Benchmark – Nursing Process: Cancer

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Benchmark – Nursing Process: Cancer

 

The National Institute of Cancer ([NIC], 2020) shows that cancer is a disease where body cells grow uncontrollably and spread to other parts of the body. If the condition is not controlled it can lead to death. While causes of cancer are unclear, various factors are known that can increase occurrence such as excess body weight, tobacco use and inherited genetic mutation (American Cancer Society [ACS], 2020). Cancer is a serious public health issue globally and second leading cause of death in the US. ACS (2020) indicates that in 2020, more than 1,806, 590 cases were diagnosed while 606, 520 were expected to die from cancer in the US.

Benchmark – Nursing Process: Cancer

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Common cancers in women include colorectal, lung and breast cancer, which account for 50% of cancers diagnosed in 2020. On the other hand, colorectal, lung and prostrates are prevalent in men and represented 43% of cancers diagnosed in 2020. Cancer mortality rate is 1538.3 per 100,000 people and the incidence is 442.4 per 100,000 individuals (ACS, 2020). The assignment will analyze the cancer approach to care. It will also provide a discussion about diagnosis, staging, complications, adverse effects of treatment and methods to decrease physical and psychological effects. It will also provide factors that lead to annual incidence, mortality rates, how the ACS might provide education, support and recommended services. Additionally, the assignment will focus on nursing process to demonstrate how it can help in the delivery of holistic and patient-focused care.  The essay will also highlight how liberal arts and science studies lead to the foundation of nursing knowledge.

Diagnosis and Staging of Cancer

Diagnosis

Physical exam, endoscopy exam, biopsy and imaging tests are used in the diagnosis of cancer (ACS, 2020). Elevated or low levels of certain substance in body fluids, blood and urine for tumor markers can help in cancer diagnosis. Furthermore, imaging tests such as nuclear scan, computed tomography (CT) scan, magnet resonance imaging (MRI), bone scan and positron emission tomography (PET) scan are used to detect areas within the body that have tumor. However, in most cases, biopsy is used in cancer diagnosis (NCI, 2020). During biopsy procedure, the doctor removes a sample tissue that is evaluated by the pathologist describing the findings and possible diagnosis.

Cancer Staging

Cancer staging is used to establish the anatomic extent of the disease (Brierley et al, 2016). Therefore, medical centers and hospitals use Tumor (T); Node (N) and Metastasis (M) (TNM) to determine cancer staging. The TNM focuses on three aspects; size and location of tumor, whether cancer has spread to nodes and if the tumor has spread to other body parts (metastasis). The results are combined to determine the stage of disease in every individual beginning with stage 0 to IV.

Stage 0 or carcinoma in situ (CIS): Characterized by abnormal cells, which have not invaded nearby tissues (NIC, 2020). Even though CIS is not cancer, it can become cancerous. However, this stage is curable by removing tumor through surgery.

Stage I, II and III: In these stages, cancer is present because the malignant tumor has spread to nearby tissues. Nonetheless, in stage 1 the tumor is small while in stages II and III, the tumor is large and deeply affected nearby tissues but other body parts are not affected (NIC, 2020).

Stage IV: This is the advanced or metastatic cancer stage where cancerous cells have spread to other body parts and it is less likely curable (Tuttle et al., 2017).

Complications of Cancer, Side Effects of Treatment, and Methods to Lessen Physical and Psychological Effects

