Nursing Process: Approach to Care Cancer

Nursing Process: Approach to Care Cancer

Cancer is a group of disorders in which abnormal cells develop fast and spread to other tissue structures. Tumors can develop due to rapidly proliferating cells and disrupt the body’s regular functioning. Cancer is among the leading causes of mortality globally.

According to the WHO (2022), cancer account for nearly one in every six fatalities in 2020. Physical mutagens, such as UV irradiation and radioisotopes, interact with 3 forms of exogenous agents: (1) chemical carcinogens, like asbestos, cigarette smoke components, liquor, (2) food contamination from aflatoxin, and drinking water contamination from arsenic; and (3) biological toxins, such as microbes from microorganisms (WHO, 2022).

WHO (2022) confirm that cancer incidence rises with age due to the accumulation of risks for particular cancers that become more prevalent with age. The mechanism of cell repair becomes less effective as a person’s age is connected to the accumulation of overall risk. This paper aims to evaluate nurses’ role in cancer management, prevention, and treatment by advocating for cancer-preventive measures such as vaccination, early and prompt diagnosis, preventing complications during treatment, participating in cancer research, and educating both nurses and the community on cancer.

Cancer Diagnosis and Staging

The examination of physiological and functional variations, as well as the findings of the diagnostic examination, are used to make a cancer diagnosis. Suspected cases of cancer are subjected to extensive testing to (1) ascertain the existence and magnitude of the malignancy, (2) recognize potential metastasis, (3) assess the function of implicated body systems and organs, and (4) obtain tissue for laboratory review, including tumor stage and grade (Hinkle & Cheever, 2018). A review of systems, a clinical assessment, radiographic examinations, laboratory investigations, and surgery and pathology reports are all part of the diagnostic evaluation.

Tumor marker identification is a diagnostic test that identifies tumor markers, which are substances produced in response by cancer cells or other body cells to malignancy. Most tumor markers are generated by both healthy and cancer cells, but cancerous cells produce them in greater quantities. Genetic profiling identifies tumor mutations and aids in diagnosis and treatment profiling.

Imaging diagnostic tests like Ultrasonography, Fluoroscopy, Computed tomography, Mammography, and MRI are used to create internal visualization of internal organs and help diagnose cancer. A biopsy is a technique that involves removing a sample of tissue from a suspected region for examination. The tissue sample is examined under a microscope, and further tests are performed to determine whether the tissue is cancerous. A pathologist explains the results in a pathology report and provides a pathology report, which is useful in diagnosing cancer and deciding on treatment choices.

A comprehensive diagnostic assessment includes determining the tumor’s stage and grade. The staging and grading of cancer determine treatment options and prognosis. The tumor’s size and the existence of local invasion and distant metastasis are all defined by staging.

Rosen and Sapra (2022) demonstrate the tumor, nodes, and metastasis (TNM) paradigm is extensively used in cancer staging. T denotes the size of the initial tumor, N, the absence or existence of lymphovascular invasion metastasis, and M, the absence or presence of distant metastasis. The progression of the malignant state is shown using numerical subsets of the TNM elements.

Tumor cells are classified via grading. Grading methods attempt to describe the kind of tissue from which cancer arose, as well as the extent to which tumor cells maintain functional and histologic features of the tissue of origin (Hinkle & Cheever, 2018). The tumor is designated a number between I and IV. Grade I tumors, also described as well-differentiated tumors, are structurally and functionally similar to the tissue of origin.

Tumors classified as poorly differentiated or undifferentiated are those that do not match the tissue of origin in form or function and are assigned grade IV. Grade IV cancers are more aggressive and less treatable than well-differentiated tumors.

Complications of Cancer, Treatment, and Side Effects

Tyerman et al. (2022), the medical surgical nursing book, explains that most cancer patients lose weight during their disease. Nutritional difficulties include anorexia, malabsorption, and cachexia. Impaired dietary status can have physical and psychological repercussions. Nutritional considerations include decreasing protein and calorie intake, metabolic or mechanical consequences of cancer, systemic illness, adverse therapeutic effects, and the patient’s mental state.

Another complication of cancer is pain. A study undertaken by Eerdekens et al. (2019) predicted that 90 to 95 percent of individuals with advanced cancer suffer pain. Pain connected to the underlying disease process accounts for 75 percent of all cancer patients’ pain (Eerdekens et al., 2019).

Pain is also linked to a variety of cancer therapies. Acute pain is associated with surgical trauma. Chronic pain symptoms, such as post-operative neuropathies, contribute to pain. Some chemotherapeutic drugs produce tissue necrosis, peripheral neuropathies, and stomatitis, all of which can be painful. Radiation therapy might result in pain as a result of skin or organ irritation. Fatigue is among the very significant and common complications encountered by cancer patients. The stress of dealing with cancer also causes fatigue.

A nationwide study by Jairam et al. (2018) shows that septicemia and septic shock are both potentially fatal adverse effects of cancer therapy caused by the immunosuppressive effects of chemotherapy. It is more common in people who are neutropenic or have hematologic cancers. Changes in mental state, increased fever, clammy skin, reduced urine production, hypotension, tachycardia, tachypnea, and unusual arterial blood gas readings are all indications of septic shock.

