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INTRODUCTION OF CANCER 2.pptx
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- 3. PRESENTED BY deepika .r m.sc(n) i-year college of nursing madras medical college chennai-03
- 4. GLOSSERY – Carcinogenesis: processof transforming normal cells into malignant cells – Benign: not cancerous; benign tumors may grow but are unable to Spread to other areas – Malignant: having cells or processes that are characteristic of cancer – Anaplasia: cells that lack normal cellular characteristics and differ in shape and organization with respect to their cells of origin; usually , anaplastic cells are malignant
- 5. GLOSSARY – Hyperplasia: increasein the number of cells of a tissue; most often associated with periods of rapid body growth – Dysplasia: bizarre cell growth resulting in cells that differ in size, shape , or arrangement from other cells of the same type of tissue – Metaplasia: conversion of one type of mature cell into another type of cell – Neoplasia: uncontrolled cell growth that follows no physiologic demand – Staging: process of determining the extent of disease, including tumor size and spread or metastasis to distant sites
- 6. GLOSSARY – Apoptosis: programmedcell death – Biopsy: a diagnostic procedure to remove a small sample of tissue to be examined microscopically to detect malignant cells – Neutropenia: abnormally low absolute neutrophil count – Oncology: field or study of cancer – Thrombocytopenia: decrease in the number of circulating platelets; associated with the potential for bleeding
- 7. GLOSSARY – Graft-versus-host disease(GVHD): an immune response initiated by T lymphocytes of donor tissue against the recipient’s tissues (skin, gastrointestinal tract, liver); an undesirable response – Graft-versus-tumor effect: the donor cell response against the – Malignancy; a desirable response – Biologic response modifier (BRM) therapy: use of agents or treatment methods that can alter the immunologic relationship between the tumor and the host to provide a therapeutic benefit
- 8. GLOSSARY – Brachytherapy: deliveryof radiation therapy through internal implants – Chemotherapy: use of medications to kill tumor cells by interfering with cellular functions and reproduction – Control: containment of the growth of cancer cells – Palliation: relief of symptoms and promotion of comfort and quality of life – Radiation therapy: use of ionizing radiation to interrupt the growth of malignant cells
- 9. GLOSSARY – Myelosuppression: suppressionof the blood cell–producing function of the bone marrow – Tumor-specific antigen (TSA): protein on the membrane of cancer cells that distinguishes the malignant cell from a benign cell of the same tissue type – Vesicant: substance that can cause tissue necrosis and damage, particularly when extravasated
- 10. GLOSSARY(CANCER TYPES) – CARCINOMAis a cancer that begins in the skin or in tissues that line or cover internal organs. – SARCOMA is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. – LEUKEMIA is a cancer that begins in blood-forming tissue, such as the bone marrow, and causes too many abnormal blood cells to be made. – LYMPHOMA and MULTIPLE MYELOMA are cancers that begin in the cells of the immune system.
- 11. GLOSSARY (CANCER TYPES) –Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
- 12. Origin of theword cancer In Greek, These Words Refer To A Crab, Most Likely Applied To The Disease Because The Finger-like Spreading Projections From A Cancer Called To Mind The Shape Of A Crab.
- 13. THE DEFINITION OFCANCER – Cancer is a group of diseases characterized by uncontrolled and unregulated growth of cells. – A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. – Cancer can start almost anywhere in the human body, which is made up of trillions of cells.
- 14. NORMAL VS CANCERCELL – Normal human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. – Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply. – These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous (benign).
- 16. DIFFERENCE BETWEEN NORMALAND CANCER CELL
- 17. INCIDENCE – Cancer incidenceand mortality statistics reported by the National Cancer Institute and other resources were used to create the list. – To qualify as a common cancer for the list, the estimated annual incidence for 2023 had to be 40,000 cases or more. – The most common type of cancer on the list is breast cancer, with 300,590 new cases expected in the United States in 2023. The next most common cancers are prostate cancer and lung cancer.
