Details

<p>Foreword xi</p> <p>Acknowledgements xii</p> <p>List of contributors xiii</p> <p>List of abbreviations xv</p> <p>Quick reference to the procedure guidelines xvii</p> <p>How to use your manual xix</p> <p>Introduction xxi</p> <p><b>1 Diagnostic investigations 1</b></p> <p>Overview 2</p> <p>Diagnostic tests and investigations 2</p> <p>Tumour markers 4</p> <p>Cervical uterine smear 8</p> <p>Diagnostic radioisotope procedures (nuclear medicine) 12</p> <p>Transrectal ultrasound (TRUS) prostate biopsy 18</p> <p>Flexible cystoscopy 24</p> <p>Breast diagnostics 36</p> <p>Clinical breast examination 38</p> <p>Core biopsy 40</p> <p>Breast fine-needle aspiration (FNA) 43</p> <p>Breast punch biopsy 45</p> <p>Nipple discharge smear 47</p> <p>Genetic testing 48</p> <p>Websites 52</p> <p>References 52</p> <p>Procedure guidelines for Chapter 1</p> <p>1.1 Cervical uterine smear using liquid-based cytology 9</p> <p>1.2 Unsealed radioactive sources for diagnostic investigations 16</p> <p>1.3 Transrectal ultrasound (TRUS) prostate biopsy 21</p> <p>1.4 Flexible cystoscopy 27</p> <p>1.5 Flexible cystoscopy with stent removal 30</p> <p>1.6 Flexible cystoscopy with bladder biopsy 32</p> <p>1.7 Flexible cystoscopy with argon plasma coagulation (APC)/cystodiathermy 35</p> <p>1.8 Clinical breast examination 38</p> <p>1.9 Core breast biopsy 41</p> <p>1.10 Breast fine-needle aspiration (FNA) 43</p> <p>1.11 Breast punch biopsy 45</p> <p>1.12 Nipple discharge smear 47</p> <p><b>2 Haematological procedures 57</b></p> <p>Overview 58</p> <p>Bone marrow procedures 58</p> <p>Aspiration and trephine biopsy 58</p> <p>Bone marrow harvest 67</p> <p>Apheresis 72</p> <p>Ribavirin administration 80</p> <p>Pentamidine isetionate administration 84</p> <p>Websites 87</p> <p>References 87</p> <p>Procedure guidelines for Chapter 2</p> <p>2.1 Bone marrow aspiration and trephine biopsy 64</p> <p>2.2 Bone marrow harvest 68</p> <p>2.3 Apheresis 76</p> <p>2.4 Ribavirin administration 82</p> <p>2.5 Pentamidine isetionate administration 85</p> <p><b>3 Cancer pain assessment and management 91</b></p> <p>Overview 92</p> <p>Cancer pain assessment and management 95</p> <p>Pain management 97</p> <p>Acupuncture 104</p> <p>Interventional techniques for managing complex cancer-related pain 107</p> <p>Single nerve blocks and injections 108</p> <p>Regional peripheral and plexus nerve blocks and infusions 108</p> <p>Neuraxial (spinal) blocks: epidural and intrathecal analgesia 109</p> <p>Entonox (nitrous oxide) administration 120</p> <p>References 125</p> <p>Procedure guidelines for Chapter 3</p> <p>3.1 Acupuncture: preparation and administration 106</p> <p>3.2 Epidural/intrathecal sensory blockade: assessment 114</p> <p>3.3 Epidural/intrathecal exit site dressing change 115</p> <p>3.4 Epidural/intrathecal catheter removal 115</p> <p>3.5 Entonox administration 123</p> <p><b>4 Administration of systemic anticancer therapies 131</b></p> <p>Overview 132</p> <p>Systemic anticancer treatment 132</p> <p>Safe handling of hazardous drugs 133</p> <p>Administration of cytotoxic medications by nurses 137</p> <p>Intravenous administration of systemic anticancer therapy 138</p> <p>Extravasation 142</p> <p>Oral administration of systemic anticancer therapy 156</p> <p>Intramuscular and subcutaneous administration of cytotoxic drugs 162</p> <p>Topical application of cytotoxic