...Running head: CANCER PAIN MANAGEMENT 1 Cancer Pain Management Lavon R. Williams University of South Alabama Running head: CANCER PAIN MANAGEMENT Cancer Pain Management Cancer is rapidly becoming a chronic illness, and an estimated that 10 million individuals in the United States are survivors of cancer (Sun, Borneman, Piper, Koczywas, & Ferrell, 2008). According to 2008, cancer statistics from the American Cancer Society, about 2 565,650 people die in the United States from cancer every year. Approximately 1.6 million new cases of cancer are expected to be diagnosed in the United States this year (American Cancer Society, 2012). This is why the health care needs of cancer patients are unique, and many are at risk for developing late or long-term side effects and pain from their primary treatments. These long-term effects may also hinder optimal physical, psychological, and cognitive functioning for patients (Sun et al., 2008). Pain is experienced by 30% to 50% of cancer patients receiving treatment and by 70% to 90% of patients with metastatic or advanced disease. In almost every cancer-related case pain is inadequately managed due to a lack of patient and professional knowledge of optimum management (Sun et al., 2008). This paper will discuss how nurses can help provide adequate pain management in advanced cancer patients. Patient and family needs Support for the patient and family may include education and information, coping skills, counseling and psychotherapy...
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...Review Starting Step III opioids for moderate to severe pain in cancer patients: Dose titration: A systematic review Palliative Medicine 25(5) 424–430 ! The Author(s) 2010 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269216310386280 pmj.sagepub.com ˚ Pal Klepstad Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Intensive Care, St Olavs University Hospital, Trondheim, Norway Stein Kaasa Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Palliative Care, St Olavs University Hospital, Trondheim, Norway Petter C Borchgrevink Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Center for Pain and Complex Disorders, St. Olav University Hospital, Trondheim, Norway Abstract The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding starting treatment and dose ...
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...unning head: CASE STUDY GRID 1 Case Study Grid “Case History of Debbie” Janet Ibrahim NUR/403 September 21, 2015 Dr. Sherrily Mulleneaux Case Study Grid “Case History of Debbie” Five factors that demonstrate nursing needs: 1. Nutritional maintenance 2. Post-operative pain and nausea 3. Lacks knowledge about the importance of self-breast exams 4. Concerned about her and family’s future (2 daughters) 5. Emotional abuse from spouse Nursing Diagnosis 1: Pain (Acute) Rationale: Common among cancer patients. This is proved by various testimonies of Class V cervical cancer patients. Acute pain results from the activity of cancer cells and is related to the body’s surgical interruption. Desired Outcome 1 Desired Outcome 2 Nursing Intervention 1 Assess the client for pain presence routinely. Monitor the clients pain on a scale of 0-10 every shift or as needed. Client will use a self-report tool to identify current pain intensity level and establish a comfort –function goal within a few hours after surgery. . Client will be able to describe and use pharmacological and nonpharmacological methods that can be used to help to achieve their comfort- function goals prior to discharge. Nursing Intervention 2 Provide rest periods to facilitate comfort, sleep, and relaxation Pain level will decrease over the next 30 days. As the patients pain level decreases, so will their fatigue over the course...
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...profound and catch the individual off guard. Other diseases, such as pancreatic cancer, creep up on a person and go unnoticed for quite some time. The gland, also known as the pancreas, is located behind the stomach. The pancreas promotes the breakdown of food by secreting pancreatic juices and controls the hormones (insulin and glucagon) used to help control blood glucose levels (Medline Plus). When one speaks of pancreatic cancer, they are describing the development of malignant cells within the tissues of the pancreas (National Cancer Institute). For one...
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...Prostate cancer Introduction Prostate cancer is a cancerous tumor in the prostate gland, a small walnut-sized gland in men that makes seminal fluid, which helps carry sperm out of the body. The prostate is located beneath the bladder and surrounds the urethra, the tube that carries urine out through the penis. Prostate tumors can be benign or cancerous. With benign tumors, the prostate gets bigger and squeezes the urethra, interrupting the normal flow of urine. This condition, called benign prostate hyperplasia or BPH, is common and not usually life threatening. Prostate cancer -- one of the most common kinds of cancer in men -- can spread beyond the prostate gland and be life threatening. Prostate cancer is the third most common cause of cancer deaths in men of all ages and the most common cause in men over 75 years old. Men younger than 40 don't usually get prostate cancer. Some are at higher risk, including African-American men older than 60, farmers, tire plant workers, painters, and men exposed to cadmium. Most cancerous tumors in the prostate grow slowly and either don't spread or don't cause harm for decades. When caught early, prostate cancer can be treated successfully in more than 90% of cases. Men 50 years old and older should talk to their doctors about being screened for prostate cancer. Signs and Symptoms Many people with prostate cancer have no symptoms at all, especially in the early stages. Some symptoms that may indicate prostate cancer include: ...
