ATI MED Surge 2019 B - ATI focused review. Includes 3 topics: Brachytherapy for Cervical Cancer, Peripheral PDF

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ATI focused review. Includes 3 topics: Brachytherapy for Cervical Cancer, Peripheral Artery Disease, and Mastectomy. Each topic has an assessment, incidence and nursing implication. ...

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ATI MED SURGE 2019 B 1. Brachytherapy for Cervical Cancer a. Assessment i. I would assess the patient during therapy for any vaginal irritation, fatigue, nausea or diarrhea. Long term effects of brachytherapy could be seen as vaginal stenosis or vaginal dryness. I would also be careful with any excretions from the patient as they are also radioactive during therapy. b. Incidence i. Brachytherapy is a type of treatment commonly used for cervical cancer because it can be placed close to the cervix so that it receives radiation but is able to limit radiation to other surrounding tissues. c. Nursing implications i. I would ensure that the patient is in a private room with a sign warning of radiation. I would wear a lead apron when providing cluster care and would limit any visitors to 30 mins visits and have them stand 6 feet away from the patient. 2. Peripheral Artery Disease a. Assessment i. I will assess for burning or cramping in legs during exercises and pain that is relieved when legs are in a dependent position. I would also asses for a bruit over the femoral and aortic arteries, a decreased capillary refill in the toes, nonpalpable pulses, dry mottled skin and dependent redness of the extremity. b. Incidence i. PAD is an outcome of atherosclerosis and is the cause of Burgers disease, subclavian steal syndrome, thoracic outlet syndrome, Raynaud’s disease and popliteal entrapment. c. Nursing implications i. I would encourage the patient to walk around the unit to promote circulation. I would also do interventions that promote vasodilation for the patient like heating pads, insulated socks and a warmer environment. I would educate the patient to avoid caffeine and nicotine because these agents promote vasoconstriction 3. Mastectomy a. Assessment i. I would assess the patients drains for the first 1-3 weeks and I would look for signs of lymphedema. b. Incidence i. Breast cancer is the 2nd leading cause of cancer in the US. Breast cancer can easily metastases to bones, lung, brain or even liver. Mastectomy is the first line surgical intervention for breast cancer. c. Nursing implications

i. I would have the patient lay with the head of the bed at 30 degrees at all times and have their effected arm lying on a pillow. Educate the patient when walking to have effected arm in a sling while walking. I would know not to take blood pressure or take labs from the effected arm....