Cancer nursing in this chapter is three concrete disciplines. Run a post-mastectomy patient forward day by day and watch which arm exercises, which drains and which restrictions are correct right now. Then step into a room where the patient herself is the radiation source and see what time, distance and shielding actually do to your exposure. Finally, match receptor status to the drug — and to the monitoring the drug demands.
Which side had the mastectomy and axillary dissection
Days since surgery1day
0 — 365 days. Drag it out past a year and see what still applies.
How you have her positioned
Drains
Output in the last 24 hours70mL
Removal is expected below roughly 30 mL in 24 hours for two consecutive days
What she is being asked to do with the arm today
Where you stand while you give care
Minutes you spend in the room20min
Plan every task before you enter, then do them all at once
Who is coming into the room
The source has dislodged into the bed. What do you do?
And afterwards. Once the implant is removed the patient emits no radiation at all and needs no precautions. External beam radiation is different again — that patient is never radioactive, and your teaching is skin care in the field, fatigue, diarrhoea, cystitis and long-term vaginal stenosis, which is why dilator use is prescribed and must be taught matter-of-factly.
Which cancer
What the pathology came back as
Ovarian status
Pathology returns three facts that determine everything: oestrogen receptor, progesterone receptor and HER2 status. Imaging never establishes the diagnosis — core-needle biopsy does.