UNDERSTANDING CANCER

ONCOLOGY NURSING
Essential Concepts of
Cancer
– What is Cancer?
– Normal Cell Growth vs.
Cancer Cell Growth
– Etiology and Causative
Factors
– Pathophysiology
– Classification of Tumors
– Effects of Cancer
NURSING PROCESS

– Assessment
– Laboratory & Diagnostic Tests
– Tumor Staging and Grading
– Nursing Diagnoses & Planning
– Implementation and Management
• Treatment Modalities
– Chemotherapy
• End-of-life Issues
WHAT IS CANCER?
CANCER is a complex of diseases
which occurs when normal cells
mutate into abnormal cells that
take over normal tissue,
eventually harming and
destroying the host
WHAT IS CANCER
A large group of diseases characterized
by:
– Uncontrolled growth and spread of
abnormal cells
– Proliferation (rapid reproduction by cell
division)
– Metastasis (spread or transfer of
cancer cells from one organ or part to
another not directly connected)
ONCOLOGY DEFINED

Branch of medicine
that deals with the
study, detection,
treatment and
management of
cancer and neoplasia
 “ROOT WORDS”
 Neo- new
 Plasia- growth

 Plasm- substance

 Trophy- size

 +Oma- tumor

 Statis- location
 “ROOT WORDS”
 A- none
 Ana- lack

 Hyper- excessive

 Meta- change

 Dys- bad, deranged

CHARACTERISTICS OF NEOPLASIA
 Uncontrolled growth of Abnormal cells
 1. Benign

 2. Malignant

 3. Borderline
CHARACTERISTICS OF NEOPLASIA
BENIGN
 Well-differentiated

 Slow growth

 Encapsulated

 Non-invasive

 Does NOT metastasize

CHARACTERISTICS OF NEOPLASIA
MALIGNANT
 Undifferentiated

 Erratic and Uncontrolled Growth

 Expansive and Invasive

 Secretes abnormal proteins

 METASTASIZES
LOSS OF NORMAL GROWTH
CONTROL
NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
1. Parenchyma, Organ or Cell
 Hepatoma- liver

 Osteoma- bone

 Myoma- muscle
NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
2. Pattern and Structure, either GROSS or
MICROSCOPIC
 Fluid-filled CYST

 Glandular ADENO

 Finger-like PAPILLO

 Stalk POLYP
NOMENCLATURE OF NEOPLASIA
Tumor is named according to:
3. Embryonic origin
 Ectoderm ( usually gives rise to epithelium)

 Endoderm (usually gives rise to glands)

 Mesoderm (usually gives rise to Connective

tissues)
 BENIGN TUMORS
 Suffix- “OMA” is used
 Adipose tissue- LipOMA

 Bone- osteOMA

 Muscle- myOMA

 Blood vessels- angiOMA

 Fibrous tissue- fibrOMA

 MALIGNANT TUMOR
 Named according to embryonic cell origin
1. Ectodermal, Endodermal, Glandular,
Epithelial
 Use the suffix- “CARCINOMA”

 Pancreatic AdenoCarcinoma

 Squamos cell Carcinoma

 MALIGNANT TUMOR
 Named according to embryonic cell origin
2. Mesodermal, connective tissue origin
 Use the suffix “SARCOMA

 FibroSarcoma

 Myosarcoma

 AngioSarcoma
“PASAWAY”

1. “OMA” but Malignant

 HepatOMA, lymphOMA, gliOMA, melanOMA
2. THREE germ layers
 “TERATOMA”

3. Non-neoplastic but “OMA”

 Choristoma
 Hamatoma
ETIOLOGY/CAUSATIVE FACTORS
• Viruses
• Chemical carcinogens
• Physical stressors
• Hormonal factors
• Genetic factors
 CANCER NURSING
Etiology of cancer
1. PHYSICAL AGENTS
 Radiation

 Exposure to irritants

 Exposure to sunlight

 Altitude, humidity
 CANCER NURSING
Etiology of cancer
2. CHEMICAL AGENTS
 Smoking
 Dietary ingredients
 Drugs
 CANCER NURSING
Etiology of cancer
3. Genetics and Family History
 Colon Cancer
 Premenopausal breast cancer
 CANCER NURSING
Etiology of cancer
4. Dietary Habits
 Low-Fiber
 High-fat
 Processed foods
 alcohol
 CANCER NURSING
Etiology of cancer
5. Viruses and Bacteria
 DNA viruses- HepaB, Herpes, EBV, CMV,
Papilloma Virus
 RNA Viruses- HIV, HTCLV