Complications

Cancer complications include neurologic, thoracic and gastrointestinal (GI). Neurologic complications in cancer can affect the brain, peripheral system and spinal cord leading to morbidity and mortality (Lee, 2020). For example, chimeric antigen receptor (CAR) T-cell therapy increases the risk of clotting, bleeding, stroke and intracranial hemorrhage. Elevated intracranial pressure leads to vomiting, headache and nausea. Therefore, healthcare professionals should understand neurological complications in cancer patients since timely diagnosis can enhance outcomes.                                                                                                                                GI complications are prevalent in cancer patients (NIC, 2020). Specifically, cancer leads to constipation, fecal impaction, bowel obstruction, radiation enteritis and diarrhea. Moreover, bowel obstruction is common in breast, colon, ovarian and stomach cancers. Nevertheless, bowel obstruction is prevalent in advanced cancer staging (NIC, 2020). In cancer patients, diarrhea is caused by immunotherapy, chemotherapy, targeted therapy surgery and bone marrow transplant.            Conversely, Nishino et al. (2017) argue that pulmonary embolism, pneumonia, hemorrhage, and pulmonary oedema are common in cancer patients. In particular, antiangiogenic therapy can contribute to pneumothorax, hemorrhage and pulmonary embolism. As such, in cancer treatment, providers should be careful in interpreting imaging results.

Side Effects of Treatment

The Center for Disease Control and Prevention ([CDC], 2019) demonstrates that cancer treatment can cause adverse effects such as pain, hair loss, neutropenia, diarrhea, eating difficulties and depression. Neutropenia is linked with reduced number of white blood cells, which is prevalent during chemotherapy. In addition, chemotherapy and targeted therapy contribute to diarrhea and flu-like symptoms (NIC, 2020). While chemotherapy leads to alopecia, hair grows back in 2 to 3 months (CDC, 20I9).

Methods to Lesson Physical and Psychological Effects

Emotional and social support can help patient to cope with physical and psychological effects of cancer. Essentially, support allows patients in decreasing anxiety, disease and treatment-related signs (NIC, 2020). Social and emotional approaches can be in form of cancer education programs, counseling, exercise and meditation or stress management. Hendriksen et al. (2019) also found that engaging in religious practices and cognitive techniques can be effective in managing cancer symptoms.

Factors Contributing to Incident and Mortality Rates of Various Cancers in Americans

The incidence and prevalence of cancer in the US can be linked to modifiable health behaviour (ACS, 2020). For example, obesity, physical inactivity, tobacco use and poor nutrition lead to yearly incidences and mortality of various cancers. The ACS (2020) shows that excessive body weight and sedentary lifestyle are modifiable health behaviour that increase annual incidence and mortality rate for breast, colon, kidney, and liver cancers. Equally, smoking is modifiable risk behaviour for liver, kidney, colon and cancer of oral cavity and pharynx (ACS, 2020). For instance, the incidence and mortality rate of lung cancer among Americans has reduced from 51% to 26% due to reduced smoking and use of tobacco products (ACS, 2020).  This indicates that awareness about regular physical activity, smoking and tobacco cessation can reduce the incidence of cancer among Americans.                                                             Consequently, the incidence and mortality rate of cervical cancer is high as a result of lack of awareness about hepatitis B virus (HBV) and human papilloma virus (HPV). Stanley (2017) alleges that HPV is the leading cause of 70% cases of cervical cancer. Similarly, HBV causes hepatocellular carcinoma (HCC) and liver cancer (Stanley, 2017). Therefore, HBV and HPV vaccinations can reduce the incidence annual incidence and mortality rate of HCC, liver and cervical cancer. Socioeconomic status and lack of insurance coverage also increase yearly incidence and mortality rate of various cancers. Research also shows that the incidence and death rate of cervical, liver, stomach and esophageal cancer was low in regions with high socioeconomic status (Singh & Jemal, 2017).

American Cancer Society (ACS)

ACS provides education and support for cancer through its website. The website provides the public with useful information about various cancers, treatment option, and deal with financial challenges, emotional support and coping with disease side effects. Moreover, ACS provide education through its publications on different types of cancer, coping skills and preventative measures such as tobacco cessation, HPV prevention, screening and eating a healthy diet. ACS also has a live chat and telephone number that provide one-on-one support with cancer information specialist or how to find support in community after diagnosis and recovery after treatment.

