CNA514 Oncology Nursing 3
Question:
Febrile Neutropenia is an extremely concerning complication of chemotherapy treatment. It can often lead to dose reductions or delays In treatments, compromising treatment efficiency (de Nauross et al. 2010). Although CT is designed to target abnormal tumour cells during development, CT similarly affects distinct cells in the body, such as hair, bone marrow, mucosa and gastrointestinal tract (Ferreira et al. 2017). CT drugs can lead to toxicities initiating a multitude of side effects: alopecia, fever and infectious symptoms and signs, to name a few (Ferreira et al. 2017). Early intervention for cases of febrile neutropenia is essential and most episodes can be resolved with antibiotic therapy (Carmona-Bayonas 2011).
One patient particularly stands out for me. Part of the oncology nurse’s role Is to educate the patient on their treatment and this includes the possible side effects. After educating this patient, explaining the possible side effects and the seriousness of acting promptly, the CT was administered with no issues. However, on day three after her treatment she developed a fever of 38 degrees. Unfortunately, she did not present to accident and emergency or to her local general practitioner as recommended when performing the education. Therefore, on day four her temperature had risen to 40 degrees and subsequently she became extremely unwell and was rushed to accident and emergency. This resulted in an admission to hospital lasting seven days, with numerous intravenous antibiotic therapies administered. Consequently, her following CT treatment had to be delayed. As the nurse educating her felt somewhat responsible, leading me to question how I explained the seriousness of such fevers and the necessity to acquire treatment promptly. Thankfully this patient did recover well and underwent her following CT cycles.
Importantly this has lead me to query what could have been done better? Researching this topic has shown me there are tools available in supporting the education of the patient and assisting the nurse. A tool that may Improve assessment and risk of febrile neutropenia Is a computer-based risk assessment tool (CBRAT). Establishing a data-based tool allows easy access to patient CT regimes and possible nsk factors for febrile neutropenia (Miller, K 2010).
Answer:
Febrile Neutropenia is a case that might have resulted on the basis of a side-effect due to the administration of chemotherapy. It significantly lowers the count of the neutrophils in the body along with the onset of high body temperature causing fever. The most common clinical intervention, as has been already talked about is the use of antibiotics to treat the case however the challenges associated with antibiotic resistance have introduced new methods such as Granulocyte-colony stimulating factor that stimulates the bone marrow or boosts up the production of neutrophils (Averbuch et al. 2013). However, interventions also incorporate the use of white blood cell transfusion which is not so popular due to the problems related to compatible graft and the stem cell therapy that has been considered as a landmark discovery to treat acute cases of Febrile Neutropenia, especially in minors and patients with bone cancer (Bennett et al. 2013). Stem cell therapy is the future of complicated physiological deformities. The procedure advances with the stem cell suspensions being collected from the liver of the developing embryo about six to twelve weeks old after the gestation period and injecting the stem cells intravenously in the patients suffering from Febrile Neutropenia. The research results showed improvement in terms of better appetite, reduction in fatigue and weakness, reduction in the body temperature and a hike in the neutrophil count. Although, the process is cost intensive but it has been reported to be the best treatment procedure to combat any complication related to genetic disorders such as Febrile Neutropenia permanently.
References:
Averbuch, D., Orasch, C., Cordonnier, C., Livermore, D.M., Mikulska, M., Viscoli, C., Gyssens, I.C., Kern, W.V., Klyasova, G., Marchetti, O. and Engelhard, D., 2013. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. haematologica, 98(12), pp.1826-1835.
Bennett, C.L., Djulbegovic, B., Norris, L.B. and Armitage, J.O., 2013. Colony-stimulating factors for febrile neutropenia during cancer therapy. New England Journal of Medicine, 368(12), pp.1131-1139.
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