BREAST CANCER BASE

How to advanced breast cancer patients in nursing Patients with advanced breast cancer, meaning those Phase III clinical above, non-surgical cases; After multiple or lymph node metastasis oc...

Relatives caring extended life of breast cancer patients Beijing, April 11 -- United States, "Journal of Clinical Oncology," recently published a research report said that the absence of...

A breast cancer surgery <BR> <BR> nursing care procedures used to the overall physical and mental patient care, can improve the efficacy of treatment to prevent the occurrence of postoperative complications.

(1) primary care <BR> a diagnosis, pre-operative <BR> (1) fear, anxiety : the ignorance and fear of illness caused surgery; Understanding illness because of organ defects, disfigurement caused.
(2) nutritional disorders, the body below the requirements : anorexia to reduce consumption; Cancer consumption; Sympathetic excited by the dominant, curb <BR> digestive system of movement and the digestive gland secretion induced anorexia.
(3) changes in a comfortable, pain : nerve cells caused by violations.
2, <BR> after surgery (1) changes in vital signs may be : with the anesthesia and surgery.
(2) a comfortable change incision pain, discomfort surgery limbs : caused by the surgery.
(3) side of the limb edema may : surgery, axillary lymph node dissection and make venous reflux caused by sluggish.
(4) the integrity of skin damage : Since surgery caused.
(5) Rehabilitation lack of knowledge : because not receive special education and limited literacy cause.
(B) a nursing <BR>, before surgery <BR> (1) provide a range of life care.
① guide patients to eat high-nutrition, digestible food, the food color, flavor and increase a patient's appetite, to meet the nutritional needs and energy reserves to achieve tolerance surgery purposes. ② develop good habits defecation and maintain patency stool, constipation incompliance grant relief when cathartic.
(2), preoperative preparation work.
① perfect inspection. ② venipuncture adept protect vein, reduce patient suffering. Because of the affected limb after venipuncture not OK. ③ do surgical skin preparation, especially axillary, should be thoroughly cleaned with soap after using sterile scissors-cut armpit skin, talc, tried again, keep the skin, skin with a knife shaving net to avoid skin damage. Take skin, but also do a good job for skin preparation.
(3) Strengthening Health Education, to provide psychological support.
As patients and their families are worried about results of operations, coupled with the economic burden is too heavy, performance anxiety, frustration, the responsibility of nurses to care, patient and considerate, understanding of the patient's mental state, patiently listening to the patient's story, and to give help and understanding of his illness were to be briefed on breast cancer the survival rate of progress and the treatment of information and related diseases and surgical knowledge, enhance confidence in the treatment of patients; the pain, nurses responsibility to have more contact with the patient, establish a good nurse-patient relationships, providing a quiet and comfortable environment and the proper use of sedation doctors analgesic drugs, improve patient bad mood to ensure rest and sleep, the body surgery at the best condition.
2, <BR> after surgery (1) closely observing patients. Patients in the continuous epidural anesthesia and intravenous anesthesia in an operation after the operation to ward after giving Reclining Position, tight monitoring of blood pressure, pulse, respiration. But sober patients with stable vital signs after giving half berth to facilitate breathing and drainage, avoid or reduce edema of limbs. Observe whether the wound dressing dry. Early partial use suction or chest belt dressing, sandbags pressure to help skin attached, avoid plot subcutaneous blood effusion. Attention drainage and patency of the operative side acromegaly revascularization.
(2) Prevention of limb edema and dysfunction. Avoid limbs uplink for venipuncture, and the appropriate elevation. After three days of activities to help patients begin the upper limb, elbow first began to extend to the shoulder. Training for their own meals, comb the hair, wash and fingers Climbing activities to promote blood circulation limbs.
