Chapter 11
Oncology: Nursing management in cancer care
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CLINICAL REASONING EXERCISES
1
You are seeing Mr and Mrs Brown, a married couple,
both in the seventh decade of life, in the clinic for blood
pressure checks. What questions regarding cancer screening
are appropriate for them? How would you respond if your
suggestions for cancer screening are met with the answer
that they are too old to worry about cancer? What special
considerations are there if the woman has a physical dis
ability that requires her to use a wheelchair?
2
A 54-year-old woman with bone metastases secondary
to breast cancer has been admitted to the hospital with
a diagnosis of hypercalcaemia. Describe the underlying
cause of hypercalcaemia and the medical and nursing
management strategies that are anticipated. What patient
monitoring would be essential before and after treatment of
hypercalcaemia?
ONLINE RESOURCES
A wide range of additional
resources to enhance teaching and learning and
to facilitate understanding of this chapter may be found
online at
, including videos,
animations, journal articles, review questions, quizzes
and the e-book. Subscribers may also access Lippincott’s
extensive online point-of-care procedure guide LNPS,
which provides a wealth of evidence-based, reliable
information.
REFERENCES AND SELECTED READINGS
Books
Abraham, J. L. (2005). A doctor’s guide to pain and symptom management in
cancer patients (2nd ed.). Boston: Johns Hopkins University Press.
American Joint Commission on Cancer (2010).
AJCC Staging Manual
(7th ed.).
Chicago: Springer Science and Business Media Inc.
Batchelor, D. (2006). Biological therapy. In Kearney, N. & Richardson, A.
(Eds).
Nursing patients with cancer
, pp. 303–328. Edinburgh: Elsevier Churchill
Livingstone.
Bruner, D. W., Haas, M. L., & Gosselin-Acomb, T. K. (2006).
Radiation oncology
nursing practice and education
(3rd ed.). Pittsburgh: Oncology Nursing Society.
Burcat, S. & McAdams, F. (2007). Hematologic effects of transplantation.
In Ezzone, S. & Schmit-Pokorny, K. (Eds).
Blood and marrow stem cell
transplantation: Principles, practice and nursing insights.
Sudbury, MA: Jones
and Bartlett.
Clancey, J. A. (2006). Syndrome of inappropriate antidiuretic hormone secretion.
In Kaplan, M. (Ed.).
Understanding and managing oncologic emergencies:
A resource for nurses.
Pittsburgh: Oncology Nursing Society.
Table 11-12 Oncological Emergencies: Manifestations and Management (continued)
Clinical manifestations and
Emergency
diagnostic findings
Management
Nursing
• Identify at-risk patients, including those in whom
tumour lysis syndrome may develop up to 1 week
after therapy has been completed
• Institute essential preventive measures (e.g. fluid
hydration, allopurinol)
• Assess patient for signs and symptoms of electrolyte
imbalances
• Assess urine pH to confirm alkalisation
• Monitor serum electrolyte and uric acid levels for
evidence of fluid volume overload secondary to
aggressive hydration
• Instruct patients to report symptoms indicating
electrolyte disturbances
