Nanda - Nursing Care Plan

Nursing Care Plan for Bone Cancer

Tumor is the growth of new cells, abnormal, progressive, where the cells never become mature. The incidence of bone tumors when compared with other types of tumors are small, ie less than 1% of all tumors of human body. Malignant tumor, when tumor capable of spreading to other places (able to metastasize) and benign tumors say, if it is not able to metastasize. Lungs, is the organ most frequently seized by child spread of malignant tumors.

There are many different types of cancer. Cancers are usually named based on the type of cell that is affected. For example, lung cancer is caused by cells that are beyond the control of the shape of the lung, and breast cancer by cells that form the breast. A tumor is a collection of abnormal cells which accumulate together. However, not all tumors are cancerous. A tumor can be benign (not cancerous) or malignant (cancerous).

Benign tumors are usually less dangerous and not able to spread to other parts of the body. Malignant tumors are generally more serious and can spread to other areas in the body. The ability of cancer cells to leave their original location and moved to another location in the body is called metastasis. Metastasis can occur with cancer cells enter the blood stream or lymphatic system body to walk to other places in the body.

When cancer cells metastasize to other parts of the body, they are still called by the type of origin of the abnormal cells. For example, if a group of cells into diseased breast cancer and metastasizes to the bones, it is called metastatic breast cancer. Many different types of cancer are able to metastasize to the bones.

The types of the most common cancers that spread to the bones are lung, breast, prostate, thyroid, and kidney. Most of the time, when people have cancer in their bones, it is caused by cancer that has spread from elsewhere in the body to the bones. It is less common to have an original bone cancer, a cancer that arises from cells that make bone. It is important to determine whether the cancer is in the bone from elsewhere or from a cancer of the bone cells. The treatments for cancers that have metastasized to the bone based on the initial type of cancer.

Causes

Bone cancer is caused by a problem with the cells that form bone. More than 2,000 people are diagnosed in the U.S. each year with a bone tumor. Bone tumors occur most commonly in children and adolescents and are less common in the older adults. Cancer involving the bone in adults older are most commonly the result of metastatic spread from another tumor.

Signs and Symptoms

The most common symptom of bone tumors is pain. In most cases, the symptoms become gradually more severe with time. At first, the pain may only be present at night or with activity. Depending on the growth of tumor, those affected may have symptoms for weeks, months, or years before seeking medical advice. In some cases, a mass or lump may be felt in the bone or in the tissues surrounding the bone. Tumors in the leg, causing the patient to walk lame, whereas tumors in the arm cause pain when the arm is used to lift some object. Swelling of the tumor may feel warm and slightly flushed.

Classification

Based on the level of malignancy, there are 3 levels of malignant tumor stages, namely:
  1. Stage I, when a low degree of malignancy.
  2. Stage II, meaning the tumor has a high degree of malignancy.
  3. Stage III, which means the tumor has spread.
Diagnostic tests
  1. Physical examination
  2. DPL
  3. X-Rays
  4. Ct-Scan
  5. MRI
  6. biopsy
  7. bone scan

Nursing Diagnosis for Bone Cancer

1. Anxiety related to change in health status.
2. Chronic Pain related to pathologic processes.
3. Imbalanced Nutrition Less Than Body Requirements related to hypermetabolic status with regard to cancer, the consequences of chemotherapy, and radiation effects.
4. Risk for Fluid Volume Excess related to damage to fluid intake.
5. Risk for Infection related to the inadequate immunosuppression, malnutrition and invasive procedures.
6. Risk for Impaired skin integrity related to radiation effects and changes in nutritional status.

Nursing Interventions for Bone Cancer
  1. Encourage clients to express feelings and thoughts.
  2. Increase a sense of calm and comfortable environment.
  3. Determine history of pain.
  4. Give a distraction relaxation techniques.
  5. Monitor the nutrient intake every day.
  6. Control of environmental factors and diet that will be provided.
  7. Create a pleasant dining atmosphere.
  8. Assess the factors that reduce appetite.
  9. Monitor nausea and vomiting.
  10. Monitor fluid input and output.
  11. Assess vital signs.
  12. Encourage increased fluid intake.
  13. Increase rest.
  14. Emphasize the importance of oral hygiene.
  15. Assess the skin as often as possible.
  16. Wash with warm water and mild soap.
  17. Instruct the client to avoid any skin cream unless there is an indication of physicians.
  18. Encourage the use of soft and loose clothing.