A Guide to Oncology Symptom Management

by Brown, Carlton G., Ph.D.

• ISBN13: 9781890504892
• ISBN10: 1890504890
• Edition: 1st
• Format: Paperback
• Copyright: 2009-10-30
• Publisher: Oncology Nursing Society

Summary

Oncology nurses provide care to people who experience multiple and varied symptoms and conditions that are related to the cancer itself, its treatment, or other comorbid conditions. Providing this care requires evidence-based information on appropriate interventions. A Guide to Oncology Symptom Managementaddresses major symptoms and conditions experienced by patients with cancer, using the most current and relevant evidence as a framework.

Author Biography

Carlton G. Brown, PhD, RN, AOCN has been an oncology nurse for more than 20 years, working as a staff nurse, nurse manager, clinical nurse specialist, educator, and nurse researcher. He received his Bachelor of Science in Nursing from the University of Louisville, his Master of Science in Nursing from the University of Pennsylvania, and his PhD from the University of Utah. Dr. Brown is a past president of the Oncology Nursing Certification Corporation and will become the president of the Oncology Nursing Society in 2010. He is currently an assistant professor at the University of Delaware, College of Health Sciences, School of Nursing, in Newark, DE. Dr. Brown has a particular interest in symptoms related to cancer treatment, and his doctoral dissertation focused on oral mucositis and other associated symptoms.

