NRS-410V Benchmark – Nursing Process: Approach to Care Solved

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be pu

blished within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Benchmark – Nursing Process: Approach to Care

Cancer is a body’s condition that is characterized by uncontrollable multiplication of body cells that spread across the body rampantly. These cells can be originally normal body cells that mutate into an abnormal cell that rapidly divides and invades other body cells and tissues. They can also be foreign cells introduced to the body that rapidly divide and attack other body cells and tissues. Cancer is a major contributor of mortality in the modern age due to the increasing change in lifestyle and technological advancements (Miller et al., 2019).The National Cancer Institute (NCI) has been on the leading foot in the studies about cancer. From various studies, this institute has come up with diagnosis and staging strategies based on the behavior of the cancer cells. The purpose of this paper is to define cancer including its diagnosis and staging, complications and effects of its treatment, and factors contributing to high cancer mortality rates. In addition, the nursing process will be applied in providing holistic nursing care to cancer patients.

Cancer Diagnosis and Staging

Depending on the location of the cancer or suspected cancer, the symptoms may vary. Some symptoms however are common in cancers, and some of these symptoms include a lump developing under the skin that can be seen or felt as an area of thickening, changes in skin integrity such as the development of non-healing sores, skin yellowing, bladder and bowel changes in habits and fatigue among others (Koo et al., 2019). Once the symptoms are indicative of an existing malignancy, confirmatory diagnostic tests are conducted. These include imaging tests, lab tests and biopsy. For lab tests, various aspects of human body samples are analyzed including body fluids such as blood and urine. A full blood count can indicate an irregular number of white blood cells or an unusual type especially in leukemia (National Cancer Institute, 2019). Blood samples can also indicate tumor markers. Tumor markers are usually produced by cells responding to the presence of cancer or by cancer cells themselves. Cancer cells however produce a higher amount of tumor markers as compared to normal cells. Higher levels of tumor markers are indicative of a malignancy.

Imaging tests include an MRI and a CT scan. Imaging tests can clearly show the body organs and abnormal growths or tumors. A nuclear scan is also an imaging test that can be used in diagnosis. For this scan, a radioactive material

s injected into the blood stream for computerized imaging (Koo et al., 2019). A bone scan can also be used to indicate bone cancers or metastasis to the bones. Radioactive material collects over the areas of bone abnormalities known as the hotspots. X-rays, PET scans, and ultrasounds are other imaging scans that can be used in diagnosing cancer. The final method of diagnosing cancer is through a biopsy. Taking biopsies is the most accurate method of diagnosing cancer. This is because biopsies are indicative of the type of cells within the area of sample collection.

There are three types of biopsies, the fine needle aspirate which involves using a needle to withdraw samples from a tissue or from body fluids. It is common for prostrate, breast, spinal taps, liver, and bone marrow aspirations. The other types are incisional biopsy which involves the removal of a small sample of the affected tissue and sending it to the lab for studies. The other type is an excisional biopsy, where the entire affected mass is excised and used for diagnosis. Biopsies offer a definitive diagnosis for cancer including the type of cells affected and the metastasis.

Staging tells how advanced the cancer is. For staging, roman numerals are used. Stage zero (0) means there is no actual cancer development, but there is a potential for cancerous development. This is also called a carcinoma in situ. A stage I means the cancer is not vastly developed and is stuck to one location. The synonym for stage I is early stage cancer. Stages II and III indicate that the cancer has metastasized to the lymph nodes and surrounding tissue (National Cancer Institute, 2019). A stage IV is the terminal stage of cancer that is irreversible even with treatment. The cancer has advanced and metastasized to other body tissues causing irreversible damage. It is also termed metastatic cancer.

The staging process incorporates the TNM system that stands for tumor, node and metastasis. Each of these is assigned values and if the specific measurement cannot be determined, an “X” is used instead. The T which stands for tumor indicates the size of the tumor given the range of 0-4. T0 means the tumor is below measureable limit. The greater the value of the T, the larger the tumor is (Rosen & Sapra, 2020). The N that represents the node is accompanied by the values 0-3, indicating the extent of lymph node involvement. The last one is metastasis that is accompanied by either 0 or 1 indicating it has either spread to other parts of the body, or it has not.

Cancer Complications and Treatment Side Effects and Methods to Lessen the Side Effects

Some of the most common cancer complications include general endocrine disorders. Some cancer cells emulate the original body cells and perform an excess of their original function. An example is hypercalcemia that is experienced in case of a malignancy. Hypercalcemia can occur due to failure of the kidneys to effectively get rid of excess calcium due to malignant disease (Koo et al., 2019). It can also occur due to a malignancy affecting the bones causing them to leak excess calcium into the blood stream. Another example is inappropriate antidiuretic syndrome characterized by an excess in the production of antidiuretic hormone. This is common in malignancies that emulate pituitary gland function and lead to an excessive production of antidiuretic hormones.

Another complication of cancer is hematologic disorders. These include anemia, which may be induced by the suppression of normal cell production by a tumor (Koo et al., 2019). The third complication is gastrointestinal complications. These are more common in cancers that affect the GIT. These complications include abdominal pains, GI bleeding, and indigestion among others.

