NRS 410 Benchmark Nursing Process Approach to Care

Sample Answer

Cancer occurs from the abnormal proliferation of cells in the body. Cancer or malignant cells are abnormal, have no useful function, and cause harm to normal body tissues. Any new or constant cell growth not required for normal development or replacement of damaged and dead tissues is called neoplasia (Walter et al., 2019). A tumor refers to any abnormal proliferation of cells, which can be benign or malignant. A benign tumor (non-cancerous) is usually confined to its original location and does not invade surrounding tissues or spread to distant body sites. The purpose of this paper is to describe cancer and the approach to cancer care using the nursing process.

Diagnosis and Staging of Cancer

Various diagnostic tests are used to diagnose cancer, including laboratory, imaging, and cytology. Lab tests like tumor marker identification use tumor cells to diagnose cancer. Imaging tests include bone scans, positron emission tomography (PET) scans, CT scans, and MRIs (Walter et al., 2019). Cytology is used to examine cells and helps to determine if they are benign, premalignant, or malignant. It is considered a definitive diagnostic test for cancer.

Staging of cancer determines the precise location of cancer and its extent of metastasis during diagnosis. The most commonly used staging method is the Tumor, Node, Metastasis (TNM) system developed by The American Joint Committee on Cancer. The TNM system outlines the general anatomic extent of a tumor and groups it from stages 0-4 (Walter et al., 2019). Stage 0 is cancer in situ, meaning there are abnormal cells located where they started and have not spread to nearby tissues.

Stage 1 is characterized by a small tumor that has not spread outside of the organ it developed in. Stage 2 indicates a locally advanced tumor in the early stages, while in stage 3, the tumor is in the late stages and usually has lymph node involvement (Walter et al., 2019). In stage 4, the malignant cells usually have spread to other body parts.

Complications of Cancer

Cancer complications include impaired oxygenation, impaired nutrition, and Infection. Impaired oxygenation occurs when tumors grow in the airways causing airway obstruction, and if lung tissue is affected, the lung capacity reduces. Tumors also compress blood and lymph vessels in the chest, obstructing blood flow through the chest and lungs (Seo et al., 2021).

Besides, tumors often thicken the alveolar membrane and injure the pulmonary blood vessels causing a decreased gas exchange. Patients with cancer often have impaired nutrition due to GI structure and function alterations. For instance, abdominal obstruct or compress structures along the GI tract, impairing the absorption of nutrients and elimination of wastes.

In addition, tumors invading the liver damage the organ impairing its metabolic functions. Infection is a common complication attributed to the invasion of the skin and mucous membranes (Seo et al., 2021). Furthermore, tumor cells invade the bone marrow and impair the production of white blood cells, which are vital for normal immune function.

Side Effects of Treatment

Commonly used cancer treatments include surgery, radiotherapy, chemotherapy, and immunotherapy, independently or in combination, to kill cancer cells. The side effects of surgery include disfigurement, scarring, and bleeding/infection at the incision site. Radiotherapy side effects include altered taste sensations, skin changes, alopecia, and fatigue (Leach, 2020).

Common chemotherapy side effects include nausea and vomiting, hair loss, mucositis, anemia, neutropenia, thrombocytopenia, altered bowel elimination, cognitive changes, and sleep disturbance. Side effects of immunotherapy include peripheral neuropathy, flu-like general malaise, fever, chills, flu-like general malaise, and skin dryness, itching, and peeling.

Methods to Lessen Effects

Mucositis can be lessened through frequent oral hygiene with teeth cleaning and mouth rinsing, which is vital in managing stomatitis and mucositis. The alopecia skin side effects can be minimized by avoiding direct sunlight, wearing a hat to cover the hairless scalp, and using sunscreen. In addition, stool softeners can be administered to patients with altered bowel function to alleviate constipation and avoid injury to the anal skin (Leach, 2020).

Pain can be alleviated using non-opioid analgesics and non-pharmacological measures like heat or cold compressions and massages. Furthermore, appetite stimulants can be used for patients with reduced appetite and at risk of nutritional deficiency.

