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Linda Miller, RN, OCN Linda Miller, RN, OCN

Linda Miller, RN, OCN - PowerPoint Presentation

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Linda Miller, RN, OCN - PPT Presentation

MetroHealth Cancer Care Center People with cancer Statistics American Cancer Society estimates for 2014 In US 1665540 new cases In US 585720 deaths In Ohio 67000 new cases Cancer is the 2 ID: 569975

nausea cancer foods people cancer nausea people foods treatment chemotherapy side pain effects provide avoid therapy fever patients care

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Slide1

Linda Miller, RN, OCNMetroHealth Cancer Care Center

People with cancerSlide2

Statistics

American Cancer Society estimates for 2014

In US 1,665,540 new cases

In US 585,720 deaths

In Ohio 67,000 new cases

Cancer is the 2

nd

most common cause of death in the US, responsible for 1 in 4 deathsSlide3

Statistics

By 2030 expect 2.3 million new cases annually in US

By 2030 cancer will be leading cause of death

People living at least 5 years after cancer diagnosis

1970s 50%

Currently 66% Slide4

Cancer treatments

Modes of treatment

Surgery

Radiation

Chemotherapy

Treatment with single mode or multiple modes

Example of multi-modal: Breast cancer (radiation to reduce tumor prior to surgery, chemotherapy after surgery)

Slide5

Chemotherapy

Usually given in outpatient setting

Prevents cancer cells from metastasizing

Systemic therapy

Given intravenously

Destroys good and bad cells

Treatments on set scheduleSlide6

Radiation therapy

Local treatment directed at specific area

Treatments scheduled daily, but treatment extends for weeksSlide7

Oral chemotherapy

Increasing number of patients receiving oral chemotherapy

PRECAUTIONS NEEDED:

Handled with proper protection including chemo gloves

Keep away from others in secure areaSlide8

Side effects of therapy

Fatigue

Nausea/vomiting

Diarrhea

Fever

Skin

Pain

OtherSlide9

Side effects of cancer treatment

Fatigue

Most common side effect

Due to decreased red blood cells leading to lower oxygen levels

Inability to perform basic tasks

No over-exertion, conserve energy

Accommodations

Frequent rest periods

Nutritious foods, plenty liquidsSlide10

Side effects of therapy

Nausea

Anti-nausea medications can prevent vomiting

Nausea triggers

Perfumes and odors

Fried foods, spicy foods, fatty foods, overly sweet foods

Dehydration

Increased risk of nausea

Women

Younger patients

Women with history of morning sickness Slide11

Helping people avoid nausea

Provide small frequent meals (nausea occurs on an empty stomach)

Avoid strong odors

Assure availability of anti-nausea medication, encourage to take as prescribed

Provide dry crackers/dry toast

Avoid spicy, greasy, fatty foodsSlide12

Helping people with diarrhea

Imodium

BRAT diet – bananas, rice, applesauce, dry toast

Avoid high fiber, high fat, greasy, spicy foods

Avoid caffeine, milk, alcohol

Increase fluidsSlide13

People with fever

Due to low blood counts, usually 7 to 10 days after chemo

Observe for temperature increase

First sign of infection

If fever of 100.4°F or 38°C (have thermometer available)

To ER or call oncologist on dutySlide14

Infection precautions

Chemotherapy patients can reside in general population shelter, but away from ill people

Dependent on instructions from physician

Provide isolation if necessarySlide15

Skin problems

Especially for people receiving radiation therapy

Redness of skin

Provide

E

ucerin

,

AquaphorSlide16

People with pain

Treat with medication

Opioids

Keep in secure place!Slide17

Other side effects

Less frequent side effects related to attack on the “good cells”

Alopecia

May use head covering, even at night

Numbness in fingers

Difficulty feeling, holding things

StomatitisSlide18

Questions to ask

If a shelter resident identifies as a person being treated for cancer, ask about

Pain medicine

Anti-nausea medicine

Oral chemotherapy

Personal supplies: ostomy bags, etc.

Time and place of next treatmentSlide19

Have available

Rest area

Nutritious foods

Fluids (water, juice, Gatorade, popsicles, Jell-O)

Imodium

T

hermometerSlide20

End of life concerns

Understanding

prognosis

patients

continue to "hope" -

requesting

more

treatments

Ask person (and listen to the answers) what care or treatment

will be needed

in the

shelter and how best to

provide the care

Ask if caregiver is with person

Ask about others providing care

Ask about advanced directivesSlide21

End of life concerns – symptom control

Pain – adequate pain control

Secretions – control and/or managing secretions

Constipation – adequate hydration, stool softeners

Anxiety – medication, comforting environment, caregivers

Dyspnea (difficulty breathing) – positioning, oxygenSlide22

POD related information

Per CDC – no live vaccines

Herpes Zoster (shingles)

Flu mist (nasal spray)

Measles, mumps and rubella (MMR)

Smallpox

Yellow fever

Chicken poxSlide23

Thank you

Questions?

Comments?