Cancer treatments possess various side effects. These include nausea and vomiting, hair loss (Alopecia), delirium, loss of appetite, thrombocytopenia, urinary incontinence, lymphedema, infertility, fatigue, thrombocytopenia etc. (Centers for Disease Prevention and Control [CDC] Breast Cancer, 2019). The physical and psychological effects of cancer and its treatment can be regulated. The physical effects can be managed using pharmacological methods. An example is the use of antiemetics to reduce nausea and vomiting. Lifestyle changes including dietary changes can also be effective in the management of GI symptoms. Psychological management is also important in managing psychological cancer effects. These patients are usually vulnerable and suffer psychological torture based on the weight of the disease. These patients require constant reassuring. They need to be indulged in activities that draw their mind off the impending diagnosis.

Factors Contributing to Incident and Mortality Rates of Various Cancers in America

Cancer is a common cause of mortality in America. This is because of the current lifestyle based on technological advancements. The feeding habits also act as a major contributor. Cheap foodstuff in America is mostly junk food found in fast food outlets and restaurants. These predispose this population to cancers raising the prevalence (Siegel et al., 2021). Familial history of cancers is also high in America. Most of the cancer patients inherited the condition from their bloodline. The high mortality rates experienced in America due to cancer are due to the increase in prevalence of cancer.

Studies however indicate that smoking rates in America have reduced b 11% which effectively reduces the rates of lung cancer significantly. Alcohol intake has however increased by 0.6% increasing the risks of liver disease and associated GIT cancer. The rates of obesity and associated risk factors have been increasing over the years and this increases the prevalence of cancer. The National Cancer Institute (2021) outlines ageing as a risk factor for cancer development. This is because ageing cells are prone to mutations and escape of normal cell development regulations. America, the ageing population is significantly high, increasing the incidence of cancer. This explains the surge in cancer cases experienced in America.

The American Cancer Society

The American cancer society (ACS) is a large widely recognized organization that offers healthcare and support services to cancer patients. They also provide educational services and information regarding cancer, its diagnosis, treatment and management. This organization can offer educational services especially during group therapy sessions. They can offer the patients a platform to express their experiences and then offer them important information regarding cancer (ACS, 2018). They also have a helpline that can be used as a source of offering educational services. When inquiries are made, they can offer additional education that tallies with the queries asked. I would recommend the breast cancer support groups as they help empower the women who feel have lost everything once they contract breast cancer (ACS, 2018). The connecting with survivors group is also an important service that can help motivate other cancer patients that they can lead a normal life even after battling cancer. It provides an essential psychological support for these patients.

Utilization of the Nursing Process across the Life Span

Cancer management can utilize the nursing process effectively. From the assessment, where the nurse evaluates the presenting symptoms, does the physical exam to come up with their diagnosis. The nurse also takes note of the patient’s complaints and uses these clusters of cues to come up with a nursing diagnosis. The primary focus of the assessment is to find out what is ailing the patient both physically and psychologically. This is what makes the care holistic. After outlining the cluster of cues, the nurse can come up with a list of nursing diagnoses that help prioritize the care (Semachew, 2018). Each nursing diagnosis originates from an actual problem based on the previous assessment or potential problems that may originate. The nurse uses this information to come up with strategies of managing actual problems and preventing the occurrence of potential problems.

This is followed by planning. For this, the nurses come up with goals that they need to achieve during the care of cancer patients. The outcome criteria indicate the expected result if the goals have been achieved (Semachew, 2018). The implementation phase follows the planning phase. Here, actual execution of the plan is conducted. The nurses perform the interventions they had planned for with a rationale for the interventions. This means each intervention has a reason for its implementation.

Lastly, the nurses evaluate the effectiveness of their interventions by checking the patient’s outcome. If the goals are unmet, the nurse starts the process over again to correct the hitches that prevented the achievement of the goal (Semachew, 2018). The target is patient well-being holistically and this requires a series of management strategies, explaining the need for the utilization of the nursing process in patient management.

Contribution of Liberal Arts and Science Studies to Nursing Knowledge

Studying liberal arts as an undergraduate has many advantages to the nursing field. This is because mathematics increases the capability of an individual to accurately give statistics as required. In the nursing field, statistics are an important phenomenon. Social sciences are important as they improve an individual’s communication skills and improve their basic social skills (Kooken & Kerr, 2018). This will be especially helpful in interacting with the patients and fellow healthcare workers. Nurses who take liberal arts have a greater capacity for critical thinking and decision making. Finally, the nurses also gain the capacity to view the society in a broader way and understand social and cultural diversities in the provision of care. This is what promotes holistic patient care.

Science studies equip the nurses with the knowledge about body processes. This gives them the ability to understand the pathophysiology of disease processes and how to effectively manage them (Kooken & Kerr, 2018). Science studies also equip nurses with the emerging treatment strategies and equip them with the scientific knowledge to conduct research on the effectiveness of such treatment strategies and their side effects.

