Nursing Management in Bone Marrow Transplantation

Nursing care of patients undergoing BMT is complex and demands a high level of skill. Transplantation nursing can be extremely rewarding yet extremely stressful. The success of BMT is greatly influenced by nursing care throughout the transplantation process.  IMPLEMENTING PRETRANSPLANTATION CAREAll patients must undergo extensive pretransplantation evaluations to assess the current clinical status of the disease. Nutritional assessments, extensive physical examinations and organ function tests, and psychological evaluations are conducted. Blood work includes assessing past antigen exposure (for example, to hepatitisvirus, cytomegalovirus, herpes simplex virus, HIV, and syphilis). The patient’s social support systems and financial and insurance resources are also evaluated. Informed...

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Posted in: Nursing Management

Classification of Chemotherapeutic Agents

Certain chemotherapeutic agents (cell cycle–specific drugs) destroy cells actively reproducing by means of the cell cycle. Many of these agents are specific to certain phases of the cell cycle. Most affect cells in the S phase by interfering with DNA and RNA synthesis. Others, such as the vinca or plant alkaloids, are specific to the M phase, where they halt mitotic spindle formation.  Chemotherapeutic agents that act independently of the cell cycle phases are termed cell cycle–nonspecific agents. These agents usually have a prolonged effect on cells, leading to cellular damage or death. Many treatment plans combine cell cycle–specific and cell cycle–nonspecific agents to increase the number of vulnerable tumor cells killed during a treatment period. Chemotherapeutic agents are also...

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Posted in: Cancer,Chemotherapy

Nursing Management in Radiation Therapy

The patient receiving radiation therapy and the family often have questions and concerns about its safety. To answer questions and allay fears about the effects of radiation on others, on the tumor, and on the patient’s normal tissues and organs, the nurse can explain the procedure for delivering radiation and describe the equipment, the duration of the procedure (often minutes only), the possible need for immobilizing the patient during the procedure, and the absence of new sensations, including pain, during the procedure. If a radioactive implant is used, the nurse informs the patient and family about the restrictions placed on visitors and health care personnel and other radiation precautions. Patients also need to understand their own role before, during, and after the procedure. See...

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Posted in: Nursing Management,Radiation Therapy

Nursing Management for Patient Undergoing Cancer Surgery

The patient undergoing surgery for cancer requires general perioperative nursing care, as described in Unit 4, along with specific care related to the patient’s age, organ impairment, nutritional deficits, disorders of coagulation, and altered immunity that may increase the risk for postoperative complications. Combining other treatment methods, such as radiation and chemotherapy, with surgery also contributes to postoperative complications, such as infection, impaired wound healing, altered pulmonary or renal function, and the development of deep vein thrombosis. In these situations, the nurse completes a thorough preoperative assessment for all factors that may affect patients undergoing surgical procedures.  The patient undergoing surgery for the diagnosis or treatment of cancer...

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Posted in: Brunner,Cancer

Diagnosis of Cancer and Related Nursing Considerations

A cancer diagnosis is based on assessment for physiologic and functional changes and results of the diagnostic evaluation. Patients with suspected cancer undergo extensive testing to (1) determine the presence of tumor and its extent, (2) identify possible spread (metastasis) of disease or invasion of other body tissues, (3) evaluate the function of involved and uninvolved body systems and organs, and (4) obtain tissue and cells for analysis, including evaluation of tumor stage and grade. The diagnostic evaluation is guided by information obtained through a complete history and physical examination. Knowledge of suspicious symptoms and of the behavior of particular types of cancer assists in determining which diagnostic tests are most appropriate .  A patient undergoing extensive...

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Posted in: Brunner,Cancer