NICOLAS, KRIZHA ANGELA S.

BSN3E
ACTIVITY 2
Critical Thinking Exercise:

Nursing Management of the client with cancer

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SITUATION: A 49- year old accountant has a 32-year history of cigarette smoking. He often eats
out with associates and typically eats red meat and potatoes. One of his associates is a 51 -year old
female whose mother died of breast cancer. She is 40 pounds over her ideal body weight because
she likes to snack during the day. She is also a heavy coffee drinker.
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1. What risk factors does each of these clients have for development of cancer?

a. The 49-year old accountant is at risk for the development of cancer because he has a
long history of cigarette smoking, this is because there are a lot of chemicals in tobacco
that are known to cause cancer by damaging your DNA. Approximately 70 of the
chemicals in cigarettes are known to cause cancer and these includes nicotine, benzene,
formaldehyde and vinyl chloride. Meanwhile, it is also stated that they both often eat
red meat and potatoes – these foods might be high in acrylamide which increases the
risk for cancer. Another factor which makes the 51-year old female at risk is because she
has a family history of breast cancer. She is also obese. In obesity, the fats in visceral
organs inhibits oxygen which causes inflammation which in long-term can possibly lead
to cancer. She is also a heavy coffee drinker – coffee also contains acrylamide which in
high amounts can be harmful. More so, at their age, there are certain types of cancer
that are likely to develop.

2. What advice can the nurse offer these individuals about reducing their risk for cancer?

a. For the 49-year old accountant who has a 32-year history of smoking, the nurse can
suggest ways on how to stop smoking or in the most effective way, the nurse can
educate them through enumerating the bad effects or possible complications of
smoking. For both individuals, they should limit the intake of foods that are carcinogenic
when taken in high amounts, such as red meat, potatoes and coffee. Instead, they
 should have a balanced diet that includes vegetable and fresh fruits, whole grains and
adequate amount of fiber, and reduce the amount of fat and preservatives, including
smoked and salt-cured meats. They must also exercise regularly. These steps can reduce
their risk of cancer.

3. What is the most important aspect of planning care for the client who has been diagnosed with
cancer?
 In planning care for a client who has been diagnosed with cancer, as healthcare
providers, we should address the person as a whole, not just their disease. The goal is to
prevent or treat, as early as possible, the symptoms of the disease from exacerbation
and the side effects of their treatment as well as to any related psychological, social,
and spiritual problems. There’s a lot more to fighting cancer than destroying cancer
cells, we have to look at a person’s medical care and needs from a holistic perspective.

4. Explain why older adults do not always respond as well to treatment of cancer as do younger
persons?
 Early detection and treatment of the factors that can lead to cancer are better
than knowing it when you’re older, not to mention, when it’s too late. This is
because old patients have weaker body and immune system to fight the disease
than the younger ones. Older patients or people over 65 years of age respond
less to treatment regimen than younger ones, probably because of the
differences in the T cell subsets in older versus younger patients. According to
an article published in ScienceDaily, researchers may have found a group of
immune cells that increase in number with age but are too worn out to fight
diseases. The accumulation of dysfunctional virtual memory T cells, in addition
to the loss of true naive T cells, may explain why older people have reduced
immune responses to cancer and vaccines, and why cancer immunotherapy is
less successful in the elderly. In addition, cancer treatment can be more
challenging and complicated for older adults, because older adults are more
likely to have chronic health conditions, such as diabetes or heart disease. Even
when you are healthy, your body will most likely respond differently to
treatment than a younger person’s body. For example, older adults are more
likely to have serious side effects from chemotherapy.