• Ineffective airway clearance related to tumor mass • Risk for imbalanced nutrition: Less than body requirementsre-lated to effects of chemotherapy • Risk for compromised family copingrelated to new diagnosis of lung cancer Although the isolated results of the studies that compose this review do not constitute irrefutable recommendations, we emphasise that the combination and synthesis of them—done here—can support the selection of interventions and the elaboration of nursing guidelines in outpatient oncology services. Table 2. 0000044850 00000 n The interpretation and synthesis of the evidence gathered from the selected articles was done in a descriptive manner, allowing the reader to understand each study included in the review, and considering the quality criteria established by nursing students [11]. Nursing care of oncology patients receiving chemotherapy As part of a research effort directed at identifying specific nursing activities related to the subsequent health status of the patient, this study explored relationships between selected nursing activities and patient outcomes for the oncology patient who was receiving chemotherapy. chemotherapy. In the MEDLINE database, two studies were preselected, in CINAHL nine, in LILACS eight, in BDENF three, and SciELO none, for a total of 22 studies. It is possible that the change in the health status of a family member [1]—one of its related factors—is mainly responsible for its occurrence in adults/elderly patients submitted to outpatient antineoplastic chemotherapy. Defined as a response to the perceived threat that is consciously recognised as a hazard, the ND Fear [1] was also described by half of the review articles [8–9]. Therefore, nurses have a great responsibility for the planning of nursing care in oncology, especially regarding decision making and actions aimed at solving problems identified in the diagnostic stage [3]. 0000010164 00000 n Increased ICP 7. Nursing Interventions Rationale; Monitor for any signs of bleeding and febrile episodes; Note laboratory findings: WBC, platelet count, Hct, and absolute neutrophil count. 4X���s2PT�-�F�0 �W0�g�c�a�ʔ������-3#��c&�;L����0�0�af`�����[[�+dz��yT?3�2�C�錙u��f2�2FŔ!$�/�C*"����2X�. Defined as an oppressive and prolonged feeling of exhaustion and diminished ability to perform physical and mental work at the usual level [1], fatigue is one of the most prevalent symptoms in cancer patients, being reported by 50–90% of patients during the course of the disease or its treatment [13]. The selection of descriptors used in the search process of the studies was done through consultation of the DeCs (BIREME Descriptors in Health Sciences) and MeSH (Pubmed Medical Subject Headings). Of the 34 actual NDs and six risks identified, at least half of the component articles in the review described the following: unbalanced nutrition, less than body requirements, risk of deficient fluid volume, diarrhoea, fatigue, impaired home maintenance, deficient knowledge, disturbed body image, interrupted family processes, ineffective sexuality pattern, anxiety, powerlessness, fear, readiness for enhanced religiosity, risk of infection, impaired dentition, risk of impaired skin integrity, acute pain, and nausea (Table 3). 0000159449 00000 n … cancer diagnosis, pathology, patient parameters, treatment plan) 1 Canadian Association of Nurses in Oncology/Association Canadienne des Infirmieres en Oncologie (CANO/ACIO). 0000159776 00000 n Rodrigues FSS and Polidori MM (2012) Confrontation and resilience of patients undergoing chemotherapy and their relatives Rev bras cancerol 58(4) 619–627, 5. Silva PO and Gorini MIPC (2008) Nursing diagnosis of patients with colorectal neoplasia undergoing chemotherapy treatment – a qualitative research Online Braz J Nurs 7(2) 27 https://doi.org/10.5935/1676-4285.20081521, 9. In addition to those highlighted, other defining characteristics of this ND, such as treatment regimen and symptoms related to the disease, help to explain its occurrence in adults/elderly subjects submitted to antineoplastic chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Here are five (5) nursing care plans (NCP) and nursing diagnosis for patients with leukemia: Table 1. Given the scarcity of publications on the diagnostic phase of the oncology nursing process, the 40 NDs identified by the present review point to the complexity of the care provided to patients undergoing chemotherapy in an outpatient setting. 