- 18. INCIDENCE – Because colonand rectal cancers are often referred to as "colorectal cancers," these two cancer types are combined for the list. – For 2023, the estimated number of new cases of colon cancer and rectal cancer are 106,970 and 46,050, respectively, adding to a total of 153,020 new cases of colorectal cancer. – The following table gives the estimated numbers of new cases and deaths for each common cancer type in 2023:
- 19. CANCER TYPE ESTIMATEDNEW CASES ESTIMATED DEATHS Bladder 82,290 16,710 Breast (Female – Male) 297,790 – 2,800 43,170 – 530 Colon and Rectal (Combined) 153,020 52,550 Endometrial 66,200 13,030 Kidney (Renal Cell and Renal Pelvis) 81,800 14,890 Leukemia (All Types) 59,610 23,710 Liver and Intrahepatic Bile Duct 41,210 29,380 Lung (Including Bronchus) 238,340 127,070 Melanoma 97,610 7,990 Non-Hodgkin Lymphoma 80,550 20,180 Pancreatic 64,050 50,550 Prostate 288,300 34,700 Thyroid 43,720 2,120
- 20. GENDER DIFFERENCES – MEN: –More men than women die from cancer-related deaths each year. – Mortality rate from lung cancer is higher in men than in women. – Cancer with the highest incidence among men is lip/oral cancer. – Men are more likely to develop liver cancer than women.
- 21. GENDER DIFFERENCES – WOMEN: –Head and neck cancer occurs more frequently in men than in women. – Cancer with the highest death rate among women is lung cancer. – Cancer with the highest incidence among women is breast cancer. – Thyroid cancer is more prevalent in women than in men. – Women are less likely to have colon cancer screenings than men. – Considerable progress has been made in controlling cancer for long periods .
- 22. BENIGN VS MALIGNANTNEOPLASMS
- 23. BENIGN VS MALIGNANTNEOPLASMS – BENIGN: – Not cancerous; benign tumors may grow but are unable to spread to other areas – MALIGNANT: – Having cells or processes that are characteristic of cancer
- 24. BENIGN VS MALIGNANTNEOPLASMS
- 26. COMMON ETIOLOGY – VIRUSESAND BACTERIA – Viruses are difficult to evaluate as a cause of human cancers because they are difficult to isolate. – For example, – the Epstein-Barr virus is highly suspect as a cause in Burkitt lymphoma, nasopharyngeal cancers, and some types of non- Hodgkin and Hodgkin lymphoma .
- 27. VIRUSES AND BACTERIA –In the early 1990s, the International Agency for Research on Cancer (IARC) identified Helicobacter pylori (H. pylori ) as the first bacterium to be termed a definite cause of cancer in humans. – H. pylori has been associated with an increased incidence of gastric malignancy related to chronic superficial gastritis, with resultant atrophic and metaplastic changes to the gastric mucosa.
- 28. ETIOLOGY-Physical Agents – Physicalfactors associated with carcinogenesis include exposure to sunlight or radiation, chronic irritation or inflammation, and tobacco use. – Excessive exposure to the ultraviolet rays of the sun, – Use of sunscreens; – Occupation; – Recreational habits; and – Environmental variables, including humidity, altitude, and latitude,
- 29. CHEMICAL AGENTS – About75% of all cancers are thought to be related to the environment. – Most hazardous chemicals produce their toxic effects by altering DNA structure in body sites distant from chemical exposure. – Aromatic amines and aniline dyes; – Pesticides and formaldehydes; – Arsenic, soot, and tars; – Asbestos; etc,,.
- 30. Genetics and FamilialFactors Abnormal chromosomal patterns and cancer have been associated with extra chromosomes, – too few chromosomes, or translocated chromosomes – Burkitt lymphoma, chronic myelogenous – meningiomas, – acute leukemias, – retinoblastomas, – Wilms tumor, and skin cancers, including malignant melanoma.
- 31. Genetics and FamilialFactors – Cancers associated with familial inheritance syndromes include – Nephroblastoma , – Pheochromocytomas, and – Breast, ovarian, colorectal, stomach, thyroid, renal, prostate, and lung cancers
- 32. Dietary Factors – Long-termingestion of carcinogens or cocarcinogens or chronic absence of protective substances in the diet. – Dietary substances that appear to increase the risk of cancer include – Fats, – Alcohol, – Salt-cured or smoked meats, nitrate-containing and nitrite- containing foods, and red and processed meats.
- 34. Dietary Factors – Alcoholincreases the risk of cancers of the mouth, pharynx, larynx, esophagus, liver, colorectum, and breast. – obesity
- 35. Hormonal Agents – Diethylstilbestrol(DES) has long been recognized as a cause of vaginal carcinomas. – Oral contraceptives and prolonged estrogen therapy are associated with an increased – Incidence of hepatocellular, endometrial, and breast cancers, but they decrease the risk of ovarian cancer. – Menses under age 12 and delayed onset of menopause after age 55, nulliparity (never giving birth), and delayed childbirth after age 30 are all associated with an increased risk of breast cancer.
