|
Management of Side Effects
G Means ask your doctor if it is okay to do then place a checkmark in the box if it is okay and
an X if it is not okay.
| Means you do not have to ask your doctor. You can do the suggestion on your own.
|
Anemia
Definition: The bone marrow is not able to make enough red blood cells, which carry oxygen to all parts
of your body. Tissues need oxygen to do their work.
Symptoms:
Pale skin, pale or bluish fingernail beds, muscle weakness, fatigue, chills, shortness of breath, dizziness, headache,
sore tongue, sleepiness, fast heart rate, or slight fever.
If the amount of oxygen reaching the brain is poor, dizziness, depression, irritability, and headaches can result; if the
oxygen reaching the tissue surrounding the heart is insufficient, angina-like chest pain may result.
Causes:
Decreased iron, vitamin K, vitamin B12 and/or folic acid intake, absorption, and/or use.
Chemotherapy.
Radiation to the pelvis, sternum, and long bones
Primary disease of bone marrow, e.g., leukemia.
of bone marrow by tumor.
diseases.
Renal/Kidney disease.
Primary tumors of the liver.
Metastatic disease of liver.
Treatment-related liver/hepatic toxicity.
Aging.
Exposure to toxic substances, e.g., benzene, antibiotics.
Blood loss.
Do:
| Get plenty of rest. Sleep more at night and take naps during the day if you can.
| Limit your activities. Do only the things that are most important to you.
| Eat a well-balanced diet.
| When sitting or lying down, get up slowly. This will help prevent dizziness.
Dont:
1. Do not be afraid to get help when you need it. Ask family and friends to pitch in with things like child
care, shopping, housework, or driving.
2. Do not do any exhausting activities.
Call MD:
Headache, dizziness (), ringing in the ears (), fast heartbeat (), hypersensitivity to cold, shortness of
breath () on exertion, and difficulty sleeping ().
Blood loss in stool, urine, vomit, monthly period, or .
Active bleeding from operative site, nose, or venipuncture site.
Your doctor will check your blood cell count often during your treatment. If your red count falls
too low, you may need a blood transfusion to increase the number of red blood cells in your body.
|
|
Bleeding
Definition: (Thrombocytopenia) A decrease in the number of circulating platelets in the blood.
Symptoms:
A steady flow of red blood, increased bruising, or nose bleeds.
Causes:
Disease of bone marrow.
Attack of marrow from tumors.
Bacterial or viral infection.
Platelet deficiency diseases.
Chemotherapy.
Radiation therapy to the pelvis, sternum, and long bones.
Massive blood transfusions.
Medications: Aspirin, Thiazides, Estrogens.
Alcohol.
Do:
G Avoid invasive procedures, e.g., catheterizations, enemas, injections, rectal temperatures.
G Avoid activities that expand the veins and arteries, e.g., hot showers.
G Avoid exhausting activities, lifting heavy objects, and bending over from the waist.
G Minimize constipation. Avoid holding your breath while bearing down (the Valsalva maneuver) when
having a bowel movement or blowing nose. A may be helpful for . Use stool softeners as recommended by doctor. Avoid
enemas, suppositories, harsh laxatives, and rectal thermometers.
G Avoid vaginal , rectal suppositories, enemas.
G Drink at least eight to ten eight-ounce glasses a day (unless fluid intake is restricted by your
doctor) to keep skin and from becoming too dry and to help prevent constipation.
G Eat a diet high in fiber and roughage. Eat protein-rich foods and beverages. Avoid alcohol. Eat
a soft, bland diet (include milk, cream, cereal, Jell-O, soup, rice, butter, crackers, eggs, tapioca, custard, cottage cheese,
and fish) and avoid foods that are very hot in flavor or temperature and foods like popcorn or hard pretzels that may irritate
the mouth.
G Avoid the use of tourniquets, tight elastic stockings, or tight bras and girdles.
G Avoid aspirin, aspirin-containing drugs, and other medications that with platelet function.
If taking corticosteroid medication make certain you take medication with food, and eat in-between meal snacks.
Use acetaminophen in place of aspirin. In case of a nosebleed, apply firm pressure to the below the and tilt the head forward.
(Tilting the head backward is sometimes suggested, but make sure that the bleeding is not in the back of the nostril.) If
bleeding does not stop in a few minutes, place ice bags on the bridge of the nose and at the back of the neck. If external
bleeding does happen, apply pressure to the site for five to ten minutes. If an arm or leg is involved, raise it above the
level of the heart and then apply pressure for a few minutes. If bleeding continues for more than five minutes, notify the
physician.
| Use soft toothbrushes, toothettes, gauze moistened with salt water and wrapped around a finger,
an, or sponge-tipped applicator. Avoid use of dental floss and toothpicks. Moisturize the lips with cocoa butter or petroleum
jelly. Check with your physician before having any dental work done. Use a low alcohol mouthwash to clean the teeth, gums,
and inside the mouth gently.
| Avoid bumps or falls. Lower the risk of injury by using side rails at night and getting help
with walking as needed.
| Avoid sharp objects, such as razors or knives. Use an electric shaver.
| Use lubrication for intercourse. Avoid.
| Blow the nose gently, dont bend over so that head is below shoulders. Humidify the room air with
a cold-water vaporizer.
| Avoid cutting toenails and fingernails. Use an emery board or fine mesh nail file to prevent
or repair rough edges.
| Avoid tight fitting or constrictive clothing. Avoid harsh fabrics, which may irritate the skin.
| Exercise as tolerated
Dont:
1. Do not strain to move bowels.
2. Do not scrub anal area.
3. Do not try to "push anything back in" if it sticks out of the anal opening (i.e., hemorrhoids).
4. Do not use enemas, douches, rectal suppositories, and laxatives.
5. Do not use rectal thermometers.
6. Do not wait longer than two hours before trying to urinate.
Call MD:
Bleeding from anywhere (e.g., mouth, nose).
Bruises on skin, little dots on skin, especially on feet or legs.
If you have unstoppable bleeding.
If you became .
If you have fever with shaking chills.
Blood in the urine, red or pink urine, cloudy or smelly urine, pain upon urination, urgency to urinate.
Pain in the lower back, or on lower sides of the back.
If symptoms do not get better after treatment.