drugs 164</p> <p>Intrathecal administration of cytotoxic drugs 165</p> <p>Intrapleural instillation of cytotoxic drugs 168</p> <p>Intravesical instillation of cytotoxic drugs 169</p> <p>Intraperitoneal instillation of cytotoxic drugs 172</p> <p>Intra-arterial administration of cytotoxic drugs 173</p> <p>Side-effects of chemotherapy 175</p> <p>Haematological side-effects 176</p> <p>Fatigue 176</p> <p>Gastrointestinal side-effects 176</p> <p>Adverse drug reactions 177</p> <p>Neurotoxicity 177</p> <p>Mucositis/stomatitis 177</p> <p>Nephrotoxicity/haemorrhagic cystitis 178</p> <p>Cardiotoxicity 178</p> <p>Pulmonary toxicity 178</p> <p>Hepatotoxicity 178</p> <p>Skin toxicities 178</p> <p>Alopecia 178</p> <p>Clinical research 184</p> <p>References 193</p> <p>Procedure guidelines for Chapter 4</p> <p>4.1 Cytotoxic spillage management 135</p> <p>4.2 Cytotoxic therapy: intravenous administration of cytotoxic drugs 141</p> <p>4.3 Extravasation management: peripheral cannula 150</p> <p>4.4 Extravasation: performing flush-out following an extravasation 152</p> <p>4.5 Cytotoxic therapy: education for patients on oral cytotoxic drugs 161</p> <p>4.6 Cytotoxic therapy: intramuscular administration of cytotoxic drugs (Z-track) 163</p> <p>4.7 Cytotoxic therapy: topical application of cytotoxic drugs 164</p> <p>4.8 Cytotoxic therapy: intraventricular administration of cytotoxic drugs via an intraventricular access device (Ommaya reservoir) 166</p> <p>4.9 Cytotoxic therapy: intrapleural instillation of cytotoxic drugs 168</p> <p>4.10 Cytotoxic therapy: intravesical instillation of cytotoxic drugs 170</p> <p>4.11 Cytotoxic therapy: intraperitoneal instillation of cytotoxic drugs 172</p> <p>4.12 Intra-arterial administration of cytotoxic drugs 174</p> <p>4.13 Scalp cooling 182</p> <p><b>5 Radionuclide therapy 201</b></p> <p>Overview 202</p> <p>Radiation 202</p> <p>Radiation protection 202</p> <p>Unsealed source therapy 207</p> <p>Sealed source therapy 211</p> <p>Sealed source iodine-125 seeds used in prostate malignancies 220</p> <p>Intraoral sealed sources 220</p> <p>Websites 223</p> <p>References 223</p> <p>Procedure guidelines for Chapter 5</p> <p>5.1 Radiation protection: major spillage of radioactive body fluids through incontinence and/or vomiting 204</p> <p>5.2 Radiation protection: contamination of bare hands by radioactive body fluids 205</p> <p>5.3 Radiation protection: death of a patient who has received unsealed radioactive source therapy 205</p> <p>5.4 Radiation protection: cardiac arrest of a patient who has received unsealed radioactive source therapy 205</p> <p>5.5 Radiation protection: evacuation due to fire of patients who have received unsealed radioactive source therapy 206</p> <p>5.6 Unsealed source therapy: entering and leaving the room of a patient who has received an unsealed radioactive source 208</p> <p>5.7 Unsealed source therapy: iodine-131 (oral capsule/liquid): administration 209</p> <p>5.8 Unsealed source therapy: iodine-131 mIBG treatment: patient care 209</p> <p>5.9 Sealed source therapy: caesium sources (manual or afterloading): patient care 216</p> <p>5.10 Sealed source therapy: low dose-rate Selectron treatment 217</p> <p>5.11 Sealed source therapy: Selectron applicator removal 218</p> <p>5.12 Sealed source therapy: insertion of sealed radioactive sources into the oral cavity 221</p> <p><b>6 