PERAWATAN KANKER. DEFINISI penyakit yang menyerang proses dasar kehidupan sel, mengubah genom sel (komplemen genetik total sel) dan menyebabkan penyebaran.

Presentasi berjudul: "PERAWATAN KANKER. DEFINISI penyakit yang menyerang proses dasar kehidupan sel, mengubah genom sel (komplemen genetik total sel) dan menyebabkan penyebaran."— Transcript presentasi:

1 PERAWATAN KANKER

2 DEFINISI penyakit yang menyerang proses dasar kehidupan sel, mengubah genom sel (komplemen genetik total sel) dan menyebabkan penyebaran liar dan pertumbuhan sel-sel. sebuah penyakit yang ditandai dengan pembagian sel yang tidak teratur dan kemampuan sel-sel ini untuk menyerang jaringan biologis lainnya, baik dengan pertumbuhan langsung di jaringan yang bersebelahan (invasi) atau dengan migrasi sel ke tempat yang jauh (metastasis). Pertumbuhan yang tidak teratur ini menyebabkan kerusakan DNA, menyebabkan mutasi di gen vital yang mengontrol pembagian sel, dan fungsi lainnya

3 “Akar Kata” Neo- raru Plasia-pertumbuhan Plasm- substance Trophy- ukuran +Oma- tumor/benjolan Statis- lokasi/regio

4 “Akar Kata” A- tidak/tidak ada Ana- kekurangan/ketiadaan Hyper- berlebihan/terlalu banyak Meta- perubahan/penyebaran Dys- kekurangan, kesakitan/nyeri

5 Karakteristik Neoplasia Pertumbuhan Sel Abnormal tidak Terkontrol 1. Benign  tumor jinak 2. Malignant  tumor ganas 3. Borderline  tumor jinak mengarah keganasan

6 Characteristics of Neoplasia BENIGN Well-differentiated Slow growth Encapsulated Non-invasive Does NOT metastasize

7 Characteristics of Neoplasia MALIGNANT Undifferentiated Erratic and Uncontrolled Growth Expansive and Invasive Secretes abnormal proteins METASTASIZES

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10 Nomenclature of Neoplasia Tumor is named according to: 1. Parenchyma, Organ or Cell Hepatoma- liver Osteoma- bone Myoma- muscle

11 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

12 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)

13 BENIGN TUMORS Suffix- “OMA” is used Adipose tissue- LipOMA Bone- osteOMA Muscle- myOMA Blood vessels- angiOMA Fibrous tissue- fibrOMA

14 MALIGNANT TUMOR Named according to embryonic cell origin 1. Ectodermal, Endodermal, Glandular, Epithelial Use the suffix- “CARCINOMA” Pancreatic AdenoCarcinoma Squamos cell Carcinoma

15 MALIGNANT TUMOR Named according to embryonic cell origin 2. Mesodermal, connective tissue origin Use the suffix “SARCOMA FibroSarcoma Myosarcoma AngioSarcoma

16 “PASAWAY” 1. “OMA” but Malignant – HepatOMA, lymphOMA, gliOMA, melanOMA 2. THREE germ layers – “TERATOMA” 3. Non-neoplastic but “OMA” – Choristoma – Hamatoma

17 Etiology of cancer 1. PHYSICAL AGENTS Radiation Exposure to irritants Exposure to sunlight Altitude, humidity

18 2. CHEMICAL AGENTS Smoking Dietary ingredients Drugs 3. Genetics and Family History Colon Cancer Premenopausal breast cancer

19 4. Dietary Habits Low-Fiber High-fat Processed foods Alcohol 5. Viruses and Bacteria DNA viruses- HepaB, Herpes, EBV, CMV, Papilloma Virus RNA Viruses- HIV, HTCLV Bacterium- H. pylori

20 6. Hormonal agents Pada beberapa penelitian diketahui bahwa pemberian hormon tertentu secara berlebihan dapat menyebabkan peningkatan terjadinya beberapa jenis kanker seperti payudara, rahim, indung telur dan prostat (kelenjar kelamin pria) 7. Immune Disease AIDS