0000013700 00000 n Melnyk BM and Fineout-Overholt E (2014) Evidence-based practice in nursing and healthcare a guide to best practice (Alphen aan den Rijn: Wolters Kluwer), 12. Oliveira SKP et al (2010) Systematization of nursing care for mastectomized women Cogitare Enferm 15(2) 319–326, 11. A selected study [8] for this review states that special attention should be given to the impaired home maintenance ND whose definition is the inability to independently maintain a safe environment for growth promotion [1]. Bittencourt AR et al (2009) The theme of body image in the national scientific production of nursing: a highlight for cancer patients Rev bras cancerol 55(3) 271–278, 13. The social stigma of cancer may lead patients to experience feelings of dread in the face of disease [8]. The ND pattern of ineffective sexuality, defined as an expression of concern about one’s own sexuality, was also described by two studies selected to compose the review [7, 9]. Chemotherapy is the primary used as adjuvant treatment postoperatively ; usually begins 4 weeks after surgery (very stressful for … As all studies selected for the review are descriptive, the low level of quality of the evidence generated by them is highlighted: level 6, on a scale of 1 to 7, where level 1 represents the highest quality Evidence [11]. 0000002213 00000 n Tavares Jomar Rafael, Furtado Gomes Rebeca Anselmo, Carvalho Leite Dayana, Ferraz Gomes Helena, Peres Ellen Marcia, Fuentes Perez Junior Eugenio (2017) As for the data source, only one article used the patient’s chart in addition to the interview and physical examination [8]. A. RTJ participated in the design and outline of the article, bibliographic research, data analysis and interpretation, discussion of results, writing, and final approval of the article. All articles selected have described the ND body image disorder, defined as confusion in the mental image of the physical self [1]. According to Resolution No. This study is an integ… 0000108546 00000 n %PDF-1.4 %���� 0000011776 00000 n The criteria for inclusion of studies in the review were as follows: be published in original article format in English, Spanish, or Portuguese; having as study subjects adult and/or elderly individuals undergoing antineoplastic chemotherapy on an outpatient basis and; the NDs being identified in this population, according to NANDA International [1] Taxonomies I or II. Requirements for documentation availability prior to ordering chemotherapy regimens (e.g. Standards and Competencies for Cancer Chemotherapy Nursing Practice. Side effects can range in severity from unpleasant to life threatening (as in severe infection) and must be weighed against the need to treat the cancer. Implications concerning adverse drug reactions consists of precise information regarding nursing interventions and the rationale for implementation. On the other hand, the identification of risk NDs also suggests that nurses are concerned about preventive aspects of care. Objective: To search in the scientific literature for nursing diagnoses identified in adult/elderly patients undergoing antineoplastic chemotherapy in an outpatient setting. Narchi NZ and Gutiérrez MGR (1997) Nursing Diagnoses in women with breast cancer undergoing anticancer chemotherapy Paul nurse Act 10(1) 33–42, 8. Requirements for access to standardized chemotherapy regimens categorized by diagnosis and an approach for orders which deviate from the standard regimen 6. Keywords: oncology nursing, nursing process, nursing diagnosis, drug therapy/antineoplastic agents, ambulatory care. Primary Nursing Diagnosis . Gastric distention 2. This is a review of the scientific literature which involved gathering, analysing and synthesising, in a systematic and orderly way, results of studies that investigated NDs in adults and seniors undergoing outpatient chemotherapy according to the following steps: formulation of the guiding question, search of the study literature, interpretation and synthesis of the evidence from the selected studies. Only one selected article [10] did not identify the fatigue ND. Methods: Review of studies published in Portuguese, English, or Spanish which were searched in five electronic databases in March 2016, using the descriptors nursing process, nursing diagnosis, neoplasms, drug therapy and hospital outpatient clinic. Stomach upset due to alcohol, drugs, blood, or iron 5. 