T-1 Mod 1 Assign Flashcards
Yellowing eyes, skin paleness, skin coldness, skin yellowing, SOB, muscular weakness, changed stool color, fatigue, dizziness, fainting, low blood pressure, palpitation, rapid heart rate, chest pain, angina, heart attack, & spleen enlargement.
Anemia
Possible nursing dx for anemia
Fatigue related to decreased hemoglobin and diminished oxygen-carrying capacity of the blood.
Altered nutrition, less than body requirements, related to inadequate intake of essential nutrients.
Altered tissue perfusion related to insufficient hemoglobin and hematocrit. (Belleza M, 2017)
Interventions (including Medications and complementary alternative therapy) for cancer related anemia
To manage stress and fatigue:
Prioritize activities. Assist the patient in prioritizing activities and establishing balance between activity and rest that would be acceptable to the patient.
Exercise and physical activity. Patients with chronic anemia need to maintain some physical activity and exercise to prevent the deconditioning that results from inactivity.
To maintain adequate nutrition:
Diet. The nurse should encourage a healthy diet that is packed with essential nutrients.
Alcohol intake. The nurse should inform the patient that alcohol interferes with the utilization of essential nutrients and should advise the patient to avoid or limit his or her intake of alcoholic beverages.
Dietary teaching. Sessions should be individualized and involve the family members and include cultural aspects related to food preference and preparation.
To maintain adequate perfusion:
Blood transfusion monitoring. The nurse should monitor the patient’s vital signs and pulse oximeter readings closely.
To promote compliance with prescribed therapy:
Enhance compliance. The nurse should assist the patient to develop ways to incorporate the therapeutic plan into everyday activities.
Medication intake. Patients receiving high-dose corticosteroids may need assistance to obtain needed insurance coverage or to explore alternative ways to obtain these medications. (Belleza M, 2017)
Low white blood cell count, low grade fever, sore mouth, painful swallowing, gingival pain and swelling, skin abscesses, recurrent sinusitis and otitis, cough, dyspnea, perirectal pain and irritation. (American Cancer Society, 2017)
Neutropenia
Nursing dx for neutropenia
Risk for injuries r/t drug caused neutropenia
Impaired mucus membrane r/t deficiency of WBC
High risk for infection r/t decreased neutrophil count
Nutrition deficiency r/t mouth sores.
Interventions (including Medications and complementary alternative therapy) for neutropenia
Avoid foods such as raw fruits, vegetables, and raw meats.
Avoid crowded areas, plants/flowers, and people with known infections or sickness.
Provide thorough oral care, prevent any wounds and infection, and wash hands frequently.
Easy or excessive bruising (purpura), superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs, prolonged bleeding from cuts, bleeding from your gums or nose, blood in urine or stools, unusually heavy menstrual flows, fatigue, & enlarged spleen.
Thrombocytopenia
Possible nursing dx for thrombocytopenia
Increased risk of bleeding r/t bleeding disorder,
impaired oral health/mucus membranes r/t bleeding gums, &
impaired skin integrity r/t superficial bleeding into skin.
Thrombocytopenia interventions
Blood or platelet transfusions, plasma exchange, medication adjustment, avoiding rectal medication/procedures, use soft toothbrush, avoid contact sports, use electric razor, avoid NSAIDS, wear shoes, stool softeners, blow nose gently, avoid smoking and alcohol use.
Issues balancing properly, abdominal pain, dysphasia, n/v, constipation, increased heart rate, orthostatic hypotension, arrythmias, pinprick sensation, decreased sensation in feet/toes/hands/arms/legs, decreased DTR, shrinking muscles/weakness.
Neuropathy
Nursing dx for cancer related neuropathy
Injury/fall risk r/t reduced sensation in extremities, impaired mobility r/t changes in gait and balance, activity intolerance r/t altered HR.
Neuropathy interventions
Check skin, feet, and extremities daily for cuts or bruising, identify triggers, use pot holders due to decreased sensation, sun screen, ask your provider about nerve medication such as gabapentin, duloxetine, opioids, and other non-pharmacological pain relievers such as acupuncture, exercise, relaxation, massage, TENS unit, and home health care if needed.
Memory loss, slowed comprehension, confusion, disorientation, memory fog, trouble concentrating and paying attention, inability to reason, and difficulty with proprioception.
Cognitive disorders related to cancer/tx
Cognitive disorders nursing dx
Impaired communication r/t cerebral impairment, ADL impairment r/t cognitive impairment, risk for violence toward self or others r/t inability to recognize people or places appropriately.
Nursing interventions for cognitive disorders
Cognitive enhancing drugs such as Namenda, Aricept, & Exelon, antidepressants, stimulants such as amphetamines and methylphenidate. Give patient only a couple options to refrain from overwhelming them, give one task at a time, post reminders and signs on walls, color code items, keep check lists, place items in same area each time, do not rearrange furniture, use a planner, encourage exercise and proper rest, eat a healthy diet/vegetables, follow a routine/schedule, ask for help to reduce burn out, and ensure safety locks on doors for patients with extreme memory impairment issues.