Blood in the stool, dark red or black bowel movements. (Remember that eating beets can cause red feces/stools and
iron tablets can cause black feces/stools. This is normal).
Blood on toilet tissue, on underwear, sheets, underparts.
(Note: Some medications may not be in this list. Consult your physician or pharmacist.) |
|
A.S.A. enseals
A.S.A. suppositories
A.S.A. pulvules
A.S.A. tablets
ABC Compound
Acucron tablets
Advil ibuprofen tablets
Advil ibuprofen caplets
Alka-Phenylbutazone
Alka-Seltzer
Alka-Seltzer Plus cold tablets
Alkabutazolidin
Alkabutazone
Alpha-Phed capsules
Alpha-Phed
Amersol
Anacin capsules
Anacin maximum-strength capsules
Analate
Ancasal Anodynos tablets
Apa-San tablets
APAP fortified tablets
Apo-Asen
Apo-Phenylbutazone
Arthra-G tablets
Dinol tablets
Disalcid capsules
Disalcid tablets
Doans pillsindocin
Dolene compound-65 capsules
Dolobid tablets
Dolprin #3 tablets
Drinophen capsules
Duoprin-S Syrup
Duradyne tablets
Durasal
Dynosal tablets
Easprin tablets
Ecotrin tablets
Ecotrin maximum-strength tablets Efficin
Emagrin tablets
Empirin with codeine tablets
Empirin tablets
Encaprin capsules
Entrophen
Equagesic tablets
Equazine-M tablets
Excedrin tablets
Excedrin extra-strength caplets, tablets
Osteolate
Oxycodone with aspirin tablets P-A-C new revised formula
P-A-C tablets
Pabalate tablets
Pabalate-SF
Pamprin-IB
Pepto-Bismol liquid
Pepto-Bismol tablets
Percodan tablets
Percodan-demi tablets
Persistin tablets
Phenetron Compound tablets
Presalin tablets Propoxyphene compound capsules
Protension tablets Cenaid tablets
Rhinex D-Lay tablets
Rhinocaps capsules
Rhinogesic tablets
Rid-a-pain compound capsules Riphen-10 |
Arthralgen tablets
Arthrin tablets
Arthritis pain formula (Anacin)
Arthritis-strength Bayer aspirin
Arthropan liquid
Ascriptin A/D tablets
Ascriptin tablets
Ascriptin with codeine tablets Ascriptin extra-strength tablets
Aspergum Aspergum junior
Aspirin and codeine phosphate tablets
Aspirin suppositories Aspirin tablets Axotal tablets Azolid
B-A-C tablets
B-A-C #3 with codeine
Bayer childrens cold tablets
Bayer aspirin tablets
Bayer childrens chewable aspirin
Bayer timed-release aspirin tablets
BC tablets
BC powder
Extra Strength Bufferin arthritis-strength tablets
Fendol tablets
Fiogesic tablets
Fiorgen PF tablets
Fiorinal capsules
Fiorinal with codeine capsules
Fiorinal tablets
Fiorinal-C
Gaysal-S tablets
Gemnisyn tablets
Haltran ibuprofen tablets
Hista-Compound #5 tablets
Histadyl and A.S.A. pulvules
(capsules)
Indocin
Intrabutazone
Isollyl Improved capsules
Isollyl Improved tablets
Kolephrin capsules
Korigesic tablets
Lanorinal tablets
Lanorinal capsules
Lortab ASA tablets
Magan capsules
Magan tablets
Magsal tablets
Robaxisol tablets
S-A-C tablets
Sal-adult tablets
Sal-infant tablets
Salatin tablets
Saleto tablets
Saleto-D capsules
Salimeph Forte tablets
Salocol tablets
Salphenyl capsules
Sine-Off
Sino-Comp tablets
Sinulin tablets
SK-oxycodone with aspirin tablets
Sodium salicylate tablets
Soma compound tablets
Soma compound with codeine
St. Joseph Aspirin for children St. Joseph cold tablets for children
Supasa |
Buf-tabs
Buff-a-Comp tablets
Buffaprin tablets
Bufferin tablets
Bufferin extra-strength analgesic tablets
Buffex tablets
Buffinol tablets
Butabarbital compound tablets
Butal compound capsules
Butal compound tablets
Butazolidin
CAMA arthritis-strength tablets
Codolan
COPE tablets
Corilyn infant liquid drops
Coryphen
Cosprin 650
CP-2 tablets
Damason-P
Darvon with aspirin
Darvon-N with aspirin
Dasikon capsules
Dasin capsules
Dia-Gesic tablets
Diflunisal
Major-cin tablets
Marnal tablets
Marnal capsules
Maximum-strength Bayer aspirin
Maximum-strength Midol
Medipren with ibuprofen tablets
Mejoral with aspirin tablets
Meprogesic Q tablets
Methocarbamol with aspirin
Micranin tablets
Midol 200 tablets
Midol caplets
Midol
Mobigesic tablets
Momentum caplets
Neo-Zoline
Norgesic tablets
Norgesic Forte tablets
Norwich extra-strength aspirin Norwich aspirin
Novasen
Novobutazone
Nuprin ibuprofen analgesic tablets Os-Cal-Gesic tablets
Synalgos-DC capsules
Suspac tablets
Synalgos
Talwin compound tablets
Tenol-Plus tablets
Tenstan tablets
Tisma tablets
Tranquigesic tablets
Trendar tablets
Triaphen-10
Trigesic tablets
Trilisalicylate
Trilisate liquid
Trilisate tablets
Tussirex syrup
Tussirex liquid
Uracel 5 tablets
Uromide tablets
Ursinus Inlay tablets
Vanquish capsules
Wesprin buffered aspirin
ZORprin |
|
Central Nervous System (CNS)
Definition: The in the body including the brain and spinal cord along with their nerves. This system controls voluntary
movements and thoughts.
Symptoms:
Peripheral neuropathy is a that may make you feel a tingling, burning, pain, weakness, or numbness in the hands and/or
feet. Other nerve related symptoms include loss of balance, clumsiness, difficulty picking up objects and buttoning clothing,
lowered to heat and cold, walking problems, jaw pain, hearing loss, stomach pain, and constipation.
Causes:
Chemotherapy (vincristine, vinblastine).
Radiation.
Injury.