- 36. Causative Factors – CARCINOGENS –Common Carcinogenic Substances – SUBSTANCE TYPE OF CANCER – Asbestos = Lung, peritoneal, pericardial
- 37. CAUSATIVE FACTORS – Benzene= Acute myelocytic leukemia – Tobacco= Lung, mouth, pharynx, larynx, esophagus, pancreas, bladder, kidney, colon, liver – Alcoholic beverages = Mouth, pharynx, larynx, esophagus, liver – Radon = Lung – Ionizing radiation = Leukemia, tumors of most organs – Sunlight (ultraviolet rays) = Skin – Diethylstilbestrol (prenatally) = Vaginal
- 38. CAUSATIVE FACTORS Estrogens, synthetic= Endometrial – Androgens , synthetic = Liver – Vinyl chloride = Liver – Aromatic amines = Bladder – Arsenic (inorganic) = Lung, skin – Chromium = Lung – Nickel dust = Lung, nasal sinuses – Chronic hepatitis B or C infection = Liver
- 39. CAUSATIVE FACTORS – HumanT-cell lymphotropic virus type 1 (HTLV-1) = Adult T-cell leukemia and lymphoma – Human papillomavirus (HPV) = Cervix, vagina, vulva, penis, anus, mouth, throat – Phenacetin = Renal pelvis, bladder – Alkylating agents (used for chemotherapy) = Acute myelocytic leukemia – Cyclosporine (used to prevent transplant rejection) = Non- Hodgkin lymphoma
- 40. CLASSIFICATION OF CANCER –TUMORS CAN BE CLASSIFIED ACCORDING TO – ANATOMIC SITE, – HISTOLOGY (GRADING), AND – EXTENT OF DISEASE (STAGING).
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- 43. HISTOLOGIC CLASSIFICATION – GradeI: Cells differ slightly from normal cells (mild dysplasia) and are well differentiated (low grade). – Grade II: Cells are more abnormal (moderate dysplasia) and moderately differentiated (intermediate grade). – Grade III: Cells are very abnormal (severe dysplasia) and poorly differentiated (high grade). – Grade IV: Cells are immature and primitive (anaplasia) and undifferentiated; cell of origin is difficult to determine (high grade). – Grade X: Grade cannot be assessed.
- 44. Extent of DiseaseClassification – CLINICAL STAGING. – The clinical staging classification system determines the anatomic extent of the malignant disease process by stages: – Clinical staging has been used as a basis for staging a variety of tumor types, including cancer of the cervix and Hodgkin's lymphoma. Other malignant diseases (e.g., leukemia) do not use this staging approach.
- 45. Extent of DiseaseClassification – Stage 0: cancer in situ – Stage I: tumor limited to the tissue of origin; localized tumor growth – Stage II: limited local spread – Stage III: extensive local and regional spread – Stage IV: metastasis
- 46. TNM Classification System –TNM Classification System – T The extent of the primary tumor – N The absence or presence and extent of regional lymph – node metastasis – M The absence or presence of distant metastasis – The use of numerical subsets of the TNM components indicates the progressive extent of the malignant disease – Primary Tumor (T) – Tx Primary tumor cannot be assessed
- 47. TNM Classification System –T0 No evidence of primary tumor – Tis Carcinoma in situ – T1, T2, T3, T4 Increasing size and/or local extent of the – primary tumor – Regional Lymph Nodes (N) – Nx Regional lymph nodes cannot be assessed.
- 48. TNM Classification System –N0 No regional lymph node metastasis – N1, N2, N3 Increasing involvement of regional lymph – nodes – Distant Metastasis (M) – Mx Distant metastasis cannot be assessed – M0 No distant metastasis – M1 Distant metastasis
- 49. COMMON CANCER TYPES –This list of common cancer types includes cancers that are diagnosed with the greatest frequency in the United States, excluding nonmelanoma skin cancers: – Bladder Cancer Breast Cancer Colon and Rectal Cancer Endometrial Cancer Kidney Cancer Leukemia Liver
- 50. Cancer types – LungCancer Melanoma Non-Hodgkin Lymphoma Pancreatic Cancer Prostate Cancer Thyroid Cancer
- 67. AMERICAN CANCER SOCIETY(ACS) RECOMMENDATIONS FOR THE EARLY DETECTION OF CANCER IN AVERAGE-RISK ASYMPTOMATIC PEOPLE – Cancer Site Test or Procedure – Breast = Breast self-examination (BSE), Clinical breast examination (CBE) – Colorectal = Mammography, Fecal occult blood test (FOBT), flexible sigmoidoscopy. contrast barium enema (DCBE), fecal immunochemical test (FIT). Prostate = Digital rectal examination (DRE) and prostate-specific antigen (PSA) test. Cervix = Pap test. Endometrial = At the time of menopause. Cancer-related checkup = On the occasion of a periodic health examination.