Conclusion

Over the years, studies have been conducted to come up with the most appropriate management strategies for cancer. The main reason why the existing remedy or cancer treatment is not effective for all cancers is that cancerous cells keep changing their configuration. The nurses are tasked with offering palliative care to patients who are suffering from stage 4 cancer. This requires empathy and understanding. It is also important to incorporate psychological support to the patient and family during their care. This is what holistic nursing care entails. Incorporating liberal and science studies in nursing has been instrumental in improving the communication skills, changing the approaches to patient care and providing scientific knowledge to nurses is instrumental in the management of cancer.

References

American Cancer Society. (2018). ACS Patient Programs and Services. Cancer.org; American Cancer Society. https://www.cancer.org/treatment/support-programs-and-services.html

CDC BreastCancer. (2019, October 30). Side Effects of Cancer Treatment. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/survivors/patients/side-effects-of-treatment.htm

Gegechkori, N., Haines, L., & Lin, J. J. (2017). Long-Term and Latent Side Effects of Specific Cancer Types. Medical Clinics of North America, 101(6), 1053–1073. https://doi.org/10.1016/j.mcna.2017.06.003

Koo, M. M., Swann, R., McPhail, S., Abel, G. A., Elliss-Brookes, L., Rubin, G. P., & Lyratzopoulos, G. (2019). Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. The Lancet Oncology. https://doi.org/10.1016/s1470-2045(19)30595-9

Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing, 34(1), 60–64. https://doi.org/10.1016/j.profnurs.2017.07.002

Miller, K. D., Nogueira, L., Mariotto, A. B., Rowland, J. H., Yabroff, K. R., Alfano, C. M., Jemal, A., Kramer, J. L., & Siegel, R. L. (2019). Cancer treatment and survivorship statistics, 2019. CA: A Cancer Journal for Clinicians, 69(5). https://doi.org/10.3322/caac.21565

National Cancer Institute. (2019). Diagnosis and Staging. National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/diagnosis-staging

National Cancer Institute. (2021, April 2). Cancer Statistics – National Cancer Institute. Www.cancer.gov. https://www.cancer.gov/about-cancer/understanding/statistics#:~:text=These%20trends%20show%20that%20progress

National Cancer Institute. (2021, May 5). What Is Cancer? National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/understanding/what-is-cancer

Rosen, R. D., & Sapra, A. (2020). TNM Classification. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553187/

Semachew, A. (2018). Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017. BMC Research Notes, 11(1). https://doi.org/10.1186/s13104-018-3275-z

Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2021). Cancer Statistics, 2021. CA: A Cancer Journal for Clinicians, 71(1), 7–33. https://doi.org/10.3322/caac.21654

The scourge of cancer has been increasingly affecting the patients, their families, and even the community at large. Its prevalence has been increasing, the effects are increasingly being experienced and reported, and the healthcare burden has been worrisome. The global incidence of cancer was 23.6 million as of 2021 with 10 million deaths occurring annually worldwide making it the second leading cost of death in the world only bested by cardiovascular deaths (Sung et al., 2021). The United States is not exempted from these impacts with the annual new cases being approximately 1.75 million and estimated deaths being 0.6 million annually (Cancer data and statistics, 2022). In addition, the affected patients also develop psychosocial effects and physical impacts of the disease that might be debilitating. Due to these high burdens of cancers, the healthcare systems have conducted studies to help in understanding the etiologies of cancer, the reasons for increasing healthcare burden related to disease, and even the preventive healthcare strategies that can be employed in reducing the burden. The objective of this paper is to provide insight into cancer by describing how it is diagnosed and staged, complications arising during its treatment, and the roles that nurses perform in managing cancers.

Cancer Diagnosis and Staging

Diagnosis

Cancer can either be diagnosed at routine screening or during the diagnosis. The screening tests are preferred by the healthcare stakeholders because it guides in the early detection of cancer before it manifests and is therefore associated with a better outcome of care. In contrast, diagnostic tests are employed to identify specific cancer when the patient has presented with the signs and symptoms suggestive of certain cancer. Diagnosis, therefore, begins with history taking and physical evaluation of the patient whose results will guide the specific diagnostic tests to order for. For instance, patients who present with chronic cough and hemoptysis with a history of cigarette smoking can be diagnosed with lung cancer as opposed to another who presents with hematuria, flank pain, and flank mass who would be diagnosed with renal cell cancer (Koo et al., 2020). In either of these cases, the diagnostic tests done are different. These tests can however be broadly considered as imaging studies, laboratory tests, and histological tests.

The laboratory tests that have been employed in cancer diagnosis utilizes specimen such as those that have been collected through biopsy. During the assessment, the structures of the collected samples are compared with the normal structures to identify any abnormalities at the cellular (cytological) or tissue (histological) levels (Wilkinson, 2021). Given the advancements in diagnosis, there is a recent application of molecular studies in the diagnosis of cancers where the molecular characteristics of the oncogenic cells can be identified through immunohistochemistry or flow cytometry to not only help in the qualitative diagnosis of specific cancer but also quantification of the oncogenic cells (Sung et al., 2021). The biopsy and visual tissue inspection are the gold standards for the diagnosis of cancer given the high cost and unavailability of molecular studies. The molecular studies are however more accurate.

