The Royal Marsden Manual of Cancer Nursing Procedures

The Royal Marsden is the world's first hospital dedicated to cancer diagnosis, treatment, research and education - a centre of excellence with an international reputation for ground-breaking research and pioneering the very latest in cancer treatments and technologies, as well as specialising in cancer diagnosis and education.

This companion volume to the internationally successful The Royal Marsden Manual of Clinical Nursing Procedures is designed to support practitioners who work specifically with oncology patients by providing detailed evidence-based procedures and rationale, and problem-solving guidance on all aspects of oncology nursing.

The Royal Marsden Manual of Cancer Nursing Procedures:

• Is organized and structured to represent the needs of the patient along their care pathway

• Provides the latest evidence underpinning all procedures

• Includes information on haematological procedures; pain assessment and management; wound care; oncological emergencies; and end-of-life care

• Gives detailed guidelines on supporting patients living with cancer with practical information on such things as benefits, exercise and nutrition.

The Royal Marsden Manual of Cancer Nursing Procedures is an invaluable, definitive resource for all those involved in the provision of cancer care and support to patients and their families.

Autorentext

Sara Lister RN, PGDAE, BSc(Hons), MSC, MBACP, The Pastoral Care Centre, The Royal Marsden NHS Foundation Trust, UK.

Lisa Dougherty OBE, RN, MSc, DClinP, Nurse Consultant Intravenous Therapy, The Royal Marsden NHS Foundation Trust, UK.

Assistant Editor: Louise McNamara, B.Nursing; MSc in Advancing Professional Healthcare Practice, UK.

Inhalt

Foreword xi

Acknowledgements xii

List of contributors xiii

List of abbreviations xv

Quick reference to the procedure guidelines xvii

How to use your manual xix

Introduction xxi

1 Diagnostic investigations 1

Overview 2

Diagnostic tests and investigations 2

Tumour markers 4

Cervical uterine smear 8

Diagnostic radioisotope procedures (nuclear medicine) 12

Transrectal ultrasound (TRUS) prostate biopsy 18

Flexible cystoscopy 24

Breast diagnostics 36

Clinical breast examination 38

Core biopsy 40

Breast fine-needle aspiration (FNA) 43

Breast punch biopsy 45

Nipple discharge smear 47

Genetic testing 48

Websites 52

References 52

Procedure guidelines for Chapter 1

1.1 Cervical uterine smear using liquid-based cytology 9

1.2 Unsealed radioactive sources for diagnostic investigations 16

1.3 Transrectal ultrasound (TRUS) prostate biopsy 21

1.4 Flexible cystoscopy 27

1.5 Flexible cystoscopy with stent removal 30

1.6 Flexible cystoscopy with bladder biopsy 32

1.7 Flexible cystoscopy with argon plasma coagulation (APC)/cystodiathermy 35

1.8 Clinical breast examination 38

1.9 Core breast biopsy 41

1.10 Breast fine-needle aspiration (FNA) 43

1.11 Breast punch biopsy 45

1.12 Nipple discharge smear 47

2 Haematological procedures 57

Overview 58

Bone marrow procedures 58

Aspiration and trephine biopsy 58

Bone marrow harvest 67

Apheresis 72

Ribavirin administration 80

Pentamidine isetionate administration 84

Websites 87

References 87

Procedure guidelines for Chapter 2

2.1 Bone marrow aspiration and trephine biopsy 64

2.2 Bone marrow harvest 68

2.3 Apheresis 76

2.4 Ribavirin administration 82

2.5 Pentamidine isetionate administration 85

3 Cancer pain assessment and management 91

Overview 92

Cancer pain assessment and management 95

Pain management 97

Acupuncture 104

Interventional techniques for managing complex cancer-related pain 107

Single nerve blocks and injections 108

Regional peripheral and plexus nerve blocks and infusions 108

Neuraxial (spinal) blocks: epidural and intrathecal analgesia 109

Entonox (nitrous oxide) administration 120

References 125

Procedure guidelines for Chapter 3

3.1 Acupuncture: preparation and administration 106

3.2 Epidural/intrathecal sensory blockade: assessment 114

3.3 Epidural/intrathecal exit site dressing change 115

3.4 Epidural/intrathecal catheter removal 115

3.5 Entonox administration 123

4 Administration of systemic anticancer therapies 131

Overview 132

Systemic anticancer treatment 132

Safe handling of hazardous drugs 133

Administration of cytotoxic medications by nurses 137

Intravenous administration of systemic anticancer therapy 138

Extravasation 142

Oral administration of systemic anticancer therapy 156

Intramuscular and subcutaneous administration of cytotoxic drugs 162

Topical application of cytotoxic drugs 164

Intrathecal administration of cytotoxic drugs 165

Intrapleural instillation of cytotoxic drugs 168

Intravesical instillation of cytotoxic drugs 169

Intraperitoneal instillation of cytotoxic drugs 172

Intra-arterial administration of cytotoxic drugs 173

Side-effects of chemotherapy 175

Haematological side-effects 176

Fatigue 176

Gastrointestinal side-effects 176

Adverse drug reactions 177

Neurotoxicity 177 ...