1. It should be noted that the eligibility criteria adopted were based on the fact that the main evidence supporting clinical practice comes from research results [6]. Infections 8. Providing a solution of hydrogen … Costa AI and Chaves MD (2014) Perception of anxiety in cancer patients under chemotherapy J Nurs UFPE on line 8(3) 649–653, 16. Bowel obstruction 2. The sample size of the studies ranged from 10 to 90 individuals, whose ages ranged from 22 to 89 years. It is known that many chemotherapy drugs can cause hypersensitivity, dryness and desquamation of the skin, as well as require the administration of large volumes of intravascular physiological solution to avoid potential complications [22]. See Critical Thinking in the Nursing Process in Appendix C. Created Date: North American Nursing Diagnosis Association (2015) Nursing diagnoses of NANDA: definitions and classification 2015-2017 (Porto Alegre: Artmed), 2. 0000012765 00000 n This is of greater importance among women who have had a mastectomy and individuals with intestinal stomas who undergo antineoplastic chemotherapy, as reported in articles that are part of this review [7–8, 10]. They eventually crowd out the good cells which impairs the growth and function of healthy cells. Jomar RT and Silva ES (2016) Nursing diagnoses more frequent in adults/elderly hospitalized in intensive care units: a systematic review Evidentia 13(53), Stay up to date with our ecancer newsletter, Explore patient resources at ecancerpatient, Find out more about ecancer and the work we do, Support ecancer's work by making a donation, The content on this site is intended for healthcare professionals only, https://doi.org/10.1590/1983-1447.2015.03.55036, https://doi.org/10.5935/1676-4285.20081521, https://doi.org/10.1590/S0104-42302011000200021, https://doi.org/10.1590/S0080-623420140000400016, https://doi.org/10.1590/S0034-71672004000200008, https://doi.org/10.1590/1518-8345.1176.2812, https://doi.org/10.1016/j.bpg.2009.04.005, https://doi.org/10.5935/1414-8145.20150028, https://doi.org/10.1590/S0104-07072013000300033, Tweaking of radiation and chemotherapy schedules is the new normal during the COVID-19 crisis: perspective from oncologists at a tertiary care health institute, https://doi.org/10.3332/ecancer.2021.1177, Renal liposarcoma: case report and review of systemic treatment, https://doi.org/10.3332/ecancer.2021.1173, Total neoadjuvant chemotherapy with FLOT scheme in resectable adenocarcinoma of the gastro-oesophageal junction or gastric adenocarcinoma: impact on pathological complete response and safety, https://doi.org/10.3332/ecancer.2021.1168, Fertility preservation in endocrine responsive breast cancer: data and prejudices, https://doi.org/10.3332/ecancer.2020.1157, Validation of the comprehensive score for financial toxicity for Brazilian culture, https://doi.org/10.3332/ecancer.2020.1158. Increasing the frequency of loose stools, unformed or liquid, can impair the permanence of food ingested in the gastrointestinal system long enough for absorption of different nutrients to occur properly [19]. '��5��Wu���r�+W��c�Ů����s��\����,p�l�^Rv@/����D��k�Ao�[�C�� Sz�屗����]�=ۣ�-h�. 0000005587 00000 n Recommending that the client discontinue chemotherapy B. Body image disturbance related to significance of loss of part or all of the breast; Pharmacological Intervention . Among the limitations of this review we point out the search and selection of studies in the form of a research article indexed in electronic databases only and the different characteristics of the populations of the studies that comprise it: two were conducted on women with breast cancer [10], one on people with colorectal cancer [8] and the other on people undergoing chemotherapy treatment for several types of cancer [9]. This is because the submission to antineoplastic chemotherapy can exclude the patient from the social roles usually performed, making him feel powerless in the face of this cancer treatment modality [8], which often has an impact on the maintenance capacity of the home due to its toxic effects. Postoperative 4. Powerlessness is an ND that is defined by the lived experience of lack of control over a situation, including a perception that the actions themselves do not significantly affect a result [1]. Published: 03/05/2017; Received: 18/01/2017. 0000004107 00000 n Table 3. In this context, the correct choice of Nursing Diagnosis increases the assistance to patients in chemotherapy, as well as contributes to the development and consolidation of scientificity and the praxis of nursing, particularly at this research on Diagnosis Nausea. A validation study of the content of the defining characteristics of NDs anxiety and fear [17] emphasised the difficult differentiation of these two diagnoses. 