 Bacterium- H. pylori
 CANCER NURSING
Etiology of cancer
 6. Hormonal agents

 DES

 OCP especially estrogen

 CANCER NURSING
Etiology of cancer
 7. Immune Disease

 AIDS
 BURKITT’S LYMPHOMA - a cancer of the
lymphatic system
Classification of Cancer
According to Behavior of Tumor
• Benign - tumors that cannot spread by
invasion or metastasis; hence, they only
grow locally
• Malignant - tumors that are capable of
spreading by invasion and metastasis. By
definition, the term “cancer”
Patterns of cell Proliferation
• Hyperplasia
• Dysplasia
• Metaplasia
• Anaplasia
• Neoplasia
Patterns of cell Proliferation
•Metaplasia
• conversion of one type of cell in a tissue to
another type not normal for that tissue
•Anaplasia
• change in the DNA cell structure and
orientation to one another, characterized by
loss of differentiation and a return to a more
primitive form.
Neoplasia
• uncontrolled cell growth, either benign or
malignant
Metastasis
• Metastasis: 3 stages
– Invasion – neoplastic cells from primary
tumor invade into surrounding tissue
with penetration of blood or lymph.
– Spread – tumor cells spread through
lymph or circulation or by direct
expansion
– Establishment and growth – tumor cells
are established and grow in secondary
site: lymph nodes or in organs from
venous circulation
 CANCER NURSING
Spread of Cancer
 1. LYMPHATIC
 Most common
 2. HEMATOGENOUS
 Blood-borne, commonly to Liver and Lungs
 3. DIRECT SPREAD
 Seeding of tumors
 CANCER NURSING
Body Defenses Against TUMOR
 1. T cell System/ Cellular Immunity
 Cytotoxic T cells kill tumor cells
 2. B cell System/ Humoral immunity
B cells can produce antibody
 3. Phagocytic cells
 Macrophages can engulf cancer cell debris
Classification of Tumors
• CARCINOMAS: EPITHELIAL TISSUE
– BODY SURFACES, LINING OF BODY CAVITIES ETC:
(ADENOCARCINOMA)
• SARCOMAS: CONNECTIVE TISSUE
– STRIATED MUSCLE, BONE, ETC (OSTEOSARCOMA)
• LYMPHOMAS AND LEUKEMIAS
– HEMATOPOIETIC SYSTEM
• NERVOUS TISSUE TUMORS
– EX. NERVE CELLS-NEUROBLASTOMA
• MYELOMA
– Develops in the plasma cells of bone marrow
Effects of Cancer
• Disruption of Function- can be due to
obstruction or pressure
• Hematologic Alterations: can impair
function of blood cells
• Hemorrhage: tumor erosion, bleeding,
severe anemia
• Anorexia-Cachexia Syndrome: wasted
appearance of client
Effects of Cancer
• Paraneoplastic Syndromes: ectopic
sites with excess hormone production
– ↑ Parathyroid hormone→
hypercalcemia
– ↑ secretion of insulin→ hypoglycemia
– ↑ Antidiuretic hormone (ADH) → fluid
retention, HTN & peripheral edema
• ↑ Adrenocorticotropic hormone
(ACTH): cause excessive secretion of
cortisone (ie: fluid retention, ↑ glucose
levels)
Effects of Cancer
• Pain: major concern of clients and
families associated with cancer
• Physical Stress: body tries to respond
and destroy neoplasm
ASSESSMENT
• Nursing History
– Health History – chief complaint and
history of present illness (onset,
course, duration, location,
precipitating and alleviating factors)
– Cancer signs: CAUTION US!
WARNING SIGNS OF CANCER
CAUTION US!
– Change in bowel or bladder habits
– A sore that does not heal
– Unusual bleeding or discharge
– Thickenings or lumps
– Indigestion or difficulty in swallowing
– Obvious change in a wart or mole
– Nagging or persistent cough or hoarseness
– Unexplained anemia
– Sudden unexplained weight loss
Change in bowel or bladder habits
– A person with colon cancer may have
diarrhea or constipation, or he may
notice that the stool has become
smaller in diameter
– A person with bladder or kidney
cancer
A sore that does not heal
– Small, scaly patches on the skin that
bleed or do not heal may be a sign of
skin cancer
– A sore in the mouth that does not heal
can indicate oral cancer
• Unusual bleeding or discharge
– Blood in the stool is often the first sign
of colon cancer
– Similarly, blood in the urine is usually
the first sign of bladder or kidney
cancer
– Postmenopausal bleeding (bleeding
after menopause) may be a sign of
uterine cancer
• Thickenings or lumps
– Enlargement of the lymph nodes or
glands (such as the thyroid gland) can
be an early sign of cancer
– Breast and testicular cancers may also
present as a lump
• Indigestion or difficulty in
swallowing
– Cancers of the digestive system,
including those of the esophagus,
stomach, and pancreas, may cause
indigestion, heartburn, or difficulty
swallowing
• Obvious change in a wart or mole
– Moles or other skin lesions that change
in shape, size, or color should be
reported
• Nagging or persistent cough or
hoarseness
– Cancers of the respiratory tract,
