Assistance is provided with personal hygiene and physical care. Physical care is directed at the maintenance of fluid and electrolyte balance and proper nutrition. Nutrition is a special concern because tumors compete with normal tissues for nutrients and grow at their expense and because the disease or treatments can cause anorexia, altered taste sensations, mouth ulcerations, vomiting, diarrhea, and draining fistulas. Elimination is maintained by administering stool softeners as necessary if analgesic drugs result in constipation. Comfort is achieved through correct body alignment, noninvasive measures such as guided imagery and cutaneous stimulation, and prescribed pharmacological measures, preferably administered on a regular schedule to prevent pain, with additional dosing to relieve breakthrough pain.
Hospice care if needed is discussed with the patient and family.
The nurse encourages family members to assume an active role in the patient's care, fosters communication between patient and family and other health-care providers, and assists the patient to maintain control and to carry out realistic decision making about issues affecting life and death. To provide effective emotional support to the patient and family, the nurse must understand and cope with personal feelings about terminal illness and death and seek assistance with grieving and in developing a personal philosophy about dying and death. The nurse will then be better able to listen sensitively to patients' concerns, to offer genuine understanding and comfort, and to help patients and family work through their grief. Taber's Cyclopedic Medical Dictionary, Edition 18. All rights reserved.