Table of Contents

Foreword	p. xiii
Acknowledgments	p. xiv
Symptoms in Older Adults	p. 1
Case Study	p. 1
Overview	p. 1
Overview of Normal Aging	p. 2
Common Health Issues in the Aging Population	p. 4
Cancer-Related Symptom Issues	p. 6
Pharmacologic Management	p. 9
Nonpharmacologic Management	p. 11
Symptom Management Outcomes	p. 12
Need for Future Research	p. 12
Conclusion of Case Study	p. 12
Conclusion	p. 13
References	p. 14
Alopecia	p. 17
Case Study	p. 17
Overview	p. 17
Pathophysiology	p. 18
Hair Loss During Cancer Treatment	p. 19
Preventing Hair Loss	p. 20
Human Responses to Hair Loss	p. 22
Clinical Practice Recommendations	p. 23
Conclusion of Case Study	p. 24
Conclusion	p. 25
References	p. 25
Anemia	p. 29
Case Study	p. 29
Overview	p. 29
Pathophysiology	p. 30
Assessment	p. 35
Evidence-Based Interventions	p. 37
Standing Orders	p. 42
Expected Outcomes	p. 42
Patient Teaching Points	p. 44
Need for Future Research	p. 44
Conclusion of Case Study	p. 45
Conclusion	p. 45
References	p. 45
Anxiety and People With Cancer	p. 49
Case Study	p. 49
Overview	p. 49
Incidence	p. 50
Pathophysiology	p. 52
Assessment	p. 53
Measurement	p. 54
Evidence-Based Interventions	p. 54
Psychosocial Interventions	p. 55
Pharmacologic Interventions	p. 56
Complementary Therapies	p. 60
Expected Outcomes	p. 60
Patient Teaching Points	p. 60
Need for Future Research	p. 61
Conclusion of Case Study	p. 62
Conclusion	p. 62
References	p. 62
Cancer Cachexia	p. 65
Case Study	p. 65
Overview	p. 65
Pathophysiology	p. 66
Assessment	p. 69
Treatment	p. 71
Evidence-Based Interventions	p. 72
Patient Teaching Points	p. 82
Need for Future Research	p. 83
Conclusion of Case Study	p. 83
Conclusion	p. 84
References	p. 84
Chemotherapy-Induced Nausea and Vomiting	p. 91
Case Study	p. 91
Overview	p. 91
Prevalence of Chemotherapy-Induced Nausea and Vomiting	p. 93
Pathophysiology	p. 94
Impact of Chemotherapy-Induced Nausea and Vomiting	p. 96
Risk Factors	p. 98
Continuation of Case Study	p. 101
Assessment	p. 101
Evidence-Based Interventions	p. 103
Nonpharmacologic Management	p. 112
Need for Future Research	p. 114
Conclusion of Case Study	p. 115
Conclusion	p. 116
References	p. 116
Cognitive Impairment	p. 123
Case Study	p. 123
Overview	p. 123
Descriptions and Consequences of Cognitive Impairment	p. 124
Pathophysiology	p. 125
Assessment	p. 129
Interventions	p. 131
Patient Teaching Points	p. 132
Need for Future Research	p. 134
Conclusion of Case Study	p. 134
Conclusion	p. 135
References	p. 135
Constipation	p. 139
Case Study	p. 139
Overview	p. 139
Pathophysiology	p. 141
Assessment	p. 143
Management and Evidence-Based Interventions	p. 145
Prevention	p. 147
Laxatives	p. 148
Enemas	p. 149
Nonpharmacologic Interventions	p. 150
Obstipation	p. 150
Patient Teaching Points	p. 150
Need for Future Research	p. 151
Conclusion of Case Study	p. 151
Conclusion	p. 152
References	p. 152
Depression	p. 153
Case Study	p. 153
Overview	p. 153
Pathophysiology	p. 155
Assessment	p. 156
Evidence-Based Interventions	p. 158
Patient Teaching Points	p. 166
Need for Future Research	p. 167
Conclusion of Case Study	p. 168
Conclusion	p. 169
References	p. 169
Diarrhea	p. 173
Case Study	p. 173
Overview	p. 173
Definition	p. 173
Incidence	p. 174
Risk Factors	p. 176
Pathophysiology	p. 177
Causes	p. 177
Osmotic Diarrhea	p. 178
Malabsorptive Diarrhea	p. 178
Secretory Diarrhea	p. 178
Infectious Diarrhea	p. 180
Dysmotility-Associated Diarrhea	p. 180
Chemotherapy-Induced Diarrhea	p. 181
Radiation-Induced Diarrhea	p. 182
Assessment	p. 182
Evidence-Based Interventions	p. 186
Nonpharmacologic Interventions	p. 187
Pharmacologic Interventions	p. 190
Expected Outcomes	p. 193
Patient and Family Teaching Points	p. 194
Need for Future Research	p. 194
Conclusion of Case Study	p. 195
Conclusion	p. 195
References	p. 195
Dyspnea	p. 199
Case Study	p. 199
Overview	p. 199
Assessment	p. 202
Evidence-Based Interventions	p. 208
Expected Outcomes	p. 215
Patient Teaching Points	p. 215
Need for Future Research	p. 218
Conclusion of Case Study	p. 219
Conclusion	p. 220
References	p. 220
Electrolyte Imbalances, Tumor Lysis Syndrome, and Syndrome of Inappropriate Antidiuretic Hormone	p. 225
Case Study	p. 225
Electrolyte Imbalances	p. 225
Syndrome of Inappropriate Antidiuretic Hormone	p. 256
Tumor Lysis Syndrome	p. 260
Conclusion of Case Study	p. 267
Conclusion	p. 267
References	p. 267
Cancer-Related Fatigue	p. 271
Case Study	p. 271
Overview	p. 271
Pathophysiology	p. 274
Assessment	p. 276
Evidence-Based Interventions	p. 281
Expected Outcomes	p. 287
Patient and Family Teaching Points	p. 287
