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Side effects of cancer treatment
Terms in this set (72)
-rash (dry, itchy, red)
**radiation damages skin
etiologies r/t skin side effects
sunburn like skin changes, hair loss, redness, tenderness, blisters, pealing, swelling/irritation, dryness and itchy skin is caused by high energy beams from a linear accelerator
ND r/t skin SE
-impaired skin integrity
-risk for impaired skin integrity
-disturbed body image
remember that we need to always...
assess the skin before AND after therapy for baseline comparison!
nursing interventions for skin (dry desquamation)
-Basic skin care per institutions protocol
-Keeping the skin moist will promote wound healing and allow minimal breakdown
-Avoid radiated skin from temperature extremes
-Do not use heating pads, ice packs, hot water bottles in tx field
-Avoid constricting garments, rubbing, harsh chemicals, deodorants - traumatize skin
-Avoid dry reaction due to pruritus, uncomfortable feelings
-Lubricate dry skin w/ a nonirritating lotion emollient that contains no metal, alcohol, perfume, or additive, - irritation.
-Radiation dermatitis - Calendula ointment and topical hyaluronic acid cream
nursing interventions for skin (wet desquamation)
-Keeping tissues clean with normal saline compresses or modified Burow's solution soaks.
-To protect skin from further damage, use moisture vapor-permeable dressings or Vaseline petrolatum gauze.
what do we as nurses want to educate our patient on in regards to skin management?
1. Gently cleanse the skin in the treatment field using a mild soap (Ivory, Dove), tepid water, a soft cloth, and a gentle patting motion. Rinse thoroughly and pat dry.
2. Apply nonmedicated, nonperfumed, moisturizing lotion or cream, such as calendula ointment, aloe gel, Aquaphor, or Biafine cream, to alleviate dry skin. Some substances must be gently cleansed from the treatment field before each treatment and reapplied. Over-the-counter hydrocortisone cream 1% may reduce itching.
3. Rinse the area with saline solution. Expose the area to air as often as possible. If copious drainage is present, use astringent compresses (such as Domeboro solution) and nonadhesive absorbent dressings (they must be changed as soon as they become wet). Observe the area daily for signs of infection.
4. Avoid wearing tight-fitting clothing such as brassieres and belts over the treatment field.
5. Avoid wearing harsh fabrics, such as wool and corduroy. A lightweight cotton garment is best. If possible, expose the treatment field to air.
6. Use gentle detergents such as Dreft and Ivory Snow to wash clothing that will come in contact with the treatment field.
7. Avoid direct exposure to the sun. If the treatment field is in an area that is exposed to the sun, wear protective clothing such as a wide-brimmed hat when out in the sun and apply sunscreen lotion.
8. Avoid all sources of excessive heat (hot water bottles, heating pads, sunlamps) on the treatment field.
9. Avoid exposing the treatment field to cold temperatures (ice bags or cold weather).
10. Avoid swimming in saltwater or in chlorinated pools during the time of treatment.
11. Avoid the use of potential irritants (e.g., perfumes, powders, or cosmetics) on the skin in the treatment field; review use of other topical medications or lotions with your health care provider during treatment. Also avoid tape, dressings, and adhesive bandages unless permitted by the radiation therapist. Avoid shaving the hair in the treatment field.
12. Continue to protect sensitive skin after the treatment is completed. Do the following:
• Avoid direct exposure to the sun. A sunscreen agent and protective clothing must be worn if the potential of exposure to the sun is present.
• Use an electric razor if shaving is necessary in the treatment field.
-some chemo drugs (anthracyclines, taxanes)
-monoclonal antibodies and tyrosine kinase inhibitors
-some leukemia drugs
-radiation to the chest
ND r/t cardiotoxicity
-decreased cardiac output
-impaired gas exchange
-risk for shock
-ineffective tissue perfusion
-risk for decreased cardiac tissue perfusion
NI r/t cardiotoxicity
-monitor heart with ECG and cardiac ejection fraction (echo)
-drug therapy may need to be modified for symptoms or deteriorating cardiac function studies
-monitor BP, skin (cyanosis), UOP, heart and lung sounds, peripheral pulses, HR, O2 sats, troponin levels, BNP, edema, SOB, coughing/sputum, skin turgor, JVD
-educate patient on s/s of HF and when to contact the provider
short term complications r/t cardiotoxicity
long term complications r/t cardiotoxicity
heart damage with chemo meds, graft vs. host
-release of intracell breakdown products stimulates vomiting center in the brain
-GI lining is destroyed with radiation and chemo
ND r/t N/V
-imbalanced nutrition: less than body requirements
-risk for electrolyte imbalance
-risk for fluid volume deficit
-risk for aspiration
NI r/t N/V
-teach patient to eat colder foods
-have the patient suck on ice chips
-eat small meals
-stay upright after treatment
-teach relaxation techniques
-administer antiemetics before meals and prophylactically before chemo
-drink plenty of fluids
-avoid unpleasant smells
-avoid spicy goods
-encourage the patient to eat and drink when not nauseated
-instruct patient to take antiemetics on a scheduled basis for 2-3 days after chemo
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