Issue #1: physiologic & psychologic vulnerability
Results in stress, affective & perceptual problems
Issue #2: vulnerability as defined by the protection the skin and mucous membranes normally provides
Impaired 1st line of defense; cancer treatment suppresses the actively reproducing integumentary cells (skin & mucous membrane problems)
Issue #3: vulnerability as defined by the protection the particular deficient blood cell provides
Decreased RBCs = Anemia
Decreased WBCs = Leukopenia
Decreased Platelets = Thrombocytopenia
Decreased RBCs = Anemia; Vulnerable to...
oxygenation and perfusion deficit
Decreased WBCs = Leukopenia; Vulnerable to...
defense protection deficit
Impaired 2nd and 3rd line of defense
Decreased Platelets = Thrombocytopenia; Vulnerable to...
hemostasis protection deficit
Body's 3 lines of defense
1. Skin
2. Inflammation
3. Immunity
Issue #4: vulnerability to thromboembolic risk both idiopathic & as defined by Virchow
-Fatigue results in decreased activity & subsequent abn blood flow (sluggish)
-Tissue destruction from the malignancy & treatments tend to trigger inflammation, inflammatory mediators can injure vascular endothelium
-Extremely Increased WBCs = i.e acute L
Issue #5: Cancer results in invasive tissue destruction
Often results in chronic pain, nutritional deficits, and other paraneoplastic problems
Clinical Manifestations of Cancer (6)
Pain
Fatigue
Cachexia
Anemia, leukopenia & thrombocytopenia
Infection
Paraneoplastic syndrome
Causes of Cancer Pain (4)
-By pressure, obstruction, invasion of sensitive structures, stretching of visceral surfaces, tissue destruction, & inflammation
-Can be caused directly by the tumor
-Can be caused by treatment
-Can be caused from other sources, i.e. infection
W.H.O."s 3 Step Pain Ladder
1. Non-opioids + adjuvant
2. Add mild opioids
3. Add strong opioids
Non-opioids
NSAIDs
ibuprofen/motrin
acetaminophen/tylenol
aspirin
naproxen
Mild opioids
oxycodone
Strong opioids
morphine
hydromorphone/dilaudid
Stoke's sign
edema of face
Collar of Stokes
edema of neck
Pemberton's sign
raise arms above head
Positive: plethora/cyanosis of face
Type 1 Hypersensitivity: Manifestations (6)
Pruritis
Urticaria
Edema
Conjunctivitis
Rhinitis
GI cramps and malabsorption
Latex Allergy connected to foods:
Avocado
Banana
Chestnut
Kiwi
Passion fruit