including lung cancer and laryngeal
cancer, may cause a cough that does
not go away or a hoarse (rough) voice
• Unexplained anemia
• Sudden unexplained weight loss
PHYSICAL ASSESSMENT
• Inspection – skin and mucus membranes
for lesions, bleeding, petechiae, and irritation
– Assess stools, urine, sputum, vomitus for
acute or occult bleeding
– Scalp noting hair texture and hair loss
• Palpation
– Abdomen for any masses, bulges or
abnormalities
– Lymph nodes for enlargement
• Auscultation – of lung sounds, heart
sounds and bowel sounds
Laboratory & Diagnostic
Tests • Cancer detection examination
• Laboratory tests
– Complete blood cell count (CBC)
– Tumor markers – identify substance (specific
proteins) in the blood that are made by the tumor
• PSA (Prostatic-specific antigen): prostate cancer
• CEA (Carcinoembryonic antigen): colon cancer
• Alkaline Phosphatase: bone metastasis
– Biopsy
Diagnostic Tests
• Determine location of cancer:
– X-rays
– Computed tomography
– Ultrasounds
– Magnetic resonance imaging
– Nuclear imaging
– Angiography
• Diagnosis of cell type:
– ▪Tissue samples: from biopsies, shedded
cells (e.g. Papanicolaou (PAP) smear), &
washings
– ▪ Cytologic Examination: tissue examined
under microscope
• Direct Visualization:
– ▪ Sigmoidoscopy
– ▪ Cystoscopy
– ▪ Endoscopy
– ▪ Bronchoscopy
– ▪ Exploratory surgery; lymph node biopsies
to determine metastases
Tumor Staging and Grading
• Staging determines size of tumor and existence of
metastasis
• Grading classifies tumor cells by type of tissue
• The TNM system is based on the extent of the
tumor (T), the extent of spread to the lymph
nodes (N), and the presence of metastasis (M).
Primary Tumor (T)
TX - Primary tumor cannot be evaluated
T0 - No evidence of primary tumor
Tis - Carcinoma in situ (early cancer that has not spread to
neighboring
tissue)
T1, T2, T3, T4 - Size and/or extent of the primary tumor
Regional Lymph Nodes (N)
NX - Regional lymph nodes cannot be evaluated
N0 - No regional lymph node involvement (no cancer found in
the lymph nodes)
N1, N2, N3 - Involvement of regional lymph nodes (number
and/or extent of spread)
Distant Metastasis (M)
MX - Distant metastasis cannot be evaluated
M0 - No distant metastasis (cancer has not spread to other parts
of the body)
M1 - Distant metastasis (cancer has spread to distant parts of the
body)
NURSING DIAGNOSES
• Acute or chronic pain
• Impaired skin integrity
• Impaired oral mucous membrane
• Risk for injury
• Risk for infection
• Fatigue
• Imbalanced nutrition: less than body requirements
NURSING DIAGNOSES
• Risk for imbalanced fluid volume
• Anxiety
• Disturbed body image
• Deficient knowledge
• Ineffective coping
• Social isolation
OUTCOME IDENTIFICATION
1. Pain relief
2. Integrity of skin and oral mucosa
3. Absence of injury and infection
4. Fatigue relief
5. Maintenance of nutritional intake and fluid
and electrolyte balance
6. Improved body image
7. Absence of complications
OUTCOME IDENTIFICATION
1. Knowledge of prevention and cancer
treatment
2. Effective coping through recovery and
grieving process
3. Optimal social interaction
IMPLEMENTATION/MANAGE MENT
• Prevention and detection
– Primary Prevention
• Reducing modifiable risk factors in the
external and internal environment
– Secondary Prevention
• Recognizing early signs and symptoms and
seeking prompt treatment
• Prompt intervention to halt cancerous
process
SOME CARCINOGENS IN THE
WORKPLACE
TREATMENT MODALITIES
• Aimed towards:
– CURE - free of disease after treatment →
normal life
– Control - Goal for chronic cancers
– Palliative Care: Quality of life maintained at
highest level for the longest possible time
• Surgery – surgical removal of tumors; most
commonly used treatment
• Preventive or prophylactic
• Diagnostic surgery
• Curative surgery
• Reconstructive surgery
• Palliative surgery
• Chemotherapy – use of antineoplastic drugs
to
promote tumor cell death, by interfering with
cellular functions and reproduction
• Radiotherapy – directing high-energy ionizing
radiation to destroy malignant tumor cells
without harming surrounding tissues
Types:
– Teletherapy (external): radiation delivered in
uniform dose to tumor; Teletherapy is
external beam irradiation and uses a device
located at a distance from the patient. It
produces X-rays of varying energies and is
administered by machines a distance from
the body 31½ to 39 inches (80 to 100 cm).
– Brachytherapy: delivers high dose to tumor
and less to other tissues; radiation source is
placed in tumor or next to it; In
