Atención integral a una mujer con úlcera neoplásica latero cervical: un caso clínico en Atención Primaria / Comprehensive care for a woman with laterocervical neoplastic ulcer: a clinical case in primary care

El aumento de episodios oncológicos en la salud supone un incremento en las heridas de etiología neoplásica, las cuales tienen un abordaje diferente del de otro tipo de heridas. En el artículo se describe el caso clínico de una mujer de 71 años que presentaba una lesión neoplásica en la zona latero cervical derecha, a la que se le realizó un plan integral de cuidados de Enfermería con la intención de efectuar un abordaje holístico. La valoración permitió detectar un riesgo de baja autoestima situacional como diagnóstico enfermero, que fue abordado en el plan de cuidados junto a los problemas de colaboración: úlcera neoplásica latero cervical y dolor agudo secundario a la lesión neoplásica. Para el plan de cuidados se utilizaron las taxonomías NOC y NIC: Curación de la herida por segunda intención (NOC: 1103), Cuidados de las heridas (NIC: 3660) y Cuidado de las heridas: ausencia de cicatrización (NIC: 3664); Control del dolor (NOC: 1605) y Manejo del dolor (NIC: 1400); Aceptación: Estado de salud (NOC: 1300) y Apoyo emocional (NIC: 5270). Hasta la muerte de la paciente se cumplieron los objetivos generales de un abordaje terapéutico dirigidos a mejorar la calidad de vida del sujeto, optimizar su autoestima y su paz espiritual

The increase of oncological episodes in health represents an increase in the wounds with neoplastic etiology, which need a different approach from that used for other type of wounds. This article describes the clinical case of a 71-year-old woman who presented a neoplastic lesion in her right laterocervical area; a comprehensive Nursing Care plan was conducted with holistic approach as objective. Assessment allowed to detect the risk of situational low self-esteem as Nursing Diagnosis, which was addressed in the Nursing Plan alongside collaborative problems: laterocervical neoplastic ulcer and acute pain secondary to the neoplastic lesion. NOC and NIC taxonomies were used for the Care Plan: Wound healing: secondary intention (NOC: 1103), Wound care (NIC: 3660) and Wound care: Non-healing (NIC: 3664); Pain control (NOC: 1605) and Pain management (NIC: 1400); Acceptance: Health Status (NOC: 1300) and Emotional Support (NIC: 5270). Until the patient’s death, the general objectives were met regarding a treatment approach targeted to improving the patient’s quality of life, optimizing her self-esteem and her spiritual peace

Nursing Management of Advanced Merkel Cell Carcinoma.

Merkel cell carcinoma (MCC) is a rare and lethal skin cancer with few known treatment options. Management of this disease is challenging, and oncology nurses must understand the medical, physical, and psychosocial burden that MCC places on the patient and family caregivers. Patients must navigate a complex medical and insurance network that often fails to support patients with rare cancers. Nurses must advocate for these patients to ensure quality comprehensive cancer care.

Cutaneous T-cell lymphoma: overview and nursing perspectives.

Cutaneous T-cell lymphoma (CTCL) is an uncommon and complex malignancy of the immune system with a wide range of clinical presentations primarily involving the skin. An extensive menu of skin-directed and/or systemic treatment options exists. Best practices in management involve multidisciplinary collaboration. Nursing care for patients who have CTCL is a critical component in the successful management of the disease and requires special attention to the patient's physical, emotional, and spiritual needs. Nurses can make a significant impact by being accessible, offering emotional support, demonstrating advocacy, and providing ongoing education for the patient and family.

Cutaneous T-cell lymphoma.

OBJECTIVE: To review recent information on the epidemiology, etiology, clinical presentation, staging, treatment approaches, and nursing management of CTCL. DATA SOURCES: Research and review articles and textbooks. CONCLUSION: Identifying the etiology and finding a cure for cutaneous T-cell lymphoma is promising as our knowledge and understanding of the T-cell biology evolves, creating more options for innovative therapies or treatment modalities. IMPLICATIONS FOR NURSING PRACTICE: It is essential for the oncology nurse to understand the disease process, treatment modalities, and side effect profiles to provide astute nursing assessment, establishment of treatment goals, management of cutaneous symptoms, treatment of side effects, and pain control while preventing infection and providing psychological/social support throughout the course of the disease.

Psychological adjustment to the melanoma experience.

OBJECTIVES: To provide a review of the literature on the psychological adjustment to malignant melanoma. DATA SOURCES: Research reports and review articles. CONCLUSIONS: Three prominent themes evolved from the literature: (1) delineation of issues concerning long-term survivorship and quality of life following a diagnosis of melanoma; (2) coping with metastatic and end-stage melanoma; and (3) identification of the possible link between immunomodulation and the evolution of melanoma. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must individualize their support and counsel according to the potential trajectory of the patient's melanoma experience. Nurses need to identify an individual's risk for psychological distress and help them enhance coping skills.

Sézary syndrome: a summary.

Sézary syndrome is the leukemic form of primary cutaneous T-cell lymphoma. It is an aggressive disease, with the lowest reported median survival of all cutaneous lymphomas. Patients with Sézary syndrome live with the awareness that they are suffering from an incurable disease. Having to cope daily with extensive skin care regimens, these patients can benefit tremendously from the expertise of dermatology nurses, who can teach them skin selfcare and who are aware of the psychologic impact of this disease. The symptoms, treatments, and emotional distress related to Sézary syndrome are summarized.