Tuberculosis, malaria, herpes zoster, diphtheria, virus infections, and Lyme disease.
Diabetes, hypothyroidism.
Tumor pressure.
Medications as barbital, sulfonamides, phenytoin, and emetine.
Carbon monoxide.
Vitamin B .
Do:
| If your fingers become numb, be very careful when picking up objects that are sharp, hot, or
dangerous. If your sense of balance or muscle strength is affected, avoid falls. Move carefully using handrails when going
up or down stairs and using bath mats in the bathtub or shower.
| Wear warm gloves and socks in winter.
Dont:
1. Do not wear slippery shoes.
2. Do not rely on your hands to see if things are hot or cold. Test temperature on an inner forearm.
Call MD:
If symptoms last more than two days.
|
|
Constipation
Definition: Passage of hard, infrequent feces/stools, which is often associated with abdominal and rectal pain.
Symptoms:
Bowel movements are hard, no bowel movement within one-two days, stomach or rectal pain, headache.
Causes:
Chemotherapy.
Low activity.
Poor nutrition.
Bowel obstruction.
Fluid and electrolyte .
Dehydration.
High calcium.
Low potassium.
Handling of intestines during surgery.
Drugs: narcotics, anticholinergics, antacids, iron, anticonvulsants, antidepressants, tranquilizers, and muscle relaxants.
Do:
G You may need to take a laxative or stool softener or use an enema (but dont use these
remedies unless you have checked with your doctor, especially if your white blood cell count is low).
G Drink plenty of fluids (at least a gallon fluid intake each day) especially warm and hot liquids
to help loosen the bowels. Decaffeinated tea or hot lemon water are good.
G Eat bran, whole-wheat breads and cereals, raw or cooked vegetables, dried fruit, nuts, and popcorn,
wheat germ, fresh raw fruits with skins and seeds, fruit juices (except apple juice), dates, apricots, prunes, prune juice.
| Increase activity as tolerated.
Dont:
1. Do not use too much force or straining in trying to move bowels.
2. Do not use laxatives and enemas if your white blood cell count is low unless prescribed by your doctor.
3. Do not use foods that can cause constipation, such as chocolates, cheese, and eggs.
Call MD:
If you have not had a bowel movement for more than a day or two.
Severe pain or bleeding with bowel movement.
If you cannot move bowels within one or two days after taking laxative.
If you have lasting cramps or vomiting. |
|
Dehydration
Definition: Loss or deprivation of fluid from body tissues.
Symptoms:
Dry mouth, thirst, dizziness, weakness, unable to swallow dry food, difficulty talking, dry skin, skin that "tents" when
pinched, swollen, cracked, or dried tongue, fever, weight loss, little or no urine, dark yellow/orange urine, fatigue, headache,
confusion, and sunken eyeballs.
Causes:
Primary tumors of the pituitary or adrenal gland, kidney, or stomach/intestines.
Metastatic disease resulting in a fluid shifts, e.g., edema, ascites, effusions.
Hemorrhage related to tumor invasion.
Surgical procedures resulting in trauma.
Wound drainage.
Nausea or vomiting.
Stomach/Intestinal suctioning.
Diarrhea.
Sweating with fever.
Excessive enemas.
Decreased water intake.
Decreased motivation to drink.
.
Inability to swallow liquids.
NPO (nothing by mouth ) ordered by the physician.
Decreased thirst sensation.
Decreased level of consciousness and/or neuromuscular control.
Drugs, e.g., diuretics, laxatives, antibiotics, tranquilizers, anti epileptics.
Do:
G Drink a minimum of a gallon of fluid each day. Try sipping fluids to avoid feeling bloated.
G Eat foods with high water content: soups, watermelon, lettuce, popsicles, Jell-O, bouillon, oranges,
cucumber, celery, and juices.
| Moisturize skin to prevent cracking.
Dont:
1. Do not drink fluids with caffeine such as coffee, tea, chocolate and soda. Caffeine acts as a which causes fluid loss.
For each cup of a caffeinated beverage you drink, you lose a cup and a half of fluid. If you do have anything with caffeine
in it, it does not count toward fluid intake.
2. Do not get up suddenly. Blood pressure drops causing dizziness.
Call MD:
If vomiting, diarrhea, or fever continues for more than twenty-four hours, if urine is either very dark in color and of
a small amount, or if there is no urine for twelve hours or more, if you become dizzy or if you feel faint as you stand up,
or if you become disoriented or confused.
|
|
Depression
Definition: A state of being sad, discouraged, and in low spirits.
Symptoms:
Fatigue, decreased energy.
Loss of appetite.
Sleep problems.
Decreased physical activity.
Slowing of responses to stimulants.
Decreased libido.
Hopelessness.
Irritability.
Emotional lability.
Lack of trust of others.
Apathy.
Guilt.
Feelings of worthlessness.
Withdrawal.
Decreased social interaction.
Inability to concentrate. Slowed cognitive processes. Indecisiveness.
Regression and/or dependency.
Decreased or increased nutritional intake.
Decreased or increased physical activity.
Decreased social interaction and/or support.
Poor use of personal, social, professional, and economic resources.
Causes:
Diagnosis.
Prognosis.
Expecting side effects of treatment.
Surgery causing a loss of body part and/or function.
Cost of illness and treatment.
Loss of personal control.
Social isolation of hospitalization and illness.
Many crises and past losses.
Age.
Inadequate social support and financial resources.
Mood swings prior to diagnosis and treatment.
Changes in mood in times of stress and/or crisis.
Reactions of significant others to changes in mood.
Effect of mood swings, especially depression, and responses of significant others on client.
Do:
See Pain-Relaxation Techniques and Chapter 3 Feelings and Relationships.
Dont:
1. Do not try to handle depression on your own.
Call MD:
If you feel depressed or suicidal.
|
|
Diarrhea
Definition: Passage of loose, watery feces/stools or greater than three bowel movements a day.
Symptoms:
Watery bowel movement, weakness or dizziness, cramping, or dehydration.
Causes:
Disease related, e.g., obstruction, presence of impaction (severe constipation with an overflow of intestinal liquids around
feces/stool that is lodged in the intestine).
Radiation therapy to the bowel.
Chemotherapy.
Surgery to bowel.
Graft-versus-host disease in bone marrow transplantation.
