Nursing Care for Cancer Patients

• The patient will report a decrease in pain.
• The patient will implement two pain relief strategies.

Assessment:

1. Assess the causes of pain.
   Pain in cancer can result from the disease process or cancer treatments. Identifying the cause of the pain will help plan and assess the most appropriate interventions.
2. Assess the impact of pain on activities.
   Assess whether the pain prevents the patient from moving, eating, or performing other daily activities.

Nursing Interventions:

1. Encourage the patient to use non-pharmacological pain relief interventions: such as massage, meditation, heat, and other recreational activities that help promote relaxation and pain relief.
2. Administer pain-relieving medications as needed: Opioids and non-steroidal anti-inflammatory drugs may be prescribed to help manage pain in cancer patients.
3. Educate the patient about the pain management plan: Better pain control is achieved when the patient has a better understanding of the nature, causes, and treatments of pain.
4. Provide resources to cope with the psychological effects of pain: Cancer pain affects all aspects of the patient's well-being. Behavioral strategies can help the patient cope with discomfort and other unpleasant effects of pain.
5. Encourage complementary therapies if there are no contraindications: Complementary therapies such as acupuncture, yoga, aromatherapy, and hypnosis can help relieve pain without the harmful effects of medications.

• Death Anxiety
Patients diagnosed with advanced cancer often report death anxiety. It is an emotional distress associated with the anticipation of death and the dying process, negatively affecting the individual's quality of life.
Nursing Diagnosis: Anxiety
Associated with: Expectation of disease outcome, expectation of pain, expectation of suffering, awareness of imminent death, uncertainty of diagnosis, discussions around death, changes in family roles.
As evidenced by: Expressing fear of death, expressing concern about the impact of one's death on family members, expressing deep sadness, expressing fear of premature death, expressing fear of pain associated with death, expressing fear of the prolonged dying process, expressing fear of suffering associated with death, expressing fear of separation from loved ones, expressing fear of the unknown, mentioning negative thoughts about death and dying, expressing helplessness.
Expected Outcomes:

• The patient will express their feelings about death and its effects and will seek help in coping.
• The patient will express acceptance of their diagnosis.

Assessment:

1. Assess the patient's condition.
2. Assess the patient's experience with pain.
   Patients with advanced cancer may require palliative care. Pain management and relief should be a priority during the final stages of cancer, as it can help improve the dying patient's experience at the end of life.

Nursing Interventions:

1. Encourage the patient to express their thoughts and feelings: Acknowledging the patient's feelings about their cancer diagnosis, its outcomes, and consequences may enhance trust and the therapeutic relationship. Oncology nurses often serve as a support system for patients undergoing cancer treatments.
2. Educate the patient about the stages of grief: The grieving process is important to help identify one's feelings. Understanding the grieving process normalizes the emotions the patient experiences after a cancer diagnosis, enabling them to cope with grief more effectively.
3. Encourage family members to participate in patient care: A reliable support system will help the patient feel less isolated. Encourage the patient to rely on friends and family for support.

• Risk for Infection
Cancer patients are at an increased risk of infection due to changes in the immune system, and cancer itself and its treatments reduce the body's ability to fight infections.
Nursing Diagnosis: Risk for Infection
Related to: Immunosuppression, cancer treatments, chronic disease processes, invasive treatment procedures.
As evidenced by: Infection risk diagnosis is not confirmed by signs and symptoms, as the problem has not yet occurred, and nursing interventions are directed at preventing symptoms.
Expected Outcomes:

• The patient will identify and begin interventions that can help reduce the risk of infection.
• The patient will be free from signs of infection.

Assessment:

1. Evaluate and assess signs of infection through laboratory tests. Certain laboratory tests may be ordered to identify the causative agents of infection and appropriate treatments, such as a complete blood count to identify bone marrow suppression due to chemotherapy effects.
2. Evaluate and monitor signs of infection. Early detection of infection in different parts of the body provides the opportunity for early intervention to prevent complications.

Nursing Interventions:

1. Encourage infection control measures: Frequent handwashing is recommended to protect the patient from infections. Screening visitors and placing the patient in isolation will help reduce the risk of infection.
2. Monitor for warning signs of infection when there are any wounds or openings (due to catheters or infusions).
3. Stay home when possible. Cancer patients should limit their interaction with large crowds, such as stores or restaurants. When going out for appointments or essential tasks, wearing a mask will reduce the transmission of diseases.
4. Ensure adequate rest while staying active: Cancer patients experience fatigue and weakness due to the effects of the disease and its treatments. Ensuring the patient gets enough rest reduces fatigue, while sufficient exercise can prevent muscle function loss and support healthy immune function.
5. The patient should notify the healthcare team if any signs of infection occur. A cold or flu virus can be harmful to a cancer patient. Ensure the patient informs the healthcare team of symptoms like fever, cough, chills, sore throat, or mouth sores.