CNA514 Oncology Nursing 3


The topic I have chosen for the assessment 1 is Febrile Neutropenia post chemotherapy (CT) treatment. I have chosen this topic because recently I have cared for a few patients suffering febrile neutropenia and I would like to gain more knowledge regarding this very serious side effect. 

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). 
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