Types of Chemo and Radiation Therapy



TYPES OF CHEMO

- Chemotherapy id the use of antineoplastic agents with a primary action of interfering with the supply and utilization of building blocks of nucleic acids, as well as interfering with intact molecules of DNA and RNA, both needed for cellular metabolism, replication and growth. Problem in this method is that they lack specificity, resulting to attacks even with the normal cells (specially those normal cells that are rapidly proliferating, like cancer cells).



Side Effects and Nursing Management of
Different Types of Chemo

1. Nausea and vomiting – small frequent, high calorie, high potassium, high protein diet; foods should be easy to swallow; frequent mouth care; pleasant environment; or NGT, IV, hyperalimentation.

2. Stomatitis – soft toothbrushes, frequent mouth care; oral salt mouth gargle, avoid commercial mouthwash that contain high alcohol; avoid hot drinks or food; bland foods is best.

3. Alopecia – advise short hair before treatment; gentle combing, use wig or scarf when necessary; online nursing classes advises you to tell the client that hair will re-grow (but with altered texture, and possibly color).

4. Diarrhea – low residue diet; increase fluids; avoid hot or cold drinks and food

5. Infections – avoid uncontrolled crowds and sources of infection; balanced diet; skin care.



RADIATION THERAPY

1. External Radiation (cobalt or linear acceleration)

- series of daily radiation exposures as patient is left alone in a room.- Marks must not be removed during entire treatment course- Keep skin dry, cornstarch is the only topical application allowed- Talcum and lotions are contraindicated- Avoid: strong sunlight; extremes of temperature; tight constricting clothing; strong alcohol mouthwash; fatigue; crowded places

2. Internal Radiation

a. Sealed Internal Radiation (radium, indium, celsium)- sealed radiation source is placed in a cavity or adjacent to cancer

b. Unsealed Internal Radiation (radio-isotope/radionuclide)- source of radiation is given orally, intravenously or instilled in cavity



Principles of Internal Radiation Therapy

1. Time – the shortest possible (not more than 30 minutes per shift)

2. Distance – as far as possible (can spend more time at distance of 20 feet)

3. Shielding – protection lead apron



Nursing Considerations for Internal Radiation Therapy

- douche, enema, perineal prep, with foley catheter before insertion of cervical radium- flat position- Never handle radium directly, use long handles forceps- keep linen in room until source of radiation are completely accounted for- no exposure to pregnant and children- Isolate patient (private room)- radiation excreted in urine, saliva, perspiration, vomitus, and feces for 8 days in radioactive iodine, and 14 days in radioactive phosphorus- careful handling of gowns, feces, dressing, utensils, and linens- always use gloves, gowns- wear detection badge to determine exposure


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