TWO RADIATION THERAPY EMERGENCIES:
- Spinal Cord Compression – a tumor is causing pressure on the blood supply to the spinal cord
- Usually occurs on patients that are being treated palliatively
Symptoms :
- Lack of bladder and bowel control
- Tingling in the toe and lower extremeties (numbeness)
**if left untreated the patient would become paralyzed from the level down from where the tumor cutoff the blood supply to the spine
transverse myelitis - paralysis
***must treat immediately and for successive weeks, the pressure will be realeased from the blood supply and the blood supply will return
- superior vena cava syndrome (SVC syndrome) – a tumor mass the presses on the superior vena cava preventing blood from the head and brain from returning to the heart
symptoms :
- head and neclk look thick and bloated
- you will know if patient has SVC syndrome
** patient must be treated immediately!!! If left untreated the patients head will literally explode from the blockage
*** initially patient has to be treated sitting upright (they won’t be able to breath if put in the lying position)
SIDE EFFECTS OF TREATMENT AND CANCER
PAIN – pain killer “cocktails” are often given to patients to relive the pain caused directly by the cancer (bone metastasis, etc…) and pain associated with certain treatments.
- They cause constipation which can often lead to Impaction of feces (the intestines absorb the water from the feces)
BRAIN TUMORS – patients with brain tumors that are given radiation treatment are often given Decadron
Decadron – an antinflammatory and steroid that reduces the swelling associated with radiation treatments
- Make the patient feel good (in a state of euphoria)
- Increases appetite (patient gains weight)
This euphoria along with weight gain often leads the patient to belive they are being cured when in reality it is only a side effect of taking Decadron. This causes the patient to go into sever depression when they are taken off of the Decadron
** Steroid are given to reduce inflammation **
SKIN REACTIONS:
- Erythema – redness and swelling. Patient is often given cornstarch.
- Dry Desquamation – flaking and itching (puritis)
- Puritis –itching
- Patients skin starts to break down
- Patient is given creams (hydrocortisone)
- Moist Desquamation - moist secretions (exudates)
- Lymphatic fluid has started to leak out of patient
- DO NOT GIVE HYDROCORTISONE (will create a breeding ground for infection)
- Patient is give Sylavadin (medication used for burn victims)
- Moist desquamation is similar to a 2nd degree burn
NASEAU, VOMITING, DIHARREA (NVD)
Compazine – given for naseau and vomiting
Immodium – given for diharrea
Hair Loss – Alopecia
Dry Mouth – XEROSTOMIA
WEIGHT LOSS – often is a side effect from cancer itself, pain meds, depression, etc….
- Patient is given supplements such as Ensure or Sustical
- If weight loss is significant and patient cannot eat a feeding tube must be used and often and IV must be implemented (parenteral nutrition)
Anorexia – severe weight loss
Cachexia – extremely severe weight loss (patient is close to death at this point)
MASLOWS HEIRARCHY OF NEEDS
- Physiological Needs – air, water, food, sex, avoidance of pain
- Safety Needs – MONEY (shelter and clothing)
- Belonging and Love Needs – friends, family, love, religion
- Esteem Needs – (pat on the back) work, school
- Self Actualization – self actualization has been reached and is an ongoing process of all 5
Self Actualized – a healthy full complete individual (you cannot move up the pyramid of needs unless the previous needs have been met)
KUBLER ROSS on Death and Dying
Stages patients with terminal illness go through :
- Denial – believe that they aren’t going to die
- Anger
- Bargaining – with GOD
- Depression
- Acceptance – at this point patient has accepted the fact they are going to die
** many patients do not go through all 5 stages / they might jump from denial straight to acceptance
*** patient doesn’t have to go through the stages in order |