ACS Services I Would recommend and Rationale

Inasmuch as ACS provides education and support for people diagnosed with various cancers, it would be important to initiate Patient Navigation Program for guiding and inform cancer patients and their families about steps of the disease process. After patients are diagnosed with cancer, they do not know where to get relevant information about treatment, support and health insurance. As such, Patient Navigation Program can enhance easy access to relevant information. Lodging services would also be imperative. Lodging services encompass rides allowing patients to access care, particularly those that cannot drive themselves to seek treatment.

Utilization of Nursing Process across the Life Span

Assessment

Lavdaniti (2017) argues that in the assessment phase, nurses use a systematic approach to gather and analyze information. Additionally, assessment comprise of spiritual, economic, sociocultural and psychological factors that help nurses to gather subjective data. In the assessment, nurses conduct physical exam to collect objective information. Thus, objective and subjective information enable nurses to get comprehensive health history. Nevertheless, to provide holistic care for cancer patients across the life span, nurses should be cognizant of the results of lab tests, imaging studies and pathology. Again, assessment serves as the basis for preparing patients to adhere to treatment that promote delivery of safe and effective care for cancer patients across the life span.

Diagnosis

Diagnosis is the clinical judgement about patient, family and community response. Treatment of cancer is based on disease staging. Conversely, Lavdaniti (20170 demonstrates that  diagnosis allows nurses to use data collected from assessment phase to evaluate patient  and determine suitable intervention leading to safe and effective cancer care across lifespan.

Outcomes / Planning

Planning focuses on goal setting and outcomes to influence evidence-based care (Melin‐Johansson et al., 2017).  In cancer treatment, care plan are developed based on the patients’ understanding of treatment goals, schedule and side effects. The care plan also highlights adherence, physical and emotional readiness to treatment. As such, planning enhances communication, documentation and continuity of care across lifespan that contribute to delivery of effective and safe care.

Implementation

Benchmark – Nursing Process: Cancer

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The implementation phase involves conducting nursing interventions in the plan of care (Melin‐Johansson et al., 2017).  In the provision of effective and safe cancer treatment across life span, implementation is important in providing care in relation to disease status.

Evaluation

Evaluation entails assessing the effectiveness of nursing care (Melin‐Johansson et al., 2017).  As such, nurses utilize evaluation to provide safe and effective cancer treatment across life span to modify care plan with regards to the type of cancer and staging (NIC, 2020). For instance, chemotherapy might be the chosen intervention, but there are no improvements. In such cases, care plan can be modified to encompass a combination of chemotherapy with surgery. Evaluation is thus essential in selecting an appropriate intervention to provide safe and effective care.

Contribution of Liberal Arts and Science Studies to Nursing Knowledge

Nursing education relies on liberal arts and science to educate and inform nursing students. Essentially, these disciplines equip nursing students with critical, humanistic, thoughtful and reflective skills (Song et al., 2019). Liberal arts and sciences also provide nursing students with skills to provide evidence-based care in dynamic healthcare settings. In this respect, liberal arts and science impact nurses with knowledge to assess, diagnose, plan, implement and evaluate complex health concerns. As such, these disciplines prepare nursing students to be flexible and adapt to the growing healthcare needs.                                       Similarly, interdisciplinary research area uses perspectives, tools and information from different disciplines (Tripp & Shortlidge, 2019). Moreover, interdisciplinary research helps in resolving a problem that cannot be addressed by one disciple. Thus, when mathematics, social and physical sciences, and science studies are integrated in nursing field they present concepts, viewpoints and information to resolve complex health issues. Tripp and Shortlidge (2019) discovered that in the twenty-first century interdisciplinary research is being adopted in social sciences to address societal issues that require in-depth knowledge base. Therefore, incorporating mathematics, science studies, physical and social sciences into research prepare nurses to become members of the interdisciplinary research team. Nurse scientists with skills and knowledge in mathematics, science studies, physical and social sciences have effective communication to provide coordinated care to communities or individuals.

