Clinical journal of oncology nursing
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Review Case Reports
Stevens-Johnson syndrome and toxic epidermal necrolysis: oncologic considerations.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe skin toxicities that may occur in patients with cancer. They are caused by infection or a drug reaction and can result in sepsis, severe ocular complications, and even death. Skin lesions usually are preceded by prodromal flulike symptoms. ⋯ The use of steroids is controversial. Healthcare professionals always should consider an early transfer to a burn unit for patients with a comorbid condition such as cancer because this action is associated with improved outcomes. Implications for oncology nurses and a case study are presented in this article.
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Concerns about suffering usually arise as patients contemplate end of life. For most, an array of available therapies will alleviate suffering. ⋯ As patients, families, and clinicians contemplate this option, controversies and concerns about hastening death, euthanasia, and limiting life-sustaining therapies can arise. This article explores some of these concerns.
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Patients with diffuse malignant pleural mesothelioma (DMPM) experience multiple symptoms from their disease and treatment, which can affect all aspects of their lives. Dyspnea, cough, pain, fatigue, depression, weight loss, anorexia, and cachexia are the most common symptoms. Early, ongoing assessment and management of these symptoms are imperative to maximize quality of life for patients with DMPM.
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Review
Why there is no cookbook approach to palliative care: implications of the P450 enzyme system.
A plethora of literature describes the impact of the P450 enzyme system, but this information is limited regarding its relevancy to nursing practice. However, oncology nurses providing palliative symptom management must have a working knowledge of the P450 enzyme system to recognize the variability that exists among individual medication reactions or why a "cookbook approach" to symptom management is not always effective and appropriate. This article describes the variations associated with medication metabolism with reference to ethnic differences. Having a basic understanding of the P450 enzyme system and, more specifically, the CYP2D6 influence on the metabolism of common medications used in palliative symptom management can help to prevent medication toxicity or underdosing, which interferes with patients' quality of life.
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Lung cancer is divided into two major histologic types: small cell lung cancer (SCLC) and non-small cell lung cancer. SCLC is rapidly progressive and, without treatment, may be fatal in as few as 12 weeks. ⋯ This article provides an overview of SCLC, including current treatment strategies for limited, extensive, and recurrent disease. By understanding the various traditional and emerging treatment modalities, nurses can better assess their patients and help to reduce potential SCLC treatment complications.