NRS 410V Nursing Process Approach To Care Essay

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

  • Describe the diagnosis and staging of cancer.
  • Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
  • Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
  • Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
  • Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
  • Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.

You are required to cite a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies: RN-BSN

  • 2.1: Incorporate liberal arts and science studies into nursing knowledge.
  • 3.1 Utilize the nursing process to provide safe and effective care for patients across the life span.

Cancer and Approach to Care Sample Paper

Based on data provided by Hulvat (2020), cancer is the second leading cause of death in the USA, after heart disease. Cancer affects not only those who are afflicted, but also their families, society, and the nation as a whole. The psychological and physical suffering has necessitated the invention and discovery of various drugs and therapies for cancer patients to lessen the pain and suffering. 

These discoveries involve the holistic care of cancer patients by providing the required palliative care for those with end-stage disease and therapy for those who have earlier stages that can be resolved with the relevant therapy (Olver et al., 2020). This article discusses cancer diagnosis and staging, its complications, the role of nursing in cancer patient care, and how liberal arts and science disciplines are integrated into nursing.

Diagnosis and Staging of Cancer

An earlier diagnosis of cancer often provides a good prognosis. Through screening, early cancer detection is possible before the manifestation of symptoms. This is especially possible in individuals with a familial history of cancer or those who are at risk of developing malignancies due to their environmental exposure (Klatt & Kumar, 2021). Otherwise, the actual diagnosis of cancer can be made through one or more of the following methods: physical exam, laboratory diagnosis, imaging tests, and biopsy. 

Laboratory diagnosis involves the use of histologic and cytologic methods to identify and differentiate cancerous cells from normal. In the histologic method, the sample tissue is prepared through fixation with formalin and then frozen pieces are sliced into tiny sections that are mounted on the slides and stained for viewing under an electron microscope (Klatt & Kumar, 2021).

To identify malignancy changes in cell appearance, cytological examination employs techniques such as fine needle biopsy, cytological pap smear, immunohistochemistry, and flow cytometry (Klatt & Kumar, 2021). Immunohistochemistry involves the use of fluorescent-tagged antibodies to identify specific cell markers on abnormal or cancer cells.

 On the other hand, flow cytometry makes use of the principle that different fluorescently labeled cells when passed in a single file through a laser can be detected, sorted, and counted depending on their light scattering or obstructive characteristics. It is commonly used in the diagnosis and classification of cancers of the blood.

Other essential laboratory tests in cancer detection include molecular diagnostics and the presence of cancer markers, for example, elevated Prostate-Specific Antigen (PSA) in prostate cancer (Klatt & Kumar, 2021). In addition to laboratory tests, various imaging modalities such as CT scans, bone scans, MRI, PET scans, ultrasounds, and X-rays are useful in the diagnosis of cancers. Despite these various methods, biopsy analysis remains the only confirmatory diagnosis for cancer. Other diagnostic methods play a role in the staging of cancer (Klatt & Kumar, 2021).

Cancer staging and grading are significant in determining prognosis and treatment protocols because they quantify the likely clinical aggressiveness, apparent extent, and dissemination of neoplasia (Klatt & Kumar, 2021). While cancer staging is based on the size of the primary lesion, extent of regional nodal involvement, and the presence or absence of metastasis, cancer grading is based on the cytological differentiation and mitotic activity of cancer cells (Klatt & Kumar, 2021). 

The TNM (T, primary cancer size, N, nodal involvement, M, metastases) and AJC (American Joint Committee) systems are the most commonly used methods for staging cancers. In the TNM system, T1, T2, T3, and T4 indicate increasing primary lesion size; N0, N1, N2, and N3 indicate gradually advancing nodal involvement; and M0 and M1 indicate the absence and presence of distant metastases, respectively (Klatt & Kumar, 2021). Cancer is classified into stages 0 to 4 using the AJC system, which takes into account the size of the main cancer, nodal involvement, and distant metastases (Klatt & Kumar, 2021).

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

Complications of Cancer

Various cancers have different complications, which when superimposed with the side effects of treatments, can be detrimental to the patient. These complications involve different systems of the body, ranging from endocrine, hematological, nervous, etc., (Klatt & Kumar, 2021). For example, a pituitary adenoma can manifest itself with endocrine symptoms of excess prolactin and, at the same time, can compress the optic nerve at the optic chiasma region to produce a mass effect (Klatt & Kumar, 2021). 

Pain is another common complication of cancer. Acute, chronic, and breakthrough pain are the three types of pain experienced by cancer patients. Acute pain is severe, occurs suddenly, and lasts for a few minutes. On the other hand, chronic pain lasts more than three months. Even if a patient is taking pain medication, they may experience a flare-up of discomfort called “breakthrough pain” (Money & Garber, 2018).

Hematological complications are common for cancers that infiltrate the bone marrow. These complications usually result from reduced production of blood cells, for example, an increased risk of infection due to leukopenia or an increased risk of hemorrhage due to thrombocytopenia (Klatt & Kumar, 2021). 