Imaging studies complement the laboratory studies in the diagnosis of cancers. They help in structural visualization and may guide in assessing the local effect of cancer or even its spread. Some of the imaging tests include CT scan, colonoscopy, esophagoduodenoscopy (OGD), MRI, and PET scans. During some of these imaging studies, targeted specimen collection can be done for the affected structures thus increasing the yield of the specimen (Koo et al., 2020). Incorporating both laboratory and imaging studies in cancer diagnosis is encouraged as it promotes accuracy in diagnosis.

Staging

After the diagnosis of cancer has been made, the oncologist helps with the cancer staging to explain the extent of its spread and determine its prognosis. Different staging classification has been in use although most of them are done based on the size of the tumor (T), the number of nodes involved in tumor spread (N), and the presence of metastasis of the tumor to the local or distant structures (M). These TNM staging that employs the three parameters is further subdivided into stages I, II, III, and IV where stage I signifies a disease that is limited locally without metastasis as opposed to stage IV which is advanced cancer with metastasis to the other structures (Padilla-Leal & Medina-Franco, 2019). The stage IV tumor has a poor prognosis and may only be addressed palliatively as compared to stage I which has a better prognosis.

Other staging classifications are dependent on the system affected by the tumor and may be based on other parameters. These stagings include the International Federation of Gynecology and Obstetrics (FIGO) staging for cancers gynecologic cancers, Manchester staging employed for breast cancer, and the Ann-Arbor staging system for lymphomas and leukemias (Sung et al., 2021). Either of these staging criteria helps in determining the severity of cancer, and its prognosis and may therefore influence the choice of therapy to be employed.

Complications resulting from Cancer, Side Effects of Drugs Used, and Methods that can be Employed in Reducing the Physical and Psychological Impacts of Cancer

Cancer Complications

The complications related to cancer can either result from cancer itself or the adverse effects of medications that are used in its treatment. Most of these complications usually present late although their symptoms depend on the affected organs. The organ-specific complications include increased intracranial pressure in brain tumors, jaundice and ascites in liver cancers, hydronephrosis in stage 3 cervical cancer, and anemia due to cancers of the bone marrow (Koo et al., 2020). In contrast, the systemic complications are usually unrelated to the cancers and may include malnutrition, cachexia, and infections. Malnutrition in cancer usually results due to reduced food intake or increased nutrient demand due to the cancer-mediated hypermetabolic state (Jairam et al., 2019). The reduced weight in malnutrition is therefore different from cachexia in which it is due to increased production of cytokines such as tumor necrosis factors that encourage. Malnutrition is responsible for reduced immunity, in addition, to the myelosuppression due to cancer that reduces the leucocyte levels in the body (Padilla-Leal & Medina-Franco, 2019). These impacts of cancer complications would increase the risk of infections.

Side Effects of Drugs used in Cancer Treatment

Chemotherapeutic drugs pose risks to the organs they act on and even other systems due to their toxicity. The drugs especially cell cycle nonspecific agents usually affect the cell cycle of normal body cells thus resulting in their adverse effects. These adverse effects that occur regardless of the agent type include myelosuppression, tumor lysis syndrome, fatigue, mucositis, and hair loss. Myelosuppression, in which the drug suppresses the bone marrow, is responsible for reduced production of blood cells and therefore presents as anemia, increased risks of infections, and bleeding tendencies in patients who are on care (Jairam et al., 2019). Tumor lysis syndrome, on the other hand, occurs especially in the treatment of cancers with high cell turnovers such as leukemias and lymphoma because the increased cell destruction causes electrolyte imbalances such as hyperkalemia, hyperuricemia, and hypercalcemia that may then affect other systemic functions (Nurgali et al., 2018). Organ-specific effects are usually due to toxicity and are also specific to the agents used such as hemorrhagic cystitis, pulmonary toxicity, and cardiotoxicity in patients on cyclophosphamide, bleomycin, and doxorubicin respectively (Sung et al., 2021). These side effects can be addressed by discontinuing the therapy and lowering the drug doses, before managing the complications that the patients present with. For instance, blood transfusion and administration of granulocyte-macrophage colony-stimulating factor (GM-CSF) may be appropriate for myelosuppression whereas adequate hydration and administration of allopurinol are indicated for the management of tumor lysis syndrome (Prieto-Callejero et al., 2020). They should therefore be anticipated, diagnosed promptly, and addressed appropriately to minimize the adverse impact on the patients.

Nursing Interventions to Minimize Physical and Psychological Impacts of Cancer

The physical complications of cancer and the effects of its treatment as well as the consequential psychological impacts should be addressed appropriately to improve patients’ wellbeing. Some of the interventions employed for managing these effects include the administration of analgesia, teaching the patients on relaxation techniques, and even meditation to help them relieve the pain they experience (Tuominen et al., 2019). Family education can also be done to promote their involvement in patient care, improve the psychosocial support system and therefore address psychological effects such as loneliness and depression that are experienced by neglected cancer patients (Wilkinson, 2021). Further, the patients may be linked with social support groups and other healthcare professionals such as nutritionists and clinical psychiatrists to provide other necessary social support and healthcare services (Tuominen et al., 2019). These interventions will strengthen the patient’s physical and psychological status thereby enhancing the outcome of care.

Reason for the Increasing Yearly Incidence and Mortality for Various Cancers in the US.

