Nursing Process: Approach to Care

Answer

Nursing Process: Approach to Care

Introduction

Cancer is the leading cause of death worldwide that is responsible for 1 out 6 deaths. Notably, in the year 2018, cancer killed about 9.6 million globally. According to Siegel, Miller, and Jemal (2019), approximately 70 percent of cancer cases occur in low and middle income countries where there are no advanced techniques and facilities to treat cancer at earlier stages. While there is no approved treatment for cancer, early diagnosis and treatment of the symptoms significantly improves the chances of remission. The disease presents with several burdens that include financial, psychological, and physical issues. This has made it one of the most feared diseases with high degree of stigmatization. A study conducted by Ernst et al. (2016), reveals that stigmatization of the disease is one of the factors the make a large number of people to die from it. It is in this context that an effective nursing process should be employed during cancer treatment in order to reduce the fatalities and other burdens that cancer causes. This paper, therefore, describes diagnosis and staging of cancer, its complications, side effects of treatments, and psychological and physical effects. The paper also describes the roles of the American Cancer Society (ACS), nursing processes, and education in managing cancer.

Diagnosis and Staging of Cancer

Like any other disease, the initial stage of cancer diagnosis is the history of the patient as well as the signs and symptoms. It requires examination of the breasts, genitals, and skin to identify any change of tissues or skin that present with the symptoms of cancer. On the same note, the history of the patient that may include sores that do not heal, unexplained weight and hair loss, and fatigue are important indicators of likelihood of cancer (Ayuso et al., 2019). In the event that care providers suspect that a patient might be suffering from cancer based on patient history and physical examinations, the patient is taken under series of laboratory tests to confirm if she/ he has cancer. Some of the most significant laboratory tests to confirm cancer are CT scan, PET, and MRI. These specific diagnoses are performed in particular regions where cancer is suspected. Thereafter, tumors that are identified through imaging or earlier processes go through biopsy or surgical excision to retrieve the tissues for a compressive microscopic examination. 

Cancer staging is an important procedure that identifies the stage of the disease. It specifically describes how cancer progresses by detailing the size of the tumor, the cell type, and if it has spread to other parts of the body. One of the commonly used method of cancer staging is TNM staging system. TNM stands for Tumor, Node, and Metastasis.  Basically, the system describes the size of the cancer also known as primary tumor (T), whether the disease has spread to the lymph nodes (N), and whether it has spread to other parts of the body (M) (Vansteenkiste et al., 2019). The system uses letters to further describe the stage of cancer. Particularly, T which refers to the size of cancer can further use 1, 2, 3, and 4 with 1 being the smallest and 4 being the largest. Likewise, N refers to whether the cancer has spread to the lymph nodes. In this case, 0 means that the lymph nodes have no cancer while 3 means that several lymph nodes contain cancer cells. Lastly, M refers to whether cancer has spread to other parts of the body. In this case, 0 means it has not spread to other parts of the body while 1 means that cancer has spread. For example, a small cancer that has moved to the lymph nodes but has not spread to anywhere in the body is described as T2N1M0. On the other, hand a more advanced cancer is described as T4N3M1.

There is another staging system known as number staging system. It also incorporates the TNM system to divide the stages of cancer into four stages, numbered from 1 to 4. Stage 1 means that cancer is small and is within the organ where it started. Stage 2 means that tumor is relatively larger than the one in stage 1 but has not started spreading to the nearby tissues. Stage 3 means that cancer is larger and has started spreading to the surrounding tissues. The cancer is also in the lymph nodes. Lastly, stage 4 means that cancer has spread to other organs (Carter & Erasmus, 2019).

Cancer Complications, Side Effects of Treatment, and Physical and Psychological Effects

First cancer causes chemical changes in the body that results in constipation, excessive thirst, and frequent urination. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is usually associated with lung cancer. In this case, patient manifests with high level of serum antidiuretic hormone, hyponatremia, and excessive thirst. Secondly, cancer tumor can press on nearby nerves in the nervous system or the brain which causes headache or stroke (DeAngelis, 2016).  This can present with several symptoms that include weakness or loss of function of certain parts of the body. It is important to seek immediate medical attention when patients have started experiencing neurological changes. Lastly, patients with cancer of the lung, breast, or leukemia experience cardiac tamponade.  This is the process by which fluids accumulate in the pericardial sac which places pressure on heart hence reduces blood flow to ventricles, prevents adequate cardiac filling, and reduces cardiac output.

Cancer treatment depends on the type of cancer, where it is located, and its stage. According to DeAngelis (2016), treatment of cancer can be surgical excision of the tumor, chemotherapy, radiotherapy, targeted therapy, immunotherapy, and a combination of two or more of the above aforementioned methods. The above mentioned methods have got certain side effects that have to be monitored carefully in order to prevent other complications during treatment. Some of the side effects include loss of appetite, anemia, constipation, skin changes, pain, thrombocytopenia, memory problems, sexual dysfunctions, bladder problems, and sleep issues.  A study conducted by Joly et al. (2016), reveals that side effects depend on the patient as there are cases where one patient does not experience the side effects while others do yet they are undergoing a similar procedure of treatment.