brachytherapy, the radiation device is placed
within or close to the target tissue. Radiation
is delivered in a high dose to a small tissue
volume with less radiation to adjacent normal
tissue, but requires direct tumor access.
• Immunotherapy – use of chemical or
microbial agents to induce mobilization of
immune defenses.
• Biologic response modifiers (BRMs) – use of
agents that alters immunologic relationship
between tumor and host in a beneficial way
• Bone marrow peripheral stem cell
transplantation – aspirating bone marrow
cells from compatible donor and infusing
them into the recipient
• Gene therapy – transfer of genetic materials
into the client’s DNA
NURSING MANAGEMENT
1. Promote measures that relieve pain and
discomfort.
• Pharmacologic and non-pharmacologic
interventions
2. Promote measures to maintain intact skin
integrity
3. Promote measures that maintain oral mucosa
4. Promote measures to prevent injury from
abnormal bleeding
• Monitor platelet count; avoid aspiring products,
etc
NURSING MANAGEMENT
1. Promote measures that identify and prevent
infection
• Monitor WBC count; encourage frequent
handwashing and overall cleanliness
2. Help decrease the client’s fatigue and increase
his activity level
3. Promote measures that ensure adequate
nutritional intake
• High protein, high calorie diet
4. Ensure adequate fluid and electrolyte balance
NURSING MANAGEMENT
1. Promote measures to enhance body image.
• Take an honest gentle, caring approach;
encourage client to express and verbalize feelings
2. Promote measures that address preventing
complications of cancer therapy
3. Instruct client and family about the disease
process and treatments; provide necessary
information for self-care.
4. Help client and family cope effectively
5. Promote measures to reduce social isolation.
Care of Clients Receiving Chemotherapy
• Classes of Chemotherapy Drugs:
• Alkylating agents:
– Action: create defects in tumor DNA
– Ex: Nitrogen Mustard, Cisplatin
– Toxic Effects: reversible renal tubular necrosis
Classes of Chemotherapy Drugs
• Antimetabolites:
– Action: phase specific
– Ex: Methotrexate; 5 fluorouracil
– Toxic Effects: nausea, vomiting, stomatitis,
diarrhea, alopecia, leukopenia
Classes of Chemotherapy Drugs
• Antitumor Antibiotics:
– Action: non- phase specific; interfere with
DNA
– Ex: Actinomycin D, Bleomycin, adriamycin
(doxorubicin)
– Toxic Effect: damage to cardiac muscle
Classes of Chemotherapy Drugs
• Miotic inhibitors:
– Action: Prevent cell division during M phase
of cell division
– Ex: Vincristine, Vinblastine
– Toxic Effects: affects neurotransmission,
alopecia, bone marrow depression
Classes of Chemotherapy Drugs
• Hormones:
– Action: stage specific G1
– Ex: Corticosteroids
• Hormone Antagonist:
– Action: block hormones on hormone- binding
tumors ie: breast, prostate, endometrium; cause
tumor regression
– Ex: Tamoxifen (breast); Flutamide (prostate)
– Toxic Effects: altered secondary sex characteristics
Effects of Chemotherapy
• Tissues: (fast growing) frequently affected
• Examples: mucous membranes, hair cells,
bone marrow, specific organs with specific
agents, reproductive organs (all are fetal
toxic; impair ability to reproduce)
Chemotherapy Administration
• Routes of administration:
– Oral
– Body cavity (intraperitoneal or intrapleural)
– Intravenous
• Use of vascular access devices because of
threat
of extravasation (leakage into tissues) & long
term
therapy
Chemotherapy Administration
• Types of vascular access devices:
– PICC lines: (peripherally inserted central
catheters)
– Tunneled catheters: (Hickman, Groshong)
– Surgically implanted ports: (accessed with
90o angle needle- Huber needles)
Nursing care of clients receiving
chemotherapy
• Assess and manage:
– Toxic effects of drugs (report to physician)
– Side effects of drugs: manage nausea and
vomiting, inflammation and ulceration of mucous
membranes, hair loss, anorexia, nausea and
vomiting with specific nursing and medical
interventions
Nursing care of clientsreceiving chemotherapy
• Monitor lab results (drugs withheld if blood
counts seriously low); blood and blood
product administration
• Assess for dehydration, oncologic
emergencies
• Teach regarding fatigue, immunosuppression
precautions
• Provide emotional and spiritual support to
clients and families
COLON CANCER
 COLON CANCER
Risk factors
1. Increasing age
2. Family history
3. Previous colon CA or polyps
4. History of IBD
5. High fat, High protein, LOW fiber
6. Breast Ca and Genital Ca
 COLON CANCER
 Sigmoid colon is the most common site
 Predominantly adenocarcinoma

