The 5 Nursing Process Steps

Benchmark - Nursing Process: Approach to Care The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care. Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper: Describe the diagnosis and staging of cancer. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects. Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans. 

Runninghead: NURSING PROCESS: APPROACH TO CARE
NURSING PROCESS: APPROACH TO CARE
Name of the student
Name of the university
Author Note

1
NURSING PROCESS: APPROACH TO CARE
Abstract
This paper stated the stages, diagnosis procedure, complication and side effects of cancer
with details. Overview of cancer and stages of cancer are discussed. A wide discussion on
TNM and Numbering staging system is given here. Different ways to diagnose cancer
discussed with stress here in this paper. The treatment of cancer often interferes with normal
cell proliferation of the body by killing new fast-growing cells. Chemotherapy kills the
proliferating cells with the cancer cell. Also, the treatment of cancer comes up with massive
physical and psychological changes in the body , leading to many complications and side
effects. Methods to reduce the psychological and physical effects are discussed vividly here.
Reports of the American Cancer Society on major causes of cancer and mortality by cancer
are discussed. The role of a nurse in taking care of a cancer patient is discussed including
holistic and person-centered care. The role of liberal arts, science, and social studies to build
up the premium qualities of a nurse has been discussed in this paper.
Keywords: Stages of cancer, complication, side effects, holistic care, person-centered care

2
NURSING PROCESS: APPROACH TO CARE
Table of Contents
Introduction:...............................................................................................................................3
Discussion:.................................................................................................................................3
Different Stages of Cancer:....................................................................................................3
Diagnosis:...............................................................................................................................4
Complications of Cancer:.......................................................................................................4
Side effects of cancer treatment:............................................................................................5
Methods to lessen physical and psychological effects:..........................................................6
Incidents and Mortality Rate by different cancers in Americans:..........................................7
Overview of the American Cancer Society:...........................................................................8
Nursing process in providing safe and effective care for patients:........................................9
Holistic approach and patient-focused care of cancer:...........................................................9
Contribution of liberal arts and sciences studies in the foundation of Nursing:....................9
Conclusion:..............................................................................................................................10
Citations and References..........................................................................................................10

3
NURSING PROCESS: APPROACH TO CARE
Introduction:
Cancer is a term given to collective diseases. It is an abnormal condition where the
body‘s normal cell starts to proliferate without revising the process of division at any cellular
checkpoint. Most of the cancer form a solid malignant tumor, whereas blood cancer does not
form any solid tumor.
Discussion:
Different Stages of Cancer:
The TNM staging system is general for all types of cancers and widely used. The T
present in the term, represents the size as well as the extent of the primary tumor. The N
represents the number of cancerous lymph nodes present nearby. The M present in the term
represents the metastasized. M stands for the spreading of the primary tumor to other distant
parts of the body (Pan., 2016).
 In the case of TX and T0, the main tumor measurement is not possible. T1, T2, T3,
and T4 define the extent of the primary tumor. The higher the T, the larger the size of
the tumor. The number of affected tissue nearby the primary tumor is higher when the
T is higher.
 In the NX and N0, no nearby lymph is affected. N1, N2, N3 represents no affected
lymph nearby. The affected lymph number is directly proportional to the number
prefixed by N.
 MX and M0 represent no metastasis in the tissue, whereas M1 refers the occurrence
of cancer all over the body.
Another widely used staging system is the numbering system.

4
NURSING PROCESS: APPROACH TO CARE
 Stage 0: This stage, also known as the carcinoma in situ (CIS) (Casey et al., 2015). In
this stage, potentially cancerous cells are present in a particular place but are not
spread to nearby tissue.
 Stage I, Stage II, Stage III: In all the three stages, cancer cells are observed, and they
get spread to the nearby lymph. The higher the stage the more it has been spread into
the tissues present nearby.
 Stage IV: the cancer tissue has been spread to almost all over the body, including the
distant pars.
Diagnosis:
 Lab Test: testing blood and tissue sample for tumor marker tests. Tumor markers are
defense molecules of the body produced against cancer or any abnormal cellular
condition and can be used as a biochemical marker of cancer.
 Imaging tests: This test produced an image of the inside organs of our body and used
to identify the tumor. The types of imaging tests include Ultrasound, CT Scan,
Nuclear Scan, MRI, PET Scan, Bone Scan, and X-ray (de Rooij et al., 2016).
 Biopsy: A sample of tissue is examined under the microscope and goes through a
series of pathological tests to identify the stage of cancer in a Biopsy (Blume-
Jensen.,2015)
Complications of Cancer:
 Nausea and vomiting are the most common complication faced by 20-30% of
cancer patients. In the severe stages of cancer, the prevalence of this
complication is 70%. Cancer patients have administrated opioids, which leads
to vomiting and nausea. The centre stimulations ( fear/ anxiety) increases in
this condition.

