RESUMEN
When a parent dies from cancer, each surviving child faces unique grief and loss issues. Nurses play a major role in caring for the child whose parent has died or is expected to die from cancer. The nurse's responsibility begins with assessing the child's coping strategies, family environment, and community resources. All three components affect the child's ability to progress through the grief process. Early assessment may identify problematic grief reactions and facilitate a positive outcome. Interventions that facilitate the grieving process include involving the child and family in grief groups, providing individual counseling, providing adequate information, assisting the child in the creation of memory keepsakes, and encouraging normalcy within the family.
Asunto(s)
Adaptación Psicológica , Actitud Frente a la Muerte , Pesar , Neoplasias/psicología , Padres/psicología , Psicología Infantil , Adolescente , Factores de Edad , Niño , Preescolar , Consejo , Mecanismos de Defensa , Educación en Salud , Humanos , Lactante , Rol de la Enfermera , Evaluación en Enfermería , Enfermería Oncológica/métodos , Derivación y Consulta , Grupos de Autoayuda , Apoyo SocialRESUMEN
Ongoing diligent patient assessment is the most important step in the equianalgesic conversion process. The conversion must take into account individual patient characteristics such as age, renal function, side effects, and the patient's pain syndrome. In addition, if the opioid dose is not adequate to begin with, the conversion dose is less likely to be effective. In all situations, once the patient is converted, liberal titration and adjustment or individualized doses for each patient are required to ensure that the conversion transition is smooth and provides the patient with the analgesia needed to adequately manage the pain. Nurses play a major role in the assessment of patients receiving opioids for pain management. Inadequate pain management despite escalating doses, untoward side effects, loss of a route of administration, and sometimes cost and reimbursement issues necessitate an opioid conversion or rotation. Nurses also play a role in recommending the change and ensuring that patients receive the correct dose.
Asunto(s)
Analgésicos Opioides/administración & dosificación , Neoplasias/complicaciones , Dolor/tratamiento farmacológico , Dolor/etiología , Administración Cutánea , Administración Oral , Esquema de Medicación , Monitoreo de Drogas/métodos , Tolerancia a Medicamentos , Fentanilo/administración & dosificación , Humanos , Hidromorfona/administración & dosificación , Morfina/administración & dosificación , Evaluación en Enfermería , Oxicodona/administración & dosificación , Dolor/diagnóstico , Dimensión del DolorAsunto(s)
Neuropatías del Plexo Braquial/etiología , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/terapia , Carcinoma Ductal de Mama/complicaciones , Carcinoma Ductal de Mama/terapia , Anciano , Antineoplásicos/efectos adversos , Neuropatías del Plexo Braquial/diagnóstico , Neuropatías del Plexo Braquial/terapia , Diagnóstico Diferencial , Femenino , Síndrome de Horner/diagnóstico , Síndrome de Horner/etiología , Síndrome de Horner/terapia , Humanos , Mastectomía/efectos adversos , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Radioterapia/efectos adversosRESUMEN
PURPOSE/OBJECTIVES: To discuss the development and implementation of a culturally sensitive breast cancer outreach program focusing on early detection, screening, and education for Plains Indian women living in Montana and northern Wyoming. DATA SOURCES: Professional journals, government reports, culturally sensitive materials, and field experience. DATA SYNTHESIS: Perceptions about cancer, the prevalence of poverty and alcoholism, the traditional role of the Native American woman, and rural living influence breast health and breast cancer education for Plains Indian women. An outreach program was developed specifically for this population and included individualized education, distribution of culturally sensitive materials, culturally sensitive professional education, and train-the-trainer seminars. CONCLUSIONS: After years of working with Native American women, the percentages of mammograms and clinical breast examinations increased by more than 100%. IMPLICATIONS FOR NURSING PRACTICE: Nurses can bridge the cultural gap and work effectively with Native American women by building trust and being sensitive to cultural customs and related healthcare behaviors. Furthermore, this program provides a model that nurses can use to develop culturally sensitive breast health programs.
Asunto(s)
Neoplasias de la Mama/enfermería , Neoplasias de la Mama/prevención & control , Planificación en Salud , Indígenas Norteamericanos , Mamografía , Salud de la Mujer , Neoplasias de la Mama/etnología , Características Culturales , Atención a la Salud , Femenino , Humanos , Tamizaje Masivo , Montana , Educación del Paciente como Asunto , Pobreza , Población Rural , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología , WyomingRESUMEN
Neuropathic pain refers to syndromes that may be related to peripheral or central neural structure compression, infiltration, or damage. Cancer-related neuropathic pain results from compression or infiltration of nerves by the tumor, nerve trauma from operative procedures, or neuropathic pain related to cancer treatment. Management of neuropathic pain includes the use of opioids, antidepressants, anticonvulsants, local anesthetics, and other adjuvant medications. Intractable neuropathic pain may require the use of intraspinal delivery or anesthetic and neurosurgical procedures. The nurse practitioner plays an important role in the assessment and "trial and error" management of cancer-related neuropathic pain.
Asunto(s)
Neoplasias/complicaciones , Síndromes de Compresión Nerviosa/etiología , Dolor/etiología , Analgésicos/uso terapéutico , Humanos , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/terapia , Enfermeras Practicantes , Evaluación en Enfermería , Dolor/diagnóstico , Manejo del Dolor , Guías de Práctica Clínica como AsuntoRESUMEN
OBJECTIVE: To provide an overview of access devices and infusion pumps available for pain management. CONCLUSIONS: Pain still remains a significant problem in patients with cancer. Access devices and infusion pumps have expanded pain management options for patients unable to use simple routes for medication administration. When access devices are selected and used appropriately, pain relief can be accomplished safely. IMPLICATIONS FOR NURSING PRACTICE: Nursing assessment is essential to develop an effective pain management regimen. Because patients are the best source of information about their pain, the nurse is in an excellent position to determine if the placement and use of an access device could be useful in controlling a patient's pain.