Medications, e.g., antibiotics, antacids.
Diet changes, e.g., tube feedings, additional nutrition.
Inflammation or infection of the bowel.
Increased stress with poor coping strategies. Anxiety.
Use of nutritional supplements with a high osmolarity (large amounts of vitamins, minerals, sugar, and electrolytes).
(the inability to digest milk and milk products.)
Bacterial and viral infections.
Do:
G Eat: apple juice, applesauce, asparagus tips, avocados, baked/ boiled mashed potatoes, bananas,
beets, boiled low-fat milk, bouillon, broth, buttermilk, canned or cooked fruit without skins, carrots, chicken or turkey
without the skin, and fish, consomme, cooked cereals such as cream of wheat or cream of rice, cooked mild vegetables such
as asparagus tips, beets, green and wax beans, carrots, peas, spinach, and squash cottage cheese, crackers made with refined
flour, cream cheese, cream soups from asparagus tips, beets, green and wax beans, carrots, peas, spinach, and squash, custard,
dairy products, eggs (not fried), fish, poultry and ground beef that is baked, broiled, or roasted until tender, gelatin,
grain products, grape juice, cranberry juice, green beans, ground beef that is baked, broiled, or roasted until tender, low-fat
milk, macaroni, mild processed cheese, natural yogurt, noodles, nutmeg, which may decrease the motility of the stomach/intestines
and could be added to foods, pasta made with refined flour, peas, peeled apples (apples contain pectin, an anti diarrheal
agent), potatoes (baked, boiled, or mashed without the skin), poultry, pudding, mashed vegetables, rice pudding, smooth peanut
butter, spinach, squash, tapioca (made with low-fat milk), wax beans, wheat or rice, white rice, white bread, toast, and yogurt.
G If your doctor has told you include foods high in potassium if signs of weakness or fatigue are
present or if laboratory data show a low potassium level, eat baked potatoes, halibut, asparagus tips, avocados, bananas,
citrus fruits, oranges, peach and apricot nectars.
G Potassium replacement may be necessary if diarrhea persists. These supplements often cause stomach
or intestinal discomfort.
G Drink at least a gallon of fluid each day. Fluids used to restore electrolyte levels include:
bouillon, fruit-ade, apple juice, grape juice, Gatorade, weak warm tea, and gelatin.
G Use a liquid diet if the diarrhea becomes severe. Gradually add foods.
G Use nutritional supplements to increase protein and calorie intakes. Due to the high consistency
of these supplements, they should be sipped slowly and diluted according to the following schedule:
Level I: 3/4 water and 1/4 supplement.
Level II: ½ water and ½ supplement.
Level III: 1/4 water and 3/4 supplement.
Level IV: full-strength supplement; this level is usually tolerated in five to seven days.
G Your doctor may prescribe antibiotics, opiates, tetracycline HCL, codeine, vancomycin
HCL (vancocin HCL), diphenoxylate HCL (lomotil), loperamide HCL (immodium), anticholinergics/antispasmodics, opium tincture,
donnatal, paregoric, natural products, aluminum carbonate (basaliel), donnagel, bismuth subsalicylate (pepto-bismol), kaolin
and pectin (kaopectate ), psyllium hydrophilic mucilloid (metamucil),
| Eat small, frequent meals; eat slowly and chew food thoroughly.
| Avoid extremely hot or cold foods. Extremes in temperature may aggravate diarrhea. Foods served
warm or at room temperature are more easily tolerated.
| Add nutmeg to foods. This spice may decrease the motility of the stomach/intestines.
| Take care of the skin and mucous membranes of the rectal area. Cleanse the rectal area after
each bowel movement with warm water and a mild soap (Dove or Ivory), rinse well and pat dry with a soft towel. Apply a topical
moisture-barrier cream (Desitin Cream) to help skin healing.
Apply a topical anesthetic (corticosteroid sprayer DecaSpray or creams may be prescribed to reduce inflammation), in ointment
or spray form to promote comfort. Take frequent warm baths or sit in a tub of warm water to promote comfort. A mixture of
1000 physiologic bicarbonate, 100 ml of diphenhydramine HCL (Benadryl ) elixir, and one bottle of viscous lidocaine HCL (Xylocaine)
may be used in a warm bath to relieve both pain and itching every four hours as needed. If happens, aluminum acetate solution
(Domeboro), one package to a quart of water can be added to the warm bath to promote healing.
| When diarrhea is present, wear loose-fitting clothing and allow the rectal area to be exposed
to the air as often as possible.
| Wear a sanitary napkin or a product such as Assure if of liquid feces/stools, to avoid embarrassment
and the need for frequent changes of clothing.
Dont:
1. Do not use alcoholic beverages, including liquor, beer, and wine.
2. Do not eat high-fiber foods which can lead to diarrhea and cramping.
3. Do not have beans, caffeinated foods, caffeine-containing soft drinks, candy, chocolate, coconut, coffee, creamed soups,
flatus-forming foods such as broccoli, onions, and cabbage, foods and beverages containing caffeine, such as chocolate, coffee,
tea, fresh and dried fruits, fried or greasy food, fruit juices (bananas, avocados, apples, and grape juice are permitted),
jellies, milk and milk products if they make your diarrhea worse, milk shakes, nuts, olives, pickles, popcorn, potato chips,
pretzels, puddings, raw vegetables, raw fruits, relishes, dried fruit, rich pastries, seeds, soft drinks, strong spices and
herbs such as chili powder, licorice, pepper, curry, garlic, horseradish, sweets, tea, tobacco products, and whole-grain bread
and cereal such as bran and granola.
4. Do not eat very hot or very cold foods.
5. Do not have only for more than two days in a row.
Call MD:
If diarrhea does not get better.
If you have 6 to 8 or more loose bowel movements per day for more than two days in a row.
If you notice blood in or around anal area or in the stool.
If you lose five or more pounds after the diarrhea starts.
If you have new stomach cramps or pain for two days or more.
If you do not urinate for twelve hours or more.
If you do not drink any liquids for more than two days.
If you have a fever greater than 100.5 degrees Fahrenheit.
If your abdomen suddenly becomes puffy or blown-up.
If you have been constipated for several days and begin to have a small amount of diarrhea or oozing of . This could suggest
an (severe constipation).