5
NURSING PROCESS: APPROACH TO CARE
 Fatigue is another complication associated with cancer. The treatment of
cancer does cell lysis and tumor necrosis, leading to the liberation of
intracellular products. Tumor necrosis also influences massive changes in
skeletal muscle. These factors cause excessive fatigue in cancer patients.
 Dyspnoea or breathlessness expressed in cancer patients (Dunger et al.,2015).
This condition has four degrees of a phenotypic component. Asthmatic
condition defines the difficulty in breathing. The sensations in the upper
airway and also pain is reported sometimes. The emotional expression like
fear, negative evaluation and anxiety become out of control. The energy of
the body decreases down in this condition. Tumor in the airway, laryngeal
palsy, extrinsic compression, and accumulation of fluid in the lungs are the
root cause of this type of complication. Radial therapy scares the patient
resulting in shortness of breath sometimes.
Side effects of cancer treatment:
The side effects of cancer treatment occur when the treatment damages the normal tissue of
the body. The side effect of treatments varies depending upon applied therapy, medicinal
dose, and health condition of the patient.
 Neutropenia is a diseased condition where the number of white blood cells (the
body’s main defense mechanism against infection) decreases. Working mechanism of
Chemotherapy is to kill all the fast proliferating cells. It kills cancer cells as well as
white blood cells in the acting mechanism (Rasmy et al.,2016).
 Lymphedema is a condition with abnormal accumulation of lymph fluid under the
skin. The lymph node gets destroyed or damaged by the treatment leading to the

6
NURSING PROCESS: APPROACH TO CARE
improper drainage of fluid. The fluid then accumulated under the skin and swelling
observed (Smith et al.,2015).
 Deep Vein Thrombosis or formation of blood clots, usually in the pelvis, thigh, or
lower body, is another side effect of cancer treatment. Clots also can be seen in the
arms. The abnormal clots sometimes travel to the lungs and develop critical
conditions (Watson et al., 2015).
Methods to lessen physical and psychological effects:
The methods to lessen the physical effects of cancer vary with different health
conditions and types of complications faced by patients. Chemotherapy, radiation, and other
cancer treatments can cause severe pain in patients. This pain can be reduced by using hot or
cold packs, tender massage, breathing exercises, relaxation exercises and intergrative
exercises. Acupuncture is an effective method to reduce the discomfort and pain of
neuropathy (Ju et at., 2017). Changing medicine also helps in reducing the side effects. A
healthy lifestyle including sufficient sleep and nutrition-filled diet helps in lessening the side
effects in a mild amount. Physical activity is recommended to keep the body active and brain
alert. People suffering from the problem of urinary incontinence can keep their problem in
check by lowering the fluid intake and urinating before bed or any strenuous activity.
Cancer comes with massive psychological turbulences. Cancer patients often feel
anger, emotional outburst, anxiety, and depression. These conditions can be overcome by
giving care, love, support, and encouraging the sufferer. The patient needs continuous mental
motivation to survive. Cognitive Behavioral Therapy and Dialectical Behavioral Therapy are
two widely accepted therapy to overcome psychological problems in cancer patients (Zayfert
& Becker, 2019). Incorporating medication in lifestyle is an amazing way to fight against this
mental condition. Antidepressant and anti-anxiety peels are also a useful aspect to treat ill-

