Showing posts with label Brunner. Show all posts
Showing posts with label Brunner. Show all posts

Wednesday, March 14, 2012

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 is often anxious about the surgical procedure, possible findings, postoperative limitations, changes in normal body functions, and prognosis. The patient and family require time and assistance to deal with the possible changes and outcomes resulting from the surgery.

 The nurse provides education and emotional support by assessing patient and family needs and exploring with the patient and family their fears and coping mechanisms, encouraging them to take an active role in decision making when possible. When the patient or family asks about the results of diagnostic testing and surgical procedures, the nurse’s response is guided by the information the physician previously conveyed to them. The patient and family may also ask the nurse to explain and clarify information that the physician initially provided but that they did not grasp because they were anxious at the time. It is important for the nurse to communicate frequently with the physician and other health care team members to be certain that the information provided is consistent. 

After surgery, the nurse assesses the patient’s responses to the surgery and monitors for possible complications, such as infection, bleeding, thrombophlebitis, wound dehiscence, fluid and electrolyte imbalance, and organ dysfunction. The nurse also provides for patient comfort. Postoperative teaching addresses wound care, activity, nutrition, and medication information.
Plans for discharge, follow-up and home care, and treatment are initiated as early as possible to ensure continuity of care from hospital to home or from a cancer referral center to the patient’s local hospital and health care provider. Patients and families are also encouraged to use community resources such as the American Cancer Society or Make Today Count for support and information. (Medical and Surgical Nursing; Brunner & Suddarth10th Edition)

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 testing is usually fearful of the procedures and anxious about the possible test results. The nurse can help relieve fear and anxiety by explaining the tests to be performed, the sensations likely to be experienced, and the patient’s role in the test procedures. The nurse encourages the patient and family to voice their fears about the test results, supports the patient and family throughout the test period, and reinforces and clarifies information conveyed by the physician. The nurse also encourages the patient and family members to communicate and share their concerns and to discuss their questions and concerns with each other. (Medical and Surgical Nursing; Brunner & Suddarth10th Edition)

 
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