 If early 90% survival

 34 % diagnosed early

 66% late diagnosis

 COLON CANCER
PATHOPHYSIOLOGY
 Benign neoplasm DNA alteration
malignant transformation malignant
neoplasm  cancer growth and invasion 
metastasis (liver)
 COLON CANCER
 ASSESSMENT FINDINGS
1. Change in bowel habits- Most
common
2. Blood in the stool
3. Anemia
4. Anorexia and weight loss
5. Fatigue
6. Rectal lesions- tenesmus, alternating
D and C
 COLON CANCER
 Diagnostic findings
1. Fecal occult blood
2. Sigmoidoscopy and colonoscopy
3. BIOPSY
4. CEA- carcino-embryonic antigen
 COLON CANCER
 Complications of colorectal CA
1. Obstruction
2. Hemorrhage
3. Peritonitis
4. Sepsis
 COLON CANCER
 MEDICAL MANAGEMENT
1. Chemotherapy- 5-FU
2. Radiation therapy
 COLON CANCER
SURGICAL MANAGEMENT
Surgery is the primary treatment
Based on location and tumor size
Resection, anastomosis, and colostomy
(temporary or permanent)
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Colostomy begins to function 3-6 days after
surgery
 The drainage maybe soft/mushy or semi-solid
depending on the site
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 BEST time to do skin care is after shower
 Apply tape to the sides of the pouch before
shower
 Assume a sitting or standing position in
changing the pouch
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Instruct to GENTLY push the skin down and
the pouch pulling UP
 Wash the peri-stomal area with soap and
water
 Cover the stoma while washing the peri-
stomal area
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Lightly pat dry the area and NEVER rub

 Lightly dust the peri-stomal area with

nystatin powder
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Measure the stomal opening

