Multiple myeloma nursing interventions The function of the nurse is to assist the individual, sick or healthy, in all stages of life, contribution activities or health, or to unamuerte recovery quiet; understanding the person as a bio-psycho-social being and looking at it from a holistic perspective.
The five stages of the process are:
- Assessment: Consists of the collection of data concerning the person, family and environment.
- Diagnostic deenfermería: is the conclusion that occurs after the assessment.
- Planning: Develop the actions of prevention, minimization or correction of problems, and health promotion.
- Execution: It is the implementation of the planned actions.
- Evaluation; Determine if they have been achieved the objectives set., if not, go back to planning.
General support measures:
- Hydration (for prevention of kidney diseases), allopurinol (to prevent hyperuricemia), diet poor in calcium (to prevent the hypercalcemia).
- Measures of bone mineralization and mobilization: mobilization and ambulation of patients avoiding the bedridden and prolonged rest to counteract the bone mass loss is recommended. Avoid being overweight. Avoid violent efforts to avoid risk of pathological fractures. The administration of pamidronate (Aminomux) may be effective in patients with Multiple myeloma, decreasing bone fractures and helping to control the pain.
- Analgesia: Dull pain is the most common symptom in these patients. The best treatment is specific for the MM but it is advisable to add a pattern of strong analgesia while takes effect applied chemotherapy. In general, a combination of salicylates, and codeine is effective.
- An option to establish good is the application of high doses of chemotherapy with subsequent transplantation Autologous stem cell, which could eliminate one much larger proportion of cells mielomatosas., causing long-lasting remissions.
Nursing care
The care of nursing in patients with MULTIPLE MYELOMA is focused on:
- Education to the patient and his family in relation to disease and treatment.
- Self-management skills teaching to improve the quality of life
- Surveillance of the signs and symptoms of complications caused by the disease and the treatment.
- The coordination of the implementation of an interdisciplinary plan of care that meets these complications.
General nursing care to patients with cancer
It is common that in a terminal patient can exist multiple symptoms, that are changing, intense and its origin is due to multiple factors and that, in addition, cause in it a certain degree of incapacitation, worry and emotional impact.
The intensity of the symptoms depends on many factors that surround the patient as the company, affection, distraction, environment, etc. that can alter the perception and sensation of pain or other symptoms. In general, as the disease progresses, the number of symptoms and their intensity increases.
When family or medical personnel caring for the sick, not only help you deal with physical problems that prevent you to meet their basic needs (food, hygiene, hydration, sleep, etc.) they get to improve their quality of life and well-being.
General care of the patient must be adapted to their situation, prognosis and location and it is necessary to establish the priorities of the moment.
The most important general care are described below.
1. Skin care
Skin care is important both in the healthy person and the sick. In the final stages of life small alterations in the texture and skin resistance are fundamental for increasing the risk of appearance of certain alterations of it.
Dehydration, cachexia, the medication, the bedridden can cause from mild, although very annoying as the itching problems for dry skin, even problems more serious and difficult to treat such as pressure ulcers.
One of the most important lesions appearing in these patients are sores or pressure ulcers that are often caused by the prolonged ward.
These ulcers occur as a result of a pressure in certain areas on a more or less hard surface. Most frequent areas of occurrence of these lesions are on bony prominences such as ankles, heels, knees, pelvis and coccyx.
Once they appear these ulcers are difficult to treat, so it is essential to prevent them.
2. Feeding and hydration
It is frequent that in the situation in which the patient is anorexia or loss of appetite. When a patient is unable to feed and hydrate as it did before the disease generated, both in it and in his family, a State of anxiety and discomfort.
A common idea is that the family thinks that if it does not feed properly the patient will not have forces to fight against the disease. However, this is not so. The terminal patient does not need the same amount of food that a person heals, now that their activity has been significantly reduced and their needs also.
The family has to adapt to the symptom by facilitating and helping the sick in their feeding and moisturizing daily.
3. Evacuation
Due to the weakness of the patient, the lack of mobility and the use of certain pain medications is frequent that the patient present difficulty at the time of the evacuation of feces, resulting in a painful and stressful process for some patients.
4. Physical activity
The chances of the patient is frequently underestimated, and physical ability decrease involves a progressive loss of autonomy in the patient, which can generate both he and the family a degree of anxiety, discomfort and concern.
6. Sleep care
Sleep and rest are very important aspects since they allow a certain degree of recovery of fatigue of the patient.
The sleep disturbance is usually very common in this period of life. The causes giving rise to it are varied, from poor control of physical symptoms (headache, vomiting, fatigue, etc…) to problems of anxiety, anguish, fear and even the feeling of loneliness.