Nursing Process: Cancer and Approach to Care
Introduction
In 1958, Ida Orlando instituted the nursing process to offer guidance to nursing care, a process which is still applied today. The nursing process can be defined as a methodical approach based on the significant doctrines of critical thinking, goal-focused tasks, client-focused treatment methods, intuition, and recommendations for evidence-based nursing practice (Karttunen, et al., 2020). The nursing process is a viable tool that applies nursing knowledge into clinical practice. Besides, all-inclusive and scientific claims are incorporated to offer the basis for delivery of quality and compassionate care. By applying the systematic problem-solving approach, a nurse can establish an individual’s care needs and deliver personalized care. This paper utilizes the nursing process in offering client-centered healthcare to cancer patients by detailing the suitable approach to care. The report presents the cancer diagnosis, staging, three main oncological complications, side effects of treatments, and methods for alleviation of both mental and physical side effects.
Cancer: The Diagnosis & Staging
Diagnosis
Cancer is defined as the uninhibited growth of abnormal cells, known as cancer, malignant, or tumor cells that infiltrate the normal body tissues anywhere in the body. There are more than 200 kinds of cancer, and the general classes of causative agents include the toxic or chemical compound exposures, pathogens, human genetics, and ionizing radiation (Leslie, 2018). There are numerous techniques applied in the diagnosis of cancer. With the latest technological advances, there has been a surge in diagnostic tools that help detect cancers. Once suspected, the cancer diagnosis is made by imaging radiologists, oncopathologists, and pathologists. Some types of cancers are diagnosed in routine screening exams. Most cancers are detected when a patient presents to your healthcare professionals with specific symptoms.
A physical examination and patient medical history, history of symptoms, are considered the first steps in diagnosis. The nurse can order several tests, the majority of which are determined by the kind of cancer and suspected location in the body. The tests localize abnormalities that offer presumptive evidence for cancer diagnosis (Leslie, 2018). The nurse may request electrolyte level tests, complete blood counts, and other lab blood studies to obtain supplementary diagnostic data. Imaging studies such as ultrasounds, X-rays, MRI, and CT scans are used to aid the physicians in detecting abnormalities that might be cancer. Endoscopy tests visualize cancerous tissues inside the throat, bronchi, and intestinal tract. Radionuclide scanning is used to scan body parts that are not well visualized, such as lymph node and interior sections of bones. The tests involve IV injections or ingestion of weakly radioactive substances to detect abnormal tissues. The definitive diagnosis is based on examinations and analysis of tissue samples obtained via biopsy (Leslie, 2018). The definitive diagnosis identifies if the tissue is cancerous, cancer type, or metastatic types of brain cancer, to help in staging cancer.
Cancer Staging
The staging is defined as the processes of establishing the anatomic extent of cancer in the patient’s body (Brierley, et al., 2016). Determining the disease’s spread helps the nurse govern the most appropriate treatments for effecting a cure, lessening the tumor’s burden, or relieving symptoms. Several different staging techniques are used for cancers, and specific criteria for staging vary amongst the cancer types. According to the data compiled by the National Cancer Institute, the elements that are considered in a staging system include primary tumor site, tumor size and number, the involvement of lymph nodes, types of cells, tumor grade, and absence or presence of metastasis. Early cancer denotes the stage I and II cancer, whereas advanced cancer indicates stages III and IV. The table below describes the stage grouping methods for cancers.
Source: National Cancer Institute
Complications of Cancer and Treatment
Nurses play a vital role in the accurate assessment of patients at high risks for oncologic complications that result directly from the disease as an indication of advancing or progressing cancer. Also, oncologic complications could occur due to chemotherapy and radiation cancer treatments. One of the cancer complications is causing fluids to fill the sacs near the heart or lungs, making it hard to breathe. Another complication occurs when cancer blocks veins returning blood from the upper body parts to the heart, which causes swelling of the chest and neck veins (Kooken & Kerr, 2018). Cancer presses on the spinal cord and nerves, which causes pain or loss of nerve functioning. Finally, hypercalcemic syndrome occurs when cancer produces hormones that dangerously elevate the calcium levels or cancer expansively attacks the bones.