(3) strengthen psychological care.由于乳腺癌术后影响病人的形体美，因此多数病人情绪极其低落，表现出烦躁、自卑，甚至缺乏治疗信心。 In addition to nurses and patients should take the initiative to communicate and be patient with the full trust, but also use them as the most acceptable ways to implement the ground inspections, more talks on the need for and importance of missionary chemotherapy and radiotherapy adverse reactions and complications of preventive measures.
(4) Assisting life care. After bedridden patients, reduced ability to take care of themselves, the responsibility of nurses in accordance with Orem model of self-reliance given to help complete some help, support education and other care in different ways to meet their own needs.
(5) diet care. Patients diet very important, in addition to the need to increase the heat, but also increase the protein, vitamins and salt, to promote tissue growth and wound healing.
(6) discharged guidance. Discharged overall guidance is an important aspect of care, to help patients understand and disease prevention, health promotion and rehabilitation play a certain role. The care and treatment to patients missionary rehabilitation knowledge, including reasonable diet, surgery limb functional training. Timely follow-up, regular chemotherapy and radiotherapy, the treatment and care programs recorded in the medical records of discharged and told to pay close attention to the families of the patients and the psychological condition changes. Xinhua PRC again <BR> two, breast care <BR> a radiotherapy, radiotherapy response gastrointestinal reactions, radiation field partial skin reaction. Sometimes systemic reactions, such as leukopenia, and so lethargic.
2, nursing <BR> 2.1 <BR> psychological care that the majority of patients with cancer is not curable, the performance of depression, fear, irritability, a small number of patients even despair, and to abandon the treatment, some patients worry that friends and relatives are aware of their condition after underestimate ourselves, Therefore, nurses should take the initiative to meet with enthusiasm to help patients establish the confidence to overcome the disease to patients on the hospital environment and hospital advanced radiotherapy equipment and radiation technology. As the patient to radiation resulting from strangers many doubt that the nursing staff should be told in advance of radiotherapy in patients with attention issues, radiotherapy should relax themselves, not tense, free mobile body, allowing patients to understand the process of radiotherapy possible adverse reactions. To help defuse tensions with the emotional anxiety and allow patients to work actively with the successful completion of radiotherapy.
Diet care 2.2
Some patients in the radiotherapy process of the digestive system there will be adverse reaction, such as nausea, taste is not sensitive, reduced appetite and the effects of food intake, resulting in a lack of nutrition, resistance dropped and is not conducive to normal tissue repair, it will be reasonable to adjust your diet and avoid a single diet, nutritional balance . Do not eat too cold, too hot and greasy so irritating strong spicy food. Eating should not over-fed, too fast, to slow eating, chewing food is fully facilitate digestion and absorption, and to prevent the rapid consumption cause abdominal pain, bloating, and also to ensure that the full body of water.
Oral care 2.3
Nurses should enable patients to maintain oral hygiene, oral remove food residue, rice logistical mouthwash, daily brushing two to three times. If oral ulcers, daily anti-inflammatory or dilute brine water gargle mouthwash several times.
Skin Care 2.4
Do patients skin care, to be effective in preventing skin reaction. Breast cancer patients radiotherapy organizations thinner skin, the skin of patients after poor flexibility, especially prone to skin reaction, before radiotherapy patients nurses should help ensure personal hygiene, appropriate to wear clean, soft, loose cotton underwear open body. Keep the beds clean, dry, soft, comfortable. Regional radiotherapy avoid skin friction pressure and avoid using provocative strong bath liquid, not overheated water bath. Irradiation region not to smear the chemical ointment, adhesive tape. If the skin red, bulging, itching, pain, respiration not obscure or hand graffiti drugs, medication should be incompliance with the effective control of the skin reaction, reducing the patient's pain and mental burden.
2.5 routine periodic inspection
Observation WBC, if found leukopenia, the decline in the body's immunity, the risk of infection, should be suspended for radiotherapy. In addition to medical treatment, patients should be protective isolation wards for ventilation, disinfection, clean air, patients should pay attention to rest, reducing trips and family visits, and maintain patient hygiene.
