RESUMO
Neutropenia is a common complication in patients with cancer who are undergoing chemotherapy. Because of treatment frequency, potential chemotherapy damage to peripheral veins and tissues, and pain from multiple venipunctures, venous access devices (VADs) often are used in the oncology setting. Although VADs have been used for 30 years, no sufficient scientific data exist to support the best care and maintenance strategies for their use in patients with neutropenia. Understanding the etiology and pathogenesis of VAD-related infections (VAD-RI) and the proper steps to prevent or quickly treat it can decrease the likelihood that patients with neutropenia will have a fatal response. This article describes the differences between VADs, the most common sources of VAD-RI, and the treatment of such infections and suggests nursing interventions to help prevent VAD-RI.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Cateteres de Demora/efeitos adversos , Neutropenia/induzido quimicamente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Infecções , Infusões Intravenosas , Neutropenia/complicações , Neutropenia/enfermagemRESUMO
The purpose of this survey was to explore how adults communicate their end-of-life preferences. Face-to-face interviews were conducted with 119 community-dwelling adults who had previously engaged in conversations about their end-of-life preferences. Factors that made it easier to initiate the discussion included having personal experience with illness or death (24.4%), being straightforward (24.4%), or having someone else facilitate the discussion (11.8%). Most described vague end-of-life preferences such as not wanting any machines (41.2%) or heroics (34.5%). Although 22.7% reported using a living will to make their preferences clear, only 5.9% mentioned repeating or reinforcing their preferences. In all, 21% had discussed their end-of-life preferences with their physicians. These findings show discussions about end-of-life preferences frequently lack the clarity and detail needed by significant others and health care providers to honor the preferences. Routine dialogue with health care providers and significant others about end-of-life preferences might provide greater clarity and comfort.