Chemotherapy and nursing responsibilities

Chemotherapy and common side effects

1. Presented by Ancy Mariam Alex 3 yr basic Bsc Nursing

2. A drug therapy to kill cancer or stop the multiplication of cancer cells Chemotherapy:-

3. Alopecia Fatigue Anemia Leukopenia Thrombocytopenia Nausea,vomiting , Diarrhea (always) Nuerotoxicity

4. Anorexia Back ache Head ache Joint ache Mucositis Edema

5. Other side effects....

6. Nursing Care

7. Nursing Diagnosis 1.Anticipatory Griving related to anticipated lose of Physiological wellbeing ( eg : Loss of part, Change in body function, Change life style) 2. Disturbed body image related to loss of weight , loss of hair 3. Situational low self esteem related to bio physical Psychosocial 4. Acute pain related to side effects of various cancer therapy agents

8. 5. Altered nutrition : Less than body requirements related to consequences of chemotherapy, Hyper metabolic state associated with cancer 6. Risk for fluid volume desicit related to excessive losses through normal roots ( Vomiting, Diarreha ) or up normal routes (wounds) 7. Fatigue related to decreased metabolic energy production, increased energy requirements Altered body chemistry : Side effects of pain and other medications , Chemotherapy

9. 8. Risk for infection related to malnutrition, chronic disease process, Invasive procedures 9. Risk for altered oral mucous membranes related to Side effects of some chemotherapeutic agents (anti metabolites), Dehydration malnutrition 10.Risk for impaired skin integrity related effects of chemo therapy, immunologic deficit 11. Risk for constipation/ Diarrhea related irritation of the GI mucosa from chemotherapy : poor fluid intake, low bulk diet

10. 12.Risk for altered family process related to situational lashes transitional crisis (long term illness/ economical status) *Developmental: Anticipated loss off a family member 13. Fear/ Anxiety related to situational crisis ( cancer) * Change in health * Threat of death * Separation from family

11. NURSING INTERVENTIONS

12. 1.Anticipatory Griving related to anticipated lose of Physiological wellbeing ( eg : Loss of part, Change in body function, Change life style) Expect initial shock and disbelief following diagnosis of cancer and traumatizing procedures Provide open , Non judgmental environment . Use therapeutic communication skills of active listening acknowledgement etc Encourage verbalization of thought or concern and accept expressions of sadness, anger, rejection Beware of mood swings hostility and other acting out behaviour Review past life experiences roll changes and coping skills. Talk about think back interest the patient

13. 2. Disturbed body image related to loss of weight , loss of hair Begins within two 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 the hair loss is Temporary

14. 3. Situational low self esteem related to bio physical Psychosocial Discuss with patient how the diagnosis and treatment are affecting the patient personal life, home and life activities Provide emotional support for patient and during diagnostic test and treatment phase Use touch during interactions and maintain eye contact

15. 4. Acute pain related to side effects of various cancer therapy agents Determine Pain history using numeric rating scale or verbal rating scale Evaluate and beware of painful effects of particular therapy's. Provide information to patient and about what to expect Provide non pharmacological comfort measures Encourage use of stress management skills or complimentary therapy's Evaluate pain relief and control at regular intervals

16. 5. Altered nutrition : Less than body requirements related to consequences of chemotherapy, Hyper metabolic state associated with cancer Monitor daily food intake of Measure height, Weight Asses skin and mucous membranes for pallor, delayed wound healing Encourage patient to eat high calorie nutrient rich diet with adequate fluid intake

17. 6. Risk for fluid volume desicit related to excessive losses through normal roots ( Vomiting, Diarreha ) or up normal routes (wounds) Monitor IO chart ( Emesis,diarrhea , Draining wounds) Monitor Vital science, Evaluate peripheral pulses and capillary , Refill Asses skin turgor and moisture Provide IV fluids as indicated Monitor laboratory studies

18. 7.Fatigue related to decreased metabolic energy production, increased energy requirements Altered body chemistry : Side effects of pain and other medications , Chemotherapy Have patient rate fatigue using a numeric scale Encourage patient to do whatever is possible. Increase the activity level as individual is able Monitor physiological response to activity Refer to physical or occupational therapy

19. 8. Risk for infection related to malnutrition, chronic disease process, Invasive procedures Promote good hand washing procedures Screen and limit visitors Emphasis personal hygiene Monitor Temperature Maintain aseptic techniques Monitor CBC Administer anti biotic as indicated

20. 9. Risk for altered oral mucous membranes related to Side effects of some chemotherapeutic agents (anti metabolites), Dehydration malnutrition Assess dental health and oral hygiene Encourage patient to assess oral cavity daily Brush with soft tooth brush or foam swab Encourage fluid intake Discuss limitation of smoking and alcohol intake

21. 10.Risk for impaired skin integrity related effects of chemo therapy, immunologic deficit Assess skin frequently for side effects of cancer therapy Bath with Luke warm water and mild soap Encourage patient to avoid vigorous rubbing and scratching in the skin

22. 11. Risk for constipation/ Diarrhea related irritation of the GI mucosa from chemotherapy : poor fluid intake, low bulk diet Ascertain usual elimination habit Assess bowel sound Monitor IO Chart and weight Provide small frequent meals of foods Encourage adequate fluid intake Adjust diet as appropriate

23. 12.Risk for altered family process related to situational lashes transitional crisis (long term illness/ economical status) *Developmental: Anticipated loss off a family member Identify patterns of communication in family and patterns of interaction between family members Not cultural and religious belief Assess roll expectation of family members and encourage discussion about them Deal with family members in a warm , caring respectful way Refer to support group clergy, family therapy as indicated

24. 13.Fear / Anxiety related to situational crisis ( cancer) Encourage patient to share thoughts and feelings Maintain frequent contact with patient . Talk with and touch patient as appropriate Permit expression of anger, fear, despair without confrontation Explain the recommended treatment and its purpose Explain procedures if the patient stay with anxiety Promote calm quite environment

25. THANKS