IV.

PATHOPHYSIOLOGY
Predisposing factor
Gender M<F
Genetic/Hereditary

Cell death = Cell

replace

Life style
Sexual practice
Virus
Environmental
Chemical
Physical

Somatic mutations in the

DNA
Activate
oncogene/deactivate
tumor-suppressor gene

Malignant transformation
of lymphoid stem cells
Uncontrolled proliferation
of lymphoblast in the bone
marrow

DiagnosticTest:
BM aspiration

Lymphoblast replace the normal

marrow elements
Decreased production of normal
blood cells

s/sx:
bone pain

Treatment:
Analgesic

Treatment:

Remission Induction
Therapy

Consolidation and
Maintenance Therapy

BM

V.NURSING CARE PLAN

ASSESSMENT
"Minsan nakirot siya at
masakit" as verbalized
by the patient

Objective
Grimace face noted
With pus discharge at
left breast
Pain scale of 5 out of
10 as 8-10 severe
pain, 5-7 moderate
pain, 0-4 mild pain

NURSING
DIAGNOSIS
Acute pain
related to
wound at
left breast
secondary
to breast
cancer

PLANNING

INTERVENTION

EVALUATION

After series of nursing

intervention the patient
will able to verbalized
that pain is relieved or
controlled

Provide with calm and quiet

environment
R. for adequate rest and
sleep

After series of nursing

intervention the patient was able
to verbalized that pain is
relieved or controlled

Provide comfort measures

R. to provide non
pharmalogical pain
management
Administer analgesics/pain
reliever as prescribed
R. to alleviate pain
Encourage adequate rest
periods
R. to prevent fatigue
Encourage use of relaxation
exercise
R. reduce skeletal muscle
tension which will reduce the
intensity of the pain
Encourage verbalization of

feeling about pain

R.be able to know the degree
of pain felt

VI. DRUG STUDY

DRUG
NAME
tamoxifen
citrate

MODE OF
ACTION
Potent anti
estrogenic effects:

INDICATION

SIDE EFFECTS

NURSING RESPONSIBILITIES

Adjunct with cytotoxic

chemotherapy following

Because of the way this medicine

acts on the body, there is a chance

. Take the drug twice a day, in the morning and

evening.

(ta mox' i
fen)ApoTamox
(CAN),Nolv
adex, NovoTamoxifen(
CAN),
Tamofen
(CAN),Tamo
ne (CAN)

competes with
estrogen for binding
sites in target
tissues, such as the
breast

Pregnancy
Category D
Drug class

Anti
estrogen

DRUG NAME

radical or modified
radical mastectomy to
delay recurrence of
surgically curable breast
cancer in
postmenopausal
women or women >50 y
with positive axillary
nodes

Treatment of advanced,
metastatic breast cancer
in women and men;
alternative to
oophorectomy or
ovarian radiation in pre
menopausal women

Preventative therapy for

women at high risk for
breast cancer

MODE OF
ACTION

that it might cause unwanted

effects that may not occur until
months or years after the medicine
is used. Tamoxifen increases the
chance of cancer of the uterus
(womb) in some women taking it.
Tamoxifen may cause blockages to
form in a vein, lung, or brain. In
women, tamoxifen may cause
cancer or other problems of the
uterus (womb). It also causes liver
cancer in rats. In addition,
tamoxifen has been reported to
cause cataracts and other eye
problems.
Discuss these possible effects with
your doctor

INDICATION

The following side effects may occur: bone pain;

hot flashes(staying in cool temperatures may
help); nausea, vomiting (small, frequent meals
may help); weight gain; menstrual irregularities;
dizziness, headache, light-headedness (use
caution if driving or performing tasks that require
alertness).

This drug can cause serious fetal harm and must

not be taken during pregnancy

SIDE EFFECTS

NURSING
RESPONSIBILITIES

Generic Name: ciprofloxacin

(oral) (SIP roe FLOX a sin)
Brand Names: Cipro, Cipro XR,
Proquin XR
CiprofloxacinBRANDNAMECiprob
ayDOSAGE250-500mgBID
GASTROINTESTINAL DRUGSLaxatives

Inhibits
bacterial DNA
gyrase thus
preventing
replication
insusceptible
bacteria

Infections of the resp. tract,

middle ear, para nasal
sinuses, eyes, kidneys
,urinary tract

PRECAUTION
Severe and persistent
diarrhea during and after
treatment
ADVERSE RXN
Common: Nausea,
diarrhea, vomiting, rash
Uncommon: Anorexia,
headache, dizziness,
fever, GI and abdominal
pain, flatulence,
confusion, vertigo

>Assess pt for previous

sensitivity
reaction>Assess pt for
any s/s of infection
before& during
treatment>Assess for
adverse
reactions>assess pt.
&familys knowledge
of drug therapy

DRUG NAME

MODE OF ACTION

Levocetirizine
BRANDNAME
Xyzal
DOSAGE
Adult and adolescents
more than12 yrs- 1tab/day
Pedia: 6-12yrs- 1 tab/day

Long-acting nonsedating antihistamine

that selectively inhibits
peripheral HI receptors

Classification: ANTIINFECTIVES-Penicillins

INDICATION

Treatment of symptoms
associated with allergic
conditions(including
ocular symptoms)

SIDE EFFECTS

PRECAUTION
Adjustment of dose is
recommended in elderly pts
w/compromised renal
function .Lactation.
ADVERSE RXN
Dry mouth, headache, fatigue,
rhinitis, abdominal pain,
migraine

NURSING
RESPONSIBILITIE
S
>obtain pt hx inc.
drug hx and any
unkown
allergies>monitor
pulse, BP,
respiration>
observe dizziness
and excessive
sedation