Overview of Hepatocellular carcinoma
Hepatocellular carcinoma is a malignant tumor of liver, which can be divided into two categories: primary and metastatic, with primary hepatocellular carcinoma being the most common. Hepatocellular carcinoma is a serious threat to the health of human beings, and its death rate is the second highest among malignant tumors. Due to the lack of specific symptoms in the early stage, most of the patients are already in advanced stage once they are diagnosed. Doing a good job of nursing care for patients with hepatocellular carcinoma is of great significance to improve the quality of life and prognosis.
Main nursing problems
1. Pain.
2. Anxiety.
3. Nutritional disorders.
4. Potential complications, such as bleeding and distant metastasis.
5.Lack of knowledge related to liver cancer treatment, nursing and rehabilitation.
Nursing measures
1. Psychological care
Due to the lack of knowledge about the disease, patients often have bad emotions such as anxiety, fear and depression. Therefore, nursing staff should care, encourage and comfort the patients, patiently explain the treatment and prognosis of the disease in detail, so that the negative emotions of the patients can be discharged and they can actively cooperate with the treatment.
2. Pain care
Pain in liver area is the most common and typical symptom of liver cancer patients. Drugs should be given on time as prescribed by doctors, not waiting until patients are in pain, so as to improve the quality of life of patients, especially in advanced cancer patients, and the dose of prophylactic drugs is also smaller and the analgesic effect is better. Drugs should be given in a stepwise manner from weak to strong according to the area, nature and duration of the patient’s pain, as well as the presence or absence of concomitant symptoms (e.g., nausea, vomiting, etc.). Patients should also be made to understand that drugs are not the only way to control pain, and they should be encouraged to exercise self-control by reading books and newspapers, listening to music, etc., to divert their attention.
3.Dietary care
Patients should eat high-protein, high-calorie, low-fat food, so as to eat less and more meals. For patients with ascites, sodium intake should be restricted and low-salt diet should be given. Attention should be paid to the supplementation of drinking water to facilitate the distribution of large amounts of heat, but avoid the intake of food containing plant fiber; attention should be paid to the supplementation of vitamins, and more fresh fruits and vegetables should be consumed.
4. Observation of condition
Observe and record the patient’s vital signs changes and consciousness state, and discover the patient’s condition changes in time. Observe the nature, degree, duration and radiation of pain in the liver area of the patient. After hepatic intermediary therapy, closely observe the patient’s blood pressure changes and the patient’s dorsalis pedis arterial pulsation and whether there is blood seepage from the wound.
5. Maintain water and electrolyte balance.
Liver cancer patients often have ascites and edema, so it is necessary to observe water and electrolyte balance, give low sodium diet, check sodium and potassium concentration in blood from time to time, record output and input in detail, and record abdominal circumference and degree of edema every day, and notify the doctor immediately if there is any abnormality, so as to do emergency treatment.
6.Bleeding care
Within 24 hours after surgery, patients should rest in bed, monitor the coagulation time, prothrombin time, platelet count, etc., and closely observe the nature, color and amount of drainage fluid. If a large amount of blood is drained in a short period of time or continuously, or if the patient’s pulse and blood pressure are still unstable after blood transfusion or fluid transfusion, the patient should notify the doctor immediately for emergency treatment.
7. Drainage tube care
Properly fix all kinds of postoperative drainage tubes to avoid folding, pressure, twisting and so on.
8. Nursing care of radiotherapy
Closely observe the patient’s reaction after radiotherapy, for serious vomiting, diarrhea should follow the doctor’s instructions to be water electrolyte supplementation, regular recheck of blood routine and so on. Immediately report to the doctor for any changes in the patient’s condition.
Health promotion
1. Encourage patients to eat more protein-rich food and fresh vegetables and fruits, and the food should be light and easy to digest.
2. Instruct patients to quit smoking and drinking.
3. Avoid constipation, prevent blood ammonia from rising, and use appropriate amount of laxative to keep the bowel movement smooth.
4. Advise patients to take medication as prescribed by the doctor and have regular follow-ups.