4.4 Applying the Nursing Process to Cancer Treatment
4.4 Applying the Nursing Process to Cancer Treatment
Nurses play a crucial role in caring for clients with cancer. Clients with cancer often require extensive, prolonged support to manage symptoms and prevent complications.
Assessment
Focused assessments and diagnostic tests are based on the type of cancer diagnosed.
Nursing Diagnoses
Clients who have been diagnosed with cancer may experience a wide variety of signs and symptoms related to the type of cancer diagnosed and the medical treatments implemented. Nurses assess for signs and symptoms of common nursing diagnoses resulting from cancer treatment, including the following[1]:
- Pain
- Risk for Infection
- Impaired Integrity of Skin and Mucous Membranes
- Fatigue
- Decreased Activity Intolerance
- Imbalanced Nutrition: Less than Body Requirements
- Constipation
- Diarrhea
- Fluid and Electrolyte Imbalance
- Disturbed Body Image
- Fear
- Hopelessness
- Powerlessness
- Spiritual Distress
- Readiness for Enhanced Knowledge
Outcome Identification
Outcome identification includes setting short- and long-term goals and creating specific expected outcome statements for identified nursing diagnoses customized to each client.
Sample expected outcomes for common nursing diagnoses related to cancer are as follows:
- The client will identify and verbalize feelings related to cancer diagnosis and treatment.
- The client will remain free from infection.
- The client will identify three measures to conserve energy and manage fatigue.
- The client will express meaning and purpose in life.
Interventions
Nursing priorities for clients with cancer include the following[2],[3],[4]:
- Managing pain
- Preventing infection
- Promoting skin integrity
- Managing treatment-related side effects such as fatigue and gastrointestinal side effects
- Facilitating nutritional intake
- Providing health teaching, health promotion, and psychosocial support
- Addressing grief and loss
- Managing end-of-life care
Managing Pain
Pain is a common experience for clients with cancer due to the invasive nature of the disease. Cancer cells can invade surrounding tissues and nerves, causing inflammation, pressure, or injury, which triggers the body’s natural response to perceive it as painful. This pain can be related to the cancer itself, surgery, radiation therapy, chemotherapy, or other treatment and can significantly impact a client’s quality of life.[5]
Nurses play a crucial role in assessing pain, implementing appropriate pain relief interventions, and monitoring the effectiveness of pain management strategies. Interventions may include administering pain medications, encouraging nonpharmacological pain relief techniques, and advocating for clients’ comfort.
Read more information about pain assessment and management in the “Comfort” chapter of Open RN Nursing Fundamentals, 2e. Using the WHO ladder when managing pain in clients with cancer is discussed in the “Pain Management” section of this chapter.
Preventing Infection
Many client