Cancer therapy can potentially cause bleeding and hemorrhage. Platelets are required for hemostasis. The most prevalent cause of hemorrhage in people living with cancer is thrombocytopenia, which is described as a platelet count of fewer than 100,000/mm3. Platelet counts less than 20,000/mm3 are linked to an elevated risk of spontaneous hemorrhage, necessitating platelet transfusion (Hinkle & Cheever, 2018).

Thrombocytopenia is frequently caused by bone marrow suppression following chemotherapy and radiation therapy, as well as tumor invasion of the bone marrow. Platelet breakdown is also linked to hypersplenism and aberrant antibody function in some instances of leukemia and lymphoma.

The nurse must recognize possible dangers to the patient’s physical and psychological health and assess the patient’s capacity to cope with the numerous intrusions on body image that occur throughout illness and treatment. Threats to self-concept arise from the patient’s realization of sickness, deformity, potential incapacity, and death. Many cancer patients are obliged to change their habits to accommodate therapies or because of the condition. The nurse needs to listen to and counsel both the patient and the family (Hinkle & Cheever, 2018).

Other approaches for reducing physical and psychological impacts include anticipating side effects of therapies and changes in the patient’s condition and reporting, reviewing, and reinforcing information verbally and in writing. Strategies for dealing with therapy side effects are explored with the patient and family.

In addition, analyzing changes in the patient’s physical state and reporting pertinent changes to the physician assist ensure that appropriate and timely therapeutic adjustments are made. The nurse also evaluates the effectiveness of pain control and other tactics to avoid or control the adverse effects of therapeutic approaches and disease progression.

Variables Contributing to Incidence and Fatalities of Different Malignancies in the United States

Much of the cancer burden in the U.S.A. can be attributed to modifiable health habits that raise disease risk. Tobacco smoking, physical inactivity, overweight and obesity, poor nutrition, and alcohol consumption have all been linked to increased cancer incidence and death. However, other lifestyle variables such as sun exposure, sexual habits, and contact with infectious blood all have a role in cancer incidence.

In an NCI (2020) report, in 2020, a projected 1,806,590 new cancer cases were diagnosed in the United States, with 0.65 million individuals dying from the illness.  Breast, lung, prostate, colon and rectum, melanoma, and bladder cancer are the most common cancers in the United States.

The NCI (2020) report also showed that the cancer incidence rate in the United States is 442.4 per 100,000 individuals per year. Based on cases reported from 2013 to 2017 mortality rate is 158.3 per 100,000 individuals per year (NCI, 2020). This is due to many Americans being smokers, obese, and living physically inactive lives, contributing to obesity.

Mendes (2022), while citing a 2014 study by  American Cancer Society researchers, states that 42 percent of cancer diagnoses and 45 percent of cancer fatalities in the  US are connected to modifiable risk factors and hence prevented. Mendes (2022) further shows that the study examined how every risk factor contributed to total cancer incidence and deaths in 2014. Tobacco smoking was at the top of the list. Tobacco smoking was responsible for 19% of all cancer diagnoses and approximately 29% of cancer deaths.

Increased BMI was responsible for 7.8 percent of cancer diagnoses and 6.5 percent of deaths, according to the study. Drinking alcohol accounted for 5.6 % of cases and 4 percent of deaths, whereas UV exposure was linked to nearly 5% of cases but only 1.5 % of deaths. Inactivity was a factor in 2.9 % of cases and 2.2 %of fatalities (Mendes, 2022).

American Cancer Society Education, Support, and Services

American Cancer Society can provide education through sharing and communication among cancer patient educators and the National Cancer Institute. It can also utilize social media and technology improvements to educate self-management, nutrition, analgesia, and management (American Cancer Society, 2022).

It can assist patients and families by providing education and assistance via telehealth to encourage them to feel comfortable and competent in handling these therapies at home. Telehealth can also be used to give follow-up visits from the nurse, which aid in the identification of issues and are generally reassuring, boosting the patient’s and family’s comfort in dealing with difficult and unfamiliar parts of treatment.

Services I would like to be provided by the American Cancer Society should promote healthy lifestyles to help people avoid cancer, conducting more cure-based investigations on cancer and its causes to obtain more explanations and better treatment, and advocating for the lives of people living with cancer to get inexpensive therapies and lifesaving policy changes. Finally, it is recommended that more workers, nurses, and counselors be hired to give emotional support and up-to-date cancer information to individuals impacted by cancer.

Nursing Process Care for Cancer Patients

Assessment Nursing diagnosis Intervention Implementation Evaluation
On assessment, the patient’s white blood cell count is elevated. The patient has a fever of 38.5 degrees Celsius. Risk of infection related to weakened immune defenses caused by myelosuppression secondary to radiation or antineoplastic drugs, as evidenced by to patient having a high fever (Hinkle & Cheever, 2018) Examine the patient for symptoms of infection by assessing vital signs every 4 hours, monitoring white blood cell count and differential every day, and evaluating all places that microorganisms may use as entrance points (Tyerman et al., 2022). Vital signs are taken every 4 hours. Displays normal body temperature and vital indicators.

