Concept map for Osteosarcoma PDF

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Nursing concept map for osteosarcoma ...

Description

Risk Factors/Medical History: Osteosarcoma peaks at age 15 during growth spurts & is more common in boys than girls. Ewing’s sarcoma occurs prior to 30 years of age and is more common in Caucasian clients than other races (ATI, 2016). Increased risk of developing osteosarcoma include previous Tx with radiation therapy, other bone disorders, such as Paget’s disease of bone & fibrous dysplasia, and certain inherited or genetic conditions, including hereditary retinoblastoma, Bloom syndrome, LiFraumeni syndrome, Rothmund-Thomson syndrome & Werner syndrome (Mayo, 2019)

Potential Medications for this problem & Pt home meds:

Diagnostic Tests (Purpose/Preparation):

Tx typically involves chemotherapy, surgery, and radiation therapy when severe. Provider’s will choose Tx options based on the location the osteosarcoma begins, the size, the type & grade of the osteosarcoma, and if the cancer has metastasized (Mayo, 2019). Often most used medications are Methotrexate (given in high doses along with leucovorin to prevent SE), Doxorubicin, Cisplatin, Epirubicin, Iflosfamide, Cyclophosphamide, Etoposide, Gemcitabine. Admin. of pain meds as ordered are also used (opioid & non-opioid), and antiemetics to Tx N/V.

Physical examination to better understand symptoms; imaging tests (helps to investigate S/S & spreading): X-ray, CT scan, MRI, PET, bone scan. Biopsy (removing a sample of abnormal cells to determine if cancerous and the grade): needle biopsy, surgical biopsy (excisional or incisional) (Mayo, 2019).

Pathophysiology (Admitting DX) Osteosarcoma-The etiology of bone cancer is unknown. One belief is that

Nursing Interventions & Collaborate Care

osteosarcoma develops due to fast and irregular bone growth & remodeling provoked by an oncogenic agent during cell proliferation and/or growth. For this reason, it is believed to occur more commonly in the long bones of children/adolescents. When a bone tumor develops, it disrupts either the osteolytic (destruction) or the osteoblastic (growth) process within the bone. Osteosarcoma are linked with the synthesis of osteoid or immature malignant bone cells; and are often detected where bone grows quickly (near ends of long bones in distal femur, proximal tibia, and/or proximal humerus) (Hoffman & Sullivan, 2017).

Pain: 1) Pain assessment-provides a baseline and is an indicator of effective/ineffective pain management. (2) Admin. of pain medication as ordered-pain is extensive & requires pharmacological intervention. (3) Teach how to take pain analgesic meds as ordered-pain management is essential to promote independent functioning & monitor for SE (Hoffman & Sullivan, 2017).

Signs/Symptoms: The following S/S may be present primarily at the tumor site: swelling, redness, pain worse with motion & unrelieved by rest, fracture, and decreased ROM (Hoffman & Sullivan, 2017). Other symptoms include bone injury or bone break for no understood reason (Mayo, 2019).

Potential Complications: Cancer that metastasizes, adaptation to limb amputation, and long-term Tx side-effects (Mayo, 2019). Other complications after surgery include delayed wound healing, osteomyelitis, wound infections, and hypercalcemia (Hoffman & Sullivan, 2017).

Mobility: 1)Assess level of activity, exercise, & independent function-independence vs dependence is a potential problem for PT’s with bone-cancer. (2) Support & position affected extremities with gentle ROM exercises-bone tumors weaken bone, causing extreme pain on movement. (3) Apply thermal therapy-hot & cold thermal therapy can reduce pain & increase functionality (Hoffman & Sullivan, 2017). Injury: 1) Assess extremity for type of surgery, condition/healing of stump, types of bandages/cast- provides info about the type of care needed. (2) Reassure the child that

feelings of anger, denial, and hostility are normal following such a loss-promotes acceptance. (3)Teach PT about the disease List 3 Potential Nursing Problems: process, symptoms management, onset & course of injury & illness-Understanding of process will help with early diagnosis Acute/chronic pain, impaired physical mobility,disease Risk for & Tx of potential re-occurrence of injury osteosarcoma (Hoffman & Sullivan, 2017).

Created by Noraky/Armstrong

Reference Hoffman, J. H., & Sullivan, N.J., (2017). Medical-surgical nursing: Making connections to practice. Philadelphia, PA: F.A. Davis Company Martin, P. (2019, April 10). 4 Osteogenic Sarcoma (Osteosarcoma) Nursing Care Plans. Retrieved March 25, 2020, from: https://nurseslabs.com/4-osteogenic-sarcoma-osteosarcoma-nursing-care-plans/4/ Rudd, K. & Kosisko, D. (2019). Pediatric Nursing: The Critical Components of Nursing. (2nd ed.). Philadelphia, PA: F.A. Davis....