Some types of cancers are preventable through lifestyle modifications. Chemotherapy, radiation, surgery, immunotherapy, and stem cell transplant can be used to treat cancer. The side effects include neutropenia, lymphedema, hair loss, nausea, vomiting, difficulty concentrating, pain, blood clots, fatigue, depression, and trouble eating. The assessment is vital as changes in the patient’s condition can either be subtle or dramatic. Different methods are used to diminish the psychological and physical effects of treatment, such as social and emotional support, relaxation and stress management, counseling, cancer education, group support medications, and exercise (Mosher et al. 2015). The oncologic complications can be analyzed to guide decisions about the aggressiveness of cancer treatments.
Factors Contributing towards the Cancer Incidence & Mortality
Various factors contribute to the annual incidence and mortality rates of different cancers among Americans. In the U.S, most of the cancer burden of cancer can be linked to modifiable health behaviors, which upturn one’s risks of disease. The five main lifestyle risk factors for increasing mortality and incidence are alcohol or tobacco use, excess body weight, physical inactivity, reproductive patterns, and poor nutrition/ diet (Torre et al. 2016). For example, tobacco use increases lung cancer, pancreatic cancer, kidney cancer, colon cancer, stomach cancer, and cervical cancer incidences as well as these cancers death rate among the Americans. Also, other lifestyle factors like exposure to ultraviolet light, sexual practices, and infected blood contribute considerably to the incidence of cancer. These factors increase the risks for common types of cancers which largely impact on major illnesses such as stroke, osteoporosis, cardiovascular disease, diabetes, and hypertension.
American Cancer Society Programs
The American Cancer Society provides education and support to patients in breakthrough cancer research, free accommodation near treatment, live helplines, and transportation to treatment (Kooken & Kerr, 2018). The ACS website offers cancer A–Z, which includes basic information on cancer causes and exhaustive information on particular types of cancer. The information also includes prevention measures, risk factors, symptoms, early detection, coping with cancer, diagnosis, side effects, and treatment options. Other American Cancer Society programs and services include breast cancer support, mastectomy products, TLC hair loss, hope lodging, rides to treatment, and online communities. One would recommend two ACS services: hope lodging and online support communities. The ACS services, including National Cancer Information Center, Reach to Recovery Websites and Apps, Cancer Survivors Networks, Belong, Beating Cancer Together, and Springboard Beyond Cancer, offer support to patients and families during and after treatment (Kooken & Kerr, 2018). Finally, ACS’s Hope Lodge provides patients and caregivers with free places to stay to receive effective treatment in other cities. Hope Lodge offers a nurturing and home-like environment where patients retreat to private rooms and connect with others while accessing various resources and information.
Nursing Process: Five Phases
The nursing process acts as a logical guide to delivering client-centered healthcare that is safe and effective for cancer patients through their life span (Leslie, 2018). The five phases are assessing, diagnosing, planning, implementing, and evaluating. The assessment step involves collecting subjective and objective data and applying critical thinking skills to identify the health problems and the physiological, emotional, and psychological state. The second stage consists of the formulation of nursing diagnosis using clinical judgment in the planning and execution of patient-focused care (Kooken & Kerr, 2018). The North American Nursing Diagnosis Association offers nurses with an updated list of diagnoses. The nursing diagnosis also incorporates the Maslow Hierarchy of Needs, which helps in prioritizing and planning care based on patient-focused outcomes. The planning phase involves the formulation of goals and outcomes, which directly impact patient care as per the EDP guidelines to ensure positive outcomes. The implementation step consists of the nursing interventions and actions delineated in the plan of care. The nursing process’s final stage entails the reassessment or evaluation to guarantee the fulfillment of desired outcomes and adaption based on new evaluation data.
