Care of the Patient with Lung Cancer

Prevention and causes Classification of lung cancer Treatment

Surgery See Chart 23-9 Radiation Chemotherapy

Palliative care

Nursing Care of the Patient with Cancer

Psychological support Pain Airway clearance Fatigue Dyspnea

Answer
False. Rationale: In adults, bone marrow is usually aspirated from the iliac crest and occasionally from the sternum.

Question
Tell whether the following statement is true or false. Common sites of bone marrow aspiration are the iliac crest and spine.

Improving Nutrition
Provide oral care before and after meals Administer analgesics before meals

Provide appropriate treatment of nausea

Provide small, frequent feedings with soft foods that are moderate in temperature Provide a low-microbial diet Provide nutritional supplements

Interventions
See Charts 33-8 and 33-9 for interventions related to risk of infection and bleeding Mucositis Frequent, gentle oral hygiene Soft toothbrush, or if counts are low, sponge-tipped applicators Rinse only with NS, NS and baking soda, or prescribed solutions Perineal and rectal care

 Major goals include absence of complications, attainment and maintenance of adequate nutrition, activity tolerance, ability for self-care and to cope with the diagnosis and prognosis, positive body image, and an understanding of the disease process and its treatment

Nursing ProcessPlanning the Care of the Patient With Leukemia

Collaborative Problems/Potential Complications

Infection Bleeding Renal dysfunction Tumor lysis syndrome Nutritional depletion Mucositis Depression

Nursing ProcessDiagnosis of the Patient With Leukemia (cont.)

Risk for excess fluid volume Diarrhea Risk for deficient fluid volume Self-care deficit Anxiety Disturbed body image Potential for spiritual distress Grieving diagnoses Deficient knowledge

Nursing ProcessDiagnosis of the Patient With Leukemia

Risk for bleeding Risk for impaired skin integrity Impaired gas exchange Impaired mucous membrane Imbalanced nutrition Acute pain Hyperthermia Fatigue and activity intolerance Impaired physical mobility

 Health history Assess for symptoms of leukemia and complications of anemia, infection, and bleeding Weakness and fatigue See Charts 33-8 and 33-9 Laboratory tests Leukocyte count, ANC, hematocrit, platelets, electrolytes, and cultures reports

Nursing ProcessAssessment of the Patient With Leukemia

Answer True. Rationale: An oral formulation of a tyrosine kinase inhibitor, imatinib mesylate (Gleevec) works by blocking signals within the leukemia cells that express the BCR-ABL protein, thus preventing a series of chemical reactions that cause the cell to grow and divide.

Question Tell whether the following statement is true or false. A medication used in the treatment of CML is imatinib mesylate (Gleevec).

Chronic Myeloid Leukemia (CML)

Mutation in myeloid stem cell with uncontrolled proliferation of cells: Philadelphia chromosome Stages: chronic phase, transformational phase, blast crisis Uncommon in people under 20; incidence increases with age; mean age is 55 to 60 years Life expectancy is 3 to 5 years Manifestations (initially may be asymptomatic): malaise; anorexia; weight loss; confusion or shortness of breath due to leukostasis; enlarged, tender spleen; enlarged liver Treatment: imatinib mesylate (Gleevec) blocks signals in leukemic cells that express BCR-ABL protein; chemotherapy, BMT, and PBSCT

Leukemia
Hematopoietic malignancy with unregulated proliferation of leukocytes Types: Acute myeloid leukemia Chronic myeloid leukemia Acute lymphocytic leukemia Chronic lymphocytic leukemia