CDC (2022) reports that there is an upward trend in the incidence and mortality rates of cancer in the US with 0.6million deaths and 1.6million new cases reported annually. It further projects the new cases to rise by up to 49% by 2050 which is approximately a 2.2million new cases annually, especially in the aging population. Some studies suggest that this trend is a consequence of the increasing size of the aging population and lifestyle changes (You & Henneberg, 2018). The lifestyle change includes an increased sedentary lifestyle, more cases of cigarette smoking and alcohol use as well as increased incidences of implicated infections.

Advanced age is a risk factor for most cancers because the aging process is associated with increased cellular damage and decreased effectiveness of repair mechanisms thus more risk of accumulation of defective cells (Koo et al., 2020). This predisposes individuals to cancers. The increased aging population which has quadrupled from 4.1% in 1900 to 16% in 2019 may therefore explain the increased incidences of cancer (Abeliansky et al., 2020).

The sedentary lifestyle that has increasingly led to obesity is also implicated in the upwards trend. Obesity is a risk factor for endometrial, colorectal, and breast cancers, and thus increased incidence of obesity to 41.9% in 2020 up from 30.5% 20 years earlier may be responsible for the increase in the incidences of these cancers (Sung et al., 2021). On the other hand, increased cases of cigarette smoking may have led to increased incidences of laryngeal, lung, throat, and oral cancers in which cigarette smoking is a risk factor. Further, for the cancers which are associated with infections such as Epstein Bar Virus (EBV) and nasopharyngeal cancer, and Burkitt’s lymphoma, increased cases of EBV especially in low socioeconomic status may result in increased incidences of the related cancers (Wilkinson, 2021).

Strategies that address the factors that are responsible for the increased incidences and mortality rates of cancer may guide in reducing both the new cases and their related mortality. Individuals should be encouraged to adopt physical exercise, nutritional modifications, and other weight reduction measures to prevent obesity (Koo et al., 2020). They should also be encouraged to reduce alcohol use and avoid cigarette smoking. Further, healthcare strategies such as screening for infection and prompt treatment of patients may also be adopted (Wilkinson, 2021).

American Cancer Society Education and Support

Patient education is a key component of the fight against cancer. The American Cancer Society is a supporting group that is a non-profit organization (NGO) that contributes to the fight against cancer by offering patient education. Their mode of education is by using flyers and brochures to enlighten the public on cancer prevention measures and encourage them to adopt routine screening and early diagnosis (Prieto-Callejero et al., 2020). Through this enlightenment, the organization prevents disinformation that is responsible for delays in health-seeking by the public.

I noticed that the organization has not been involved in financial support for the patients or research institutions. My recommendation is therefore that they offer financial support to the cancer patients to assist with transport and purchase of drugs, therefore, improving their adherence to therapy sessions. Further, financing research will improve knowledge on how to prevent cancers and treat the patients effectively.

Nursing Processes that are Applied in the Care of Cancer Patients

Management of cancer patients requires a multidisciplinary approach. The nurses are therefore engaged in the care process through their nursing processes including the assessment, diagnosis, planning, implementation, and evaluation (ADPIE). When the patient reports to the facility, the nurses can provide an initial assessment that would help in making the nursing diagnosis that guides patient care (Wilkinson, 2021). The implementation process includes administration of prescribed drugs, monitoring of patient’s vitals, and cooperation with other healthcare professionals during patient management (Jairam et al., 2019). The nurses may also engage in patient education that would increase the acceptance of the diagnosis and enhance their adherence to therapy.

Contributions to the Undergraduate Education in Liberal Arts and Science

Holistic care of the patients not only requires the understanding of medical knowledge but also an understanding of other patient factors that may influence patient care. Liberal art and sciences help the nurses to incorporate other patient-specific characteristics such as their racial factors and socioeconomic status during the care process. Training the nurses in these fields, therefore, equip them with knowledge and skills that they can apply in predicting how socioeconomic factors or the geographical origin of the patient affects their disease presentation and outcome of care (Abeliansky et al., 2020). It may also help the nurses to modify these characteristics to improve the outcome of care.

Conclusion

Cancer is a malady that has been increasing in incidence and impact due to the increased size of the aging population and lifestyle changes. Early diagnosis and screening may help in better management of patients and prevention of cancer complications although the side effects and toxicity of the chemotherapeutic agents should also be considered and appropriately managed. Among the interventions that the nurses can employ include family education and pain management to promote the physical and psychological well-being of the patients. Their care process should incorporate the knowledge of liberal arts and sciences to promote holistic care for cancer patients.

