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PERAWATAN KANKER

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

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PERAWATAN KANKER

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  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. “AkarKata” • 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

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

  9. 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

  10. 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)

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

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

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

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

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

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

  17. 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

  18. 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

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

  20. 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

  21. DIAGNOSTIC 1. BIOPSY • The most definitive 2. CT, MRI 3. Tumor Markers

  22. GRADING The degree of DIFFERENTIATION • Grade 1- Low grade • Grade 4- high grade

  23. 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. • Stage IV: The cancer has spread to other parts of the body (distant metastasis).

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

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

  26. 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

  27. 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

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

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

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

  31. Nursing Intervention MANAGEMENT OF ALOPECIAAlopecia 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

  32. 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

  33. Nursing Intervention RELIEVE PAIN • Mild pain- NSAIDSModerate pain- Weak opiods • Severe pain- Morphine • Administer analgesics round the clock with additional dose for breakthrough pain

  34. Nursing Intervention DECREASE FATIGUE • Plan daily activities to allow alternating rest periods • Light exercise is encouraged • Small frequent meals

  35. 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

  36. 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

  37. 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

  38. Nursing Intervention MANAGE COMPLICATION: Septic shock • Monitor VS, BP, temp • Administer IV antibiotics • Administer supplemental O2

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