肿瘤化疗护理Chapter 10 Tumor chemotherapy nursing
学习目标
1.了解化疗饮食指导
2.了解化疗常见不良反应
3.掌握下列词汇
chemotherapy 化疗
side effect 副作用
metabolic 新陈代谢的
leukopenia 白细胞减少症
nausea 恶心
vomit 呕吐
antiemetic drug 止吐药
Zhang Jun is a patient in bed #15 who has been diagnosed with malignant tumors.He comes to the hospital for chemotherapy.Li Na is his primary nurse.She is talking with the patient and giving him a health instruction.
Li Na: Good morning, Zhang Jun.How was your sleep last night?
Zhang Jun: Good morning, Li Na.I had a good sleep.
Li Na: You will undergo an intravenous chemotherapy this time.
Zhang Jun: Well, I am a bit worried.How about my diet during this procedure?
Li Na: You need to eat a variety offoods before chemotherapy.The foods should be low in fat, high in protein and vitamin and easy to digest.Besides three meals a day, you may also have tea breaks and night snacks.One day before chemotherapy, you should reduce the intake of sugar and grease, and eat fresh fruits and vegetables which are rich in vitamins.During the 24 hours after chemotherapy,you are advised to eat light meal, as taste may change due to the side effects ofchemotherapy.A moderate amount oflean meat, fruits and vegetables, beans, and egg white is also recommended.Your body functions cannot return to normal shortly after chemotherapy.During this period, you should choose easy-to-digest food, and eat small but frequent meals.Slow down when you drink and eat and avoid highfat, fried, sweet, and greasy foods.Choose foods that are colorful and delicious enough to increase your appetite.You may also take a moderate amount of foods rich in vitamin C, such as fruits and vegetables, which help to prevent constipation, boost immune system, and facilitate the recovery.Drink plenty ofwater to promote metabolism.Stay away from perfume, cigarettes, and kitchen fumes.
Zhang Jun: Okay, thank you, Li Na.Could you tell me something about the side effects and precautions ofchemotherapy?
Li Na: Because of the fundamental metabolic differences between cancer cells and normal cells, chemotherapeutic drugs can cause some damage to normal tissues and induce various reactions while killing cancer cells.For example, you might lose hair during and after the treatment.But in general, your hair will start to grow two to three months after the chemotherapy.Bone marrow suppression may also occur.Leukopenia will cause a decline in immunity.According to the blood test results, we may use medications to increase your white blood cell count when necessary.Reduction in platelet count might occur and lead to spontaneous and hard-to-stop bleeding.Therefore, you need to spend more time in bed and brush teeth with soft-hair toothbrush.Press the injection spot for five to ten minutes after extraction of the needle.Rinse your mouth after meal to prevent oral ulcers.Eat foods rich in coarse fiber.In case of nausea or vomiting, we are going to give you injection ofantiemetic drugs.
Zhang Jun: OK, thank you, Li Na.I will keep your advice in mind.
译文
张军是15床患者，他患有恶性肿瘤，到医院进行化疗。李娜是他的责任护士，她正在和患者对话，进行健康教育。
李娜：早安，张军，昨天休息的怎么样？
张军：早安，李娜，昨天休息的还可以。
李娜：这次入院要进行静脉药物化疗。
张军：是的，我有点紧张，用药期间饮食上需要注意什么？
李娜：化疗前期食物应当做到多样化，选择低脂肪、高蛋白质、多维生素和易消化的食物，除了一日三餐，还可以适当增加下午茶和宵夜。接受化疗前一天，应减少糖分、油脂的摄入，多吃富含维生素的新鲜果蔬。在接受化疗的24小时内，饮食要清淡，因为在不良反应的影响下口味会发生变化。可以吃适量瘦肉、果蔬、豆类和蛋清。化疗结束后，身体功能短时间内无法恢复至正常状态，在此期间吃易消化的食物，少食多餐，喝水和吃饭速度不宜过快；勿食高脂、油炸、甜腻食物；食物要色香味俱全，以增进食欲。适当吃些富含维生素C的食物，如水果、蔬菜，起到防止便秘、提高免疫力的作用，有利于化疗后的恢复。多饮水，促进药物代谢。远离香水、香烟、油烟等气味。
张军：好的，谢谢你，李娜，你能不能给我说说化疗有哪些不良反应和注意事项？
李娜：由于肿瘤细胞和正常细胞之间存在根本性的代谢差异，化疗药物在杀死肿瘤细胞的同时也会对正常组织产生一定的损伤而引起不同的反应。比如，会出现脱发，但一般停用化疗药2～3个月会长出新发。比如，会出现骨髓抑制，白细胞减少会引起身体抵抗力下降，根据血化验结果，必要时使用升高白细胞的药物；血小板减少容易出血，要多卧床休息，用软毛牙刷刷牙，拔针后按压5～10分钟。餐后漱口，预防口腔溃疡。多吃粗纤维食物，预防便秘等。如果有恶心、呕吐，我们会给你注射止吐药物。
张军：好的，谢谢你，李娜，我会认真牢记你的建议。