Wound management 227</b></p> <p>Overview 228</p> <p>Malignant fungating wounds 228</p> <p>Wound assessment 230</p> <p>Treatment options 232</p> <p>Principles of the management of dressings for a malignant fungating wound 235</p> <p>Local wound management 235</p> <p>Graft-versus-host disease wounds 244</p> <p>Definition 244</p> <p>Skin care following radiotherapy 245</p> <p>Websites and useful addresses 249</p> <p>References 249</p> <p>Procedure guidelines for Chapter 6</p> <p>6.1 Assessing a malignant fungating wound 231</p> <p>6.2 Dressing a malignant fungating wound 243</p> <p><b>7 Acute oncology 253</b></p> <p>Overview 254</p> <p>Haematological emergencies 255</p> <p>Central venous access device complications 255</p> <p>Thrombosis (catheter related) 259</p> <p>Sepsis 260</p> <p>Major artery rupture 261</p> <p>Superior vena cava obstruction 262</p> <p>Metabolic emergencies 264</p> <p>Hypercalcaemia of malignancy 264</p> <p>Hypomagnesaemia 267</p> <p>Side-effects from chemotherapy agents 268</p> <p>Diarrhoea (chemotherapy and radiotherapy induced) 268</p> <p>Nausea and vomiting 271</p> <p>Neutropenic sepsis 277</p> <p>Pneumonitis 280</p> <p>Structural 281</p> <p>Ascites (malignant) 281</p> <p>Bowel obstruction (malignant) 287</p> <p>Metastatic spinal cord compression 289</p> <p>Pericardial effusion (malignant) 301</p> <p>Raised intracranial pressure due to malignant disease 302</p> <p>References 303</p> <p>Procedure guidelines for Chapter 7</p> <p>7.1 Carotid artery rupture (CAR) 262</p> <p>7.2 Abdominal paracentesis 284</p> <p>7.3 Log rolling for suspected/confirmed cervical spinal instability 292</p> <p>7.4 Positioning for suspected/confirmed cervical spinal instability: pelvic twist to right 295</p> <p>7.5 Log rolling for suspected/confirmed thoracolumbar spinal instability 297</p> <p>7.6 Early mobilization of the patient in bed 298</p> <p><b>8 Living with and beyond cancer 311</b></p> <p>Overview 312</p> <p><b>Section 8.1 Introduction 312</b></p> <p>The experience of living with or beyond cancer 312</p> <p><b>Section 8.2 Welfare advice 315</b></p> <p>Overview 315</p> <p>Websites 326</p> <p>Useful addresses 326</p> <p><b>Section 8.3 Supporting individuals with sexual concerns as a consequence of cancer 326</b></p> <p>Women’s sexual concerns following cancer 329</p> <p>Interventions 331</p> <p>Men’s sexual concerns following cancer 332</p> <p>Interventions 333</p> <p>Websites 334</p> <p><b>Section 8.4 Nutritional status 334</b></p> <p>Websites 339</p> <p><b>Section 8.5 Compression therapy in the management of lymphoedema 339</b></p> <p>Lymphoedema 339</p> <p>Assessment of the patient with lymphoedema and calculation of limb volume 341</p> <p>Compression bandaging 348</p> <p>Compression garments 357</p> <p>Adjustable wrap compression systems 361</p> <p>Websites 365</p> <p><b>Section 8.6 Non-pharmacological management of breathlessness 366</b></p> <p>Non-pharmacological support 367</p> <p>Websites 371</p> <p><b>Section 8.7 Physical activity for people with cancer 371</b></p> <p>Websites 377</p> <p><b>Section 8.8 Cancer-related fatigue and sleep 377</b></p> <p>Cancer-related fatigue 377</p> <p>Sleep 380</p> <p><b>Section 8.9 Communication for a patient with a laryngectomy 383</b></p> <p>Websites and useful addresses 389</p> <p><b>Section 8.10 Nipple tattooing 390</b></p> <p>References 396</p> <p>Procedure