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...Advanced Pathophysiology Case Study 6 Case Study 6 Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL). He had a white blood cell count of 250,000. Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue. Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia. Pathophysiology signs and symptoms The primary pathophysiological etiology for signs, symptoms and laboratory findings in 4 year-old John’s case study are secondary splenomegaly as a result of primary Acute Lymphoblastic Leukemia (ALL). Because of its proximity to the diaphragm, splenomegaly results in pain or fullness in the left upper abdomen (subsequent tenderness and loss of appetite) that may spread to the left shoulder (non-specific arthralgia). Splenomegaly may result in anemia (bruising, bleeding gums, decrease in pallor) fatigue and frequent infections (4 year old John’s WBC 250, 000 count and fever 102°F). However, in John’s case, some of the symptoms related to splenomegaly can also overlap with those of his diagnosis of ALL such as fever and abdominal distention. Additionally, anorexia, headache, seizures, lethargy, arthralgia, infection, and bruising are also potential side effects (Ghazi et al., 2010). Pathophysiology of acute lymphoblastic leukemia-AML comparison According to Gedaly...
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...Cancer and its related complications are areas of interest for researchers these days because of the complexity of the signs, symptoms and progression of the disease. Cancer patients are chronic sufferers and require effective physiological and psychological management of the complications. Pain is a common complication of end stage cancer patients who are undergoing either curative or palliative treatment. It can range from mild, moderate and severe depending on the progress of the disease. When it comes to palliative or end stage cancer (terminal illness), severe chronic pain management becomes even difficult for the family and health care providers. In fact, in such cases pain becomes primary and chief complaint of people for referrals....
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...TREATING A PATIENT WITH CANCER: MAINTAINING PATIENT QUALITY OF LIFE Introduction Cancer is one of the most prevalent diseases in the U.S. Case (2011) noted that the 2010 report of the American Cancer Society (ACS) indicated that more than a million an d a half new cases of cancer are diagnosed every year. Along with physical disease, cancer also brings a significant impact on the patient’s overall quality of life (QOL). This paper asserts that for optimal patient outcome, healthcare workers, particularly nurses, need to attend to the cancer patient’s overall QOL rather than simply focusing on the physical disease of cancer. This essay will first address the issue of understanding what constitutes the patient’s QOL. Then key factors that directly affect the QOL are reviewed in the context of current best evidence. That will be followed by a section that addresses the nursing implications of this subject. The paper concludes with a brief summary and conclusion about the importance of maintaining patient QOL in cancer patients. The first element, is thus to define what is meant by “quality of life.” The next section of this paper addresses that specific issue. Defining Patient Quality of Life Before patient QOL can be addressed in a nursing practice, it is essential to understand what is meant by QOL. Bahrami (2011) has noted that no specific, well accepted definition of patient QOL exists. One reason for this lack of consensus on QOL is that life quality is a highly...
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...not legal at the federal level. Several pros and cons exist to support whether medical marijuana should be or not be legalized nationwide. The primary arguments in debating the pros and cons of legalizing medical marijuana nationwide focus primarily on medical benefits, disease prevention, medical risk, substance abuse, and legal issues. Many scientific professionals and patients claim medical marijuana provides some sort of medical benefits. Although it has been a contentious battle between the states and federal governments to legalize or not medical marijuana nationwide, there are three important points to take under consideration; first, marijuana is a potent analgesic in patients with chronic pain. Second, it is a strong anti-emetic for patients receiving cancer chemotherapy treatment. Third and most important, medical marijuana should be legal, so patients do not have to break the law to receive treatment. Across the nation state organizations strictly supervise medical marijuana to ensure it is grown, sold, and used properly. According to “Harborside Health Center” (n.d.), which is one of the United States largest dispensaries of medical marijuana, “Harborside Health Center sees this as the key for achieving safe and legal access to medical cannabis for all suffering and sick Americans” (para. 3). Physicians should be able...
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...mammography screening for women 40 to 49 years of age. Data Sources: English-language publications in MEDLINE (1966 – 2005), Pre-MEDLINE, and the Cochrane Central Register of Controlled Trials and references of selected studies through May 2005. Study Selection: Previous systematic reviews; randomized, controlled trials; and observational studies. Data Extraction: Two independent reviewers. Data Synthesis: In addition to publications from the original mammography trials, 117 studies were included in the review. Metaanalyses of randomized, controlled trials demonstrate a 7% to 23% reduction in breast cancer mortality rates with screening mammography in women 40 to 49 years of age. Screening mammography is associated with an increased risk for mastectomy but a decreased risk for adjuvant chemotherapy and hormone therapy. The risk for death due to breast cancer from the radiation exposure involved in mammography screening is small and is outweighed by a reduction in breast cancer mortality rates from early detection. Rates of falsepositive results are high (20% to 56% after 10 mammograms), but false-positive results have little effect on psychological health or subsequent mammography adherence. Although many women report pain at the time of the mammography, few see pain as a deterrent to future screening. Evidence about the effect of negative screening mammography on...