0000001753 00000 n The exclusion criteria adopted were literature reviews, updates, experience reports or any other format where it was not stated that the results were obtained from collection of data from adults/seniors undergoing outpatient chemotherapy (interview and/or physical examination) or review of their medical records. The ND of anxiety was described by almost all the articles components of this review [7–8, 10]. Tube feeding Biophysical: 1. However, it is worth emphasising that descriptive observational studies are inevitably the most likely to achieve their objectives [23]. Ferreira SMA et al (2013) Sexuality of women with breast cancer: analysis of scientific production in nursing Texto Contexto Enferm 22(3) 835–842 https://doi.org/10.1590/S0104-07072013000300033, 22. There are many types of leukemia. Mock V et al (2007) Cancer-related fatigue. 5,941 studies were found in the MEDLINE database, in addition to 186 in CINAHL, 227 in LILACS 227, 152 in BDENF, and 17 in SciELO, for a total of 6,523 studies, which were then preselected from those with titles and abstracts which met the criteria explained previously. Cross‐sectional approach using Richard Fehring's Clinical Diagnostic Validity Model. The present study deals with the diagnostic stage of the nursing process. In relation to NANDA International [1] Taxonomies, only one article did not specify which Taxonomy was used [7], while all others used Taxonomy II. An experimental study that evaluated the effect of prayer on the anxiety of cancer patients in chemotherapy treatment [16] showed that prayer is an efficient strategy to reduce this feeling. 0000001056 00000 n 0000004902 00000 n Nursing diagnoses in adults/elderly undergoing outpatient antineoplastic chemotherapy, according to domain and class (n/N)*. The bone marrow produces abnormal white blood cells that do not function properly. Malnutrition, chronic disease process; Invasive procedures; Desired Outcomes. The references cited by the selected articles were analysed to identify publications not found by the search strategy in the electronic databases, but no additional studies were identified at this stage. HFG, EMP, and EFPJ participated in the critical review and final approval of the article. 0000010972 00000 n @����EhxE 9����P^���8����q9���9B��dq�� %$����! 0000160037 00000 n If used as a guide for the investigation of NDs among adult/elderly users of oncology outpatient services, the results of this review may contribute to the advancement and improvement of the nursing process. Purpose: To explore the use of NANDA, NIC, and NOC classification systems in the psychological and physical care of patients experiencing chemotherapy-induced alopecia. Carvalho CC et al (2014) Effectiveness of prayer in reducing anxiety in cancer patients Rev Esc Enferm USP 48(4) 684–690 https://doi.org/10.1590/S0080-623420140000400016, 17. New Customers. 0000003098 00000 n �vx?d�@��r��n>g@'��v��v�,�Y�R@An~�ǁǮ�)9�����u�O�" M��;Y��=��xYsQ�҉�lr�2Y�tai����o�� ��`��ke�dZ�%dz7��8�H�ƭ���^6��bz�f�j�G+n M+9�1/3%ÐUB��S��ص��3J�B� H�\�͊�@��}���݋&�:u�Bl���0�\@LJ'0��»���5=0��k'e=���a{����߇[}��;�]3���1�ѝ���yᚶ?�M�k�gyZ||��x=t�[V�.��.����^���_����ġ�.�����������k�F7s��k�9}З��Z]�˧eo�&]o��[Z��>�bz? Diarrhoea, defined as the elimination of loose and unformed stools [1], and nausea, defined as a subjective phenomenon of unpleasant sensation in the back of the throat and stomach, which may or may not result in vomiting [1] , were also identified by half of the studies selected to compose the review [7, 9], such as the unbalanced nutrition ND: lower than the body needs [7–8], whose definition is insufficient intake of nutrients to satisfy the metabolic needs [1]. Overview Antineoplastic Chemotherapy Anti-: Against -neoplastic: abnormal cells or growth Chemo-: chemical, drug -therapy: given for therapeutic benefit Drugs given to kill cancer cells and/or stop their growth Administration of Chemo Patient Safety Staff Safety Infection Prevention Immunocompromise Central Line Associated Blood Stream Infections (CLABSIs) Patient Education … -The nurse will educate the patient on how to take antiemetics prescribed by the md prior and after each chemotherapy treatments.-The nurse will educate the patient on 5 foods or liquids to avoid prior and after chemotherapy treatment that makes nausea worst.-The nurse will … In the present review, six of the 40 nursing diagnoses identified were at risk. Moysés AMB et al (2016) Integrative review of factors related to the nursing diagnosis nausea during antineoplastic chemotherapy Rev Latino-Am Enfermagem 24 e2812 https://doi.org/10.1590/1518-8345.1176.2812, 19. The authors declare that there are no conflicts of interest. In addition to the pain that can be generated by the tumour itself, this therapy can cause several painful side effects such as headache, myalgia, gastralgia, burning and tingling [4]. Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects of cancer treatment for patients with cancer (de Boer-Dennert et al., 1997; Hickok et al., 2003). It is worth noted that diarrhoea is also one of the defining characteristics of unbalanced nutrition ND: less than body requirements [1]. Cancer treatment may include chemotherapy, radiation, and/or surgery. of the nurse's role in cancer chemotherapy. 0000014517 00000 n An integrative review on ND nausea, concluded that young age, female gender, motion sickness, emetic potential of chemotherapy, anxiety, conditioned stimulus and expectation of nausea after treatment are the most frequent factors related to the occurrence of this condition in patients submitted to antineoplastic chemotherapy [18]. In March 2016, with no restrictions on the nature of the study or language, two authors independently searched for indexed studies in the electronic databases Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), and Nursing Database (BDENF). As all the studies selected for this review have a descriptive character, we must highlight the low level of the quality of the evidence generated by them [11]. Chemotherapy Nursing Practice toolkit is intended for use by trained Registered Nurses (RNs). The ND deficient knowledge, defined as absence or deficiency of cognitive information related to a specific topic [1], was identified by half of the review studies [7, 10]. METHOD. Some types can be cured while others cannot. Nursing diagnoses in adults/elderly undergoing outpatient antineoplastic chemotherapy, according to domain and class (n/N)*. José Alencar Gomes da Silva National Cancer Institute (2015) 2016 estimate of cancer incidence in Brazil (Rio de Janeiro: INCA), 6. During chemotherapy, an oncology client has a nursing diagnosis of impaired oral mucous membrane related to decreased nutrition and immunosuppression secondary to the cytotoxic effects of chemotherapy. 0000006372 00000 n 0000003210 00000 n Here are 13 cancer nursing care plans (NCP) and nursing diagnosis : Anticipatory … 0000002984 00000 n A summary of the main features of the articles included in the review is presented in Table 2. NDs nausea and unbalanced nutrition: less than bodily needs have a defining characteristic in common, food aversion [1]. Findings: Two key nursing diagnoses are related to alopecia. RAFG participated in the bibliographic research, data analysis and interpretation, critical review, and final approval of the article. Editor’s note: One of a series of articles on managing cancer-related symptoms from the Oncology Nursing Society. The following assessment tools can assist in determining the incidence and severity of CINV. Among the countries of origin of the studies, Brazil stood out with three of the four articles selected [7–8, 10], of which only one was not published in Portuguese, but in Spanish [9]. These studies were conducted mainly in women with breast cancer submitted to antineoplastic chemotherapy, which helps explain the identification of this ND, since, especially among mastectomised women, body image affects sexuality [21]. Leukemia is cancer of the blood forming tissues and usually involves the white blood cells. FINDINGS. Manrique FMC and Pedraza HMP (2008) Prevalence of nursing diagnoses in people undergoing cancer treatment Invest Educ Enferm 26(2) 212–217, 10. Both ND risk of impaired skin integrity, defined as vulnerability to alteration in the epidermis and/or dermis, and ND deficient fluid volume, defined as vulnerability to decreased intravascular, interstitial and/or intracellular fluid, have pharmacological agents as a related risk factor [1]. Findings. Chemotherapy affects each person differently and the duration of side effects may vary from hours to months to years. Remain afebrile and achieve timely healing as appropriate. . 0000122752 00000 n �-�.:u�. To allow for easy reference, a tabular format is used to present systematically organized adverse reactions related to cancer chemotherapy. As a search strategy, 12 different combinations of the descriptors were used: Nursing Process (Nursing Process), Nursing Diagnosis (Nursing Diagnosis), Neoplasms (Neoplasms), Chemotherapy (Drug Therapy) and Outpatients Clinics Hospital (Outpatient Clinics Hospital) (Table 1). 0000104983 00000 n The impaired dentition ND, defined as rupture in dental developmental/eruption patterns or structural integrity of each tooth [1], was identified by half of the studies selected for review [9–10]. Twitter. 0000008316 00000 n Copyright: © the authors; licensee ecancermedicalscience.