Patient Care

Question 1

Lung side effects

Answer 1

fibrosis, pneumonitis

Question 2

Mepitel

Answer 2

• Alleviate or reducing side effects

- Used for breast patient

Question 3

When should side effects be discussed with the patient?

Answer 3

• 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

Question 4

Who is part of a multidisciplinary team?

Answer 4

• Councillor, dieticians, psychologist, physio, OT, social worker

Question 5

What is the role of the social worker?

Answer 5

Income, transport, housing

Question 6

How often does the body turn over blood

Answer 6

every 90 - 120 days

Question 7

Lung: Pneumonitis

Answer 7

• 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

Question 8

Lung: Fibrosis

Answer 8

• It is a fibrotic change will may cause the lung to become firmer and drier, have less vascularisation and a loss of elasticity
• Chronic

Question 9

Breast Side Effects

Answer 9

• 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

Question 10

RTOG Grading Scale

Answer 10

Evaluation of radiation treatment 
RTOG 0
RTOG 1 
RTOG 2 
RTOG 2.5 
RTOG 3
RTOG 4

Question 11

RTOG 0

Answer 11

No visible change to skin

Question 12

RTOG 1

Answer 12

Faint or dull erythema

Mild tightness of skin and itching may occur

Question 13

RTOG 2

Answer 13

Bright Erthema/dry desquamation

Sore itchy and tight skin

Question 14

RTOG 2.5

Answer 14

Pathcy moist desquamation

Yellow/pale green exudate

Soreness with oedema

Question 15

RTOG 3

Answer 15

Confluent moist desquamation

Yellow pale green exudate

Soreness with oedema

Question 16

RTOG 4

Answer 16

Ulcreration, bleeding, necrosis (rarely seen)

Question 17

What is the most likely cause of erythema on the breast for women?

Answer 17

Movement and irritation is the most likely cause

Can be a result of the irritation from wearing a bra

Question 18

Effects associated with Whole Brain

Answer 18

• Alopoecia - transicent or permanent
• Nausea
• Cognitive impairment
• Desquamation
• RICP (from tumour growth or from sweeling caused by treatment)
• Loss of taste or other senses

Question 19

Effects associated with prostate

Answer 19

• 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

Question 20

Radiotherapy Side Effects causing altered nutritional status

Answer 20

• 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

Question 21

How to treat swelling or RICP

Answer 21

Dexamethosome

Question 22

How to Manage fatigue

Answer 22

Light to moderate exercise (physio OT, physiologist)

Question 23

Radiotherapy Skin reaction cycle

Answer 23

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