,
narrow pulse pressure,
lowest blood pressure,
sortness of breath,
weakness, chest pain,
anxiety,
lethargy.
Diagnostic evaluation
history taking and physical examination
ecg,
chest x-ray,
ultrasound,
ct scan,
mri.
management
pericardial aspiration,
Close monitoring of ECG.
Referral to cardiologist when performing pericardial aspiration.
Cardio vascular pressure should be carefully monitored.
Maintaining hygienic condition of patient.
To maintain the nutritional status of the patient.
Providing patient assurance.
Providing a comfortable position of the patient.
Providing comfort to the patient.
Monitor the patient for any other complications.
disseminate intravascular coagulopathy
Introduction
This is an anti-coagulant dish order that prevents the blood from clotting and continues to bleed.
This bleeding can be either internally or externally.
etiology
hematological cancer,
Cancer of the prostate gland,
Abnormality in the Gastro Intestinal Track and Lungs.
chemotherapy,
sepsis,
Hepatic failure.
Diagnostic evaluation
history taking and physical examination,
decrease hemoglobin,
decrease hematocrit,
Elevated fibrinogen split products.
positive protamine sulfate precipitation test.
clinical manifestation
blood clot formation,
greater risk for impaired circulation,
tissue hypoxia,
fibrinolysis may occur.
management
To check patient’s vital signs.
Checking the patient’s intake output.
Checking the patient’s skin integrity.
Checking vital signs and mainly temperature of the patient’s body.
Checking the patient’s visual acuity.
To check whether the patient has chest pain or not.
Checking the patient and abdominal tenderness.
To check the orifices of the patient’s body through which the tube is inserted for bleeding or not. To perform laboratory tests of the body.
Reducing the patient’s physical activity.
Assess the patient’s oxygen level.
Prevent the patient from bleeding.
Applying excessive pressure to the patient’s venipuncture site.
Maintain patient’s oral hygiene.
Teach the patient deep bridging exercises.
To provide work and comfortable environment to the patient.
syndrome of inappropriate sections of antidiuretic hormone (SIADH)
INTRODUCTION
This is a condition in which there is an uncontrolled release of antidiuretic hormone.
which is released from abnormal tumor or due to abnormal stimulation of hypothalamic pituitary network and due to this the volume of extracellular fluid increases and condition of hyponatremia (hyponatremia := low level of sodium in body) and sodium level through urine. One is excreted.
Etiology
small cell cancer of lungs,
Antineoplastic agents also stimulate adh (antidiuretic hormone) secretion.
clinical manifestation
A person’s personality changes.
Irritability occurs.
vomiting,
weight gain,
headache,
feel tired
confusion,
seizure,
abnormal reflexes,
papilledema,
coma,
death.
Diagnostic evaluation
history taking and physical examination,
decrease serum sodium level,
increase urine osmolarity,
increase urinary sodium level,
decrease creatinine, albumin.
management
Reduce fluid intake to 500 to 1000 ml/day fluid intake.
Use of diuretic therapy.
Monitoring patient’s intake output.
To check the patient’s level of consciousness.
Listen to the patient’s lungs and his heart sound.
To check patient’s vital signs.
Check the patient’s weight daily.
Checking the patient’s urine specific gravity.
Conducting laboratory tests of the patient.
To check the electrolyte of the patient.
Blood and urine test of the patient.
Reducing the patient’s activity level.
Maintain patient’s oral hygiene.
Maintain environmental safety of the patient and ask to reduce fluid intake.
Providing patient coping and psychological therapy.
tumor lysis syndrome
INTRODUCTION
This is a complication in which a cancerous tumor breaks down.
This is a complication of chemotherapy and radiation therapy in which the cancerous tumor breaks down and due to which the cancerous tumor releases new fluid and accumulates in the body and the kidneys do not function properly and this causes the collection of intracellular fluid in the body. occurs and an oedematous condition is produced.
And this condition is very fatal i.e. harmful.
clinical manifestation
fatigue,
weakness,
memory loss,
altered mental status,
muscle cramp,
tetanus,
seizure,
Elevated blood pressure,
dysrhythmias,
cardiac arrest,
anorexia,
nausea,
vomiting,
abdominal cramps,
diarrhea,
oliguria,
anuria,
Renal failure,
acidic urine pH.
Diagnostic evaluation
history taking and physical examination,
laboratory investigation,
management
Provide diuretic medicine.
administration of hypertonic dextrose and regular insulin.
it shifts potassium into cells and lowers the potassium level.
Identification of high risk patients.
Maintain patient’s hydration status.
Check if the patient has any type of electrolyte imbalance.
Assay the pH of the patient’s urine.
Monitoring the patient’s fluid and electrolyte balance.
Maintain patient’s hydration status.
Providing psychological support to the patient.