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Clinical journal of oncology nursing [journal]
- Diagnosis and treatment of lymphedema in patients with breast cancer. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):E97-E101.
Lymphedema is a distressing consequence of breast cancer treatment affecting the patient in all domains of quality of life. Early identification and diagnosis are key to preventing long-term consequences. The goal of lymphedema management is to slow the progression and provide symptomatic relief to maintain quality of life. Preoperative education, intensive postoperative follow-up, and long-term survivorship care are important to minimize risk factors for developing lymphedema and to provide a mechanism for early detection, treatment, and patient self-care. An interdisciplinary approach, including nutritionists, physical therapists, psychologists, and advanced practice registered nurses (APRNs), is essential to provide a patient-centered approach to the management of lymphedema. APRNs are critical in providing comprehensive assessments, ongoing follow-up care, and patient education in self-care strategies.
- Ribavirin: the need for exposure precautions. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):E93-6.
Ribavirin is used in the treatment of respiratory syncytial virus (RSV) in high-risk patients, including patients who have undergone hematopoietic stem cell transplantation, to reduce mortality from RSV pneumonia. It is classified as a hazardous drug with potential for carcinogenicity and teratogenicity. Very few recent studies have examined the risk of exposure, and recommendations for exposure precautions are lacking. Administration should include the use of personal protective equipment and terminal cleaning of the patient room after each administration. This article examines ribavirin use among patients who have undergone hematopoietic stem cell transplantation and have RSV-related pneumonia and explores safety considerations for staff. Nursing leaders on a hematopoietic stem cell transplantation unit addressed gaps in knowledge about ribavirin therapy, and completed a review of the hospital's ribavirin policy, which led to policy revisions, increased knowledge about the safe administration of ribavirin, and improvements in staff and patient education.
- Essentials of oral oncolytics: developing a nursing reference. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):E88-92.
A convenience sample of oncology clinicians from 17 practices throughout the northeastern United States participated in roundtable discussions. Discussions about oral adherence were initiated in multiple practices, and attendees were asked to describe what resources they currently use and what resources are lacking. A need for a new tool for oral adherence in oncology was identified during roundtable discussions. Essential information about oral oncolytics in a user-friendly format that is rapidly accessible and organized would be an ideal nursing resource. Review of the literature demonstrated a lack of usable tools, with one exception that was outdated. Desire for an oral oncolytic resource was consistently mentioned. Additional suggestions for the resource included severe drug reactions, initial dosing and dosing adjustments, and how the drug should be taken. The clinicians wanted the information to be organized in a condensed chart that remains current as approvals continue. A condensed resource, the Essentials of Oral Oncolytics Guide (EOOG), was developed to address this need and includes guidelines for starting oral oncolytics, scheduling of patient monitoring, and pertinent need-to-know aspects of each oral oncolytic. The EOOG includes newly approved oral oncolytics and new indications as of December 2013.
- Louder than words. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):602.
Some nurses will say they didn't choose oncology … oncology chose them. When people ask what I do, their reaction to my response is usually the same: "I don't see how you can do that. It must be so depressing." However, if you were to ask my colleagues, the majority would agree that the rewards outweigh the heartaches.
- Screening for lung cancer. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):601.
To assess whether screening methods of the chest (sputum examinations, chest radiography, or computed tomography [CT] scanning) are effective in reducing lung cancer mortality.
- Nursing expertise and the evaluation of psychosocial distress in patients with cancer and survivors. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):598-600.
The number of cancer survivors in the United States will continue to grow because of improved screening, early detection practices, and advances in treatment. The cancer experience has a significant impact on the patient and his or her family, which increases the risk for psychosocial distress. Untreated distress experienced by a patient with cancer contributes to poorer treatment adherence, medical outcomes, and quality of life. To provide high-quality, safe patient care, oncology nurses must increase clinical expertise and knowledge. The current article provides an overview of clinical tools available for nurses to use when screening for distress in patients throughout the cancer care continuum.
- Malignant phyllodes tumor of the breast: a case study. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):595-7.
Malignant phyllodes tumors of the breast are rare, fast-growing tumors that can be difficult to diagnose. A case study is featured about a young adult patient who lacked insurance and received a delayed diagnosis of malignant phyllodes tumor of the breast. This article includes pertinent clinical and age-specific considerations for comprehensive management.
- Lactic acidosis in patients with cancer. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):592-4.
Lactic acidosis is the most common metabolic acidosis in hospitalized patients-the result from an underlying pathogenic process. To successfully manage lactic acid production, its cause needs to be eliminated. Patients with cancer have many risk factors for developing lactic acidosis, including the cancer diagnosis itself. Patients with lactic acidosis are critically ill, requiring an intense level of nursing care with accompanying frequent cardiopulmonary and renal assessments. The mortality rate from lactic acidosis is high. Therefore, appropriate nursing interventions may include end-of-life and palliative care.
- Exploring different types of hatha yoga for patients with cancer. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):586-90.
Yoga has been practiced for more than 5,000 years and is based on the collective experiences of yoga practitioners over time. Western countries and sophisticated medical facilities use this practice as a complementary therapy with standard medical treatments. Yoga has been shown to improve quality of life. Several types of yoga potentially can benefit people with cancer, including Hatha yoga. The type of recommended Hatha yoga is dependent on the physical conditions and fitness level of patients. This article explores the impact of different types of Hatha yoga on various cancer-related symptoms in patients with cancer. The article also provides guidelines for healthcare personnel-particularly nurses-to help choose the right kind of Hatha yoga that suits their patients' needs and interests. Additional information is provided on measures and instructions that are essential for healthcare providers to know before recommending any yoga type to their patients. Evidence of the feasibility and potential efficacy of yoga for patients with cancer is provided.
- 5-Fluorouracil toxicity and dihydropyrimidine dehydrogenase enzyme: implications for practice. [Journal Article]
- Clin J Oncol Nurs 2014 Oct 1; 18(5):581-5.
5-fluorouracil (5-FU) is a fluorinated pyrimidine analog, which is commonly used in combination chemotherapy for treating solid tumors. Dihydropyrimidine dehydrogenase plays an important role in catabolism and clearance of 5-FU. Any alteration in that sequence of enzymatic activity can lead to toxicity and even death in some patients. The most common loss of a functional allele of the dihydropyrimidine gene is the splice-site mutation c.1905+1G>A, which leads to deficiency of the enzyme. However, because of the small percentage of the population in which the deficiency occurs, routine screening is not recommended, and commercial testing is costly. Treatment measures for 5-FU toxicity are mainly supportive, including palliation of symptoms. Good patient assessment and education are imperative to early treatment of 5-FU-induced toxicity. Advanced oncology practitioners and oncology nurses should thoroughly educate patients and their caregivers on both the common and adverse side effects of 5-FU-based therapy and when it may be necessary to immediately contact their healthcare provider.