Nursing Process Approach to Care of Cancer
Question
The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.
Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:
Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.


Solution
Nursing Process
Approach to Care of Cancer
A nursing process is applied to
systematically identify problems and prevent and treat them to promote health
and wellness. The five steps are assessment, diagnosis, planning,
implementation, and evaluation. Similarly, this approach is adequately utilized
in patients diagnosed with cancer, a group of more than 200 distinct diseases
characterized by the uncontrolled growth of abnormal cells in the body. Therefore,
the nursing process is functional in providing patient-centered care through
the above nursing process steps. It is resourceful in identifying the cancer
patients’ potential needs and developing goal-oriented plans to deliver nursing
interventions.
Diagnosis of cancer involves a series
of events based on knowledge and experience accumulated by healthcare
professionals over their theoretical training and practice period. It involves
several systematic methods to make a diagnosis effectively. Family and personal
medical history is one way to determine cancer. Factors such as genes,
environment, occupation, and lifestyle give significant clues that help
determine the risk of developing cancer. It can also be ruled out through its
symptoms of cancer. Although these symptoms may be similar to those of other
diseases, health care professionals need to be keen not to miss the vital
signs. These are the presence of a lump, abnormal bleeding, prolonged cough,
unexplained weight loss, change in bowel movement, body sputum, loss of
function, and many others. A practical nursing process approach makes these
signs less likely to be missed.
Also, a thorough physical exam
through smell, palpation, and percussion of the respective body parts helps
identify lumps and other abnormalities that could be highly suggestive of
cancer. Laboratory tests of blood, urine, and lymph can reveal existing
abnormalities that may be cancer-related, such as a complete blood count that
may indicate an elevated level of white blood cells which is related to
leukemia and other cancer-related illnesses. Imaging tests allow detailed
examination of internal organs, including bones (Forner et al., 2019). The
imaging tests include; a computerized tomography scan that uses a computed and
processed combination of a series of X-rays measures taken from distant angles.
Other imaging tests are Magnetic Resonance Imaging (MRI), position emission
tomography, ultrasound/sonography, and radiography.
A cancer diagnosis can also be made by
obtaining tissue to screen for the presence of cancer either through microscopy
or laboratory tests. These tissues can be obtained through Fine Needle
Aspiration (FNA), where primary lesions are screened to determine the
involvement of lymph nodes and other secondary sites. Other methods include
bone marrow biopsy, punch biopsy, core needle biopsy, incisional, and
excisional biopsy. However, biopsy examination is the only definite way to
diagnose cancer.
Cancer staging refers to determining
the extent of cancer in the body. It describes the severity of cancer on an
individual based on the size of the spread and the magnitude of the primary
tissues. It also describes the distance to the surrounding tissues and organs
(Forner et al., 2019). A numerical system of staging tumors is the most
commonly used method. Stage 0 describes cancer in situ limited to surface cells
and has not spread to nearby tissues. Stage 1 is usually a tumor with evidence
of growth but is limited to the tissue of origin. Stage 2 describes cancer with
the limited spread of cancer cells. Stage 3 refers to extensive local and
regional distance may include involvement of lymph nodes. In contrast, stage 4
describes cancer that has spread to other body organs, advanced or metastatic
tumor
s.
Another form is the TNM staging
method used for most malignancies. The tumor (T), lymph nodes (N), and if
cancer has spread (metastasis) are all described using letters (M). The letter
T for tumor describes how large the primary tumor is and the location, N (lymph
nodes) defines whether cancer has spread to lymph nodes, and M (Metastasis)
describes if the spread has spread to other parts of the body, where and how
much has it lay. Pathological staging involves microscopic examination of the
tumor by a pathologist after its surgical removal to determine the extent.
Clinical staging is done based on information available that may have been
obtained through a detailed physical examination, biopsy, and imaging tests.
Lastly, post-neoadjuvant therapy is done on some cancers on treatment other
than surgery. After the first treatment intervention, this staging is done to
measure cancer’s response to treatment.
Oncologic complications resulting
from cancer progression occur in almost all cancer patients. They are an indication
of advancing disease and are life-threatening. Therefore, nurses should be in
the frontline in assessing through the nursing process to identify patients at
high risk of developing these complications. Cardiac tamponade is one
complication resulting from cardiac muscle compression due to fluid
accumulation within the pericardial sac (Casanovas Blanco, 2019). It may constrict
the pericardium’s constriction by a tumor, hence reducing blood flow to
ventricles and cardiac output. With time it develops into myocardial ischemia.
Increased intracranial pressure is another complication due to increased brain
volume, cerebral blood volume, and cerebral spinal fluid within the skull and
meninges. Approximately 20-40% of oncology patients develop brain metastases
increasing the risk of brain herniation and death.
Spinal cord compression results from
the epidural abscess. This complication occurs mainly in patients with cancer
that spreads to the bone. Spinal cord compression eventually causes edema and
ischemia that causes damage to the neural tissue. Disseminated intravascular
coagulation is a bleeding disorder that results from alteration of the
blood-clotting mechanism due to depletion of clotting factors. It is related to
disease progression and cancer therapy. Hypercalcemia is an oncologic
complication occurring due to the rise of serum calcium above the normal. It
can, in turn, lead to renal failure, cardiac arrest, or coma. Pleural effusion
may also result due to fluid accumulation in the pleural cavity. This directly
alters the respiratory function since it restricts lung expansion and decreases
lung volume, affecting gas exchange. Septic shock also occurs due to systemic
inflammatory response syndrome leading to irreversible multiorgan failure that
eventually causes death.
