Clinical journal of oncology nursing
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Review
The use of oral transmucosal fentanyl citrate during high-dose-rate gynecologic brachytherapy.
Gynecologic brachytherapy is a form of cancer treatment in which radioactive sources are placed into the pelvic organs via specialized applicators. Traditional low-dose-rate (LDR) brachytherapy has been performed over several days in a hospital setting. ⋯ The purpose of this article is to discuss the use of oral transmucosal fentanyl citrate (OTFC) for the management of pain during gynecologic HDR brachytherapy. OTFC provides noninvasive, rapid analgesia with a low incidence of side effects and may be appropriate for other forms of procedure-related cancer pain.
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Review Case Reports
Understanding Lynch syndrome: implications for nursing.
Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the United States. Approximately 10% of CRC is hereditary, and hereditary nonpolyposis CRC (HNPCC), or Lynch syndrome I, is the most common form. Lynch syndrome I is characterized by onset at an early age, poor differentiation, predominance of proximal tumors, and an excess of synchronous and metachronous tumors. ⋯ Lynch syndrome is an inherited autosomal dominant disorder caused by a germline mutation in one of several genes responsible for DNA mismatched repair. Amsterdam I criteria, Amsterdam II criteria, and Bethesda guidelines are the international diagnostic criteria for Lynch syndrome. Nursing care for patients with Lynch syndrome includes identifying patients who would benefit from genetic counseling, providing education, and assessing and meeting patient psychosocial needs.
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Review
Chemotherapy-induced peripheral neuropathy: a review and implications for oncology nursing practice.
Advances in supportive care have increased the likelihood that previously less common adverse effects of chemotherapy will be more evident. The incidence of chemotherapy-induced peripheral neuropathy (CIPN) is increasing because more neurotoxic drugs have been developed and because patients are living longer and receiving multiple chemotherapy regimens. This article reviews the anatomy of the peripheral nervous system, the proposed mechanisms of CIPN, and manifestations of CIPN from vinca alkaloids, taxanes, and platinum analogs. Major topics of this article are evidence-based data regarding symptom management, a review of medical management, and a synthesis of nursing care for patients at risk for or experiencing CIPN.
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Anthracycline chemotherapy agents bind to DNA and cause cell death when they extravasate into healthy tissue. Although many approaches to managing extravasations have been studied and reported, data from two prospective clinical trials suggest that Totect (dexrazoxane for injection, TopoTarget USA, Inc.) is an effective anthracycline extravasation treatment. Only 1 of 54 patients with doxorubicin or epirubicin biopsy-confirmed extravasations treated with Totect developed tissue necrosis. Because nurses are on the forefront of extravasation prevention and management, they need to be knowledgeable about this new agent and how it is administered.