Nursing Care of a Cancer Patient
Rasmussen College NUR2392: Multidimensional Care II
45-year-old female patient Anna has many risk factors that
... [Show More] could predispose her to [breast] cancer. Some of these risk factors include, history of diabetes, smoking, obesity, genetics, age, and noncompliance of diet and medications, (Rebar, Ignatavicius, & Workman, 2018). Patient Anna has explained that she has not been feeling well the past six months and has become unusually tired. Extreme fatigue is usually one of the most common symptoms of cancer development. She also discovered a lump on her right breast while doing a self-breast exam along with recent right nipple pain. Nipple pain caused by cancer wills usually only affect one breast and nipple. Although Anna did not describe the type of lump she felt in her right breast, it is abnormal from what her breasts normally feel like and a firm, irregular shaped lump is normally cancerous. Anna admits to never having a mammogram performed on herself before. This discovery shows that there was no way to identify this issue ahead of time before it progressed to the stage of development that it is now. A mammogram is an X-ray image of the breasts to screen for breast cancer and plays a key role in early detection and helps decrease breast cancer deaths, (Rebar, Ignatavicius, & Workman, 2018). Since Anna has never had one performed, it is difficult to determine whether the lump is cancerous or not and if so, what stage of development the cancer has progressed to. During the breast exam in the physician’s office, her practitioner palpated a lump in Anna’s right breast, but no discharge from the nipple.
Although nipple discharge accompanying a lump in the breast increases the chances of cancer, no nipple discharge is a good sign for the patient but does not rule out cancer completely. Anna also admitted to tenderness in her right breast upon palpation. Normally breast pain is not associated with breast cancers and less than 3% of breast cancers are associated with pain, (Samiian, 2019). There was no symmetry between both breasts. The left breast had no
abnormalities. When breast symptoms are not symmetric, it can be a sign of cancer. All these examples could be considered signs and symptoms of developed cancer for patient Anna.
Upon diagnosis of breast cancer, Anna is going to be subjected to a completely different lifestyle change, that she is going to have to comply with, in order to overcome her disease. She is also going to have many different expressions of emotion, concerns, and feelings, that as healthcare providers, we must listen to and be supportive of these during her treatment and plan of care. Encouragement of counseling and/or therapy with trained professionals is beneficial with coping of the diagnosis, (Rebar, Ignatavicius, & Workman, 2018). Discussion of possible genetic predispositions passed down to her children should be considered and early detection tests should be performed. Different treatment options will need to be discussed as well as what would be best for her diagnosis and the severity of the cancer upon detection. Examples of these treatments include, chemotherapy, radiation therapy, hormone therapy, targeted therapy, gene therapy, and surgery, (Rebar, Ignatavicius, & Workman, 2018).
One of the most important care strategies for this patient during treatment would involve regulation and reduction of pain as much as possible. This patient is already experiencing pain before treatment is involved; therefore, the intensity of the pain is most likely to increase during treatment. Comfort is critical during a patient’s healing process. Another care strategy when providing quality care to the patient would be diet and nutrition alterations. Anna is currently obese with diabetes and should be following a routine regimen that correlates with her current disease; however, she is not compliant with it. A strict healthy diet should be adhered to during treatment, especially during chemotherapy. Foods to avoid are added sugar, fat, red meat, processed foods, and alcohol, (Susan G. Komen). These may increase the risk of breast cancer and can cause further damage if consumed after diagnosis. Eating 100 percent whole grain foods,
legumes, and at least 2 ½ cups of fruits and vegetables daily is recommended, (Susan G. Komen, 2018).
Lastly, educating the patient on her diagnosis, and providing the patient with as many resources and educational materials as possible to help cope and meet their needs, is essential during the treatment process of breast cancer, (Rebar, Ignatavicius, & Workman, 2018). This care strategy is critical to motivate and encourage the patient to stay positive and keep pushing forward through treatment. There are many online reliable sources such as the National Breast Cancer Foundation, American Cancer Society, Breast Cancer Research Foundation, Susan G. Komen, National Cancer Institute, American Breast Cancer Foundation, and many others, for instance to find information about the journey they are enduring. There are also support groups, such as Cancer Fighters, to help encourage the patient by others with similar stories and how they battled with cancer and came out on the other side of it cancer free.
As the patient’s primary physician, it is my responsibility to set patient Anna up for success, educate her on her diagnosis, and be available for her every step of the way in battling breast cancer. I must ensure that she is offered all of the options for treatments (or refusal, if that is her wish), along with reliable educational materials and support groups available to her advantage during this vulnerable time in her life. These care strategies listed are important aspects in providing effective and quality care to the patient and their needs so that the desired health outcomes are achieved.
References
Rebar, C., Ignatavicius, D., Workman, M. L. (2018). Medical-Surgical Nursing. [Bookshelf Ambassadored]. Retrieved
from https://ambassadored.vitalsource.com/#/books/9780323461580/
Samiian. (2019, June 31). What to do when a patient presents with breast pain. Retrieved January 8, 2020, from https://www.mdedge.com/obgyn/article/202222/breast-cancer/what-do- when-patient-presents-breast-pain/page/0/1#.
Susan G. Komen. (2018, December 12). Diet and Breast Cancer. Retrieved January 8, 2020, from https://ww5.komen.org/BreastCancer/BreastCancerAndDiet.html. [Show Less]