Factors Contributing to Incident and Mortality Rates of Various Cancers in Americans

Cancer is the second leading cause of mortality in Americans after heart disease. The American Cancer Society (ACS) projects that about 1.9 million new cancer cases will be diagnosed in 2023, and 609,820 cancer-related mortalities will occur. Cancer is associated with lifestyle factors like alcohol consumption, tobacco smoking, physical inactivity/sedentary behavior, overweight/obesity, and poor dietary habits. Zhang et al. (2020) found that consuming 50 and 100 g of ethanol per day was linked with 22 and 91% higher cancer risks, and heavy drinkers had a 31% higher risk of cancer mortality than non-drinkers.

Tobacco smoking is the most vital risk factor for cancer morbidity and mortality. The risk of cancer in smokers increases by several folds for cancers, like laryngeal, pharyngeal, lung, upper GI tract, and oral cancer. Furthermore, being overweight and obese was linked with 5–50% higher risks of breast, esophageal, colorectal, endometrial, kidney, liver, gallbladder, ovarian, stomach, pancreas, and thyroid cancer (Zhang et al., 2020). Besides, obese males and females, obesity had 6 and 10% higher risks of cancer mortality than their healthy-weight counterparts.

In addition to lifestyle factors, viruses (oncoviruses) have been associated with various cancers. Viral carcinogenesis occurs when viruses infect body cells and destroy DNA strands (Das, 2021). Hepatitis B virus is linked with Primary liver carcinoma, while Hepatitis C is associated with Primary liver carcinoma and B-cell lymphomas. Human papillomavirus (HPV) causes vulvar carcinoma, cervical carcinoma, and other anogenital carcinomas (Das, 2021). Besides, Epstein-Barr virus is linked with B-cell lymphoma, Burkitt’s lymphoma, and nasopharyngeal carcinoma.

How the ACS Might Provide Education and Support

The ACS is on a mission to make the world a cancer-free place. To achieve this, it provides funds, conducts research, shares expert information, support cancer patients and their families, and increases the general population’s knowledge about cancer prevention. The ACS can provide education on cancer diagnoses, cancer treatments and side effects, self-management, and coping strategies (ACS, 2019).

For instance, the ACS offers information on its website on cancer, including clinical features, diagnostic tests, and staging. This can help cancer patients understand more about their diagnosis. In addition, the ACS provides information on treatment interventions for various cancers and the associated side effects.

Furthermore, the ACS provides patients with education on lifestyle interventions like nutrition, physical activity, working on one’s appearance, and working when on cancer treatment (ACS, 2019). The ACS provides information on how to cope with cancer diagnosis and treatment. This is essential in helping cancer patients, and their families prepare for treatment and to adjust to life with cancer.

A nurse can recommend the Breast Cancer Support service offered by the ACS. Breast cancer is the most common cancer in American women and the second leading cause of death, which makes this service essential for women with the disease. Breast Cancer Support helps patients cope with the breast cancer experience as early as the cancer is diagnosed (ACS, 2019).

The support continues for as long as the disease remains a concern to the patient. Breast cancer patients are given an opportunity to communicate their feelings, express their worries, and ask questions to survivors. The patients are given support and hope, which is crucial in promoting their emotional and mental health.

Utilizing the Nursing Process for Cancer Patients

Nurses use the five phases nursing process to provide care to cancer patients. In the assessment phase, the nurse takes the patient history, performs a physical exam, and orders necessary diagnostic tests. The assessment helps to identify any complications with cancer and treatment side effects.

The nurse assesses the patient’s vital signs, pain level, fatigue level, skin problems, signs of infection, hair loss problems, nutrition, self-esteem level, and psychosocial well-being (Tuominen et al., 2019). The assessment findings guide the nurse in making a diagnosis. Examples of common findings in cancer patients include pain, fever, mucositis, decreased muscle mass, and low self-esteem.

In the diagnosis phase, the nurse uses the objective and subjective findings in the assessment phase to make actual or potential diagnoses. An example of an actual diagnosis is Acute pain related to the compression of nerve tissue by a tumor, as evidenced by the patient’s report of pain (Tuominen et al., 2019). A potential nursing diagnosis is a Risk for infection related to the suppression of the bone marrow and reduced WBC count.

