Nursing Care for Older Adults with Cancer

Nursing Considerations for Older Adults with Cancer

• Pain, reduced physical activity, malnutrition, sleep disturbance, irritation of oral cavity, risk for infection, disruption in family relationships, social isolation, inability to engage in meaningful activities, depression, grief, and need for information/education are possible nursing problems of patients with terminal cancer.

Polypharmacy and Interactions

• Polypharmacy is the use of multiple medications, which increases the risk of drug-food interactions.
• Cardiovascular agents, antihypertensive, analgesics, antiarthritic agents, sedatives, tranquilizers, laxatives, and antacids are commonly used medications in older adults.

Preventing Complications

• Monitor closely to minimize disability and prevent mortality.
• Assess to detect respiratory complications, including respiratory rate and volume, pulse, blood pressure, temperature, neck veins, patency of airway, cough, secretions, and mental status.

Ensuring Safe Oxygen Administration

• Use oxygen prudently to prevent carbon dioxide narcosis.
• Monitor blood gases and assess oxygen equipment.
• Ensure home oxygen safety and evaluate the home environment.

Promoting Productive Coughing

• Coughing is important for removal of secretions.
• Measures to promote productive coughing include hard candy to increase secretions, breathing exercises, use of humidifier, expectorants, and increase fluid intake.

Reducing Risks to Safety

• Restraints can lead to serious complications, such as aspiration, circulatory obstruction, cardiac stress, skin tears, ulcers, anorexia, dehydration, constipation, incontinence, and fractures and dislocations.
• Alternatives to restraints include placing clients in rooms near the nursing station, 1 to 1 supervision or companionship, electronic devices, repositioning, soothing communication, touch, comfort measures, frequent reality orientation, and reassurance.

Nutrition

• The elderly should ingest 1500 mls of fluid daily.
• Adequate intake is very important to prevent fatigue, weakness, and dizziness.

Vision and Hearing Aids

• Check if clients need glasses or hearing aids.
• Ensure hearing aids are turned on.

Mobility Limitations

• Eliminate clutter, poorly fitting shoes, and advise against taking risks like climbing ladders or sitting on ledges.

Preventing Infection

• Vaccines, such as influenza and pneumococcal, are important for older adults.

Safe Medication Use

• The Beers Criteria identify drugs that carry high risks for older adults and provide criteria for potentially inappropriate medication use.
• Medications act differently in older adults and require careful dosage adjustment and monitoring.

Cardiovascular Disease

• Hypertension, congestive heart failure, coronary artery disease, and hyperlipidemia are common cardiovascular diseases in older adults.
• Symptoms may be less evident in older adults, leading to delayed treatment.
• Education and promotion of cardiovascular health are important.

Terms to Know

• Polypharmacy, Beers Criteria, and geriatric-specific drug therapy are important terms to know.

Endocrine Function

• Diabetes mellitus, hypothyroidism, and hyperthyroidism are common endocrine disorders in older adults.
• Patient education and management are crucial for diabetes mellitus.

Care Plan Goals

• Goals for care plans include preventing complications, promoting health, and improving quality of life.