Complications of cancer: Nursing

Notas

COMPLICATIONS OF CANCER

KEY POINTS
NOTES
DEFINITION
  • Group of diseases characterized by abnormal cell growth and differentiation
  • Complications are related to cancerous tissue, side effects of treatment, or a combination of both

PAIN
  • Acute or chronic pain
  • Comprehensive pain assessment
  • Pain management goals
  • Use of pharmacologic interventions
  • Use of nonpharmacologic interventions
  • Coordinate with interdisciplinary team

INFECTION
  • Factors leading to infection
    • Tissue damage from ulceration
    • Necrosis caused by cancerous tissue
    • Tumors compressing organs
    • Decreased immunity due to cancer or treatment
  • Monitor for signs of infection
  • Patients could be asymptomatic
  • Help prevent infection
  • Monitor temperature  daily
  • Report symptoms of infection

NUTRITION
  • Reasons for altered nutrition
    • Tumors in GI tract
    • Nausea or anorexia
    • Decreased nutrient absorption
    • Increases in metabolism
  • Deficient intake
  • Malnutrition
  • Cachexia
  • Regular weights
  • Monitor laboratory results
  • Administer enteral or parenteral nutrition
  • Diet modifications
  • Avoid irritants
  • Take antiemetics and appetite stimulants

PSYCHOSOCIAL
  • Anxiety, fear, loss of control, relationship stress, financial burdens
  • Assess emotional responses, coping strategies, and other psychosocial needs
  • Caring attitude
  • Active listening
  • Teach ways to maintain lifestyle and improve quality of life
  • Refer to support services as needed

Transcripción

Ver video solo

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, perform a comprehensive pain assessment on an ongoing basis. Discuss their pain management goals, and the use of pharmacologic interventions, including nonsteroidal antiinflammatory drugs, or NSAIDs; opioids; and adjuvant medications like corticosteroids; and nonpharmacologic interventions, such as guided imagery, relaxation breathing, distraction, massage, and acupuncture.

Then, coordinate care with the interdisciplinary team to provide other interventions, such as radioactive medications for bone pain, nerve blocks, and epidural or intrathecal analgesia as indicated. You may also refer your patient to a pain management or palliative care specialist to help control their pain and improve quality of life.

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 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. However, keep in mind neutropenia can diminish signs of infection, so your patient may have an infection and be asymptomatic.

Now, to help prevent infection, administer hematopoietic myeloid growth factors as prescribed. Then, teach your patient 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. Teach them to monitor their temperature daily and stress the importance of immediately notifying their health care 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, or decreased nutrient absorption; 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.

Fuentes

  1. "Lewis's medical-surgical nursing: Assessment and management of clinical problems (12th ed.)" Elsevier (2022)
  2. "Medical-surgical nursing: Concepts for interprofessional and collaborative care (10th ed.)" Elsevier (2021)
  3. "Lewis’s medical-surgical nursing in Canada: Assessment and management of clinical problems (5th ed.)" Elsevier (2023)