- 68. DIAGNOSTIC AIDS USEDTO DETECT CANCER – TUMOR MARKER IDENTIFICATION – Analysis of substances found in body—tissues, blood, – or other body fluids that are made by the tumor or cancers – by the body in response to the tumor – example – Breast, colon, lung, ovarian, testicular, prostate
- 69. GENETIC PROFILING – Analysisfor the presence of mutations (alterations) in genes found in tumors or body tissues. – Assists in diagnosis, selection of treatment, prediction of response to therapy, and risk of progression or recurrence – EXAMPLE: – Breast, Jung, kidney, ovarian, brain cancers, leukemia, and lymphoma (many uses of genetic profiling are considered investigational)
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- 71. DIAGNOSTIC EVALUATION – MAMMOGRAPHY –Use of x-ray images of the breast. – EXAMPLE: – Breast cancer. – MAGNETIC RESONANCE IMAGING(MRI). – Use of magnetic fields and radiofrequency signals to create sectioned images of various body structures
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- 73. Computed tomography (CT) –Use of narrow-beam x- ray to scan successive layers of tissue for a cross-sectional view. – EXAMPLE: – Neurologic, pelvic, skeletal, abdominal, thoracic cancers.
- 74. Fluoroscopy – Use ofx-rays that identify contrasts in body tissue – densities; may involve the use of contrast agents. – EXAMPLE. Skeletal, lung, gastrointestinal cancers
- 75. Ultrasonography (ultrasound) – High-frequencysound waves echoing off body tissues are converted electronically into images; used to assess tissues deep within the body – EXAMPLE: – Abdominal and pelvic cancers
- 76. Endoscopy – Direct visualizationof a body cavity or passageway insertion of an endoscope into a body cavity or opening; – allows tissue biopsy, fluid aspiration, and – excision of small tumors. Used for diagnostic and – therapeutic purposes – EXAMPLE: – Bronchial, gastrointestinal cancers
- 77. Nuclear medicine imaging –Uses intravenous injection or ingestion of radioisotope – substances followed by imaging of tissues that have – concentrated the radioisotopes – EXAMPLE: – Bone, liver, kidney, spleen, brain, thyroid cancers
- 78. Bone scan – Aprocedure to check for abnormal areas or damage in the bones. – A very small amount of radioactive material is injected into a vein and travels through the blood. – The radioactive material collects in the bones and is detected by a scanner
- 79. Positron emission tomography(PET) – Through the use of a tracer, provides black and white or color-coded images of the biologic activity of a particular area, rather than its structure. Used in detection of cancer or its response to treatment
- 80. Positron emission tomography(PET) – EXAMPLE: – Lung, colon, liver, pancreatic, head and neck cancers; Hodgkin and non-Hodgkin lymphoma , melanoma
- 81. PET fusion – Useof a PET scanner and a CT scanner in one – machine to provide an image combining anatomic – detail, spatial resolution, and functional metabolic – abnormalities
- 82. Radioimmunoconjugates – Monoclonal antibodies arelabeled with a radioisotope and injected intravenously into the patient; antibodies that aggregate at the tumor site are – visualized with scanners.
- 83. Radioimmunoconjugates – EXAMPLE: – Colorectal,breast, ovarian, head and neck cancers; the lymphoma and melanoma
- 84. OTHER COMMON LABINVESTIGATION – Blood chemistry test – Complete blood count (CBC) – Cytogenetic analysis – Immunophenotyping – Liquid biopsy – Sputum cytology – Tumor marker tests – Urinalysis – Urine cytology
- 85. Management of Cancer –Treatment options offered to cancer patients should be based on treatment goals for each specific type of cancer. – The range of possible treatment goals may include complete – Eradication of malignant disease (cure), prolonged survival – And containment of cancer cell growth (control), or – Relief Of symptoms associated with the disease (palliation).
- 87. common Management ofCancer – There are three traditional modes of therapy for malignancies: surgery, Radiation, and Chemotherapy. Hormone manipulation, Immunotherapy with biologic response modifiers, and Bone marrow or Stem cell transplantation are treatments combined with traditional therapies.