2.6 patients should pay attention to rest and physical inactivity, disease upper limbs do functional training, the blood returning to maintain patency, clothing before wearing disease side, first removing the healthy side strip.
Three discharged guidance
After the patient is discharged to maintain ease of mind, emotional stability, attention and not fatigue, attention to diet, appropriate physical activity, protect radiotherapy parts of the skin, periodic review to the hospital.
3, breast care <BR> current chemotherapy, surgical treatment of breast cancer remain the main means. But the basic and clinical studies have confirmed the clinical diagnosis of breast cancer at 50% to 60% of small metastases already exist, simple surgical treatment can not be radical mastectomy. So, the treatment of systemic chemotherapy, increasingly attention. Preoperative chemotherapy for breast local tumor metastases and the retreat and expansion of surgical indications to narrow the scope of surgery; The cancer can reduce the activity, the prevention of tumor cells spread, control clinical discovered in the tiny metastases in breast cancer metastasis; And reminders of tumor right of use spa programs sensitivity. Practice confirmed that preoperative chemotherapy can reduce the phased advantage. Make chemotherapy smooth, care is extremely important.
A nursing issues <BR> 1.1 100% of the fear patients have a phobia. Patients fear mainly from two aspects : first, because the community "cancer = death" erroneous understanding of the impact. Most people wrongly believe that cancer is incurable, you have cancer, it is tantamount to a death or sentenced to death with reprieve, the fear of cancer mainly from the fear of death. Two of chemotherapy fear of adverse reactions. Because chemotherapy may cause vomiting, alopecia, partial necrosis of the skin and other serious adverse reactions, the majority of patients mistakenly believed chemotherapy drug is a poison, which mainly from the fear of ignorance of chemotherapy drugs, chemotherapy and the lack of knowledge of self-image after chemotherapy worry.
1.2 anxiety patient anxiety comes mainly from the lack of knowledge. Since the majority of patients mistakenly believed that surgery is the only treatment of disease, surgery sooner the better, and so preoperative chemotherapy awaiting surgery to extend the time, the patient's emotional anxiety will increase.
Such sentiments 1.3 melancholy mainly from domestic conditions more difficult patients. On the fears of families and a strong sense of responsibility, patients will have concerns. As preoperative chemotherapy awaiting surgery to extend the time, hospitalization costs will increase, with the fraught emotions will rise sharply, and negative sentiment on the more will be adversely affected.
2, nursing <BR> 2.1 <BR> 2.1.1 psychological care for cancer patients to eliminate the fear patients frank answer questions and patiently explain to patients the knowledge of cancer and cancer patients are not told the incurable disease, with medical development there are many cancers can be cured, and some can even radical, to resume a normal life; According to the patient's capacity to understand and explain the appropriate condition, telling patients bad mood right after the more diseases and the impact on patients to the success of the previous cases, the patients eliminate the fear and create warfare disease-confidence, actively cooperate with the treatment. It should also be appropriate to the patient died education, in order to reduce the patient's fear of death.
2.1.2 eliminate the anxiety patients patiently and carefully to patients in the preoperative chemotherapy on the meaning and need for surgery patients told is not the only method of treatment, so that patients understand the feelings of medical staff and patients in the mind of the same, doctors will work out the best treatment programs try to its cure, and it enjoyable for treatment.
2.1.3 eliminate patients on chemotherapy fear of adverse reactions depending on the patient's understanding and tolerance of chemotherapy to patients on the drug mechanism of action and the possibility of adverse reactions. Pay attention to a statement of artistic, more conversations with patients and patiently listening to patients Honghai, with the questions, so patiently and carefully explained. Tell patients, chemotherapy will be a bit uncomfortable, but chemotherapy drugs, before application of preventive measures and drugs, if there is not, the medical profession will find a way to give, allowing patients to eliminate ideological concerns, it is necessary to the mental preparations and actively cooperate with the treatment.