Need for Future Research	p. 288
Conclusion of Case Study	p. 289
Conclusion	p. 290
Reference	p. 290
Hot Flashes	p. 299
Case Study	p. 299
Overview	p. 299
Risk Factors	p. 300
Pathophysiology	p. 301
Assessment	p. 303
Evidence-Based Interventions	p. 303
Pharmacologic Interventions	p. 305
Nonpharmacologic Interventions	p. 307
Patient Teaching Points	p. 308
Need for Future Research	p. 308
Conclusion of Case Study	p. 309
Conclusion	p. 309
References	p. 309
Lymphedema	p. 315
Case Study	p. 315
Overview	p. 315
Quality of Life	p. 318
Pathophysiology	p. 319
Assessment	p. 321
Treatment	p. 322
Expected Outcomes	p. 328
Patient Teaching Points	p. 328
Need for Future Research	p. 329
Conclusion of Case Study	p. 329
Conclusion	p. 330
References	p. 330
Oral Mucositis	p. 333
Case Study	p. 333
Overview	p. 333
Risk Factors and Associated Incidence	p. 334
Pathophysiology	p. 336
Assessment	p. 338
Interventions	p. 339
Patient Teaching Points	p. 342
Expected Outcomes	p. 342
Need for Future Research	p. 343
Conclusion of Case Study	p. 343
Conclusion	p. 343
References	p. 344
Neutropenia and Infection	p. 347
Case Study	p. 347
Overview	p. 347
Definitions	p. 347
Risk Factors	p. 349
Pathophysiology	p. 351
Assessment	p. 351
Interventions	p. 353
Patient Teaching Points	p. 358
Need for Future Research	p. 359
Conclusion of Case Study	p. 359
Conclusion	p. 359
References	p. 359
Osteoporosis and Bone Health	p. 363
Case Study	p. 363
Overview	p. 363
Epidemiology: Prevalence and Impact	p. 364
Risk Factors	p. 365
Pathophysiology	p. 369
Screening	p. 372
Assessment	p. 372
Diagnosis	p. 373
Case Study (Part 2)	p. 375
Prevention and Treatment	p. 376
Case Study (Part 3)	p. 378
Pharmacologic Treatment	p. 378
General Principles of Treatment	p. 380
Patient Teaching Points	p. 380
Conclusion of Case Study	p. 381
Conclusion	p. 382
References	p. 382
Cancer Pain	p. 389
Case Study	p. 389
Overview	p. 389
Pathophysiology	p. 390
Assessment	p. 391
Evidence-Based Interventions	p. 392
Principles of Cancer Pain Management	p. 392
Pharmacologic Cancer Pain Management	p. 394
Nonpharmacologic Cancer Pain Management	p. 399
Expected Outcomes	p. 399
Patient Teaching Points	p. 399
Need for Future Research	p. 400
Conclusion of Case Study	p. 400
Conclusion	p. 401
References	p. 401
Peripheral Neuropathy	p. 405
Case Study	p. 405
Overview	p. 405
Definition	p. 406
Incidence	p. 407
Risk Factors	p. 408
Pathophysiology	p. 410
Characteristics of Peripheral Neuropathy	p. 411
Assessment	p. 411
Tests	p. 412
Grading	p. 414
Evidence-Based Interventions	p. 416
Expected Outcomes	p. 416
Patient Teaching Points	p. 417
Need for Future Research	p. 417
Conclusion of Case Study	p. 418
Conclusion	p. 419
References	p. 419
Altered Sexuality Patterns	p. 423
Case Study	p. 423
Overview	p. 423
Erectile Dysfunction	p. 424
Dyspareunia	p. 429
Altered Body Image	p. 433
Changes in Libido	p. 436
Infertility	p. 440
Expected Outcomes for Altered Sexuality Patterns	p. 447
Patient Teaching Points for Altered Sexuality Patterns	p. 448
Need for Future Research for Altered Sexuality Patterns	p. 449
Conclusion of Case Study	p. 449
Conclusion	p. 450
References	p. 450
Skin and Nail Alterations	p. 457
Case Study	p. 457
Overview	p. 457
Nail Bed Changes	p. 459
Hyperpigmentation	p. 461
Paronychia and Onycholysis	p. 462
Palms and Soles	p. 462
Incidence of Rash: Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors	p. 463
Pathophysiology	p. 464
Assessment	p. 465
Interventions for Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Rash	p. 466
Patient Teaching Points	p. 468
Need for Future Research	p. 469
Conclusion of Case Study	p. 469
Conclusion	p. 469
References	p. 470
Sleep-Wake Disturbances	p. 473
Case Studies	p. 473
Overview	p. 474
Sleep Physiology	p. 475
Sleep-Wake Disturbances in Patients With Cancer	p. 478
Assessment of Sleep-Wake Disturbances	p. 480
Evidence-Based Interventions	p. 482
Expected Outcomes	p. 489
Patient and Family Teaching Points	p. 489
Need for Future Research	p. 489
Conclusion of Case Studies	p. 490
Conclusion	p. 491
References	p. 491
Spiritual Care From the Oncology Nurse	p. 497
Case Study	p. 497
Overview	p. 497
Meaning of Spirituality	p. 497
What Patients Have to Say About the Spirit	p. 498
Prerequisites and Self-Care for Engagement in Spiritual Care	p. 499
Assessment of Spiritual Needs	p. 500
Application of FICA to Case Study	p. 502
Interventions	p. 502
Community-Based Spiritual Care	p. 506
Interventions in the Case Study	p. 506
Conclusion	p. 506
References	p. 507
Index	p. 509
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