The Nursing clinics of North America
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During the last decade, significant advancements have been made in supportive care of neutropenic patients with cancer, including broad-spectrum antimicrobial agents and hematopoietic growth factors. Despite these achievements, infection continues to be the major cause of morbidity and mortality in patients with cancer because of alterations of normal host defenses. Because infection in patients with immunocompromised cancer is a potentially life-threatening situation, it is imperative that clinicians have optimal knowledge of therapeutic interventions directed toward the prevention, detection, and treatment of infection. Furthermore, the clinician should have basic knowledge about the pathophysiology of febrile neutropenia.
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Malignant pleural effusion, an abnormal accumulation of fluid in the intrapleural space, is a common complication of cancer resulting in debilitating symptoms including dyspnea, pain, and fatigue. The goal of treatment is aimed at symptomatic control, relief and control of dyspnea, and obliteration of the intrapleural space to prevent reaccumulation of pleural fluid. Treatment options include chemotherapy, radiation, intrapleural instillation of sclerosing agents, indwelling pleural catheters with intermittent drainage, pleuroperitoneal shunts, and pleurectomy. Therapeutic approaches used in the management of malignant effusions must be directed at maintaining or improving the quality of life for the individual.
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Fatigue is a commonly reported and observed symptom among patients at the University of Texas M. D. ⋯ Caring for patients with this debilitating symptom is a major challenge. The nurse practitioner in the Fatigue Clinic has a special role in the management of these patients.