Ask your doctor if you should try a clear liquid diet to give your bowels time to rest. As you feel better, you gradually
can add the low-fiber foods listed above. A clear liquid diet doesnt provide all the nutrition you need, so dont follow one
for more than three to five days.
If your diarrhea is very severe, you may need to get intravenous fluids to replace the water and you have lost.
|
|
Edema
Definition: Swelling caused by excess fluid.
: Swelling due to clogging of the vein, damage of lymphatic , or lymph node dissection as in a mastectomy
with lymph node .
Symptoms:
Pain and swelling in the arms.
Causes:
Vein obstruction, e.g., pressure from tumor, infection, .
Damage to lymphatic vessels, e.g., tumor infiltration, obstruction, inflammation, and due to radiation,
surgery to lymph nodes.
Increased tiny blood vessel pressure and .
Blood clots that prevent return of blood flow to the heart.
Emotional response caused by the nervous system, e.g., laryngeal edema resulting in hoarseness.
Decreased plasma proteins.
Abnormal protein losses in renal dysfunction.
Inadequate dietary intake of proteins.
Liver disease.
Allergic reactions.
Bacterial infections.
Fluid becomes trapped in fluid spaces, e.g., peritoneal, pericardial, and/or pleural spaces.
Medications, e.g., estrogens, ACTH.
Do:
G Offer a high protein, low salt diet.
G Limit fluid intake.
G Exercises.
G Avoid invasive and/or constrictive procedures in involved area, e.g., venipunctures, blood pressure
measurements.
G Follow medical orders as indicated:
Diuretics.
Lymphedema sleeve.
Mechanical pumps.
Consults with occupational and physical therapy departments.
Provide referrals to support groups, e.g., Reach to Recovery.
| Raise swollen areas above the heart while at rest.
| Follow skin care instructions.
| Stay in an upright position to help the diaphragm and lungs expand if you have pulmonary edema.
| Avoid tight clothing or jewelry on swollen areas.
| Use loose protective clothing, e.g., gloves, long sleeved shirts, slacks.
| Avoid contact with irritants to skin, e.g., allergic substances.
| Test temperatures with unswollen hands before touching things, e.g., bath water, cooking utensils.
| Use tools or things that help you reach.
Dont:
1. Do not try to apply elastic stockings to decrease swelling unless ordered by the doctor.
Call MD: Check with your doctor or nurse if you notice swelling or puffiness in your face, hands, feet, or abdomen.
|
|
Fatigue
Definition: A feeling of weariness, tiredness, or temporary loss of physical or emotional. is a temporary state relieved
by rest. may not be relieved by rest, lasts over time, and often prevents you from doing daily activities. Approximately ninety
percent of people with cancer may have both acute and chronic fatigue because of the illness, a side effect of treatment,
and a result of the emotional stress caused by the diagnosis.
Symptoms:
Decreased concentration and memory, increased hours of sleep without feeling rested and revitalized, impaired problem solving
ability feeling tired or exhausted, difficulty concentrating, and sleeping more.
Causes:
Alcohol.
Amputation.
Anemia.
Anorexia.
Anxiety.
Biotherapy.
Bone marrow depression.
Chemotherapy.
Depression.
Diabetes.
Illness progression.
Fever.
Liver/Kidney damage.
Low potassium.
Poor nutrition.
Destruction of cells.
Metastasis.
Nausea and vomiting.
Pain.
Radiation therapy.
Side effects of medications.
Sleep changes.
Surgery.
A buildup of waste products in the body.
Do:
G Unless your doctor restricts you, drink at least a gallon of fluid every day to avoid the buildup
of waste products.
G Reach and maintain good nutrition by including foods that are rich in protein, vitamins, and
iron (e.g., liver, organ meats, cheese, seafood, green leafy vegetables, yogurt, cereals, nuts, and legumes).
Include nutritional supplements if unable to maintain a balanced diet (e.g., Sustacal, Ensure, Carnation Instant Breakfast).
G Prevent or reduce pain.
G Drink warm, non-caffeinated drinks such as warm milk with honey before sleep.
G Take sleeping medications as ordered by your doctor.
| Prioritize activities to allow for independence. Plan and rest between activities according to
energy level.
| tasks or get help with household chores and usual activities such as child care, bathing, grooming,
toileting, feeding, mobility, meal preparation, housework, and home maintenance. Ask friends or hire services if possible.
| Allow for periods of uninterrupted sleep during day (naps) and night. Maintain usual patterns
of rest and sleep by following usual bedtime rituals, minimizing distractions, and avoiding strenuous activity before bedtime.
| Use relaxation techniques.
| Maintain as much as possible usual lifestyle patterns but pace activities according to energy
level.
| Plan consistent periods of active exercise.
| Avoid having caffeine-containing foods and drinks in the evening after 6 P.M..
| Be aware of the effect of emotional distress. Encourage family members to inform health professionals
of noticeable changes in mood, personality, and affect.
| Go to a quiet environment to rest during the same time each day.
| Take sleeping medication or analgesics prescribed by the doctor at a regular time each night.
| Rest more often. Rest before or after cancer therapy, sleep later in the morning, or go to bed
earlier at night.
| Minimize noise and other distractions.
| Work part-time if a full schedule is no longer possible. Some employers will encourage this to
avoid losing a valued employee. Have your physician or nurse call your employer to explain the necessity for rest periods
or absences for medical treatment during the day.
Dont:
1. Do not drink stimulants, such as coffee, tea, or cola, late in the day.
Call MD:
Your doctor may order blood transfusions if the cause is due to low blood levels, sedatives, antidepressants, or professional
counseling.
|
|
Fever/Chills
Definition: Body temperature above 100 degrees Fahrenheit or 39 degrees Celsius.
Symptoms:
Flushed face, hot and dry skin, aching, increased pulse and breathing.
Causes:
Decreased absolute granulocyte count (SEGS + BANDS) WBC
Transfusions.
Drugs, e.g., amphotericin.
Heat.
Exercise.
Dehydration.
Caffeine.
Infection.
Inflammation.
Do:
G Increase fluid intake.
G Take cool or lukewarm baths/compresses with water or alcohol. Use ice packs or cooling blankets
if lying down
G Use warm blankets with chilling.