- 89. Surgery – Surgical removalof the entire cancer remains the ideal and most frequently used treatment method. – the specific surgical approach may vary for several reasons. – it may be – Diagnostic Surgery – Surgery as Primary Treatment – Prophylactic Surgery – Palliative Surgery – Reconstructive Surgery
- 90. Diagnostic Surgery – DiagnosticSurgery – Diagnostic surgery, such as a biopsy, is usually performed to – Obtain a tissue sample for analysis of cells suspected to be malignant. – Biopsy Types – The three most common biopsy methods are the – Excisional, – Incisional, and – Needle methods
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- 94. Surgery as PrimaryTreatment – The goal is to remove the entire tumor or as much as is feasible (a procedure sometimes called debulking) and any involved surrounding tissue, including regional lymph nodes. – Two common surgical approaches used for treating primary – Tumors are local and wide excisions. – LOCAL EXCISION, – Often performed on an outpatient basis, is warranted when the mass is small. It includes removal of the mass and a small margin of normal tissue that is easily accessible.
- 95. Cont… – WIDE ORRADICAL EXCISIONS – include removal of the primary tumor, lymph nodes, adjacent involved structures, and surrounding tissues that may be at high risk for tumor spread – Video-assisted endoscopic surgery is increasingly replacing – surgery associated with long incisions and extended recovery – periods to minimize surgical trauma
- 96. Cont…. – Salvage surgeryis an additional treatment option that uses an extensive surgical approach to treat the local recurrence of a cancer after the use of a less extensive primary approach.
- 97. Prophylactic Surgery – Prophylacticsurgery involves removing nonvital tissues or organs that are at increased risk to develop cancer.
- 98. Palliative Surgery – Palliativesurgery is performed in an attempt to relieve complications of cancer, such as ulceration, obstruction, hemorrhage, pain, and malignant effusion. – Example, In pancreatic cancer, – Palliative surgery- cancer cannot be removed completely, and is used to relieve symptoms and prevent complications. – Stent placement- a small tube is placed in a blocked bile duct to keep it open. – Bypass Surgery- relieving a blocked bile duct, by rerouting bile from the common bile duct to the small intestine. –
- 100. Reconstructive Surgery – Reconstructivesurgery may follow curative or radical surgery in an attempt to improve function or obtain a more desirable cosmetic effect.
- 102. Radiation Therapy – Radiationtherapy may also be used to control malignant disease when a tumor cannot be removed surgically or when local nodal metastasis is present, or it can be used neoadjuvant (prior to local definitive treatment) – with or without chemotherapy to reduce the size of a tumor to enable surgical resection.
- 103. Cont,,, – Radiation therapymay be used prophylactically – to prevent the spread of a primary cancer to a distant area ( eg , irradiating the brain to prevent leukemic infiltration or metastatic lung cancer)
- 104. Radiation Therapy – Twotypes of ionizing radiation— – electromagnetic radiation(x- rays and gamma rays)and – particulate radiation( électrons , beta particules , protons, neutrons, and alpha particules )
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- 108. Toxicity – Alopecia (hairloss). – Stomatitis (inflammation of the oral tissues), – Xerostomia(dryness of the mouth), – Change and loss of taste, and – Decreased salivation. – The entire gastrointestinal mucosa may be involved, and – Esophageal irritation with chest pain and – Dysphagia
- 109. Toxicity – Certain systemicside effects are also commonly experienced – By patients receiving radiation therapy. These side effects – Include fatigue, malaise, and anorexia – Late effects (months to years after treatment) of radiation – Decreased vascular supply, and are irreversible. – Severe late effects may affect the lungs, heart, central nervous – System, and bladder.
- 110. Chemotherapy – In chemotherapy, antineoplasticagents are used in an attempt – to destroy tumor cells by interfering with cellular – functions, including replication.
- 111. Classification of chemotherapy –Chemotherapeutic agents are also classified by chemical – Group, each with a different mechanism of action. – These include – The alkylating agents, – Nitrosoureas, – Antimetabolites, – Antitumor – Antibiotics, – Plant alkaloids, – Hormonal agents, and miscellaneous – Agents.
