The adjuvant chemotherapy for gastric cancer (ACGC) was implemented massively in clinical, which had become a clinical pathway (CP). The rapid development of ACGC technique had brought many new challenges to the nursing work. Based on “The Clinical Pathway of ACGC” (Version 2012), we focused on the new problems
and analyzed the key points in ACGC’s clinical nursing, including psychological problems, Selleckchem Lorlatinib gastrointestinal reaction, bone marrow suppression, adverse drug reaction, PICC pipe and phlebitis, alopecia etc. Methods: The main psychological problems in ACGC are the anxiety and fear. The patients are worried about the unpredictable effect of adjuvant chemotherapy, the adverse reaction occurred on body and the side effects of the drug. The main psychological nurse methods includes the nursing communicates adequately with the patients in the whole treatment
progression, and getting the supports from the patients’ family members to release the anxiety and fear. Gastrointestinal reaction includes decreased appetite, obvious BMS-777607 price nausea and vomiting, diarrhea and so on. The traditionary methods are the tropisetron hydrochloride injection in 30 min before chemotherapy, and some patients with serious reaction should be injected with metoclopramide. The additional methods includes that the antiemetic and sedative drugs are injected by intravenous or intramuscular to relieve gastrointestinal reaction in 3 ∼ 4 h after chemotherapy. The chemotherapy drugs must be stopped at these moments. We must pay more attention to the http://www.selleck.co.jp/products/BAY-73-4506.html allergic reaction at the fifth or sixth injection because the Oxaliplatin belongs to platinum-based chemotherapy drugs, which can be resolved by intramuscular injection of diphenhydramine, intravenous injection of dexamethasone in 30 min before chemotherapy to reduce the probability of drug allergy. Other drugs injection is forbidden at the moment of oxaliplatin infusion. The toxic reaction of chemotherapy on peripheral nerve, blood and vital organs should be focused on, and the corresponding treatments must be taken
immediately. For peripheral nerve toxicity reaction, the nurse needs to remind patients to keep warm mission, and avoid skin contact with a cold object. For toxicity of organs, common methods are the injection of aid to liver, myocardial nutrition medicine and drug to enhance the body resistance. The patients with serious critical bone marrow depression should be given leukocyte increasing agents such as granulocyte colony-stimulating factor. The other necessary treatment includes clearing the ward, keeping satisfied temperature and humidity and so on. We suggest that the patients received the adjuvant chemotherapy use PICC catheter at the first time if the patients have particularly vulnerable vascular. The puncture site of PICC should be kept clean and dry, and the dressing and heparin lock connection should be changed in time.