Care for cancer patients undergoing chemotherapy

Chemotherapy through a urinary catheter is a procedure used to treat certain types of cancer, such as bladder cancer. The chemotherapy drugs are directly delivered into the bladder through a urinary catheter.

Tools Required:

1. Sterile catheter (14-16 French for adults).
2. Chemotherapy drug prepared according to the prescribed dosage.
3. Sterile gloves.
4. Sterile water or saline solution for washing.
5. Sterile gel.
6. Urine collection bag.
7. Personal protective equipment (protective gown, mask, and eye protection).
8. Hazardous waste disposal bag.

Confirming Patient Identity: Verify the patient's identity by name and date of birth, and ensure the correct procedure and treatment plan are being followed.

Patient Assessment:

• Review the patient's medical history, including allergies and previous reactions to chemotherapy.
• Assess for any contraindications, such as active urinary tract infections. Check recent blood tests and kidney functions (creatinine and glomerular filtration rate).
• Ensure the patient has emptied their bladder.

Environment Preparation:

• Provide adequate lighting.
• Ensure proper ventilation.
• Maintain privacy.

Preparing the Patient:

• Introduce yourself to the patient.
• Explain the procedure to the patient.
• Obtain the patient’s consent for the procedure.
• Assess the patient's general condition.
• Cleanse the genital area thoroughly using sterile materials.
• A local anesthetic may be applied to minimize discomfort.

Nursing Steps:

• Position the patient comfortably in a reclining position with legs slightly apart. Cover the patient to maintain their privacy.
• Wear personal protective equipment:
• Long neck gloves.
• Long-sleeved protective gown.
• Protective glasses and face mask.
• Disposable shoes and head cover.

Administering Chemotherapy:

• Prepare the chemotherapy drug according to the prescribed dosage.
• Follow sterile techniques when preparing the medication.
• Double-check the medication name and dosage to prevent errors.
• Connect the chemotherapy syringe to the catheter and slowly administer the drug into the catheter.
• After administration, close the catheter to prevent the drug from leaking outside the bladder.
• The drug should remain in the bladder for 1-2 hours based on the treatment protocol.
• After the specified time, open the catheter to empty the bladder.
• Introduce saline to ensure the drug is flushed out of the bladder.

Monitoring the Patient Post-Administration:

• Monitor the patient immediately after administering the drug for any abnormal reactions.
• Watch for side effects such as discomfort, bleeding, or signs of infection.
• Instruct the patient on the importance of keeping the drug in the bladder for the specified duration and avoiding urination.

Catheter Removal:

• Remove the catheter if no further medical procedure is required.
• Open the catheter and allow the bladder to empty.
• Remove the catheter carefully and dispose of it in a kidney basin.
• Advise the patient to increase fluid intake and monitor for any signs or symptoms of infection.

Documentation:

• Record all nursing interventions provided to the patient in their medical file, including the medication name, dosage, time of administration, and any abnormal reactions observed.

Nursing Actions Post-Chemotherapy Administration:

• Dispose of all used waste properly.
• Remove personal protective equipment and wash hands.

Health Education for the Patient:

• Provide guidance on what to expect after chemotherapy administration, such as discomfort or burning sensations in the bladder.
• Advise the patient to seek help if they experience signs of infection, severe pain, or bleeding.

Follow-up:

• Set up a follow-up schedule to monitor the effect of the drug on the bladder or the occurrence of side effects.
• Answer any questions the patient may have regarding the treatment.
• Monitor the patient for complications such as infections or allergic reactions.