Stromberg: deWit’s Medical-Surgical Nursing, 4th Edition
Chapter 8: Care of Patients With Cancer
Answer Guidelines for Think Critically
What are the characteristics of malignant cells that differ from those of normal cells?
Malignant cells are cancer; they invade the tissues and may break away and travel to distant
tissue sites in the body. Cancer cells do not behave like normal cells because of damage to their
DNA.
Identify carcinogens that you may be exposed to in your home or workplace. What can you do to
reduce your exposure and decrease the risk of cancer?
Common carcinogenic chemicals are pesticides, tobacco, asphalt, nitrates, and nitrites.
Exposure can be reduced by following directions carefully, using protective outerwear such as
gloves, and making sure not to ingest foods or drugs that are carcinogenic. Avoiding cooking
foods to a charred state helps reduce oncogenic potential. Being certain the area is well
ventilated when using chemical cleaners indoors is protective. Thoroughly washing the hands
and any exposed skin after using compounds containing carcinogenic chemicals provides
protection.
You are caring for a patient who has a history of type 2 diabetes and who has just been
diagnosed with cancer. What types and amounts of whole grains, fruits, and vegetables would
you advise the patient to eat?
A balanced diet with a glow glycemic index is best for cancer and diabetes. The
recommendations are:
Consider a 9" plate:
½ of the surface should be covered with vegetables, fruits and/or beans. These are fiber-
containing foods that slow stomach emptying, making them low in glycemic index.
¼ of the surface is covered by starches, such as rice or potatoes. These potentially have a
higher glycemic index, but with significant differences depending on the choices you
make.
¼ of the surface is covered by lean protein sources. Protein slows carbohydrate
absorption. Choose lower fat options and plant sources of fat, such as olive oil, to limit
saturated fats.
Identify three specific changes you could make in your personal diet and exercise program that
might decrease your risk for cancer? How would you change your diet and exercise plan?
Ingesting ascorbic acid with nitrates reduces risk. Reducing consumption of alcohol and tobacco
reduces risk. Stopping consumption of barbecued meat reduces risk. Reducing calories so that
obesity is reduced is also a good way to protect against cancer. Eating less meat and more fresh
fruits and vegetables is helpful. A regular exercise program can also reduce risk. The student’s
answer will vary based on their current level of activity.
Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Can you prepare a teaching plan for the care of the skin in a patient having external beam
radiation to the chest?
Use mild shampoos and soaps and avoid all lotions. Because the skin is very dry and sometimes
brittle, do not rub the skin. It is better to pat the skin dry. Also, do not soak for long periods in
the tub, as this can make the skin even drier. There are many skin products available specifically
for patients undergoing radiation therapy. These may be prescribed by the health care provider
and are useful in keeping the skin moist.
You came to work with a slightly scratchy throat and a drippy nose this morning. The charge
nurse has assigned you to a cancer patient who has bone marrow suppression. What would you
do in this situation?
Ask the charge nurse to assign you to activities where you will not come in contact with
immunosuppressed patients. Wear a mask and wash hands frequently during the day for all
other care activities assigned.
A patient with advanced cancer tells you that the long-acting opioid currently being taken for
pain control is not effective. How would you assess the patient’s level of pain? What can you
suggest to the health care provider to enhance the patient’s pain relief?
You should first approach the health care provider and ask for a time to discuss the patient, and
you should be prepared with specific details as to the pain level, location, and nature of the pain.
You need to discuss how often the patient asks for relief and state the behaviors the patient
exhibits, specifying why you think the patient’s regimen is not working and what would be an
acceptable pain level for the patient. You should be prepared with what will work, in case the
health care provider asks.
Copyright © 2021 by Elsevier, Inc. All rights reserved.
Chapter 8: Care of Patients With Cancer
Answer Guidelines for Think Critically
What are the characteristics of malignant cells that differ from those of normal cells?
Malignant cells are cancer; they invade the tissues and may break away and travel to distant
tissue sites in the body. Cancer cells do not behave like normal cells because of damage to their
DNA.
Identify carcinogens that you may be exposed to in your home or workplace. What can you do to
reduce your exposure and decrease the risk of cancer?
Common carcinogenic chemicals are pesticides, tobacco, asphalt, nitrates, and nitrites.
Exposure can be reduced by following directions carefully, using protective outerwear such as
gloves, and making sure not to ingest foods or drugs that are carcinogenic. Avoiding cooking
foods to a charred state helps reduce oncogenic potential. Being certain the area is well
ventilated when using chemical cleaners indoors is protective. Thoroughly washing the hands
and any exposed skin after using compounds containing carcinogenic chemicals provides
protection.
You are caring for a patient who has a history of type 2 diabetes and who has just been
diagnosed with cancer. What types and amounts of whole grains, fruits, and vegetables would
you advise the patient to eat?
A balanced diet with a glow glycemic index is best for cancer and diabetes. The
recommendations are:
Consider a 9" plate:
½ of the surface should be covered with vegetables, fruits and/or beans. These are fiber-
containing foods that slow stomach emptying, making them low in glycemic index.
¼ of the surface is covered by starches, such as rice or potatoes. These potentially have a
higher glycemic index, but with significant differences depending on the choices you
make.
¼ of the surface is covered by lean protein sources. Protein slows carbohydrate
absorption. Choose lower fat options and plant sources of fat, such as olive oil, to limit
saturated fats.
Identify three specific changes you could make in your personal diet and exercise program that
might decrease your risk for cancer? How would you change your diet and exercise plan?
Ingesting ascorbic acid with nitrates reduces risk. Reducing consumption of alcohol and tobacco
reduces risk. Stopping consumption of barbecued meat reduces risk. Reducing calories so that
obesity is reduced is also a good way to protect against cancer. Eating less meat and more fresh
fruits and vegetables is helpful. A regular exercise program can also reduce risk. The student’s
answer will vary based on their current level of activity.
Copyright © 2021 by Elsevier, Inc. All rights reserved.
, Can you prepare a teaching plan for the care of the skin in a patient having external beam
radiation to the chest?
Use mild shampoos and soaps and avoid all lotions. Because the skin is very dry and sometimes
brittle, do not rub the skin. It is better to pat the skin dry. Also, do not soak for long periods in
the tub, as this can make the skin even drier. There are many skin products available specifically
for patients undergoing radiation therapy. These may be prescribed by the health care provider
and are useful in keeping the skin moist.
You came to work with a slightly scratchy throat and a drippy nose this morning. The charge
nurse has assigned you to a cancer patient who has bone marrow suppression. What would you
do in this situation?
Ask the charge nurse to assign you to activities where you will not come in contact with
immunosuppressed patients. Wear a mask and wash hands frequently during the day for all
other care activities assigned.
A patient with advanced cancer tells you that the long-acting opioid currently being taken for
pain control is not effective. How would you assess the patient’s level of pain? What can you
suggest to the health care provider to enhance the patient’s pain relief?
You should first approach the health care provider and ask for a time to discuss the patient, and
you should be prepared with specific details as to the pain level, location, and nature of the pain.
You need to discuss how often the patient asks for relief and state the behaviors the patient
exhibits, specifying why you think the patient’s regimen is not working and what would be an
acceptable pain level for the patient. You should be prepared with what will work, in case the
health care provider asks.
Copyright © 2021 by Elsevier, Inc. All rights reserved.
