Nursing Care of Cancer Complications for the LPN

Cancer, or malignancy, refers to a group of diseases characterized by abnormal cell growth and differentiation, which changes cellular appearance and function.

These changes are harmful to normal cells and can cause several complications, which can be directly related to cancerous tissue, a side effect of treatment, or a combination of both.

Let’s look at some of the complications of cancer, starting with pain. Patients with cancer are at risk for acute and chronic pain, which can decrease quality of life.

When caring for your patient with cancer, ask about their pain and encourage open discussion about their pain on an ongoing basis.

Be sure to report any uncontrolled pain to the registered nurse, or RN. Reinforce teaching about the use of pharmacologic interventions, including nonsteroidal anti-inflammatory drugs, or NSAIDs; opioids; and adjuvant medications like corticosteroids; and nonpharmacologic interventions, such as guided imagery, relaxation techniques, distraction, massage, and acupuncture.

Reassure your patient that combinations of treatments can be tried to find pain management that is effective. Then, coordinate care with the RN and interdisciplinary team to provide interventions as indicated to carry out the plan of care.

Alright, next let’s explore infection as a complication of cancer. Several factors can lead to an infection in your patient with cancer, including tissue damage from ulceration; necrosis caused by cancerous tissue; tumors compressing organs; and decreased immunity due to the cancer or treatment-induced neutropenia, which is a low number of neutrophils, or the infection-fighting white blood cells.

When providing care, be sure to monitor your patient for signs or symptoms of infection, such as a temperature of 100.4 F or 38 C or higher, cough, or diarrhea.

Keep in mind, though, that neutropenia can diminish signs of infection, so your patient may have an infection and be asymptomatic.

Now, to help prevent infection, administer filgrastim as prescribed to stimulate production of neutrophils. Then, reinforce education about infection prevention strategies, including strict hand washing; meticulous hygiene and skin care; avoiding crowds and people with infections; wearing a mask in public; as well as safe food practices, such as eating food cooked to the proper temperature and washing fruits and vegetables.

Remind them to monitor their temperature daily and stress the importance of immediately notifying their healthcare provider if they notice signs or symptoms of infection.

Okay, cancer can also cause altered nutrition. This can be caused by tumors in the GI tract; treatment-related nausea; anorexia; decreased nutrient absorption; altered taste; difficulty eating due to sores in the mouth, called mucositis; mouth inflammation, called stomatitis; or from cancer-related increases in metabolism, which can result in additional nutrient requirements.

These effects can lead to deficient intake, malnutrition, or cachexia, which is a complex syndrome characterized by extreme tissue wasting and atrophy.

When caring for your patient with cancer, be sure to weigh them regularly, report signs of altered nutrition to the RN, and administer enteral or parenteral nutrition as prescribed.

Remind them to eat small, frequent meals of soft, nonirritating, high calorie and high protein foods like casseroles, milkshakes, and peanut butter; and to add supplemental nutrition to foods, like eggs or mashed potatoes.

Also, reinforce teaching about avoiding tobacco, alcohol, and other irritants, such as spicy foods; and remind them to take antiemetics and appetite stimulants as prescribed.

If altered taste is contributing to appetite loss, encourage them to experiment with adding a variety of herbs and other seasonings, and refer them to a registered dietitian as needed.

Now, psychosocial complications may occur anytime throughout your patient’s cancer journey and can include anxiety, fear, loss of control, relationship stress, and financial burdens.

Gather information about your patient's emotional responses, coping strategies, and other psychosocial needs, including those related to their spiritual beliefs.

Be sure to display a caring attitude, maintain hope, and build an open, honest relationship with your patient. Also, offer active listening, reassurance, and provide them with accurate information about their cancer and treatment.

Remind them about the ways they can maintain their lifestyle and improve quality of life, such as symptom self-management and stress reduction.

Lastly, refer them to counseling, social work, and community resources like support groups, as needed. Alright, as a quick recap… Cancer is a group of diseases caused by abnormal cell growth and differentiation which changes cellular appearance and function.

Complications of cancer are related to the cancerous tissue itself, treatment side effects, or a combination of both. Types of complications include pain, infection, altered nutrition, and psychosocial issues.

Nursing care for patients experiencing cancer complications involves gathering patient information, carrying out the plan of care alongside the interdisciplinary team,