 The pouch opening is about 0.3 cm larger

than the stomal opening
 Apply adhesive surface over the stoma and
press for 30 seconds
 COLON CANCER
NURSING INTERVENTION: COLOSTOMY CARE
 Empty the pouch or change the pouch
when
 1/3to ¼ full (Brunner)
 ½ to 1/3 full (Kozier)
 BREAST CANCER
 The most common cancer in FEMALES
 Numerous etiologies implicated
 BREAST CANCER
RISK FACTORS
1. Genetics
2. Increasing age ( > 50 yo)
3. Family History of breast cancer
4. Early menarche and late menopause
5. Nulliparity
6. Late age at pregnancy
 BREAST CANCER
RISK FACTORS
7. Obesity
8. Hormonal replacement
9. Alcohol
10. Exposure to radiation
 BREAST CANCER
PROTECTIVE FACTORS
1. Exercise
2. Breast feeding
3. Pregnancy before 30 yo
 BREAST CANCER
ASSESSMENT FINDINGS
1. MASS- the most common location is the
upper outer quadrant
2. Mass is NON-tender. Fixed, hard with
irregular borders
3. Skin dimpling
4. Nipple retraction
5. Peau d’ orange
 BREAST CANCER
LABORATORY FINDINGS
1. Biopsy procedures
2. Mammography
 BREAST CANCER
Breast cancer Staging
 I - < 2cm

 II - 2 to 5 cm, (+) LN

 III - > 5 cm, (+) LN

 IV- metastasis
 BREAST CANCER
MEDICAL MANAGEMENT
 1. Chemotherapy

 2. Tamoxifen therapy

 3. Radiation therapy
 BREAST CANCER
 SURGICAL MANAGEMENT
1. Radical mastectomy
2. Modified radical mastectomy
3. Lumpectomy
4. Quadrantectomy
LUMPECTOMY
QUADRANTECTOMY
 BREAST CANCER
NURSING INTERVENTION : PRE-OP
1. Explain breast cancer and
treatment options
2. Reduce fear and anxiety and
improve coping abilities
3. Promote decision making
abilities
4. Provide routine pre-op care:
 Consent, NPO, Meds, Teaching
about breathing exercise
 BREAST CANCER
NURSING INTERVENTION : Post-OP
1. Position patient:
 Supine

 Affected extremity elevated to reduce

edema
 BREAST CANCER
NURSING INTERVENTION : Post-OP
2. Relieve pain and discomfort
 Moderate elevation of extremity

 IM/IV injection of pain meds

 Warm shower on 2nd day post-op

 BREAST CANCER
NURSING INTERVENTION : Post-OP
3. Maintain skin integrity
 Immediate post-op: snug dressing with
drainage
 Maintain patency of drain (JP)

 Monitor for hematoma w/in 12H and apply

bandage and ice, refer to surgeon
 BREAST CANCER
NURSING INTERVENTION : Post-OP
3. Maintain skin integrity
 Drainage is removed when the
discharge is less than 30 ml in 24 H
 Lotions, Creams are applied ONLY when
the incision is healed in 4-6 weeks
BREAST CANCER
NURSING INTERVENTION : Post-OP
Promote activity
 Support operative site when moving

 Hand, shoulder exercise done on 2ndday

 Post-op mastectomy exercise 20 mins TID

 NO BP or IV procedure on operative site

BREAST CANCER

NURSING INTERVENTION : Post-OP

Promote activity
 Heavy lifting is avoided

 Elevate the arm at the level of the heart

 On a pillow for 45 minutes TID to relieve

transient edema
BREAST CANCER

NURSING INTERVENTION : Post-OP

MANAGE COMPLICATIONS
 Lymphedema

 10-20% of patients

 Elevate arms, elbow above shoulder

and hand above elbow
 Hand exercise while elevated

 Refer to surgeon and physical

therapist
BREAST CANCER

NURSING INTERVENTION : Post-OP

MANAGE COMPLICATIONS
 Hematoma

 Notify the surgeon

 Apply bandage wrap (Ace wrap) and ICE

pack
 BREAST CANCER
NURSING INTERVENTION : Post-OP
MANAGE COMPLICATIONS
Infection
 Monitor temperature, redness, swelling
and foul-odor
 IV antibiotics

 No procedure on affected extremity

 BREAST CANCER
NURSING INTERVENTION : Post-OP
TEACH FOLLOW-UP care
 Regular check-up

 Monthly BSE on the other breast

 Annual mammography
THE END
LUALHATI M. FLORANDA RN MAN