References

Abeliansky, A. L., Erel, D., & Strulik, H. (2020). Aging in the USA: similarities and disparities across time and space. Scientific Reports, 10(1), 14309. https://doi.org/10.1038/s41598-020-71269-3

Cancer. (2022, June 7). Cdc.gov. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm

Cancer data and statistics. (2022, June 2). Cdc.gov. https://www.cdc.gov/cancer/dcpc/data/index.htm

Jairam, V., Lee, V., Park, H. S., Thomas, C. R., Jr, Melnick, E. R., Gross, C. P., Presley, C. J., Adelson, K. B., & Yu, J. B. (2019). Treatment-related complications of systemic therapy and radiotherapy. JAMA Oncology, 5(7), 1028–1035. https://doi.org/10.1001/jamaoncol.2019.0086

Koo, M. M., Swann, R., McPhail, S., Abel, G. A., Elliss-Brookes, L., Rubin, G. P., & Lyratzopoulos, G. (2020). Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study. The Lancet Oncology, 21(1), 73–79. https://doi.org/10.1016/S1470-2045(19)30595-9

Nurgali, K., Jagoe, R. T., & Abalo, R. (2018). Editorial: Adverse effects of cancer chemotherapy: Anything new to improve tolerance and reduce sequelae? Frontiers in Pharmacology, 9, 245. https://doi.org/10.3389/fphar.2018.00245

Padilla-Leal, K. E., & Medina-Franco, H. (2019). The eighth edition of the American Joint Committee on Cancer staging system: are we getting closer to the ideal classification for gastric cancer? Annals of Translational Medicine, 7(Suppl 1), S52. https://doi.org/10.21037/atm.2019.03.05

Prieto-Callejero, B., Rivera, F., Fagundo-Rivera, J., Romero, A., Romero-Martín, M., Gómez-Salgado, J., & Ruiz-Frutos, C. (2020). Relationship between chemotherapy-induced adverse reactions and health-related quality of life in patients with breast cancer. Medicine, 99(33), e21695. https://doi.org/10.1097/MD.0000000000021695

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660

Tuominen, L., Stolt, M., Meretoja, R., & Leino-Kilpi, H. (2019). Effectiveness of nursing interventions among patients with cancer: An overview of systematic reviews. Journal of Clinical Nursing, 28(13–14), 2401–2419. https://doi.org/10.1111/jocn.14762

Wilkinson, A. N. (2021). Cancer diagnosis in primary care: Six steps to reducing the diagnostic interval. Canadian Family Physician Medecin de Famille Canadien, 67(4), 265–268. https://doi.org/10.46747/cfp.6704265

You, W., & Henneberg, M. (2018). Cancer incidence increasing globally: The role of relaxed natural selection. Evolutionary Applications, 11(2), 140–152. https://doi.org/10.1111/eva.12523

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Important information for writing discussion questions and participation

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Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
Student paper example
Citing Sources
The Writing Center is a great resource

Cancer is one of the health problems that are facing a significant proportion of population in America and the rest of the world. The morbidity and mortality rate due to cancer is significantly high. The existing statistics shows that about 1806590 new cases of cancer were diagnosed in America in 2020. The population was most likely to be diagnosed with the leading types of cancers that included breast, lung, prostate, and colon and rectum cancers. The national data shows that about 43% of cancers diagnosed in the US in 2020 were colorectal, lung and prostate cancers. Nurses play an important role in the prevention and management of cancer. Nurses educate the population about the risk factors, signs and symptoms, diagnosis and importance of early treatment. Nurses also educate the public about the preventive strategies for the most common types of cancers that effect the population. Therefore, this essay examines cancer and its management using the nursing process approach. The paper examines topics that include diagnosis and staging of cancer, complications, factors contributing to the yearly incidence, role of the American Cancer Society in supporting cancer patients and utilization of nursing process in cancer management.

Diagnosis and Staging of Cancer

Diagnosis of cancer utilizes both subjective and objective assessments. The subjective assessments focus on the symptoms that patients with cancer present with to the hospital. Patients with suspected cancer presents to the hospital with a myriad of signs and symptoms. The signs and symptoms include bone pain, weight loss, fatigue, fever, changes in the skin, sores or wounds that do not heal, hoarseness that do not respond to common treatments unusual bleeding, anemia, and difficulties in passing urine in men among others. Comprehensive history taking is therefore essential to come up with an accurate diagnosis of the specific cancer that the patient might be suffering from during a clinical visit. Objective assessments are utilized in the diagnosis of cancer. The objective assessments include observation, percussion, auscultation, and palpation. There is also the utilization of clinical investigations such as lab works, imaging tests and biopsy. Laboratory investigations show whether there is an elevation or reduction in biomarkers for cancers. Imaging tests that are utilized in the process include CT scans, X-rays, bone scan, nuclear scan, and MRI scan (Hinds & Linder, 2020). Tissue biopsy is also done to provide an accurate assessment and diagnosis of cancer.

Staging of cancer occurs once one is diagnosed with the disease. Staging is important to enable the determination of the most effective aggressive treatment that can be adopted to slow the spread of cancerous cells. Staging of cancer can be done using a number of approaches. One of the approaches is the TNM staging system. The TNM staging system focuses on the tumor size, number of lymph nodes affected by cancer, and if the cancerous cells have metastasized or not. The classification based on tumor is measured as TX (tumor cannot be measured), T0 (tumor cannot be found), and T1, T2, T3, and T4 to represent the size of the main tumor, with the high the T number implying more growth of tumor cells to the surrounding tissues. The classification based on regional lymph nodes is measured as NX(cancer in surrounding lymph nodes not measurable), NO (there is no cancer in surrounding lymph nodes), N1, N2, and N3 to demonstrate spread of cancerous cells to the surrounding lymph nodes. The diagnoses based on metastasis is denoted as follows; MX (metastasis not measurable), M0 (cancer has not metastasized) and M1 (cancer has metastasized) (Charnay-Sonnek & Murphy, 2019).