G Take fluids high in sodium and potassium.
G Eat high caloric and high protein foods.
G Take medicine as ordered by your doctor: without aspirin, antibiotics, steroids, warm
enemas and antihistamines.
| Change wet linen and clothing with sweating (diaphoresis).
| Cool room.
| Provide for rest.
Dont:
1. Do not take over-the-counter or prescription products (especially with aspirin) without asking your doctor.
Call MD:
Your doctor may order blood work to find the cause or prescriptions to treat it. |
|
Hair Loss (Alopecia)
Definition: Loss of hair.
Symptoms:
Hair loss can happen anywhere on the body (scalp, facial, axillary, pubic)
Causes:
Radiation to the scalp greater than 4500 rads can cause permanent or temporary loss.
Chemotherapy:
Chronic stress.
Protein loss.
Medications.
Aging.
Endocrine diseases.
.
Heredity.
Do:
G The use of a cold compress or "ice turban" on the head during the chemotherapy may slow
blood flow to the head, preventing the drugs from reaching the scalp . Scalp tourniquets have also been used for the same
effect. Although studies are not sure if this works, some physicians may allow this.
| Try on different wigs until you find one that you really like. Consider buying two wigs.
| Get scarves, turbans, caps, and/or wigs before hair loss so that the wig shop can match your
hair color and texture. Wear them outside so you dont lose heat from the scalp or get sunburned.
| Wash hair less frequently with a mild shampoo or a dry shampoo. Use a wide-tooth comb or soft
hair brushes. Avoid the use of permanents, hair coloring, excessive use of blow dryers, curling irons, heated rollers, hair
clips, elastic bands, barrettes, bobby pins and brushing. Sometimes clumps of hair are found on the pillow in the morning.
Loss happens over a period of days to weeks. Regrowth happens six to eight weeks after therapy is completed. Changes in texture,
thickness and color of hair may happen after regrowth.
| Get a prescription from your doctor for a wig. Insurance usually covers it. Get a list of wig
shops in your area from your doctor or nurse, or from the phone book Yellow Pages.
Dont:
Try hair transplant techniques or products that claim to grow hair.
Call MD:
If you have concerns regarding hair loss. |
|
Infection
Definition : Bacteria, viruses, fungi and parasites enter the body, multiply, and injure the tissues.
Symptoms:
Redness, swelling, tenderness, pain, pus, fever more than 100 degrees Fahrenheit or 38 degrees Centigrade, shaking chills,
sweating,, fatigue, , cough, unusual vaginal discharge or itching, abnormal breath sounds, back pain, diarrhea, burning
and/or pain on urination, frequent urination, rectal discomfort with bowel movements, sore throat, earache, or runny nose.
Causes:
Decrease in the ability of the body to resist infection.
Tumor infiltration of bone marrow.
Nutritional deficiencies.
Exposure to toxic substances.
Genetically acquired immune deficiency syndromes (AIDS).
Immunosuppressive therapy, e.g., anti rejection agents, chemotherapy, and radiation therapy.
Age.
Steroid therapy.
Primary cancer of blood-forming tissues, e.g., leukemia and lymphoma.
Autoimmune illnesses.
Decreased secretions in eyes, ears, nose, mouth, and throat.
Loss or impaired function of hair or cilia, e.g., absence of eyelashes, absence of cilia movement in bronchial trees after
smoking.
Poor skin condition, e.g., IV , surgery, cutaneous lesions, mucosal lesions.
Immunosuppression.
Effects of tumor growth, e.g., invasion, obstruction, necrosis.
Viral, bacterial, or fungal infection.
Drug reactions.
Do:
G Drink a lot of liquids.
G Take Tylenol or other medicine for fever if prescribed by the doctor.
G Avoid contact with persons with contagious and/or infectious illnesses ex. chickenpox, measles,
pneumonia, cold sores, shingles, colds, flu.
G Avoid immunizations or people who have received live vaccines within three months such as vaccines
for polio, measles, mumps and rubella (German measles).
G Limit or avoid exposure to children, pets (bird, cat, and dog feces, they have high levels of
fungi and bacteria). Avoid cleaning birdcages and cat litter boxes.
G Avoid unpeeled fresh fruits, raw vegetables, flowers, house plants, raw eggs, raw milk and products
made from raw milk, and cold cuts and deli items that others may have handled.
G Use medical gloves when caring for open wounds or lesions.
G Avoid all causes of water: flower vases, denture cups, irrigating containers, respiratory equipment,
soap dishes, and liquid soap. To decrease the growth of microbes, a teaspoon of chlorine bleach should be added to each quart
of water used in flower vases and a teaspoon of vinegar to each quart of water or saline solution used for respiratory equipment.
Dirty items should be cleaned by scrubbing with a seventy-percent alcohol solution, a solution of one part bleach to thirty
parts water, or a one to two percent iodine solution.
G Vaccination against pneumococcal bacteria may be ordered by your doctor.
| Wash hands before eating or smoking, before and after using the bathroom, after sneezing or coughing.
Lather hands with antibacterial soap and warm water, scrub for ten to twenty seconds, then use a paper towel to wipe dry.
| Get enough rest.
| Take temperature every two to three hours. Use cold compresses to the forehead if hot.
| Shower instead of taking a bath. Use antibacterial soap.
| Brush teeth with a new soft toothbrush.
| Wipe from front to back after going to the bathroom.
| Avoid douches.
| Limit or avoid exposure to large crowds.
| Use an electric shaver instead of a razor to prevent breaks or cuts in your skin.
| Use lotion or oil to soften and heal your skin if it becomes dry and cracked.
| Clean cuts and scrapes right away with warm water, soap, and an antiseptic.
Dont:
1. Do not take temperature rectally.
2. Do not take enemas.
3. Do not take any medications in suppository form.
4. Do not take any medications that have aspirin or acetaminophen unless the doctor orders it.
5. Do not try to "bring the fever down" with ice baths or alcohol baths.
Call MD:
Report signs and symptoms of infection: redness, swelling, tenderness, pain, pus, fever more than 100 degrees Fahrenheit
or 38 degrees Centigrade, shaking chills, sweating, low body temperature, fatigue, generalized discomfort, cough, unusual
vaginal discharge or itching, abnormal breath sounds, back pain, diarrhea, burning and/or pain on urination, frequent
urination, rectal discomfort with bowel movements, sore throat, earache, or runny nose.