Benchmark – Nursing Process: Cancer

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Conclusion

Cancer is a public health issue globally and second leading cause of death in the US.  Again, based on treatment options, cancer can lead to alopecia, depression, diarrhea and neutropenia. Biopsy is widely used in the diagnosis of cancer while TNM is used to determine cancer staging. While social and emotional support approaches can reduce physical and psychological effects of cancer, the incidence and mortality rates are higher in Americans due to the physical inactivity, smoking and lack of awareness about HPV and HBV vaccines. Nursing process is also vital in the delivery of effective and safe cancer treatment across life span. The analysis also demonstrates that liberal arts and sciences equip nurses with critical, humanistic, thoughtful and reflective providers to provide evidence-based care. Interdisciplinary research area also presents nurses with skills, knowledge and perspective for addressing complex health conditions.

Benchmark – Nursing Process: Cancer

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References

American Cancer Society. (2020). Cancer facts and figures 2020. Cancer.org.            https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and  statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf

Brierley, J., Gospodarowicz, M., & O’Sullivan, B. (2016). The principles of cancer staging.             Ecancermedicalscience, 10. https://doi.org/10.3332/ecancer.2016.ed61

Center for Disease Control and Prevention. (2019). Side effects of cancer treatment. Cdc.gov             https://www.cdc.gov/cancer/survivors/patients/side-effects-of-treatment.htm

Hendriksen, E., Rivera, A., Williams, E., Lee, E., Sporn, N., Cases, M. G., & Palesh, O. (2019).    Manifestations of anxiety and coping strategies in patients with metastatic lung cancer           and their family caregivers: a qualitative study. Psychology and Health, 34(7), 886-899.         https://doi.org/10.1080/08870446.2019.157990

Lavdaniti, M. (2017). Holistic nursing approach to patients with cancer. Journal of Nursing           Care, 6, e136.             https://doi.org/10.4172/2167-1168.1000e136

Lee, E. Q. (2020). Neurologic complications in patients with Cancer. Continuum: Lifelong            Learning in Neurology, 26(6), 1629-1645. https://doi.org/10.1212/CON.0000000000000937

Melin‐Johansson, C., Palmqvist, R., & Rönnberg, L. (2017). Clinical intuition in the nursing          process and decision‐making—A mixed‐studies review. Journal of Clinical Nursing,     26(23-24), 3936-3949. https://doi.org/10.1111/jocn.13814

National Institute of Cancer. (2020). Cancer statistics. cancer.gov https://www.cancer.gov/about            cancer/understanding/statistics

Nishino, M., Hatabu, H., Sholl, L. M., & Ramaiya, N. H. (2017). Thoracic complications of          precision cancer therapies: A practical guide for radiologists in the new era of cancer            care. Radiographics, 37(5), 1371-1387. https://doi.org/10.1148/rg.2017170015

Singh, G. K., & Jemal, A. (2017). Socioeconomic and racial/ethnic disparities in cancer     mortality, incidence, and survival in the United States, 1950–2014: Over six decades of         changing patterns and widening inequalities. Journal of Environmental and Public             Health, 2017. https;//doi.org/10.1155/2017/2819372

Song, C. E., Kim, W. G., & Lim, Y. J. (2019). An analysis of evidence-based practice courses in  Korean nursing education systems. Heliyon, 5(10), e02650.   https://doi.org/10.1016/j.heliyon.2019.e02650

Stanley, M. (2017). Tumour virus vaccines: Hepatitis B virus and human papillomavirus.   Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1732),           20160268. https://doi.org/10.1098/rstb.2016.0268

Tripp, B., & Shortlidge, E. E. (2019). A framework to guide undergraduate education in   interdisciplinary science. CBE—Life Sciences Education, 18(2), es3.    https://doi.org/10.1187/cbe.18-11-0226

Tuttle, R. M., Haugen, B., & Perrier, N. D. (2017). Updated American Joint Committee on           cancer/tumor-node-metastasis staging system for differentiated and anaplastic thyroid     cancer: What changed and why? Thyroid, 27(6): 751-756.           https://dx.doi.org/10.1089%2Fthy.2017.0102

 

Benchmark – Nursing Process: Cancer

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