Side Effects of Treatment

Cancer treatment involves chemotherapy, radiotherapy, or surgical excision for cancer in its early stages. These modes of cancer treatment are associated with side effects that can be acute or chronic. Diarrhea, nausea, and vomiting are some of the most common acute side effects of chemotherapy and radiotherapy drugs. Diarrhea is commonly associated with rinotecan (Zhang et al., 2018). 

Secondly, some chemotherapeutic agents are associated with specific side effects, such as ototoxicity and nephrotoxicity associated with cisplatin (Zhang et al., 2018). Toxicities limit the administration of curative doses of chemotherapeutic agents to cancer patients. Lastly, a common side effect associated with cancer treatment is the tumor lysis syndrome. 

This is a constellation of metabolic derangements that occur when large numbers of neoplastic cells are rapidly destroyed with the release of intracellular ions and metabolic by-products into the body (Belay et al., 2017). These metabolic derangements range from hyperkalemia, hypocalcaemia, hyperphosphatemia, and hyperuricemia.

Methods to Lessen Physical and Psychological Effects

As mentioned earlier, cancer is associated with physical and psychological effects on the patient and society. The American Society of Clinical Oncology (ASCO) provides guidelines for the management of physical pain associated with cancer. Non-opioid pain relievers (NSAIDS, such as acetaminophen) and opioids, such as hydromorphone, fentanyl, and hydrocodone, are some of the drugs used to treat pain. 

According to Ferrell et al., (2017), opioids are the recommended drug of choice for the treatment of moderate-to-severe pain. Treatment of anemia due to hemorrhage in cancer patients includes blood transfusion and promotion of hematopoiesis through medications such as erythrocyte stimulating agents and vitamin or mineral supplementation of iron, folic acid, and vitamin B12 (Ferrell et al., 2017).

Other specific effects such as loss of appetite, nausea and vomiting are approached individually through the administration of antiemetics for nausea and vomiting, as well as addressing the cause of loss of appetite and consulting with a dietician (Ferrell et al., 2017). Emotional and social support are essential for cancer patients to cope with depression, anxiety, and treatment-related symptoms. The approaches to relieving psychological effects, as highlighted by Olver et al. (2020), include supportive care such as relaxation and comfortability training, counseling/talk therapy, cancer education sessions, and exercises. Antidepressant and anti-anxiety medications may be used to alleviate the psychological effects. Additionally, because cancer patients are prone to psychological problems, monitoring for distress is necessary during therapy (Olver et al., 2020).

Factors Contributing to Increased Yearly Incidence and Mortality Rates of various Cancers

The incidence and mortality of cancer is increasing yearly, earning it a spot as the second leading cause of death among Americans. Much of the increased incidence and mortality of cancer yearly can be attributed to modifiable factors, including poor diet, lack of enough physical activity, tobacco use, alcohol, and overweight/obesity (Islami et al., 2020). Further, Islami et al. (2020) argue that smoking causes around 440,000 cancer-related deaths per year, accounting for almost 30% of all cancer-related deaths. 

Recent evidence has shown the causal relationship between smoking and various cancers, including lung, oral, pancreatic, esophageal, bladder, pharyngeal, kidney, and laryngeal cancer. The opposite is true; quitting smoking has been linked to plenty of health benefits. Scientific evidence suggests that smokers who quit live longer than those who continue to do so (Islami et al., 2020). Reduced physical activity has been associated with an increase in the risk of mortality and developing cancer.

On the other hand, engaging in physical activity has been associated with health benefits, including reduced risks of colon, endometrial cancer, and breast cancer. As Viale (2020) notes, poor physical exercise may be responsible for 11 to 15% of breast and colorectal cancers. Obesity is another modifiable risk factor that is associated with many health concerns, including cancer. Studies on cancer have shown that obesity is associated with colorectal, breast, and uterine cancers (Viale, 2020). 

Additionally, studies have shown the implication of diet in carcinogenesis. Diets rich in roughage, especially fruits and vegetables, have been shown to be fundamental in the reduction of the risk of developing certain cancers. The opposite has been shown to be true with an increased risk of developing cancers and mortality in those who do not include vegetables and fruits in their diet (Viale, 2020).

 Finally, alcohol has been implicated in the increased mortality and incidences of cancer. Accordingly, Hulvat (2020) contends that alcohol is a substantial risk factor for malignancies of the upper aerodigestive tract and liver. Generally, these modifiable factors contribute largely to the increased incidence and mortality rates of various cancers among Americans.

American Cancer Society

Through research, education, advocacy, and service, the American Cancer Society (ACS) is dedicated to eliminating cancer as a significant health problem. They are involved in providing guidelines for care for newly diagnosed patients, those on treatment, and those who are directly involved in caring for their loved ones with cancer (Viale, 2020). The ACS provides education and support directly or indirectly through the following ways: It avails cancer information specialists all the time to respond to questions about medications, treatment options, cancer prevention, and screening, among other things. 