Your doctor may postpone your next treatment or give you a lower dose of drugs for a while.
|
|
Loss of Appetite (Anorexia)
Definition: A feeling that you dont want to eat or cant.
Symptoms:
Food tastes different, feeling full, metal taste in the mouth, unable to eat without gaging, feeling like a lump is in
your throat, nausea, and the smell of food is not pleasing.
Causes:
Poor nutrition and low levels of zinc.
Surgery or radiation to head, neck, mouth, sinus, ear and throat.
Chemotherapy and other drugs.
Biological response modifiers.
Nausea and vomiting often cause a continuing aversion to specific foods and beverages.
Poor oral hygiene. Dentures that cover the taste buds. Infection of the mouth.
Aging.
Do:
G Increase flavor by using such as lemon, salt, vanilla, cinnamon, bacon bits, toasted almonds,
lemon slices, slivers of ham, marinades, herbs, spices, wine sauces, or butter in cooking. Adding sugar will mask salty food.
Adding salt will mask sweet foods. Try adding fresh or dried ginger roots to soups, sauces, and gravies for a pleasant flavor.
G Eating sugar-free mints, chewing sugar free gum, or eating other foods that have a pleasant taste
to mask a metallic, medicinal or bitter taste sensation.
G Avoid beef, pork, chocolate, coffee, and tomatoes. Substitute other high-protein foods such as
cheese, peanut butter eggs, milk and milk products, chicken, and fish for a minimum of three servings daily.
G Exercise before meals. A five to ten minute walk, or even range-of-motion exercises in bed (the
physical therapist has specifics), can increase the appetite.
G Avoid foods that are filling or gas-forming, such as salads, vegetables (e.g., cabbage or broccoli),
fruits, and beer.
G Avoid liquids with meals or an hour before, since they can be filling and spoil your appetite.
Liquids should be nutritious: milk, juice, or soup rather than soft drinks or water.
G If pain is present, take medicine thirty to sixty minutes before mealtime.
| Prevent or reduce dryness of the oral mucosa. Spray water, saline, or artificial saliva to lubricates
the mouth and lips. Humidify your home.
| If nausea is not a problem, taking in the aroma of food cooking may help stimulate the appetite.
| Make mealtime an event; wash the hands and face, rinse the mouth with half strength mouthwash
to freshen it before eating. Serve all foods attractively and in a pleasant environment. Company, soft music, and a glass
of wine (if allowed) may stimulate the appetite.
| Eat smaller, more frequent meals. Six or eight small meals are better than three full meals a
day. Many hors doeuvres provide high-protein food in small amounts.
| Eat more slowly to allow the stomach to empty while eating, thus reducing nausea and vomiting.
Chew everything thoroughly.
| Get rid of the strange taste in your mouth with fresh fruit, juice, or sour hard candy.
| Use plastic utensils if you have a metallic taste in your mouth. Use straws instead of drinking
out of a glass.
Dont:
1. Do not take appetite stimulants without consulting your doctor.
Call MD: If you have poor appetite, weight loss, unable to drink fluids, or if you have concerns.
|
|
Loss of Breast or Testacle
Definition: Removal or part or all of the breast or testicle.
Symptoms: none
Causes:
Surgery.
Radiation.
Do:
G After a mastectomy, a woman needs to exercise the affected side to maintain muscle tone and improve
circulation. Also, there are certain limits for lifting heavy objects. For the rest of your life, do not allow blood pressure
or venipunctures to be done on the affected arm.
| Get information about breast and testicle/penile and .
: A surgical procedure to recreate the natural contour of your breast by using a prosthesis or your own tissue.
It can be done at the time of your mastectomy, weeks later, or years later. A breast implant is a rubber sac filled with either
saline or silicone. Usually a tissue expander is placed in the breast under anesthesia first to stretch the skin to
fit the size of the implant. This can be done outpatient. Over time, the expander is filled with saline by inserting a small
needle into the sac periodically. A few months later, the skin is stretched enough to fit the implant.
involves moving fat and muscle from one area of the body to the breast. This involves a hospital stay of several days.
This is beneficial since a nipple can be created. In either case, consult a plastic surgeon to find out more details about
the benefits and risks, and to see if you are a candidate for reconstructive surgery.
| Prostheses may feel heavy, but they should feel comfortable, show natural contour and
consistency, and remain in place when you move.
| Ask if the prosthesis absorbs perspiration and about how to care for it.
| Try many different types. Prostheses vary in shape, weight, and consistency. Custom-made
forms are also available.
| Shop around to find the best fit and the right price.
| Penile implants or prostheses are placed six to twelve months after original surgery.
Three different types are available: inflatable; semi-rigid rod; and hinge type.
Dont:
1. Do not try new methods without consulting your doctor.
Call MD:
If you are experiencing pain, bleeding, discomfort, or concerns. |
|
Mouth Sores (Stomatitis)
Definition:
: Inflammation of the esophagus.
: Inflammation of the oral cavity.
: Dryness of the mouth.
: Difficulty swallowing.
: Inflammation of the mucous membranes.
Symptoms:
Redness, swelling, bleeding, sores, white patches, dry cracked areas, or pain in the mouth and throat.
Causes:
Chemotherapy.
Antibiotics.
Radiation therapy that includes head and neck, salivary glands, chest, abdomen, and pelvis in treatment
fields.
Graft-versus-host disease.
Poor mouth care.
Dehydration.
Immunosuppression.
Surgical removal of the salivary glands.
Drugs, e.g., antihistamines, atropine, phenothiazines for nausea.
Alcohol or nicotine.
Do:
G Use saliva.
G Crush medicine in pill or tablet form; mix in juice or in applesauce, jelly, or pudding (check
with your nurse or pharmacist first, because some medicines interact negatively with some foods).
G Use a toothpaste or a baking soda . (Swish fluid around the mouth and gently gargle, then spit
out). Use baking soda (one teaspoon) and water (two cups) or salt (½ teaspoon), baking soda (one teaspoon) and water (one
quart) or hydrogen peroxide and water (one part peroxide to three parts water)(never use hydrogen peroxide full strength in
the mouth); mix right before use and hold in mouth for 1-1/2 minutes, then spit out and rinse with plain or salt water keep
lips moist with K-Y jelly or Chapstick. Rinse the mouth with one teaspoon of Kaopectate, then spit out. Ask your doctor to
prescribe a mixture of Carafate (this is a ready-to use mixture of sucralfate, water, and 70% Sorbitol syrup). Swish around
mouth and spit out.
