Navigating the Sea of Cancer Care Flashcards
Supportive Care Framework: Domains of Health
- Physical
- Emotional
- Psychological
- Spiritual
- Social
Created in 2005, the Infirmiere Pivot in oncology (nurse Navigator) role is:
- Provide continuity of care
- Provide p/f with a main contact person
- Address the different needs of patients (social, financial, psychological)
As a member of an interdisciplinary team, the pivot nurse has 4 practice functions which are:
- Assessment of needs and symptoms
- Teaching
- Support
- Coordination/continuity of care
Tx/management of bone metastases:
- Biphosphanates
- Radiation therapy
- Surgery
- Pain management
- Chemotherapy.
Transition point in the disease trajectory are indentified as the most vulnerable periods for p/f, the nurse’s role during those period is to:
- Be present
- Accompany the p/f
- Symptom management
- work closely with the team
Ovarian cancer symptoms:
- Exfoliation and implantation of cancel cells on surfaces of peritoneal cavity
- Ascites, bowel obstruction, pleural effusion
Tumour Marker of ovarian cancer:
CA-125
Chemotherapy induced Peripheral Neuropathy (CIPN):
- Toxic neuropathy affect sensory, motor +/- autonomic nerves.
- Reversible but may be permanent.
- Important to frequently assess patients during therapy and to treat and recognize pre-existing conditions that put patient at risk (age, intensity, cumulative dose, duration of tx, multiple agents)
- Agents that cause peripheral neuropathy can lead to lodd of deep tendon reflexes. Risk of injury related to sensory and motor deficits.
- Once neuropathy occurs, continuing the same therapy may lead to progressive nerve damage and loss of function.
Characteristic of the Chemotherapy Induced Peripheral Neuropathy (CIPN):
- Symmetrical
- Begins in distal sites first
- As cumulative doses increase, symptoms progress in severity and to more proximal sites (Toes–>feet–>ankles) (Fingertips –>hands)
Assessment of Chemotherapy Induced Peripheral Neuropathy (CIPN):
- Recognize changes in peripheral neuropathy once the tx begins
- Assess motor, sensory and autonomic function (before, during and after the tx)
Medications for peripheral neuropathy pain:
Anticonvulsants (Gabapentin)
Antidepressants tricyclics (amitriptyline)
Opioids
Pregabalin (lyrica)
Malignant Bowel Obstruction (MBO) is:
- Any condition that prevents the normal flow of chyme through the intertinal lumens
- Common in relapsed ovarian cancer
- Requires a multidisciplinary approach to surgical, non-surgical management and skilled clinical judgment
Classifications of Malignant bowel obstruction (MBO):
- Acute, chronic or recurrent
- Partial, complete bowel obstruction
- Acute bowel obstruction (rapid onse of cramps, abdominal distension, vomiting) or insidious obstructions (develop over weeks)
Infirmiere pivot en oncologie (IPO) Goal:
To work to reduce the effect of a diagnosis of cancer on the person experiencing cancer and their family throughout the period of care, from diagnosis to the end of the illness.
Unique characteristics of the Infirmiere pivot en oncology (IPO):
Availability
Continuity of Care
Partnership
Expertise
