Chapter 11
Oncology: Nursing management in cancer care
245
Continues on following page
Nursing interventions
c. Use normal saline mouth rinses
every 2 hours while awake; every
6 hours at night.
d. Use soft toothbrush.
e. Remove dentures except for meals;
be certain dentures fit well.
f. Apply lip lubricant.
g. Avoid foods that are spicy or hard
to chew and those with extremes
of temperature.
Severe stomatitis
(confluent
ulcerations with bleeding and white
patches covering more than 25% of
oral mucosa).
h. Obtain tissue samples for culture
and sensitivity tests of areas of
infection.
i. Assess ability to chew and swallow;
assess gag reflex.
j. Use oral rinses as prescribed or
place patient on side and irrigate
mouth; have suction available (may
combine in solution saline, anti-
Candida agent, such as Mycostatin,
and topical anaesthetic agent as
described below).
k. Remove dentures.
l. Use toothette or gauze soaked with
solution for cleansing.
m. Use lip lubricant.
n. Provide liquid or pureed diet.
o. Monitor for dehydration.
4. Minimise discomfort.
a. Consult doctor for use of topical
anaesthetic, such as a lidnococaine
viscous mouthwash 1%.
b. Administer systemic analgesics as
prescribed.
c. Perform mouth care as described.
Rationale
c. Assists in removing debris, thick
secretions and bacteria.
d. Minimises trauma.
e. Minimises friction and discomfort.
f. Promotes comfort.
g. Prevents local trauma.
h. Assists in identifying need for
antimicrobial therapy.
i. Patient may be in danger of
aspiration.
j. Facilitates cleansing, provides for
safety and comfort.
k. Prevents trauma from ill-fitting
dentures.
l. Limits trauma, promotes comfort.
m. Promotes comfort.
n. Ensures intake of easily digestible
foods.
o. Decreased oral intake and
ulcerations potentiate fluid deficits.
4.
a. Alleviates pain and increases
sense of well-being; promotes
participation in oral hygiene and
nutritional intake.
b. Adequate management of pain
related to severe stomatitis can
facilitate improved quality of life,
participation in other aspects of
activities of daily living, oral intake
and verbal communication.
c. Promotes removal of debris, healing
and comfort.
Expected outcomes
• Exhibits healing (reepithelialisation) of
oral mucosa within 5 to 7 days (mild
stomatitis).
• Exhibits healing of oral tissues within
10 to 14 days (severe stomatitis).
• Exhibits no oral ulceration.
• Consumes adequate fluid and food.
• Exhibits absence of dehydration and
weight loss.
Plan of Nurs ing Care
Care of patient with cancer
(
continued
)
CHART
11-4
Nursing interventions
1. Discuss potential hair loss and
regrowth with patient and family.
Rationale
1. Provides information so patient and
family can begin to prepare cognitively
and emotionally for loss.
Expected outcomes
• Identifies alopecia as potential side
effect of treatment.
Nursing problem:
Impaired tissue integrity: alopecia
Goal:
Maintenance of tissue integrity; coping with hair loss
