Nursing Care and Patient Teaching in Cancer Treatment

Overview

• Focus on chemotherapy, internal radiation, external radiation, malnutrition, and mucositis.

Chemotherapy

• PPE Requirements: Follow facility policy; typically involves special gowns and gloves.
• Handling Linens: Double-bag linens with an impervious bag on the outside.
• Spill Management: Be prepared for chemotherapy spills, follow facility guidelines.
• Toilet Protocol: Double flush and use a splash guard prior to flushing.

Internal Radiation (Brachytherapy)

• Room Precautions:
  • Keep the door closed.
  • Place a warning sign on the door.
• Visitor Guidelines:
  • Limit visits to 30 minutes.
  • Maintain a 6-foot distance from the patient.
• Protective Gear: Wear a lead apron and a dosimeter film badge.
• Positioning: Face the patient to ensure the lead apron is effective.

External Radiation

• Marking Care: Do not wash off skin markings.
• Skin Care:
  • Use gentle soap and pat dry.
  • Avoid lotions, powders, or ointments unless prescribed.
  • Wear loose, soft clothing.
  • Avoid sun and heat exposure.

Chemotherapy Complications

Malnutrition

• Causes: Often due to nausea and vomiting from chemotherapy.
• Nursing Actions:
  • Administer antiemetics like ondansetron (Zofran) 30 minutes before chemotherapy.
  • Consider appetite stimulants like megestrol.
• Patient Teaching:
  • Avoid liquids with meals.
  • Focus on high-calorie, high-protein, nutrient-dense diet.
  • Prefer room temperature or cooler foods.
  • Use supplements if necessary.

Mucositis

• Definition: Inflammation and ulceration of mucosal membranes in the mouth.
• Nursing Care:
  • Provide meticulous oral care before and after meals.
  • Avoid mouthwashes with glycerine or alcohol.
  • Rinse with saline twice a day.
  • Use a soft toothbrush.
• Dietary Advice: Avoid foods with sharp edges (e.g., crackers, chips); prefer soft foods like scrambled eggs.

• More complications and care strategies to be discussed in the next session.