The other way of staging cancer adopts the stage 0 to IV approach. In this approach, stage 0 cancer implies the presence of abnormal cells but not metastasized, stage I,II, and III implying presence of cancer, with the higher the number the larger the size of tumors and metastasize. Stage IV implies that cancer has metastasized to distant body parts (Hinds & Linder, 2020).

Complications of Cancer

Cancer is associated with a number of complications. One of them is cardiac tamponade. Cardiac tamponade occurs due to the compression of the cardiac muscle secondary to fluid accumulation in the pericardiac sac. The compression of the myocardium by the accumulated fluids lead to inadequate cardiac filling in the diastole phase of cardiac cycle, hence, reduced stroke volume. Breast cancer, leukemia, lymphoma, and lung cancer are associated with this complication (Russo et al., 2018). The other complication of cancer is increased intracranial pressure. Increased intracranial pressure is attributable to the rise in the volume of meninges and skull. The cause of increased intracranial pressure is metastasis of cancer cells to the brain. Often, patients with breast and lung cancer experience this type of complication. The last complication of cancer is spinal cord compression. Spinal cord compression may arise due to the encroachment of neoplasm in the epidural space of the spinal cord. The risk of this complication is high in patients with cancers associated bone metastasis (Warnakulasuriya & Greenspan, 2020).

Side Effects of Treatment and Methods of Lessing Side Effects

Cancer treatment is also associated with side effects. Cancer treatments such as chemotherapy are associated with side effects that include fatigue, alopecia, infection, anemia, constipation, diarrhea, nausea and vomiting, and weight changes. Patients may also experience additional side effects such as bladder and urine changes, peripheral neuropathy, fertility problems, and changes in sexual function and libido. The use of treatment approaches such as radiotherapy is associated with side effects that include dry mouth, gum sores, hair loss, tooth decay, lymphedema, and difficulty in swallowing (Wright, 2019).

The above physical and psychological effects of cancer treatment can be lessened with the adoption of a number of interventions. For instance, the gastrointestinal side effects of the treatment can be lessened by increasing fluid intake, drinking fluids between meals, and taking anti-diarrheal medications. Interventions such as taking tart fruits, chilled foods, cleaning mouth before eating, and using seasonings may be adopted to address the issue of changes in sense of taste. Interventions such as use of relaxation techniques, eating small but frequent meals, avoiding foods that are hard to digest, and resting after meals may be used to manage nausea and vomiting. The psychological effects of hair loss can be managed by using wigs or wearing hats, linking patients to social support programs, and avoiding excessive combing of the hair (Wright, 2019).

Factors Contributing to the Yearly Incidence and Mortality Rates of Cancer in Americans

A number of factors contribute to the yearly incidence and mortality rates of cancer in Americans. One of the factors is the increased predisposition of the population to the modifiable risk factors for cancer. Accordingly, the majority of the American population engages in lifestyle and behavioral factors that increase their risk of developing cancers. An example is the high rate of smoking among the population that increases the risk of lung and throat cancer in the population. Lung cancer has been named the leading type of cancer diagnosed among the Americans due to the effect of modifiable factors such as smoking (Nipp et al., 2018). The second factor contributing to the yearly incidence of cancer in Americans is poor uptake of cancer screening services among the population. The effective management of cancer is achieved if the disease is diagnosed in its early stages. Early diagnosis of cancer depends largely on the health seeking habits of the population. Poor uptake of the cancer screening services translates into delayed diagnosis and poor prognosis in cancer treatment. Factors such as stereotypes and cultural influences on the utilization of cancer screening services contribute to yearly incidence as well as mortality rate of cancers in America (Hong et al., 2018; Rees et al., 2018). The last factor that contributes to the yearly mortality rate of cancer in America is the cost of treatment. Cancer treatment is expensive for patients and their significant others. According to Yabroff et al., (2019), the yearly incidence of mortality due to cancer in America is attributable to challenges in access to and affordability of cancer care. As seen from the study by Allcott et al., (2019), financial burden of cancer treatment leads to poor adherence to treatment regimen, hence, the high rate of mortality in cancer patients. Therefore, embracing responsive strategies could prevent early mortalities among cancer patients due to the effect of cost burden to them.

Role of American Cancer Society

The American Cancer Society (ACS) may provide the support that cancer patients and their significant others require in managing the disease. Firstly, ACS provides cancer patients and their significant others support that include free transportation and lodging to patients seeking specialized treatment in distant locations. The aim of these services is to reduce the cost burden and psychological effects of cancer treatment. ACS also provides patients and their significant others resourceful information that can guide the in making informed decisions about the treatment options. The organization provides educational resources that have accurate information about the different approaches to cancer treatment that patients may explore for the effective management of the disease. The organization also links patients to national resources that they can utilize for the effective management of cancer. For example, patients benefit from social services, support groups, and wigs and prostheses to manage the psychological impacts of the disease. ACS also has an online community where cancer patients share their experiences with the disease and practical tips of lessening the impacts of the disease (ACS, n.d.). The online community empowers patients with interventions to improve their health and wellbeing.

