nursing management of chemotherapy side effects

Chemotherapy can prolong a person’s life, and potentially rid them of cancer. The severity and duration of allergic skin reactions may be independent of dose and may persist after the drug has been discontinued. After chemotherapy, use soft-bristle brushes. ", National Cancer Institute: "Nausea and Vomiting;" "Hair Loss;" "Skin and Nail Changes;" and "Fatigue. And damage to cells at the hair roots, or follicles, can lead to hair loss. Talk to your doctor about the best anti-nausea drug for you. Use a sweet marinade to help bring flavor to your main dish. Side effects are unpredictable and depend on the type of chemo drug a person is using. In some patients, chemotherapy can lead to anemia and low red blood cell counts. Use a daily planner to help you manage -- and remember -- appointments, names, addresses, numbers, and to-do lists. Everyone reacts differently. Changes in practice As a result of systematic assessment, we have introduced a change to our practice. If you just can't shake the feeling of being tired, check with your doctor. Chemotherapy can also damage healthy cells and cause side effects. of the nurse's role in cancer chemotherapy. Implications concerning adverse drug reactions consists of precise information regarding nursing interventions and the rationale for implementation. Learn about steps you can take to prevent or manage the side effects listed below: Anemia; Appetite Loss National Cancer Institute: "Nausea and Vomiting;" "Hair Loss;" "Skin and Nail Changes;" and "Fatigue." Wear a hat or scarf in cold weather, and use. Fast-growing cells like blood cells, hair cells, skin cells, cells that make up the gastrointestinal tract (mouth, throat, stomach, intestines) and cells of the reproductive system are at risk. If so, try poultry, mild-flavored fish, or dairy products instead. Wash it with mild moisturizing shampoos and conditioners, and apply gentle lotions. Apple juice, tea, and flat ginger ale may help. This can lead to mouth sores, diarrhea or … – Terms & Conditions – Privacy Policy – Disclaimer -- v7.7.5, /getattachment/164cee26-0b7a-4be9-9801-528af963666c/Chemotherapy-Side-Effects.aspx, Calming the COVID-19 Storm - Q&A Podcast Series, Improving Health through Board Leadership, Profiles in Nursing Leadership: Pathways to Board Membership, Nurses Month May 2020: Week 4 – Community Engagement, Trust and Spheres of Influence: An Interview with Karen Cox, PhD, RN, FACHE, FAAN, Uniting Technology & Clinicians: An Interview with Molly McCarthy, MBA, RN-BC, Where are our N95s? Your health care team can treat and/or talk with you about ways to reduce these side effects, so you feel better. Feel Your Best During Treatment for Breast Cancer, How to Manage Your Emotions During Chemotherapy, Alternative Therapies for Chemo Side Effects. This article describes a nurse-led project that consisted of developing bespoke management guidelines covering the main immune-related adverse events (irAEs) seen in patients treated with immunotherapy. If your treatment does, here's what you can do: You may be more sensitive to sunlight in the months following treatment. Follow these tips to better enjoy eating: You may find yourself feeling tired, but there are ways to help manage that. This can lead to mouth sores, diarrhea or other issues with the digestive system. Relaxation techniques like deep breathing and meditation may also help stop these side effects. Avoid. Medications that may alleviate symptoms (Shapiro, 2019): Nonsteroidal anti-inflammatory drugs (NSAIDs), Symptoms vary from mild, moderate, or severe depending on the chemo medication, Administer antiemetics/anti-nausea medications as prescribed, Suck on ice, popsicles or hard candy during chemo treatment, Increase fluid intake but avoid drinking with meals, Avoid strong odors, caffeine, and smoking during chemotherapy, Chemotherapy-induced peripheral neuropathy (CIPN) may cause nerve damage resulting in motor and sensory symptoms such as pain, numbness, weakness, burning, tingling, or unusual sensation in arms and legs (Shapiro, 2019), Symptoms usually resolve after treatment is discontinued, Duloxetine may be effective to treat chemotherapy-induced neuropathy (Shapiro, 2019), Some chemo medications may cause pneumonitis which leads to dyspnea, cough, malaise or fever, Most symptoms resolve after treatment is discontinued, Glucocorticoids may be used in severe cases (Shapiro, 2019), Chemo may lower testosterone levels and libido, Traces of chemo may be found in semen after treatment, Chemo can damage sperm in men and germ cells in boys, Discuss medications and procedures available to treat erectile dysfunction, Advise patients to use condoms to prevent partner exposure to chemo in semen, Discuss fertility preservation options (sperm banking), Chemo may lower estrogen levels and affect ovarian function causing hot flashes, irregular or no periods, and vaginal dryness that can cause painful intercourse, Chemo may affect vaginal tissue and