Patients experiencing acute tumor lysis syndrome require expert and immediate medical and nursing intervention. Attempts are made to minimize possible complications by early management of metabolic abnormalities. The patient who presents with renal failure before treatment may require dialysis before chemotherapy begins. The metabolic disturbances resulting from tumor lysis syndrome usually endure 5 to 7 days because of the "finite period of cytolysis." Proactive preventative therapy may minimize or avert the life-threatening complications of tumor lysis syndrome.
The words writers have used to characterize unrelieved cancer pain, render the notion of emergency--that which is urgent, requiring prompt action--compelling. This information, together with the knowledge that families whose loved ones died in pain have more difficulty with their bereavement and our ethical responsibility to do no harm cannot be ignored. It is interesting that one can read an account of cancer pain that describes agony, isolation, and preoccupation in a classic work of literature such as The Death of Ivan Ilyich, written in 1886. It is disturbing that contemporary literature, even in works published as recently as 1986, contains accounts of cancer pain that describe similar experiences--experiences with pain that exclude thought of anything else that those who are painfree would associate with life, experiences that suggest one is dying while living rather than living until death. How is it that in 100 years art, which is said to imitate life, does not reflect the significant advances made in the scientific understanding and treatment of cancer pain? Can it be that we are less willing to apply this scientific information clinically than other advances? These lay accounts confirm what clinical experience and professional literature suggest--there is an abyss between the scientific advances that have been made in understanding pain and its pathophysiology, the availability of effective therapies, and the clinical application of this knowledge. Why does this gap exist? In part it exists because many professionals and laypersons believe that that's the way it is, that nothing can be done, that cancer is necessarily a painful disease.(ABSTRACT TRUNCATED AT 250 WORDS)
The relationship between caregiver and elder is a unique one. It cannot be compared to a mother-infant dyad; there is no role reversal. Family caregiving is undertaken out of a sense of filial obligation on the family's part coupled with the needs of the elderly person. The relationship that emerges is based on the dependency of one adult on another and is functional for the family and for society at large. We need families to continue to care for their elderly members at home and families need us to insure their survival. We must constantly be aware that care needs increase over the years, whereas family resources do not. Nursing by its very nature is tied to insuring that families are given the guidance and assistance with which to meet these needs.
Because head nurses will utilize the same orientation guide within the Division of Nursing, more consistency in management will be realized between sections and inpatient and outpatient units within the hospital.
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