I would recommend a number of services offered by ACS to cancer patients and significant others. One of the services is the online community. Cancer patients should join the online community to get the psychological support that they need by learning from the experiences of other patients. The other service is support with products for lessening the physical impacts of cancer. This includes encouraging the patients to seek support in supply of mastectomy and hair loss products to minimize the psychological impacts of the disease. The other service is breast cancer support where patients can talk with trained professionals and breast cancer survivors to gain the needed social and emotional support in managing the disease (ACS, n.d.).

Utilization of the Nursing Process

The nursing process can be utilized to provide safe and effective care for cancer patients across the life span. The nursing process can be used to develop, implement, monitor, and evaluate the effectiveness of treatments to cancer patients. In the assessment phase, the nurse should aim at obtaining both subjective and objective data concerning the health status and needs of the patients. Nurses perform comprehensive history taking and patient assessment to identify the actual and potential health needs of cancer patients. Nurses use the information from patient assessment to plan the care that cancer patients need. Nurses use the information to develop actual and potential nursing care plans that will guide the administration of treatment, monitoring and evaluation (Charnay-Sonnek & Murphy, 2019). The implementation of the nursing care plans follows where nurses the prioritized nursing diagnoses are addressed to meet the critical needs of the patients. The nurses monitor the patients following the implementation process to determine the response of patients to treatment alongside the need for additional treatments and adjustments. The last phase in the nursing process, evaluation, is done to determine whether the adopted interventions were effective in meeting the care needs of the patients or not (Hinds & Linder, 2020). Through this approach, patients receive high quality, safe and patient-centered care.

Undergraduate Education in Liberal Arts and Science

Undergraduate education in liberal arts and science contributes to foundation of nursing knowledge and prepares nurses to work with patients utilizing nursing process. Education in the above areas develops the desired creative and critical thinking among nursing students, which is important in nursing care. Nurses learn the skills of using carefully thought processes of addressing the needs of their patients. The education in the above areas also increases the level of awareness on the complex needs of patients and the need for the utilization of structured approaches in nursing care. For instance, the education in liberal arts and science opens their understanding about the importance of other aspects of care such as culture and religion, hence, their consideration in the nursing care and process. Lastly, the education in the above areas makes the nursing students to have knowledge and skills to address all issues in nursing and health (Kooken & Kerr, 2018). The students become all-rounded in addressing health-related issues affecting their diverse populations.

Conclusion

In summary, the diagnosis of cancer utilizes both subjective and objective assessment methods. Staging of cancer is important in determining the effective treatments for patients. Cancer and its treatment are associated with significant complications. Interventions to lessen the complications and side effects of the treatment should be explored. The American Cancer Society provides critical resources that benefit cancer patients. Therefore, education in liberal arts and sciences is important to enable students understand the ways in which the needs of cancer patients can be meet efficiently.

References

ACS. (n.d.). How We’re Providing Support. https://www.cancer.org/about-us/what-we-do/providing-support.html

Allcott, N., Dunham, L., Levy, D., Carr, J., & Stitzenberg, K. (2019). Financial burden amongst cancer patients treated with curative intent surgery alone. The American Journal of Surgery, 218(3), 452–456. https://doi.org/10.1016/j.amjsurg.2019.01.033

Charnay-Sonnek, F., & Murphy, A. E. (2019). Principle of Nursing in Oncology: New Challenges. Springer.

Hinds, P. S., & Linder, L. (2020). Pediatric Oncology Nursing: Defining Care Through Science. Springer Nature.

Hong, Y.-R., Tauscher, J., & Cardel, M. (2018). Distrust in health care and cultural factors are associated with uptake of colorectal cancer screening in Hispanic and Asian Americans. Cancer, 124(2), 335–345. https://doi.org/10.1002/cncr.31052

Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing, 34(1), 60–64. https://doi.org/10.1016/j.profnurs.2017.07.002

Nipp, R. D., Sonet, E. M., & Guy, G. P. (2018). Communicating the Financial Burden of Treatment With Patients. American Society of Clinical Oncology Educational Book, 38, 524–531. https://doi.org/10.1200/EDBK_201051

Rees, I., Jones, D., Chen, H., & Macleod, U. (2018). Interventions to improve the uptake of cervical cancer screening among lower socioeconomic groups: A systematic review. Preventive Medicine, 111, 323–335. https://doi.org/10.1016/j.ypmed.2017.11.019

Russo, A., Novo, G., Lancellotti, P., Giordano, A., & Pinto, F. J. (2018). Cardiovascular Complications in Cancer Therapy. Springer.

Warnakulasuriya, S., & Greenspan, J. S. (2020). Textbook of Oral Cancer: Prevention, Diagnosis and Management. Springer Nature.

Wright, J. L. (2019). Toxicities of Radiation Treatment for Breast Cancer: Risks and Management Strategies. Springer.

Yabroff, K. R., Gansler, T., Wender, R. C., Cullen, K. J., & Brawley, O. W. (2019). Minimizing the burden of cancer in the United States: Goals for a high-performing health care system. CA: A Cancer Journal for Clinicians, 69(3), 166–183. https://doi.org/10.3322/caac.21556