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Teaching during radiationtherapy Nutrition

Rest

Skin care Redmarking vs. tatoo

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Nursing Diagnosis - RT Knowledge deficit

Impaired skin integrity

Fatigue

Other pertinent Nsg. Diagnoses

Nutrition

Infection

Impaired mucous membranes

Diarrhea

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Interventions for Fatigue R/TRadiation Therapy

Recognize that fatigue is compounded bythings

Assess impact on life / ADLs Assess labs

Incorporate rest periods

Reduce activity to level

Mild exercise

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Care of Pts with Implants Pvt room & Pvt bath

Keep door closed as much as possible

Wear a badge

Wear lead apron

Limit visitors to hr per day & must stay sixfeet from pt

Save all dressings and linens until source isremoved

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Chemotherapy Action depends on type of Tx

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Common Side Effects ofChemotherapy1. N/V (60%) constipation, diarrhea, stomatitis

2. Alopecia

3. Myelosuppression resulting in neutropenia,thrombocytopenia, and anemia

4. Renal cells are sensitive to chemo agents resultingin increased uric acid secretion indocin allopurinol

5. Cardiomyopathy with heart failure can result.

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Risk for Infection1. Assess CBC leukopenia and a

decrease in WBCs

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Risk for Infection cont.6. Teach risk s/s

7. Promote good hygiene, especially skin

& mouth8. Strict hand washing

9. Follow protocols for care of VAD

10. Limit ill family / friends11. Private room

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Risk for Injury: bleeding1. Assess bleeding potential

2. Assess petechiae, hgb/hct, prolongedbleeding from invasive procedures, change

in LOC3. Decrease bleeding potential by soft

toothbrush, electric razor, minimizeinjections, blood draws.

4. Assess OTC meds ASA, NSAIDS5. Educate the patient and family

6. Anticipate platelet transfusion for < 20,000

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Impaired gas exchange R/Tanemia1. Assess for fatigue, dyspnea,

headache etc.

2. Anticipate blood transfusion ifsymptomatic. Concerned @ hgb 8.

3. Anticipate administration

Epogen/Procrit- stimulates the bonemarrow to release RBCs.

4. Maximize oxygen.

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Management of blood relateddeficiencies Transfusions

Procrit, Epogen H&H, RBCs

Neupogen

WBCs Platelets

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Nausea R/T effects ofchemotherapy1. Assess nausea

2. Adjust oral and fluid intake

3. If nutrition is compromised dietary consult

4. Emphasize high calorie, high protein

5. Anticipate enteral / parenteral feedings

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ere nu r on: ess anrequirements R/T nausea, anorexia,stomatitis1. Treat nausea ondansetron,dolastron

2. Small meals

3. If nutrition is compromised, seek Oral care

including management of stomatitis, removedentures, offer rinse

4. Routine weights - dietary consult

5. Assess albumin levels, Fe

6. Anticipate enteral / parenteral feeding.Lipids and TPN is not uncommon

7. Up as much as possible Bone mets

hypercalcemia

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Fatigue1. Balance activities throughout the day

2. Schedule rest periods.

3. Avoid being in bed all day4. Reassignment of home duties and roles

5. Blood or blood products, Epogen.

6. Recognize own limits of intolerance

7. Assess oxygenation.

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Pain One of the most feared effects of cancer.

Collaborative management of pain.

Adjunct drugs antiemetics, antidepressents,

anxiolytics. Organized pain assessment method

Understand pharmacology of drugs beingused, tolerance may develop and largerdoses may be required.

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Pain Nursing Diagnosis Analgesic

Mild to moderate use NSAIDS &adjuvants (Elavil, Prednisone)

Severe narcotics, oral (MS Contin,Oxycontin) patches (Fentanyl / Durgesic)suppository, SL MSO4, PCA

Non Invasive Relaxation

massage