cause sores, Chemo can stop ovaries from releasing eggs and estrogen or lower the number of eggs in the ovaries, Discuss medications to decrease pain during intercourse (i.e. All rights reserved. Drink an hour before or after meals rather than when you eat. Cancer Care: "Possible Side Effects of Chemotherapy" and "Combating Chemo Brain." Wear long pants, long sleeve shirts, and wide-brimmed hat when outdoors. After a chemotherapy session, call your doctor or nurse if you notice any of these side effects of chemotherapy: • Fever (body temperature above 101ºF) • Sore mouth or gums • Pain or swelling in the gums • Swollen, inflamed or pus-filled skin sores • Sinus or ear infections • Cough and shortness of breath with fever • Irritation in and around the anus Lippincott NursingCenter’s Best Practice Advisor, Lippincott NursingCenter’s Cardiac Insider, Lippincott NursingCenter’s Career Advisor, Lippincott NursingCenter’s Critical Care Insider, Chronic Obstructive Pulmonary Disease (COPD), Extracorporeal Membrane Oxygenation (ECMO), Prone Positioning: Non-Intubated Patient with COVID-19 ARDS, Prone Positioning: Mechanically Ventilated Patients,,,,, PocketCard_Chemotherapy-Side-Effects_November-2019.pdf, Myalgias (muscle pain); arthralgias (joint pain), Sexual health and fertility issues in men, Sexual health and fertility issues in women, Low red blood cell (RBC) production in the bone marrow, Encourage proper nutrition, for example foods high in protein and iron, Erythropoietin-stimulating agents (ESAs) foster production of RBCs, but may increase risk for thromboembolism (Shapiro, 2019), Instruct patient to brush teeth gently with a soft toothbrush, Administer stool softeners and/or laxatives as needed, See measures to manage nausea, vomiting, and diarrhea below, Chemo affects the smooth muscles in the GI tract (NCI, 2015), Dietary modifications such as the BRAT diet; avoidance of milk, alcohol and caffeine; avoidance of fatty, spicy and high fiber foods; eating smaller meals more frequently, Fluid build up in the tissues may be caused by chemotherapy or heart, liver or kidney failure, May also be caused by poor nutrition or blockage of veins or the lymph system, Avoid tight clothing and shoes; avoid crossing legs when sitting; compression stockings and sleeves may be needed, Chemo-induced anemia and/or vasomotor symptoms that result in sleep difficulties and depression, Typically resolves when chemo is discontinued, Assess patient for causative factors such as anemia, pain, depression, hypoxia or fluid and electrolyte imbalances, Discuss proper nutrition and encourage foods high in protein and iron, Some types of chemo cause hair to fall out, Hair thinning may begin after the second or third cycle of treatment, Treat hair gently: use a soft brush; avoid hair dryers, irons, gels, clips; use a mild shampoo and wash less frequently, Protect the scalp with sunscreen or a hat when outside, Reassure the patient that hair often grows back in 2 to 3 months after treatment has ended, Scalp cooling devices used before, during and after treatment may reduce or prevent hair loss by restricting blood flow to the scalp and activity of hair follicles (ACS, 2019), Elevated bilirubin, alkaline phosphatase (ALK), aspartate transaminase (AST), and alanine transaminase (ALT) levels may result from chemotherapy, Treatment may not be needed, instead dose adjustments may be indicated, If severe, treatment discontinuation may be considered, Chemo may cause a decrease in white blood cell production leading to neutropenia which increases risk of infection (Shapiro, 2019), Neutropenia may occur 10 to 14 days after each cycle and typically resolves prior to the next chemo treatment, Monitor for signs of infection (fever, cough, sore throat, pain, rash, sores on mouth or tongue, swelling, redness), Encourage good hand hygiene, both patient and close family, Avoid crowds, people who are sick and people that have recently received a live vaccine, Encourage patients to use a mask when out in public, Symptoms include forgetfulness; difficulty concentrating; memory issues; trouble multi-tasking or remembering common words, Exercise the brain with puzzles; take a class to learn something new, Use planners or smart phone applications to set reminders and stay organized, Chemo may cause a chemical or metallic taste, a change in taste or smell, dry mouth, infections, mouth sores, pain/swelling, sensitivity to hot or cold, dysphagia, cavities, and mucositis (inflammation of the oral mucosa), Low platelet count may cause bleeding in the mouth, Dental check-up and cleaning before treatment begins, Swishing ice chips around mouth for 30 minutes may alleviate inflammation and sores (Shapiro, 2019), Topical diphenhydramine, oral antacids and lidocaine may soothe symptoms (Shapiro, 2019), Muscle and joint pain are associated with certain chemo drugs such as biologic therapies and growth factors, Blood infections can cause muscle aches and fever.

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