Patients are also educated by the society, which publishes several patient education leaflets and pamphlets, as well as books and professional publications. These include, among other things, books on individual malignancies, coping strategies, and cancer prevention (Viale, 2020). They also provide support through community programs and functions to the vast number of patients diagnosed each year, as well as their families and friends, free of charge (Viale, 2020).

I propose that the ACS provide transportation to treatment centers for patients who cannot afford to pay for transportation and accommodation, which can be expensive for those living in isolated, remote areas and having to travel to these centers. This is extremely beneficial to patients who live a long distance away from treatment facilities. Additionally, ACS should come up with cosmetic effects such as women’s wigs, bras, hats, and prosthetic breasts for patients who experience alopecia and breast disproportional due to excision during therapy. Moreover, ACS could encourage online interactions and group therapy through their platforms for cancer patients to improve their supportive care.

Utilization of Nursing Process Across the Life Span

Nurses are involved in the entirety of the care of cancer patients. They are involved in the assessment, diagnostic, and result evaluation processes, as well as the therapy implementation and nursing care evaluation. Nurses partake in the evaluation of patients’ physical and emotional well-being as well as their medical history, health habits, and awareness of the disease by both the patient and their family (Rieger & Yarbro, 2019). 

They carry out detailed physical examinations and take histories during patients’ oncologic visits. When it comes to cancer diagnosis, the nurse considers all relevant laboratory, pathology, and imaging results, as well as clinical practice knowledge, to help with diagnosis and potential health implications (Rieger & Yarbro, 2019).

Once a nursing diagnosis has been made, its integrity is validated when the nurse can clearly identify and link the illness to its distinguishing characteristics or risk factors. During the planning phase, the oncology nurse prioritizes the patient’s issues based on their severity and likelihood of causing significant harm. Each problem is approached with the aim of attaining a certain recovery goal. 

The nurses execute the care plan during the implementation phase. They achieve care implementation through participating in the patient’s therapy, management of symptoms, and disposition of the patient to the next point of care. They also participate in patients’ and families’ therapy during the process of diagnosis and care. Finally, the nurse assesses the progress made toward the previously set goals and outcomes. If the patient’s progress is slow or unfavorable, the care plan is changed. However, if the goal has been met, treatment can be terminated and new goals for care set.

Contribution of Liberal Arts and Science Studies to Nursing Knowledge

In nursing education, liberal arts and sciences are an important element of the curriculum. They play an important role in enforcing critical thinking, creativity, and holistic caring abilities amongst nurses. Kooken and Kerr (2018) describe nursing as both an art and a science as they both have central roles in nursing. Liberal arts, especially social science improve the nurse’s general knowledge, decision-making skills, and communication skills. 

It also enables them to think globally, enabling them to navigate through diverse ethnicities and nursing care processes. Furthermore, when caring for individuals with a complex medical, behavioral, economic, or spiritual history, the capacity to discern and seek solutions to problems becomes critical (Kooken & Kerr, 2018). 

Mathematics and physical sciences play an important role in the development of knowledge on calculation of drug dosages, understanding drug-drug interactions, and organization of workplace through inventory and stock keeping (Nibbelink & Brewer, 2018).

Conclusion

Nurses play an important role in the care of cancer patients. Therefore, understanding the process of diagnosis, treatment, and side effects of the various therapies is crucial in ensuring holistic care of cancer patients. Successful incorporation of the nursing process into the care of cancer patients can only be successful if the nurses have knowledge of social sciences and liberal arts in addition to medical knowledge. Additionally, the incorporation of organizations such as ACS into the palliative care of cancer patients and education of the public on cancer plays a big role in reducing the mortality and incidences of various cancers.

References

  • Belay, Y., Yirdaw, K., & Enawgaw, B. (2017). Tumor lysis syndrome in patients with hematological malignancies. Journal of Oncology, 2017, 9684909. https://doi.org/10.1155/2017/9684909
  • Ferrell, B. R., Temel, J. S., Temin, S., Alesi, E. R., Balboni, T. A., Basch, E. M., Firn, J. I., Paice, J. A., Peppercorn, J. M., Phillips, T., Stovall, E. L., Zimmermann, C., & Smith, T. J. (2017). Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 35(1), 96–112. https://doi.org/10.1200/JCO.2016.70.1474
  • Hulvat, M. C. (2020). Cancer incidence and trends. The Surgical Clinics of North America, 100(3), 469–481. https://doi.org/10.1016/j.suc.2020.01.002
  • Islami, F., Siegel, R. L., & Jemal, A. (2020). The changing landscape of cancer in the USA – opportunities for advancing prevention and treatment. Nature Reviews. Clinical Oncology, 17(10), 631–649. https://doi.org/10.1038/s41571-020-0378-y
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  • Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 34(1), 60–64. https://doi.org/10.1016/j.profnurs.2017.07.002
  • Money, S., & Garber, B. (2018). Management of cancer pain. Current Emergency and Hospital Medicine Reports, 6(4), 141–146. https://doi.org/10.1007/s40138-018-0170-9
  • Nibbelink, C. W., & Brewer, B. B. (2018). Decision-making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5–6), 917–928. https://doi.org/10.1111/jocn.14151