guidelines for Chapter 8</p> <p>8.1 Conducting a holistic needs assessment (HNA) 314</p> <p>8.1a Developing and actioning a care plan 315</p> <p>8.1b Closure and follow-up 315</p> <p>8.2 How a patient should make a claim for Personal Independence Payment 322</p> <p>8.3 How a patient should make a claim for Attendance Allowance 323</p> <p>8.4 How a patient should make a claim for Carer’s Allowance 324</p> <p>8.5 How a patient should make a claim for Employment and Support Allowance 325</p> <p>8.6 Assessing a patient’s sexual health concerns 327</p> <p>8.7 Measuring the weight, height and waist circumference of the patient 336</p> <p>8.8 Compression therapy limb volume calculation: lower limb 346</p> <p>8.9 Compression therapy limb volume calculation: upper limb 346</p> <p>8.10 Compression bandaging (multilayer short-stretch): bandaging arm and the fingers 350</p> <p>8.11 Compression bandaging (multilayer short-stretch): bandaging a leg and the toes 354</p> <p>8.12 Elastic compression garments: application to the leg 359</p> <p>8.13 Elastic compression garments: application to the arm 360</p> <p>8.14 Adjustable wrap compression system: application to the lower leg 363</p> <p>8.15 Adjustable wrap compression system: application to the arm 364</p> <p>8.16 Breathlessness management: using a handheld fan 368</p> <p>8.17 Breathlessness management: essential oil administration via aroma stick inhaler 370</p> <p>8.18 Supporting physical activity 375</p> <p>8.19 Fatigue management 378</p> <p>8.20 Relaxation and anxiety management 382</p> <p>8.21 HME placement 387</p> <p>8.22 Voice prosthesis: cleaning in situ 388</p> <p>8.23 Nipple tattooing 394</p> <p><b>9 End of life care 403</b></p> <p>Overview 404</p> <p>Last Offices 408</p> <p>Websites and useful addresses 416</p> <p>Online resources 416</p> <p>References 416</p> <p>Procedure guideline for Chapter 9</p> <p>9.1 Last Offices 411</p> <p>Index 419</p>

<p><b><b>Sara Lister</b> </b>RN, PGDAE, BSc(Hons), MSC, MBACP, The Pastoral Care Centre, The Royal Marsden NHS Foundation Trust, UK.<b><br /><br />Lisa Dougherty</b> OBE, RN, MSc, DClinP, Nurse Consultant Intravenous Therapy, The Royal Marsden NHS Foundation Trust, UK.</p> <p>Assistant Editor: <b>Louise McNamara, </b>B.Nursing; MSc in Advancing Professional Healthcare Practice, UK.</p>

<p>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.  </p> <p>This companion volume to the internationally successful <i>The Royal Marsden Manual of Clinical Nursing Procedures</i> 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.</p> <p><i>The Royal Marsden Manual of Cancer Nursing Procedures</i>:</p> <ul> <li>Is organized and structured to represent the needs of the patient along their care pathway</li> <li>Provides the latest evidence underpinning all procedures</li> <li>Includes information on haematological procedures; pain assessment and management; wound care; oncological emergencies; and end-of-life care</li> <li>Gives detailed guidelines on supporting patients living with cancer with practical information on such things as benefits, exercise and nutrition.</li> </ul> <p><i>The Royal Marsden Manual of Cancer Nursing Procedures</i> is an invaluable, definitive resource for all those involved in the provision of cancer care and support to patients and their families.</p>

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