Cancer

A.Biopsy Procedure
1. Liver: have patient lie on the affected side afterwards
2. Bone marrow: hold pressue to the site for 5-10 mintues
*** Be sure to use a sterile dressing over the biopsy site
B.Radiation
1. Internal Radiation : have private room, warn of exposure, encourage self care, wear film badge records exposure, have a lead container in the room. Visitors cannot stay more than 30 minutes or get closer than 6 feet. No visitor can be pregnant or under 16, Remain in position to avoid dislodging the implant
2. External Radiation: skin care with mild soap, water. Don’t apply powder, ointment, lotion or perfume to the site, do not remove radiation tattoos, avoid tight clothing, do not expose skin to sun or heat
Questions

1. In which situation should the nurse intervene?
a. A pt with internal radiation, who’s guest is 19 years old, sneezing standing 6 feet away.
b. A pt with external radiation, who is wearing a hat to avoid sun exposure
c. A UAP moving the patient with internal radiation around in bed to change the linens
d. A pt with external radiation who takes a bath with mild soap
ANSWER: C, you wouldn’t want to move a patient around with internal radiation because it could dislodge the implant.

2. Which statement below indicates the nurse knows proper procedure after a biopsy?
a. I will apply pressure to the site of a liver biopsy for 5 minutes
b. I will lie a patient with a bone marrow biopsy and the affected side
c. I will avoid placing any pressure on the biopsy site
d. I will use a sterile dressing to cover the site.
ANSWER : D

Male Cancers

1. Prostate Cancer

What you will see? Painless hematuria, urinary hesitancy, recurrent bladder infections, urinary retention, painful ejaculation with elevated BUN/ Creatine. Blood or bacteria in urine and a PSA above 4ng/ml
Interventions: administer hormone therapy, ( Luprone, Flutaminde). use the PCA by elevating the scrotum and penis while applying ice, SCD, antiembolism stockings, instruct client on cath care. Give antispasmodics and monitor I&O

Radical prostatectomy Surgery
1. Why: Prostate cancer
2. Pre- procedure: administer meds, prepare client, ensure full understanding, educate regarding complications like irreversible erectile dysfunction and refractory urinary incontinence
3. Post- Procedure: care for them similarly to an abdominal surgery, give pain meds, cath care, avoid strenuous activity avoid tub baths for 2-3 weeks.

Questions

Which complications are common for a radial prostactomy surgery?
a. Constipation
b. Erectile dysfunction
c. Refractory urinary incontinence
d. Pelvic pain
Answers: B &C

What statement made by a patient after a radial prostatectomy should the nurse correct?
a. “ I can’t wait to go home and take a long bath”
b. “ Ill need to avoid strenuous activity like weight lifting”
c. “ I need to avoid showers for 2-3 weeks”
Answers: A &C, you want to avoid tub baths for 2-3 weeks not showers

Testicular Cancer

What you will see: swelling or lumps in the testes, signs of metastisis like abd masses, back pain and gynecomastia.

Interventions

To detect early: perform testicular self exams every month after a shower
Before surgery: bank sperm
After surgery: treat pain, no heavy lifting or strenuous activity for specified period

Meds

1. Alkalating agents
a. Use: cause cell death or mutation of malignant growth
b. s/e: tremors, muscular twitching, confusion, n&v, bone marrow depression, sterility, alopecia, cystitis, cancer acute leukemia
c. important info: talk to provider before receiving vaccination, report bleeding or infection, a diet low in purines is recommended, good oral hygiene with soft toothbrush, DO NOT use toothbrush when platelet count is < 50,000. Reduce n & v by eating small meals and refer for dietary consult
d. drugs: busulfar, carboplatin, carmustine, cisplastin, ifofamide, lomustine, mechlorethamine, melphalan,