Chemotherapy care <BR> 2.2 2.2.1 medical information ready before chemotherapy, the patients should be measured height, weight, blood routine ready, ECG, liver function, renal function, such as materials testing, I fully understand the various chemotherapy drugs side effects, so there adverse reactions at the treatment accordingly.
2.2.2 master skilful manipulation to protect the small veins of skilled technical and operational painless injection techniques for chemotherapy patients to reduce the fear. Skilled nursing staff should have the technique and rich business knowledge, there are plans to use the affected limb superficial vein. Because breast cancer should avoid limb of intravenous fluid, it only after infusion in healthy side, for the protection of contralateral vein, preoperative chemotherapy should choose limb superficial vein.
2.2.3 attention to oral hygiene and diet since the beginning of chemotherapy, two times daily oral care, maintaining good oral cleaning. To encourage patients into nutrient-rich food, water rich in potassium and the fresh juice, helping patients develop a reasonable diet.
Chemotherapy adverse reactions 2.3 Prevention and treatment of gastrointestinal <BR> 2.3.1 reaction is to tell patients of the most serious and most worrisome side effects of chemotherapy [3], which can lead to malnutrition and the treatment effect and therefore it should make full preparations. To create a good environment for the treatment and elimination of the room smell, guiding patients with a reasonable diet, it would not be fasting or after a meal at the line chemotherapy in 2 ~ 3 hours after meals chemotherapy best; Catering to Eat smaller meals throughout the chemotherapy during inedible Supersaturated and too greasy food. Intramuscular injection 30 minutes before chemotherapy Phenergani 25mg, 20mg metoclopramide, or static push Kytril, the board must stop, mine-drops, as ondansetron antiemetic drug. Ground inspections chemotherapy ward, many conversations with patients, decentralized its attention, conditional, could listen to music, watch television undergoing chemotherapy. Stool maintain patency, when necessary to alleviate the cathartic; Chemotherapy nausea, vomiting should be timely, severe vomiting, should be given intravenous nutrition.
2.3.2 Myelosuppression chemotherapy drugs is the most common side effects. Chemotherapy should be directed at the same time give or interleukin drugs, blood regularly reviewed, interleukin less than 1.0 x 10 9 / L, in getting preventive antibiotics, segregated treatment and care, access restrictions to prevent cross-infection.
2.3.3 alopecia hair loss caused due to the "special chemotherapy image" affects the self-esteem is a serious problem, it should be before chemotherapy, the problems that may occur to tell patients that it is fully prepared mentally. In the course of chemotherapy Perry to the ice cap or when using rubber of the scalp and genocide prevention.
2.3.4 extravasation of chemotherapy drugs to prevent chemotherapy drugs can be addressed to extravasation of tissue necrosis, once the formation of skin ulcers, long time to heal, the lack of effective treatment options, with emphasis on prevention. Chemotherapy drugs should require preparation starts with a chemotherapy drug-free liquid vascular puncture, puncture to be successful, indeed no extravasation after liquid-containing liquid chemotherapy drugs. When injected intravenously, should its stock, to see the blood before the injection. Injection process, the repeated observation of its stock, in order to push the speed too fast not, we should not be too slow, so as to avoid leakage and phlebitis, injection time to 10 to 15 minutes after it is advisable. Intravenous infusion, should regularly roving observation. Chemotherapy drug injection or infusion after another with a non-chemotherapy drugs washing liquid venous access.
2.3.5 extravasation of chemotherapy drugs to deal with chemotherapy drugs in case of extravasation, should immediately stop the injection, injection of dexamethasone 5 mg after Needle, continuous ice within 24 hours, 24 hours after the partial remains swollen, Tu acetate ointment examination of loose, wet dressing or dexamethasone, and the pain is to use the benefit ropivacaine and hydrocortisone sodium succinate the pine line partially closed, dexamethasone and gentamicin alternating wet dressing. Obviously partial necrosis, ulcers, surgical debridement treatment.

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