Exhibits no symptoms of inflammation such as local edema, erythema, discomfort, or warmth.

On assessment, the patient looks emaciated and weak and vomits frequently Nutritional imbalance, less than the body requires, related to nausea and vomiting, as evidenced by patients losing weight (Tyerman et al., 2022) Adjust the patient’s diet before and after medicine delivery based on their preferences and tolerance.

Administer  antiemetics, sedatives, and corticosteroids before chemotherapy

Maintain appropriate fluid hydration before, during, and after medication delivery; monitor intake and output (Hinkle & Cheever, 2018).

Assess and identify other possible causes of nausea and vomiting, such as constipation, gastrointestinal problems, electrolyte imbalance, and radiotherapy.

The patient switched to intravenous medication and treatment.

Antiemetics administered

The patient reports a decrease in nausea.
On assessment, the patient complains of chronic pain and cannot manage activities of daily living. Chronic pain and fatigue related to the disease process as evidenced by a pain scale of 8/10 evaluate pain using the pain scale and check for  quality, regularity, and length

Evaluate other contributes to the patient’s pain like fear, exhaustion, rage, etc.

Provide analgesics to promote optimal pain relief.

Encourage pain-relieving tactics that the patient has used effectively in prior pain experiences, as well as educate the patient on new pain-relieving strategies, such as distraction, visualization, relaxation, and cutaneous stimulation(Hinkle & Cheever, 2018).

Pain scale measured

Morphine 5ml sublingual administered

Pain-relieving measures taught.

On the pain scale, reports less pain.

Education in Liberal Arts and Science Studies In Foundation Of Nursing

The liberal arts and sciences are important to the nursing curriculum because they support analytical reasoning, creativity, and holistic care.  According to Kooken and Kerr (2018), science has taken on a more significant role in nursing education. Nursing students acknowledge that liberal arts strengthen their abilities to communicate, make sense of the world, negotiate diversity, make judgments, and better their human selves; hence, the deliberate incorporation of liberal arts and humanities into the nursing curriculum should be ensured.

Conclusion

As discussed in this paper, it is advisable that individuals have yearly clinical checkups to screen or detect cancer early. This will prevent early deaths related to cancer. Additionally, society must embrace cancer vaccines to prevent cancer. Education and research for cancer at undergraduate, master’s, and Ph.D. levels is imperative to find better ways to take care of patients.

Furthermore, it is critical for nurses to manage cancer care plans since cancer is a pandemic in and of itself. Evidence shows that cancer patients are more likely to experience problems with the disease and treatment process. Nurses’ primary management tactics for cancer victims include clear symptomatology management, teaching about infection risk factors, and infection control practices during the disease process. Nurses must also contemplate active intervention in the cancer population and provide tailored care. Telemedicine may be utilized to assist patients during follow-up appointments to reduce the number of visits.

References

American Cancer Society. (2022). What we do. Cancer.Org. https://www.cancer.org/about-us/what-we-do.html

Mendes, E. (2022). More than 4 in 10 cancers and cancer deaths linked to modifiable risk factors. American Cancer Society. https://www.cancer.org/latest-news/more-than-4-in-10-cancers-and-cancer-deaths-linked-to-modifiable-risk-factors.html

NCI. (2020). Cancer statistics. National Cancer Institute. https://www.cancer.gov/about-cancer/understanding/statistics

Eerdekens, M.-H., Kapanadze, S., Koch, E. D., Kralidis, G., Volkers, G., Ahmedzai, S. H., & Meissner, W. (2019). Cancer-related chronic pain: investigation of the novel analgesic drug candidate cebranopadol in a randomized, double-blind, noninferiority trial. European Journal of Pain (London, England)23(3), 577–588. https://doi.org/10.1002/ejp.1331

Hinkle, J. L., & Cheever, K. H. (2018). Brunner and suddarth’s textbook of medical-Surgical Nursing. Wolters Kluwer. https://books.google.at/books?id=yS7vDwAAQBAJ

Jairam, V., Park, H. S. M., & Yu, J. B. (2018). Treatment-related complications of chemotherapy and radiation therapy: an analysis of the nationwide emergency department sample. International Journal of Radiation Oncology, Biology, Physics, 102(3), e416-e417. https://www.redjournal.org/article/S0360-3016(18)32675-0/abstract

Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: creating a portrait for the 21st century. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing34(1), 60–64. https://doi.org/10.1016/j.profnurs.2017.07.002

Rosen, R. D., & Sapra, A. (2022). TNM Classification. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553187/

Tyerman, J., Cobbett, S., Harding, M. M., Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2022). Lewis’s medical-Surgical Nursing in Canada – E-book: Assessment and management of Clinical Problems. Elsevier Health Sciences. https://books.google.at/books?id=uwxsEAAAQBAJ

WHO. (2022). Cancer. Who.Int. https://www.who.int/health-topics/cancer

Nursing Process: Approach to Care Cancer Instructions

 
                 The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.