Undergraduate Education: Liberal Arts & Science Studies
Nursing entails more than applying technical skills and knowledge. Extraordinary nurses are well-rounded, critically thoughtful, masterful communicators, and culturally competent. Undergraduate education in various liberal arts, mathematics, physical and social sciences, and science studies can contribute effectively to the foundation of nurses’ knowledge and preparation to collaborate with cancer patients in using the nursing process (Leslie, 2018). Over the years, science has undertaken a central role in education, notwithstanding the recognized significance and contribution of liberal arts like history, music, literature, philosophy, fine arts, and architecture. Furthermore, the science studies encourage critical thinking as they help understand quantitative research and data vital to evidence-based nursing practice. A student can draw on diverse learnings from other courses and gain critical skills and knowledge from different disciplines to deliver safe care for patients in practice (Kooken & Kerr, 2018).
Besides, the liberal arts courses aid in transcultural nursing and religion as one becomes culturally competent by understanding and appreciating the needs of all patients and their families. One of the primary goals of integrating liberal arts courses in the undergraduate curriculum helps make students well-rounded and well-balanced. They are well prepared to be successful in practice. Nursing students consent that liberal arts enhance their communication skills, thinking globally, navigating diversity, making decisions, and improving their human selves (Kooken & Kerr, 2018). A well-balanced education plan helps students think outside the box from diverse perspectives like psychology and philosophy, enhancing one’s appreciation for all facets of life and connecting with the world through arts, music, movements, theory, and literature. In summary, the liberal arts and different sciences are integral parts of the nursing curriculum’s educational discipline as they undergird critical-thinking, problem-solving, creativity, and delivery of holistic and culturally competent care.
Conclusion
Healthcare is dynamic and ever-changing, as evidenced by the transformation of traditional nurses’ roles to fulfill the demands of the healthcare environment. The nursing process enables nurses to promote changes and positively impact patient delivery healthcare models in the long-run. The paper utilized the nursing process to offer healthcare guidance among cancer patients and approach to diagnosing and staging cancer, its complications, treatment options, and approaches to reducing psychological and physical effects. Even though there are numerous screening tests and presumptively diagnosing cancer, the definite cancer diagnosis is made through the examinations of biopsy samples of suspected cancerous tissue. The results of the biopsy also determine cancer staging. It helps ascertain the type of cancer, degree of cancer spread, and treatment protocols. Finally, the treatment protocols differ according to cancer type and staging. The majority of the treatment protocols are planned to match an individual patient’s cancer disease. Nevertheless, most cancer treatments include at least one of the interventions: surgery, chemotherapy, radiation, immunotherapy, stem cell transplant, and radiation therapy. The overall goal is to prevent, reverse, and minimalize life-threatening complications through early detection, prophylactic measures, and effective management.
References
Brierley, J., Gospodarowicz, M., & O’Sullivan, B. (2016). The principles of cancer staging. Ecancermedicalscience, 10, ed61. https://doi.org/10.3332/ecancer.2016.ed61
Leslie, J. L. (May 01, 2018). Employment of the Nursing process to facilitate recovery from surgery: A case study. Online Journal of Issues in Nursing, 23, 2, 1-1. https://doi. 10.3912/OJIN.Vol23No02PPT07
Kooken, W. C., & Kerr, N. (January 01, 2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing, 34, 1.) https://doi: 10.1016/j.profnurs.2017.07.002.
Mosher, C. E., Ott, M. A., Hanna, N., Jalal, S. I., & Champion, V. L. (2015). Coping with physical and psychological symptoms: a qualitative study of advanced lung cancer patients and their family caregivers. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 23(7), 2053–2060. https://doi.org/10.1007/s00520-014-2566-8
Karttunen, M., Sneck, S., Jokelainen, J., & Elo, S. (March 01, 2020). Nurses’ self-assessments of adherence to guidelines on safe medication preparation and administration in long-term elderly care. Scandinavian Journal of Caring Sciences, 34, 1, 108-117. https://doi: 10.1111/scs.12712
Torre, L. A., Siegel, R. L., Ward, E. M., & Jemal, A. (January 01, 2016). Global Cancer Incidence and Mortality Rates and Trends–An Update. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 25, 1, 16-27 https://doi:10.1158/1055-9965.EPI-15-0578