21 Spread of Cancer 1. LYMPHATIC Most common 2. HEMATOGENOUS – Blood-borne, commonly to Liver and Lungs 3. DIRECT SPREAD – Seeding of tumors

22 PRTAHANAN TUBUH MELAWAN 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

23 DIAGNOSTIC 1. BIOPSY – The most definitive 2. CT, MRI 3. Tumor Markers

24 GRADING The degree of DIFFERENTIATION Grade 1- Low grade Grade 4- high grade

25 Cancer Staging 1. Uses the T-N-M staging system T- tumor N- Node M- Metastasis 2. Stage 1 to Stage 4 Stage 0: A small group of cancerous cells have been found in one location in the lung. Stage I: The cancer is only in the lung and has not spread anywhere else. Stage II: The cancer has spread to nearby lymph nodes. Stage III: The cancer has spread to more distant lymph nodes, and/or other parts of the chest like the diaphragm.diaphragm Stage IV: The cancer has spread to other parts of the body (distant metastasis).

26 CANCER NURSING GENERAL MEDICAL MANAGEMENT 1. Surgery- cure, control, palliate 2. Chemotherapy 3. Radiation therapy 4. Immunotherapy 5. Bone Marrow Transplant

27 CANCER NURSING GENERAL Promotive and Preventive Nursing Management 1. Lifestyle Modification 2. Nutritional management 3. Screening 4. Early detection

28 SCREENING 1. Male and female- Occult Blood, CXR, and DRE 2. Female- SBE, CBE, Mammography and Pap’s Smear 3. Male- DRE for prostate, Testicular self-exam

29 Nursing Assessment Utilize the ACS 7 Warning Signals CAUTION C- Change in bowel/bladder habits A- A sore that does not heal U- Unusual bleeding T- Thickening or lump in the breast I- Indigestion O- Obvious change in warts N- Nagging cough and hoarseness

30 Nursing Assessment Weight loss Frequent infection Skin problems Pain Hair Loss Fatigue Disturbance in body image/ depression

31 Nursing Intervention MAINTAIN TISSUE INTEGRITY Handle skin gently Do NOT rub affected area Lotion may be applied Wash skin only with SOAP and Water

32 Nursing Intervention MANAGEMENT OF STOMATITIS Use soft-bristled toothbrush Oral rinses with saline gargles/ tap water Avoid ALCOHOL-based rinses

33 Nursing Intervention MANAGEMENT OF ALOPECIA Alopecia begins within 2 weeks of therapy  Regrowth within 8 weeks of termination  Encourage to acquire wig before hair loss occurs  Encourage use of attractive scarves and hats  Provide information that hair loss is temporary BUT anticipate change in texture and color

34 Nursing Intervention PROMOTE NUTRITION  Serve food in ways to make it appealing  Consider patient’s preferences  Provide small frequent meals  Avoids giving fluids while eating  Oral hygiene PRIOR to mealtime  Vitamin supplements

35 Nursing Intervention RELIEVE PAIN  Mild pain- NSAIDS Moderate pain- Weak opiods  Severe pain- Morphine  Administer analgesics round the clock with additional dose for breakthrough pain

36 Nursing Intervention DECREASE FATIGUE  Plan daily activities to allow alternating rest periods  Light exercise is encouraged  Small frequent meals

37 Nursing Intervention IMPROVE BODY IMAGE  Therapeutic communication is essential  Encourage independence in self-care and decision making  Offer cosmetic material like make-up and wigs

38 Nursing Intervention ASSIST IN THE GRIEVING PROCESS  Some cancers are curable  Grieving can be due to loss of health, income, sexuality, and body image  Answer and clarify information about cancer and treatment options  Identify resource people  Refer to support groups

39 Nursing Intervention MANAGE COMPLICATION: INFECTION  Fever is the most important sign (38.3)  Administer prescribed antibiotics X 2weeks  Maintain aseptic technique  Avoid exposure to crowds  Avoid giving fresh fruits and veggie  Handwashing  Avoid frequent invasive procedures

40 Nursing Intervention MANAGE COMPLICATION: Septic shock  Monitor VS, BP, temp  Administer IV antibiotics  Administer supplemental O2