In the planning phase, the nurse collaborates with the patient to develop desired outcomes. The goals are guided by the assessment findings and nursing diagnosis, aiming to alleviate or reduce their impact on the patient. For instance, the goal for Acute pain can be for the patient to report adequate pain control within 24 hours (Tuominen et al., 2019). The desired outcome for Risk of infection can be for the patient to remain free from infection during the hospitalization period.

The nurse implements nursing interventions in the intervention phase to attain the desired patient outcomes. The interventions should be based on best practices and evidence-based practice, and the nurse should have a rationale for implementing them. The nursing interventions for acute pain include administering analgesics, cutaneous stimulation with hot/cold compressions, and teaching the patient relaxation techniques (Tuominen et al., 2019).

On the other hand, the nursing interventions for risk for infection include frequently monitoring vital signs, complete blood count, and daily assessment of all body systems for clinical features of infection. These interventions can help in the early recognition and treatment of infection. In the evaluation phase, the nurse assesses if the desired outcomes were achieved within the period indicated in the goal. If the goal was not attained, the nurse identifies why they were not achieved and new interventions to help attain the outcomes.

Contribution of Liberal Arts and Science Studies to Nursing Knowledge

Interdisciplinary research incorporates data, tools, techniques, perspectives, theories, or concepts from two or more disciplines of specialized knowledge. Cancer is a complicated disease, and its causes and treatment solutions are beyond the scope of the nursing discipline. Synergistic efforts are constantly being made to bring knowledge from fields unrelated to healthcare, like social sciences and liberal arts, to develop new detection and treatment methods for cancer (Bellah, 2018). Therefore, interdisciplinary research helps advance the fundamental understanding and address cancer-related problems.

Conclusion

Diagnostic tests used to diagnose cancer include laboratory tests like Tumor marker identification, imaging tests like CT, PET, MRI, and bone scan, and cytology. The TNM system is used to stage cancer, and it outlines the general anatomic extent of a tumor and groups it from stages 0-4. Cancer patients experience complications like impaired oxygenation, impaired nutrition, and infection. The ACS provides information to cancer patients on cancer diagnoses, treatments and side effects, self-management, and coping strategies. Using the nursing process in the care of cancer patients allows the nurse to assess, plan goals, and evaluate care.

References

• American Cancer Society. (2019). How we’re providing support. American Cancer Society | Information and Resources about for Cancer Breast, Colon, Lung, Prostate, Skin. https //www.cancer.org/about-us/what-we-do/providing-support.html
• Bellah, M. M. (2018). The emergence of interdisciplinary research in cancer diagnostics. J. Nanomedicine Res, 6(1). DOI 10.15406/jnmr.2017.06.00161
• Das, D. K. (2021). An Overview of 8 Viruses That Can Cause Cancer. Oncology Times, 43(13), 10–11. DOI 10.1097/01.COT.0000765036.82174.d0
• Leach, C. (2020). Complications of systemic anti-cancer treatment. Medicine, 48(1), 48–51. https //doi.org/10.1016/j.mpmed.2019.10.002
• Seo, S. K., Liu, C., & Dadwal, S. S. (2021). Infectious Disease Complications in Patients with Cancer. Critical care clinics, 37(1), 69–84. https //doi.org/10.1016/j.ccc.2020.09.001
• Tuominen, L., Stolt, M., Meretoja, R., & Leino-Kilpi, H. (2019). Effectiveness of nursing interventions among patients with cancer An overview of systematic reviews. Journal of clinical nursing, 28(13-14), 2401–2419. https //doi.org/10.1111/jocn.14762
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• Zhang, Y. B., Pan, X. F., Chen, J., Cao, A., Zhang, Y. G., Xia, L., … & Pan, A. (2020). Combined lifestyle factors, incident cancer, and cancer mortality a systematic review and meta-analysis of prospective cohort studies. British journal of cancer, 122(7), 1085–1093. https //doi.org/10.1038/s41416-020-0741-x