Chemotherapy in patients with gastric cancer care, because chemotherapy drugs destroy cancer cells but also in normal tissues and cells to varying degrees of damage to cause some adverse reactions, so the whole process of chemotherapy, nursing care is very important.
(A) of the chemotherapy drugs and care of local adverse reactions
1. Chemotherapeutic drug extravasation causing local tissue necrosis, the need to immediately stop the injection, drip from the original antidote after IV access needle injection, partially closed. After 24 hours of the methods available topical anti-inflammatory pain. Local necrosis ulcers approach should be surgical dressing.
2. Embolic phlebitis due to chemotherapy drugs to stimulate the cells lining blood vessels, inflammation of the venous occlusion, especially when excessive injection of anti-cancer drug dose or concentration is too high, causing more. Generally along the vein to be dark brown pigmentation, there is pain. Care points: administered by infusion method, may have planned to choose the forearm or hand vein, and often replace the injection site.
(B) of the anticancer drug systemic adverse reactions and nursing care
1. Digestive reaction and nursing of the most common are nausea, vomiting, anorexia, cisplatin, fluorouracil and so often happens in the administration of 1-6 hours duration from 24 hours to 1 weeks. Mainly because of drug or drugs to stimulate gastric mucosa caused by stimulation of the vomiting center. The extent of gastrointestinal reactions and drug type, dosage, drug delivery and patient psychological factors, physical related. Nursing should be noted: conscious when injected with the patient to talk, distraction; Before chemotherapy, prophylactic use of antiemetic 5 – Jing-color plastic antagonist; increase the dose of antiemetic agent, changing the timing, or combination antiemetic agents; encourage patients to eat at the appropriate time, for example, chemotherapy drugs in the morning 7:00 on the day the advance of high-quality breakfast, 4-6 hours after chemotherapy is best not to eat, to eat at night.
Chemotherapy in patients with gastric cancer care 2. Marrow suppression and nursing of the main factors of bone marrow suppression: and drug concentration and time-related; related with age, young people better bone marrow reserve; and tumor burden (size) relevant; on the nutritional status of the patient; with the patient's liver and kidney function.
Bone marrow suppression manifested as bone marrow suppression components: usually manifested initially granulocyte white blood cells, especially the reduction of white blood cells normally 7-10 days of chemotherapy treatment began to decline, the main risk is infection; thrombocytopenia; severe hemoglobin will be reduced, patients can produce anemia, hyperthyroidism card.
Care points: white blood cell count <4X 109 / L and platelet count <50X109 / L, in principle, should not be given chemotherapy. If the white blood cell count <1X109 / L, it is easy serious infection. check every week or every blood before treatment, WBC less than 3X109 / L, platelets less than 50 x 109 IL – 80 x 109 IL, should be temporarily discontinued or extended course of treatment. prevention of secondary infection, serious implementation of disinfection and isolation system to monitor body temperature changes. cell below the self-1×109 / L should be taken to protect the isolation ward strict disinfection, and all use of materials, equipment can be used by the sterilization treatment, and a small number enter the new blood. thrombocytopenia often bleeding tendency, to observe patients with and without gingival bleeding, petechiae, ecchymosis, with or without hematuria, blood in the stool and so on. Instruct patient not to pick your nose, when you need to use electric razors to shave his beard to prevent skin damage. In addition to routine care, the patient can give moxibustion Ojo, Zusanli, 2 times a day for 10 minutes per point to increase patient resistance.