Cancer Nursing Diagnosis and Care Plans

Cancer Nursing Care Plans Diagnosis and Interventions

Cancer NCLEX Review and Nursing Care Plans

Cancer is an umbrella term for diseases that involve the rapid and uncontrollable division of abnormal cells that are able to cause the destruction of normal body cells and tissues. Cancer is known as a leading cause of death worldwide, second to cardiovascular disease.

However, modern research has tremendously improved treatments for various cancers, resulting in positive leaps in survival rates as well as the quality of life of cancer patients.

Signs and Symptoms of Cancer

• Fatigue that is usually unexplained
• Lump
• Unintentional weight loss or weight gain
• Unexplained bruising and/or bleeding
• Changes in the skin – may include erythema or redness, yellowing or darkening of the skin, existing moles that changes in size, shape and/or color, and sores that do not heal
• Bladder or bowel changes
• Hoarseness of voice
• Difficulty of breathing
• Difficulty swallowing
• Persistent cough
• Indigestion that does not go away
• Unexplained joint and/or muscle pain that may be unrelieved by over-the-counter pain relievers
• Unexplained fevers and/or night sweats
• Persistent indigestion

Causes of Cancer

There are two major causes of cancer and these are:

• Genetics – genetic mutations can be inherited by children from their parents.
• Carcinogens – chemicals and biologic agents can initiate the malignant transformation of cells. Carcinogenesis or the process of cell transformation due to carcinogens involve:
  • Initiation – exposure to the carcinogen
  • Promotion – repeated exposure that causes the alteration of cells
  • Progression – the abnormal cells show malignant behavior

  Risk Factors of Cancer

  • Age – most people are diagnosed with cancer at age 65 or older, although cancer can be diagnosed at any age
  • Gender – in general, there are more male cancer patients than females; however, the cancer type can be a factor in relation to gender (for example, women are more prone to breast cancer than men)
  • Family history – some types of cancer can be inherited
  • Lifestyle and habits – frequent exposure to sun, drinking more than the recommended alcohol limit, smoking, unsafe sex, sedentary lifestyle, and other habits and lifestyle factors may predispose a person to cancer
  • Chronic health problems – having ulcerative colitis, for instance, may increase the risk for developing colorectal cancer; obesity can also contribute to the development of cancer
  • Environment – second hand smoking greatly increases the risk for lung cancer

  Pathophysiology of Cancer

  1. Genetic mutation. The disease process of cancer starts when the genetic mutation in the cellular DNA transforms an abnormal cell.
  2. Neoplasia or proliferation. The abnormal cells grow uncontrollably without following any physiologic demand. Cancer cells also do not appear the same as normal cells and are termed “undifferentiated”. They tend to increase in number and size at the periphery while attempting to infiltrate the body tissues nearby in order to destroy them.
  3. Metastasis. Malignant cells invade other parts of the body by means of using blood and lymphatic channels. They can also “metastasize” or spread to a distant body part or region.

  Complications of Cancer

  • Fatigue
  • Pain
  • Weight loss
  • Breathing problems
  • Bowel changes such as diarrhea or constipation
  • Nausea and vomiting
  • Chemical imbalances in the body
  • Metastasis of cancer – advancement and spread
  • Cancer recurrence – cancer may come back even after successful treatment

  Diagnosis of Cancer

  • Cancer screening – screening exams are useful in diagnosing cancer early to give the patient the opportunity to be treated as soon as possible
  • Physical exam -the doctor will find lumps, skin changes, and other signs and symptoms related to cancer
  • Imaging tests – X-rays, CT scans, PET scans, ultrasounds, and other imaging exams can be used to examine the body in a non-invasive method; imaging tests are useful in knowing the extent of cancer, also known as cancer staging
  • Biopsy – the collection of cell samples and the subsequent examination of these cells under a microscope; this can be a definitive diagnostic tool to determine if cancer cells exist

  Treatment for Cancer

  There are different objectives of cancer treatment, and they are:

  1. Curative – the goal of curative cancer treatment could be to cure the cancer for an optimal quality of life.
  2. Neoadjuvant / primary – the goal of primary cancer treatment is to reduce the tumor burden, usually in patients with locally advanced or early stage disease; this cancer therapy is given to the patient prior to surgery.
  3. Adjuvant – the goal of adjuvant cancer treatment is to destroy the remaining cancer cells after neoadjuvant or primary cancer therapy has been administered; it aims to lower the chance of cancer recurrence; it can be radiotherapy, chemotherapy, hormone therapy, or a combination of these.
  4. Palliative – the goal of palliative cancer treatment is symptom control, which is the relief of the symptoms of cancer and the side effects of treatment in order to make the patient comfortable and allow him/her to have an optimal quality of life.

  Prevention of Cancer

  1. Smoking Cessation. It is strongly recommended to stop smoking or not to start smoking at all. Smoking has been associated not only to lung cancer, but also other types of cancer such as esophageal and mouth cancers.
  2. Reduce exposure to the sun. Studies show that long exposures to the sun greatly increase the risk for skin cancer. The ultraviolet or UV rays from the sun causes severe damage to the outer layer of the skin. Make sure to spend time under the sun in the recommended hours (such as before 10 AM and after 3PM), wear protective clothing, apply sunscreen on the skin, and stay in the shade.
  3. Perform regular exercise. Exercising at least 30 minutes a day during most days of the week can reduce the risk of cancer. Walking is a good beginner’s exercise for people who are not used to regular exercise.
  4. Adhere to healthy food and diet and maintain a healthy weight. Eating processed meats regularly increases the risk of cancer. A diet rich in vegetables, fruits, lean proteins, and whole grains can help lower one’s cancer risk. Obesity is associated with cancer, so ensure to eat healthy and exercise regularly.
  5. Avoid alcohol, or at least drink in moderation. Healthy women may have up to 1 unit of alcoholic drink per day, while men can have 2 units per day.
  6. Get immunized. Some cancers such as cervical cancer and liver cancer are caused by viruses. To prevent getting infected and to lower the risk for these types of cancer, it is important to have immunizations against HPV and other cancer-associated viruses.
  7. Attend cancer screening. Patients should be encouraged to have cancer screening exams and to speak up about their risk factors such as family history.

  Nursing Diagnosis for Cancer

  Nursing Care Plan for Cancer 1

  Nursing Diagnosis: Deficient Knowledge related to a new diagnosis of cancer as evidenced by the patient’s verbalization of “I want to know more about my new diagnosis and care”

  Desired Outcome: At the end of the health teaching session, the patient will be able to demonstrate sufficient knowledge of cancer and its management.

  Nursing Care Plan for Cancer 2

  • Nursing Diagnosis:Imbalanced Nutrition: Less than Body Requirements related to abdominal pain and cramping secondary to cancer, as evidenced by abdominal cramping, stomach pain, bloating, weight loss, nausea and vomiting, and loss of appetite

  Desired Outcome: The patient will be able to achieve weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

  Nursing Care Plan for Cancer 3

  Nursing Diagnosis: Fatigue related to side effects of chemotherapy for cancer and/or emotional distress due to the diagnosis, as evidenced by overwhelming lack of energy, verbalization of tiredness, generalized weakness, and shortness of breath upon exertion

  Desired Outcome: The patient will establish adequate energy levels and will demonstrate active participation in necessary and desired activities.

  Nursing Care Plan for Cancer 4

  Acute Pain

  Nursing Diagnosis: Acute Pain related to the tumor pressing on the nerves and bones secondary to cancer as evidenced by reports of discomfort and pain score of 10 out of 10.

  Desired Outcome: The patient will report a reduced level of pain between 0 to 3 out of 10.

  Nursing Care Plan for Cancer 5

  Nausea/ Vomiting

  Nursing Diagnosis: Nausea/ Vomiting is related to the expected side effects of chemotherapy secondary to cancer as evidenced by verbal reports of nausea and/or vomiting.

  Desired Outcome: The patient will verbalize being free from the feeling of nausea.

  Nursing References

  Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon

  Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

  Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon

  Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon

  Disclaimer:

  Please follow your facilities guidelines, policies, and procedures.

  The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

  This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

  Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.