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...MA, MS,§ for the RANDFSouthern California Evidence-Based Practice Center (See editorial comments by Dr. Jean S. Kutner, pp 160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven of 32 studies addressed this as an outcome; two of the three that compared satisfaction between groups showed a significant difference. Evaluations used many different measures...
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...Treatment Types for Oncologic Pain James Skelton Mercy College of Health Sciences Treatment Types for Oncologic Pain Nearly all those who are diagnosed with cancer will have some kind of pain associated with the disease process. This pain may be visceral, neuropathic, procedural, or psychological in nature. This paper is a discussion of the different procedural guidelines that are currently used by the World Health Organization in the treatment of oncologic pain. This is also a look at alternative therapies that may be used in conjunction with the previously accepted pharmacological treatment of Western medicine. Article Summary One The article written by Fielding, Sanford, and Davis (2013) is a review of the current step-by-step guidelines the WHO has had in place for some time along with a comprehensive assessment of pain, the use of opioids and their adverse affects, the role of adjuvants, and non-pharmacological means of cancer pain treatment. The WHO bases its algorhythm on simplistic, broad categories such as mild, moderate, and severe pain. The article itself is geared towards nurses because they have a unique role in advocating for the patient. The WHO has had a three step analgesic ladder that it has used as a basis for cancer pain treatment for nearly 30 years now. Fielding, et al. (2013), stated that health professionals need to go beyond this three step ladder that focuses primarily on physical pain. Cancer pain is not just a physical but a biopsychosocial...
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...In Virginia, a bill for medical marijuana is to be established on Tuesday by the Virginia house committee. However the bill was not passed, but if it had been passed medically prescribed marijuana can be used for medical purposes. However, many people believe marijuana is a gateway drug and can lead you to other harmful drugs. That is not the case because people have control over what they put into their bodies. Medical marijuana is legal in some states but it should also be legal in Virginia. Medical marijuana should be made legal in Virginia because it can help those with medical conditions, medical marijuana is a classified drug that has not caused a single death, and it can help those who are on chemotherapy. Medical marijuana can be used...
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...policy regarding geriatric and/or demented patients and pain control. I believe this needs to be changed because although we have an initial assessment protocol, we do not have any kind of protocol to control a geriatric or demented patients pain. Since demented patients are quite often left unable to communicate their feelings, I believe there would be, less adverse effects and better patient outcomes for this group of people and better satisfaction with their families. B There are many people associated with proposing the change within the facility. First would be to go through the assistant nurse manager and nurse manager who would then bring the proposal to the nursing and medical directors for the ER. The ANM and NM would have to decide whether the proposed change would be beneficial for the patients and their outcomes and do further research which they would then propose to the directors. From there, they would decide whether the research was sufficient enough to implement a change. C Full APA citation for at least 5 sources | Evidence Strength (1-7) and Evidence Hierarchy | 1. H., Bell, J., Karttunen, N. M., Nykänen, I. A., M., & Hartikainen, S. A. (2013). Analgesic Use and Frailty among Community-Dwelling Older People. Drugs & Aging, 30(2), 129-136. doi:10.1007/s40266-012-0046-8 | 2 and Experimental | 2. Haasum, Y., Fastbom, J., Fratiglioni, L., Kåreholt, I., & Johnell, K. (2011). Pain Treatment in Elderly Persons With and Without Dementia...
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...Various Methods Rebecca Bruce Oklahoma City University Abstract Colorectal cancer screening (CRC-S) should be a simple, safe, convenient, and inexpensive as possible, with high sensitivity and specificity that allows increased patient participation (Stevenson, 1991). As the third leading cause of US cancer-related deaths, colorectal cancer (CRC) is a serious health concern (CDC, 2014). In 2007, an estimated 158,500 people in the United States were diagnosed with CRC and an estimated 53,000 people died from colon cancer related deaths (ACA, 2014). A goal of healthcare professionals should be to provide education and outreach to all eligible patients for colorectal cancer screening at every possible opportunity. This goal will involve many different screening methods or a combination of these methods. The effort to reach more patients for CRC-S is a group effort among all disciplines and education levels. Keywords: colon cancer, colorectal screening, patient participation, screening methods CRC-S Increasing By Various Methods In the United States, Colorectal cancer can be prevented by the detection and removal of adenomatous polyps. Whenever possible, providers should educate and discuss with their patients the various methods available. Background and Significance The U.S. Preventive Services Task Force (USPSTF) currently recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, flexible sigmoidoscopy or colonoscopy...
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