G If possible, see your dentist before you start chemotherapy to have your teeth cleaned
and to take care of any problems such as cavities, abscesses, gum disease, or poorly fitting dentures. Ask your dentist to
show you the best ways to brush and floss your teeth during chemotherapy. Chemotherapy can make you more likely
to get cavities, so your dentist may suggest using a fluoride rinse or gel each day to help prevent tooth decay.
| Avoid mouthwashes, dental floss, tobacco, alcohol, coarse, high fiber foods, spicy foods, lemon-glycerin
swabs, poorly fitting dentures.
| , soft, liquid, high caloric, high protein foods, tart, sugar-free candy, or hot tea with lemon,
chewing gum, Gatorgum. (Include milk, cream, cereal, Jell-O, soup, rice, butter, crackers, eggs, tapioca, custard, cottage
cheese, and fish)
| Sip liquids with meals. Use extra butter, gravies, and sauces to moisten food.
| Moisten foods with liquids and sauces, e.g., gravy, cream, soups, beverages.
| Keep a container with preferred fluids nearby.
| Do mouth care thirty minutes before and after eating and every four hours while awake.
| Brush the teeth using a soft nylon bristle toothbrush. To increase the softness of the bristles,
soak the brush in hot water before brushing and rinse with hot water during brushing. If the toothbrush hurts, use a popsicle
stick with gauze wrapped around it or cotton swabs instead.
| Rinse toothbrushes well after use and store in a cool, dry place.
| Remove and clean dentures between meals.
| Choose soft, soothing foods, such as ice cream, milkshakes, baby food, soft fruits (bananas and
applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, cottage cheese, macaroni and cheese, custards,
puddings, and gelatin. You also can cooked foods in the blender to make them smoother and easier to eat.
| Avoid irritating, foods, such as tomatoes, citrus fruit, and fruit juice (orange, grapefruit,
and lemon); spicy or salty foods; and rough, coarse, or dry foods such as raw vegetables, granola, and toast.
Dont:
1. Do not use extreme temperatures in foods.
2. Do not eat foods that need much chewing, such as tough meats, chewy candy, or raw whole vegetables.
3. Do not use lemon or glycerine swabs.
4. Do not use citrus fruits such as oranges, lemons, limes, tomatoes, or juices of these fruits. Instead, use apricot,
pear, or peach juice and avoid carbonated beverages.
5. Do not eat hot, spicy foods such as pepper, curry powder, horseradish.
6. Do not use petroleum jelly if using oxygen therapy.
Call MD:
If inside the mouth and gums look red, shiny, or swollen, blood in mouth, small ulcers or sores in the mouth, on gums,
or on tongue, a white or yellow film in the mouth decreased appetite pain in the mouth, feelings of dryness, mild burning,
or increased sensitivity to hot and cold foods, soft whitish patches or pus in the mouth.
|
|
Nausea and Vomiting
Definition: Unpleasant sensation similar to sea sickness or motion sickness. Can lead to emptying stomach contents.
Symptoms:
Throwing up, dizziness, dislike smells, pain in abdomen, or queasiness.
Causes:
Cancer of the central nervous system.
Food toxins, infection, or motion sickness.
Chemotherapy.
Radiation therapy to the stomach, intestines, esophagus, and/or brain.
Waste products from cell destruction.
Irritation or obstruction of .
Drugs, e.g., digitalis, morphine, antibiotics, vitamins, iron.
Pain.
Concentrated supplemental feedings.
Electrolyte imbalances, e.g., .
Kidney problems.
Nausea caused by thinking of treatment.
Tension, anxiety.
Seeing or smelling things that trigger nausea.
Do:
G Replace fluids lost with high calorie, electrolyte-rich, cool liquids, e.g., Gatorade, popsicle,
soft drinks.
G Take antinausea medications as ordered.
G Follow a clear liquid diet for one to twelve hours before chemotherapy, and for one to
twenty-four hours after chemotherapy.
G Request that medications be prescribed in suppository form.
| Avoid noises, smells, and lighting that causes nausea.
| Provide well-ventilated, cool environment.
| Avoid sudden movement.
| Rearrange activities during times of increased nausea.
| Change diet to include cool, bland foods (include milk, cream, cereal, Jell-O, soup, rice, butter,
crackers, eggs, tapioca, custard, cottage cheese, and fish).
| Use relaxation or distraction techniques.
| Wash face with cool cloth.
| Eat cold foods or those served at room temperature such as sandwiches, cottage cheese, cereals,
and desserts. These foods are usually better tolerated than warm or hot foods, since the odors of hot foods often aggravate
the sensation of nausea. Use a clear liquid diet to reduce nausea. Liquids such as apple juice, cranberry juice, lemonade,
fruit-ades, broth, Gatorade, ginger ale, 7-UP, popsicles, gelatin, tea, or cola are usually well tolerated. These liquids
should be sipped slowly. Bland foods (include milk, cream, mashed potatoes, applesauce, sherbert, cereal, Jell-O, soup, rice,
butter, crackers, eggs, tapioca, custard, cottage cheese, and fish) Hard or soft mints and sour candy are also generally well
tolerated.
| Avoid sweet, fatty, highly salted, spicy foods, and foods with strong odors.
| Avoid contact with food being cooked or people eating during this time.
| Avoid eating or drinking for one to two hours before and after chemotherapy.
| Eat frequent light meals (five to six) throughout the day. Nausea can happen even when a person
is not thinking about food. A person can vomit even if he or she has not eaten anything and hasnt had any nausea.
| Eat the foods you like. Many people develop a distaste for red meat and meat broths. Substitute
protein fish and chicken.
| Eat foods with long-lasting, pleasant odors, such as lemon drops or mints, ginger ale, apple
juice, broth, Popsicle, Jell-O, tea, etc.
| If you feel nauseas, relax and take slow deep breaths.
| Eat ice chips or frozen juice chips that can be munched slowly. |
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