Cancer presents with several effects that may be physical or psychological. Although most types of cancer are treated especially when diagnosed at an early stage, the process puts individual under several trepidations that may be long term or short term. Physically, some cancer patients may lose parts of the body such as legs, breast or uterus. Cancer patients also experience dramatic weight loss, fertility loss, and skin changes. According to Lawrie et al. (2018), some of the patients undergo severe pain which forces them to lose hope and even request for euthanasia.

On the other hand, cancer also presents with psychological effects that includes anger, hopelessness, anxiety, stress, depression, and loneliness. Joly et al. (2016) states that psychological effects extend even to family members who may also contract other diseases that include depression and anxiety disorders. Therefore, cancer patients together with close family members require counseling and encouragement in order to prevent psychological effects of the disease.

Factors That Contribute to cancer Incidences and Mortality in America

According to World Health Organization (WHO), about 42 % incidences cases of cancer and 45% death cases of cancer are attributed to by modifiable risk factors that can be prevented (Malhotra et al., 2016). Particularly, lifestyles that can be avoided are the major causes of cancer in most families. They include second hand smoke exposure, smoking cigarettes, excessive consumption of red and processed meat, excessive consumption of alcohol, and poor diet that are low in fiber but high in fat content. According to the study conducted by DeAngelis (2016), cigarette has contributed to about 19% of cancer cases and 29 percent of the fatalities as result of cancer. On the same note, alcohol consumption, excess body weight, and poor diet combined have also contributed to about 19 percent of the cases of death. On the other hand, high mortality rate has been identified in poor regions of the United States. This shows that socioeconomic status of individuals is also an important factors that can reduce the mortality rates of the disease.

American Cancer Society Education and Support

The American Cancer Society (ACS) is nationwide voluntary health organization whose main function is to eliminate cancer. ACS provides a holistic and multicultural support to families and patients who have been affected by providing several assistance that include insurance and financial guidance. ACS has several activities of which all of them target not only prevention but also total elimination of cancer. First, the organization provides grants to researchers who are studying the causes of disease and its connection with risk factors such as smoking and excessive consumption of alcohol. It also runs public health advertisement campaigns that create awareness about cancer, its causes, and treatments. As stated by Runowicz et al. (2016), because of lack of awareness, majority of cancer patients rush to seek medical attention when the disease has reached advanced stages that are difficult to treat. Additionally, the organisation provides educational services about cancer through several avenues. One of such avenues is the creation of an official website that educate people about cancer its causes, prevention, risk factors, and of importance, treatment methods. One of the services that I would recommend is that the organization should establish several physical centers in regions that are highly affected by cancer. When the organizations can be easily assessed then it means that services will reach the target audience effectively.

Nursing Processes in Provision of Effective Cancer Care

The nursing process is a care provider’s guide for a systematic holistic method to quality patient care.  It involves five major steps that must be followed in order to provide safe and effective care for cancer patients across the life span. The first step is assessment. This is the step in which the nurse perform not only head to toe but also asses the psychological, emotional, and spiritual aspects of the patient (Shimizu et al., 2017). For cancer patients, these steps are significant in diagnosing not only cancer but also other diseases that the patient might be suffering from. The second step is diagnosis. This an important part of disease prevention hence should be done not only accurately but also timely. During diagnosis, the nurse should ascertain the type and stage of cancer in order to provide most effective interventions.  The next stage is care plan. According to Mayouf et al. (2019), an effective care plan follows the results from assessment and diagnosis. It is in this context that the earlier procedures should be accurate. During care plan effective medication or therapy is applied to cancer patients depending on the type and stage of the disease. The next step is Implementation where nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured. In cases of cancer patients, procedures must be well adhered to using the correct medication in order to prevent further spread of the cells to other parts of the body. The last step is evaluation. This is assessing the patient condition as per the care plan. It is important for cancer patient because through it, the progress of the patient can be determined hence medication can be changed or continued based on the condition.

Importance of Liberal Arts and Science Studies in Nursing

Care providers, particularly nurses need to be well-versed with several skills to critically provide individualized and holistic care to patients. Notably, humanities within liberal arts are indispensable to the nursing experience and education.  Particularly, languages and literature enables nurses to communicate effectually with patients and other health care providers. On the same note, psychology, history, theology, and sociology expose nurses to different spiritual and cultural beliefs that enable nurses to suitably address cultural and spiritual needs that form part of treatment procedures.  Sciences and math courses provides interpretation and calculation skills that enables nurses to  interpret, vital signs,  lab values, and complete IV drip calculations.