7
NURSING PROCESS: APPROACH TO CARE
mental health conditions. Zoloft, Wellbutrin, Paxil are some well-known antidepressants used
to treat the low mental health of cancer patients.
Incidents and Mortality Rate by different cancers in Americans:
As claimed by a recent report of the American Cancer Society, more than 16.9 million
people in America with the history of cancer were alive until 1st January 2019 and it is
expected that more 1.8 million people will be diagnosed with cancer in 2020. 606,520
number of death is expected by cancer in the year 2020 in America (Cancer.org, 2020). The
prevalence of cancer is higher in older people than younger peoples. An individual with a
history of cancer in the family is more prone to cancer. However, exposure to a risk factor is
a major factor of cancer. A smoker has a 25% higher chance of developing lung cancer than a
non-smoker. Here some risk factors are described below according to the type of cancer:
 The probability of developing Breast Cancer is way more in older women. Weight
gain after the age of 18, menopausal hormone therapy, regular alcohol consumption
and low or no physical activity are some other risk factors associated with breast
cancer.
 The risk factors of Childhood Cancer are not well identified yet. This cancer believed
to be caused by random cell mutation. External cause like exposure to ionization,
prior radiation therapy increases the risk of childhood cancer and other different types
of cancers.
 Colon cancer is mainly associated with excess body weight, no or low physical
activity, smoking for a long time, poor diet with consumption of excess red meat and
alcohol. No incorporation of vegetables, grains and fruits in the diet increases the risk

8
NURSING PROCESS: APPROACH TO CARE
of colon cancer. Some other associated factors are Lynch syndrome, family history of
cancer, personal history of bowel disorder.
 Fifty percent of people with kidney and renal cancer are reported to be obese and
tobacco smokers. Tobacco and excess weight are the major risk factors for kidney and
renal cancer. Other factors associated with cancer are high blood pressure, exposure to
chemical risk factors, alcohol consumption and renal failure.
Overview of the American Cancer Society:
American Cancer Society provides help, support and guide to the cancer patients
throughout his/her journey with cancer. It gives different services which are listed below:
 Giving information about cancers, available treatment options, medicines,
side effects, coping with care, pain control, clinical trials, preventions, medical
screening and quitting tobacco.
 Providing resources like patient services, support group, medical equipment,
wigs and prosthetics, financial programs, transportation and quilting.
 Publications to educate about cancer.
 Community programs and services
 Day to day help and support to patients.
The ACS provides huge numbers of support to the patients, and all of them are very much
needed for a patient to fight against cancer. Though, the publications of them is one of the
best support strategy among all. The publications include brochures, pamphlets, book and
journals in cancer. These publications give vivid knowledge about cancer, treatment, coping
issues and other important aspects of cancer. These journals are not only useful for cancer
patients but also helpful for the health professional, family members of patients and to create
awareness about cancer in people (Cancer.org, 2020).

9
NURSING PROCESS: APPROACH TO CARE
Nursing process in providing safe and effective care for patients:
A nurse in the oncology department is expected to provide care to the patient during
the entire course of treatment and after that. The five fundamental phases, assessment,
diagnosis, outcome, implementation, and evaluation are applied throughout the caring
process.
Holistic approach and patient-focused care of cancer:
The holistic approach of nursing is a concept of taking nursing care to the spirit and
mind of a patient (Giske & Cone, 2015).
This approach considers the psychological, social and physical needs of a patient. The nurse
takes charge to know about the patient’s feelings, emotions and answer their queries. The
approach recommends living a healthy life with introducing medication, proper sleep, good
diet beside usual medication.
Patient-focused care or palliative care of cancer concerns the enhancement in the
quality of a patient’s life. This approach includes relief from physical and psychological
symptoms, relief from the social problem like a financial burden, treatment cost, and leading
a spiritual life. This care is given throughout the life of the patient (Nelson et al.,2016).
Contribution of liberal arts and sciences studies in the foundation of Nursing:
Nursing is a dynamic profession and needs excellence in many other degrees like
cultural competence, critical thinking, and thoughtfulness. To build the niche of a perfect
nurse all the subjects including liberal arts, mathematics and science play chief role (Holland,
2017).

