Patient Care Flashcards
Lung side effects
fibrosis, pneumonitis
Mepitel
- Alleviate or reducing side effects
- Used for breast patient
When should side effects be discussed with the patient?
- At the time of the first nursing consultation
- On the first day of treatment
- During the first few days of treatment
- When the side effects first appear whislt on treatment
- At the completion of treatment (reiterate that the die effects will continue for several weeks and the care regime should be followed until follow up appointment
- If there are any concerns after treatment has finished do not hesitate to contact the department for advice on management
Who is part of a multidisciplinary team?
- Councillor, dieticians, psychologist, physio, OT, social worker
What is the role of the social worker?
Income, transport, housing
How often does the body turn over blood
every 90 - 120 days
Lung: Pneumonitis
- Inflammation of the air cells
- Occur during treatment (towards the end) or slightly after
- Acute
- Can do steroid therapy, antibiotics, and exercise to help alleviate
Lung: Fibrosis
- It is a fibrotic change will may cause the lung to become firmer and drier, have less vascularisation and a loss of elasticity
- Chronic
Breast Side Effects
- Erthema
- Desquemation
- Swelling (could be due to fluid retention, or be hormonal)
- Lymphoedema (due to removal of lymphatic vessels/nodes)
- Fibrosis
- Telangiectasia
- Shrinkage
- Nausea
- Oesophagitis
RTOG Grading Scale
Evaluation of radiation treatment RTOG 0 RTOG 1 RTOG 2 RTOG 2.5 RTOG 3 RTOG 4
RTOG 0
No visible change to skin
RTOG 1
Faint or dull erythema
Mild tightness of skin and itching may occur
RTOG 2
Bright Erthema/dry desquamation
Sore itchy and tight skin
RTOG 2.5
Pathcy moist desquamation
Yellow/pale green exudate
Soreness with oedema
RTOG 3
Confluent moist desquamation
Yellow pale green exudate
Soreness with oedema
RTOG 4
Ulcreration, bleeding, necrosis (rarely seen)
What is the most likely cause of erythema on the breast for women?
Movement and irritation is the most likely cause
Can be a result of the irritation from wearing a bra
Effects associated with Whole Brain
- Alopoecia - transicent or permanent
- Nausea
- Cognitive impairment
- Desquamation
- RICP (from tumour growth or from sweeling caused by treatment)
- Loss of taste or other senses
Effects associated with prostate
- bladder irritation
- UTIs
- Rectal urgency
- Diarrhoea
- Steatorrhoea (inability to absorb fat content in the bowel)
- Gas, bloating
- Nocturia
- Dysuria (uncomfortable urination)
- Alopecia
- Genitourinary
- Gastrointestinal
- Errythemia
Radiotherapy Side Effects causing altered nutritional status
- Nausea and vomitting
- Mucositis (inflammation of the mucous membrane)
- Dysphagia (difficulty while eating)
- Anorexia (pshychological eating disorder)
- Cachexia
- Diarrhoea
- Malabsorption (cells inability to absorb sufficiently)
- Acute Radiation enteritis
- Psychological factors
How to treat swelling or RICP
Dexamethosome
How to Manage fatigue
Light to moderate exercise (physio OT, physiologist)
Radiotherapy Skin reaction cycle
1) Radioterhapy starts - Activates inflammatory response
2) 10-14 Days - Damaged basal cells migrate to skin surface. Errythema develops
3) Further skin damage. New cells reproduce before old dead cells shed. Dry desquamation
4) No new cells to replace dead cells. Moist desquamation
5) Treatment completed. Takes 10-21 days for basal cells to recover and new skin to grow