Treatment approaches to treat cancer
are always prone to adverse side effects to patients that may be
life-threatening and alter the normal functioning of an individual. These side
effects are; neutropenia which results from chemotherapy treatment, thereby
causing a reduced number of white blood cells which functions in helping the
body fight against infection. Chemotherapy works by killing rapidly growing
cancer cells and white blood cells. Lymphedema is another side effect resulting
from radiation therapy that damages lymph nodes and vessels; hence, the lymph
fluid cannot drain correctly. Alopecia (hair loss), nausea, and vomiting are
caused by chemotherapy and other cancer treatment medication. Other side
effects are; anemia, constipation, loss of appetite, thrombocytopenia, edema,
fatigue, sleep problems, and loss of fertility.
To lessen cancer treatment’s physical
and psychological effects, emotional and social support is critical to help
them cope. This reduces anxiety, depression, and disease-therapy-related
symptoms. This includes training on relaxation techniques, meditation, stress
management, talk therapy through cancer education sessions, and exercise. Also,
antidepressants and anxiolytic medications may be given to manage depression
and anxiety. Advising them to spread their daily activities throughout the day,
taking breaks to rest between them, and taking short naps consistently
throughout the day, instead of one long nap, can help reduce the physical
effects of cancer treatment.
The burden of cancer in the United
States can be associated with modifiable lifestyle behaviors that increase
disease risk. These factors are the significant contributors to annual
incidence and mortality rates related to cancer in America. Tobacco use is
responsible for over 440 000 deaths due to lung cancer every year. Other
factors are lack of physical activity, overweight, poor diet, and excessive
alcohol consumption. Some factors substantially contribute to cancer
incidences; these include exposure to ultraviolet rays, sexual practices, and
occupation factors.
The American Cancer Society provides
support and education regarding cancer through various strategies. It publishes
many educative brochures, pamphlets, journals, and books that are educative to
patients, their families, caregivers, and health care professionals. It
includes preventive and coping strategy books (Rock et al., 2020). It also
offers community programs and services that aim to help over 1.4 million
patients diagnosed with cancer every year and the 14million survivors of cancer
and their families. Educative information and emotional support are provided to
this population. The ACS also helps day-to-day support such as getting rides to
treatment, lodging, mastectomy and hair loss products, breast cancer support,
and sharing experiences through an online community. Some cancer patients
contact ACS via phone and chat; they are helped to offset isolation feelings.
However, I would recommend educative reading materials since it offers
preventive education and coping strategies for cancer patients. Emotional
support and community programs also help lessen cancer’s physical and
psychological effects and its treatment.
A nursing process is a systematic
tool that promotes evidence-based practice in the nursing process in
identifying and addressing patient problems (Leslie, 2018). Assessment is the
first step of the nursing process. It involves prioritizing patient issues by
obtaining detailed baseline information on presenting symptoms, the patient’s
family history, and medical history. Assessment should address activity,
elimination, intake, pain, respiration status, and neurosensory status of the
patient. Diagnosis is drawn based on the assessment data through
prioritization. Although it might be impossible to address every diagnosis,
nursing focus and priority diagnoses need to be addressed. Systematically
reviewing those areas improves patient outcomes.
Planning in the nursing process
developing a plan of action. Through assessment prioritization, measurable
goals are set, and an expected beneficial outcome is to track the patient’s
wellness. Implementation is done by following through on a decided plan of
action that focuses on achieving the desired outcomes to promote patient
health. It involves putting into action interventions such as patient
education, providing chemotherapy and radiotherapy, and surgical procedures to
remove the tumor. Evaluation is done once all the interventions have been
implemented. It is done to determine whether the goals to promote patient
wellness have been met. If the goals were not met, the nursing process begins
again to ensure that cancer patients provide safe and effective care.
Undergraduates in liberal arts and
studies contribute the foundation of nursing knowledge and prepare nurses to
provide patient care by utilizing the nursing process. It is achieved since
liberal arts and sciences encourage critical and creative thinking. Nursing
practice requires one to understand quantitative data and research and a course
like mathematics provides this (Kooken, 2019). Nursing process implementation
involves looking at evidence and research findings that are practical and
reliable. It consists of the ability to think, ask, evaluate and come up with a
solution reinforced through the liberal arts and science curriculum critically.
The core role is that liberal arts
and science help nursing students and practicing nurses improve their
communication skills think critically, navigate diversity, make goal-oriented
decisions, and make better versions of themselves. Also, it contributes to
nursing practice since they are eye-opening and changes the way one approaches
it. Nurses are involved in caring for different patients with diverse
conditions. Therefore, one needs to be competent culturally and understand the
needs of all patients and their families. The liberal arts and sciences serve
as a core component in educational discipline throughout nursing practice. For
a while, science has performed a central task in nursing education.
References
Casanovas Blanco, M.
(2019). A critical review of emergency department management of chemotherapy
complications in cancer patients. European Journal of Cancer Care, 28(2),
e12974.
Forner, A., Vidili, G.,
Rengo, M., Bujanda, L., Ponz‐Sarvisé, M., & Lamarca, A. (2019). Clinical
presentation, diagnosis and staging of cholangiocarcinoma. Liver
International, 39, 98-107.
Kooken, W. (2018). Blending
the liberal arts and nursing: Creating a portrait for the 21st century.
National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/29406141 Blending the
liberal arts and nursing: Creating a portrait for the 21st century.
Leslie, J. (2018). Employment of the Nursing
Process to Facilitate Recovery from Surgery: A Case Study. OJIN: The
Online Journal Of Issues In Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02ppt07.
Rock, C. L., Thomson, C., Gansler, T.,
Gapstur, S. M., McCullough, M. L., Patel, A. V., ... & Doyle, C. (2020).
American Cancer Society guideline for diet and physical activity for cancer
prevention. CA: a cancer journal for clinicians, 70(4),
245-271.



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