10
NURSING PROCESS: APPROACH TO CARE
 A nurse needs to think critically, ask questions and understand the quantitative and
research data. Mathematics and social studies help to encourage a nurse to think
critically.
 To become a successful nurse, one should be well grounded and balanced. Liberal art
is crucial to make one well grounded.
 Liberal arts also build up leadership qualities among nurses.
Conclusion:
The paper gives well-balanced knowledge about cancer and nursing care for cancer.
The different approaches to cancer care are also discussed in this paper. The prevalence of
cancer in America and the risk factors discussed considering the reports of ACS. The role of
different subjects in nursing is incorporated. The holistic approach is not a well established
and well-known approach, which should be widely used to cure and prevent cancer. Lifestyle,
the major cause of cancer, should be checked, and the government should be more concerned
about controlling the prevalence of cancer.
Citations and References
Blume-Jensen, P., Berman, D. M., Rimm, D. L., Shipitsin, M., Putzi, M., Nifong, T. P., ... &
Ernst, C. (2015). Development and clinical validation of an in situ biopsy-based
multimarker assay for risk stratification in prostate cancer. Clinical cancer
research, 21(11), 2591-2600.

11
NURSING PROCESS: APPROACH TO CARE
Cancer.org. (2020). American Cancer Society | Information and Resources about for Cancer:
Breast, Colon, Lung, Prostate, Skin. Retrieved 12 February 2020, from
https://www.cancer.org/
Casey, R. G., Catto, J. W., Cheng, L., Cookson, M. S., Herr, H., Shariat, S., ... & Black, P. C.
(2015). Diagnosis and management of urothelial carcinoma in situ of the lower
urinary tract: a systematic review. European urology, 67(5), 876-888.
de Rooij, M., Hamoen, E. H., Witjes, J. A., Barentsz, J. O., & Rovers, M. M. (2016).
Accuracy of magnetic resonance imaging for local staging of prostate cancer: a
diagnostic meta-analysis. European urology, 70(2), 233-245.
Dunger, C., Higginson, I. J., Gysels, M., Booth, S., Simon, S. T., & Bausewein, C. (2015).
Breathlessness and crises in the context of advanced illness: A comparison between
COPD and lung cancer patients. Palliative & supportive care, 13(2), 229-237.
Giske, T., & Cone, P. H. (2015). Discerning the healing path–how nurses assist patient
spirituality in diverse health care settings. Journal of Clinical Nursing, 24(19-20),
2926-2935.
Holland, K. (2017). Cultural awareness in nursing and health care: an introductory text.
Routledge.
Ju, Z. Y., Wang, K., Cui, H. S., Yao, Y., Liu, S. M., Zhou, J., ... & Xia, J. (2017).
Acupuncture for neuropathic pain in adults. Cochrane Database of Systematic
Reviews, (12).
Nelson, E. C., Dixon-Woods, M., Batalden, P. B., Homa, K., Van Citters, A. D., Morgan, T.
S., ... & Lind, C. (2016). Patient focused registries can improve health, care, and
science. Bmj, 354, i3319.

12
NURSING PROCESS: APPROACH TO CARE
Pan, J. J., Ng, W. T., Zong, J. F., Chan, L. L., O'Sullivan, B., Lin, S. J., ... & Kan, W. K.
(2016). Proposal for the 8th edition of the AJCC/UICC staging system for
nasopharyngeal cancer in the era of intensity‐modulated radiotherapy. Cancer, 122(4),
546-558.
Rasmy, A., Amal, A., Fotih, S., & Selwi, W. J. J. C. P. C. R. (2016). Febrile neutropenia in
cancer patient: epidemiology, microbiology, pathophysiology and management. J
Cancer Prev Curr Res, 5(3), 00165.
Smith, B. G., Hutcheson, K. A., Little, L. G., Skoracki, R. J., Rosenthal, D. I., Lai, S. Y., &
Lewin, J. S. (2015). Lymphedema outcomes in patients with head and neck
cancer. Otolaryngology–Head and Neck Surgery, 152(2), 284-291.
Watson, H. G., Keeling, D. M., Laffan, M., Tait, R. C., Makris, M., & British Committee for
Standards in Haematology. (2015). Guideline on aspects of cancer‐related venous
thrombosis. British journal of haematology, 170(5), 640-648.
Zayfert, C., & Becker, C. B. (2019). Cognitive-behavioral therapy for PTSD: A case
formulation approach. Guilford Press.