- 112. – Implanted infusionport for administration of chemotherapy drugs or continuous morphine
- 113. Toxicity – Gastrointestinal System.Nausea and vomiting – Hematopoietic System. Most chemotherapeutic agents – cause myelosuppression – Renal System. renal damage – Cardiopulmonary System. signs of – heart failure must be monitored closely. – Neurologic System, neurotoxicity
- 114. – Hormone Therapy –Hormone therapy is used as an adjunct to other types of cancer therapy. It can slow tumor growth – or prevent cancer recurrence – Immunotherapy Using Biologic Response Modifiers – Biologic response modifiers (BRMs) are agents that manipulate the immune system in the hope of – controlling or curing a malignancy with little or no toxic effect on normal cells. These agents either – stimulate or suppress immune activity
- 115. – Bone Marrowand Stem Cell Transplantation – Bone marrow transplantation (BMT) is mainly used to correct the severe bone marrow damage – caused by chemotherapy or radiation – Gene Therapy – As research reveals the genes believed to be responsible for various types of cancers, the possibility – of gene splicing or replacement becomes a reality
- 116. Complementary and IntegrativeMedicine – Traditional Chinese medicine – (Including acupuncture), Ayurveda , homeopathy, and naturopathy; mind-body interventions, – Which include meditation, hypnosis, dance, music, and art therapy; – Herbal and plant therapies, nutrition, and biologic pharmacology; and manipulative and – Body-based methods, which include chiropractic and osteopathic manipulation and massage therapy.
- 118. Patient Teaching – CancerTreatment and Infection Prevention – Wash your hands well with an antimicrobial soap or alcohol-based hand rub: – Before eating – After using the toilet – After blowing your nose – After handling items many people have handled, such as railings,
- 119. Cont… – money, shoppingcarts, library books, newspapers, and pieces of – mail – After touching a pet – After spending time out in public – Do not share personal care items (razor, toothbrush, toothpaste, washcloth, towels, deodorant, – hand lotion, lipstick, etc.). – Clean toothbrushes by running them through the dishwasher or soaking them in a bleach or – hydrogen peroxide solution.
- 120. Cont…. – Stay awayfrom people with respiratory or other infections. – Bathe daily if possible; use an antimicrobial soap. – Examine the mouth daily for sores or white patches; perform mouth care frequently. – Examine the skin, especially the feet, for signs of broken areas daily. – Wash dishes, utensils, and items used in cooking in hot sudsy water or run them through a – dishwasher.
- 121. – Drink onlyfresh, bottled water. – Do not reuse drinking cups or glasses without washing them. – Keep lips moist with lip balm or petroleum jelly to avoid cracking. – Stay out of crowded places. – Eat only canned or cooked foods. – If leukocyte count is extremely low, maintain a low-bacteria diet by avoiding salads, raw fruits – and vegetables, undercooked meat, pepper, or paprika.
- 122. Cont… – Do nothandle garden flowers, plants, or earth. – Do not clean out cat litter boxes or bird cages. – Have someone else change the water in flower arrangements if they are allowed. – Monitor temperature daily.
- 123. – Cont…. – Becareful not to nick or scratch the skin. – Report the following signs of infection to the provider immediately: – Temperature over 100° F (38° C) – Persistent cough – Colored or foul-smelling drainage from wound or nose
- 124. – Colored orfoul-smelling drainage from wound or nose – Presence of a boil or abscess – Cloudy, foul-smelling urine or burning on urination – The diet is modified to avoid irritating foods. Stool softeners are given to keep the stool soft and – to prevent the Valsalva maneuver that occurs with constipation. No rectal suppositories or enemas are given, and rectal temperatures are contraindicated.
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- 126. Common Nursing Problemsfor Patients With Cancer – Altered nutrition due to increased metabolic demand and nausea, vomiting, diarrhea, or mucositis – Potential for infection due to bone marrow depression – Pain, acute or chronic, due to effects of tumor on body structures or cancer therapy – Altered skin integrity due to surgical or radiation therapy – Altered body image due to weight loss or hair loss – Potential for injury to patient, staff, and visitors due to exposure to a radioactive implant
- 127. Cont,,,, – Altered physicalmobility due to restricted activity secondary to a radioactive implant – Diarrhea and dehydration due to effects of cancer treatment – Constipation due to effects of chemotherapy – Altered urinary elimination due to radiation therapy or secondary to effects of chemotherapy – Fatigue –
- 128. Cont…. – Insufficient knowledgeof drugs and their potential side effects – Altered self-care ability due to weakness and fatigue – Fear of dying – Limited coping due to the significance of cancer – Altered family coping due to a anxiety over patient's prognosis