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Clinical Manual for the Oncology Advanced Practice Nurse

Clinical Manual for the Oncology Advanced Practice Nurse

This book is intended to serve as a quick reference for advanced practice nurses (APNs) caring for oncology patients, from diagnosis through treatment and rehabilitation. With the advances made over the past several years in prevention, early detection, and treatment, oncology patients are living longer and developing other diseases that must be managed. In the inpatient and outpatient oncology settings, the role of the oncology APN is becoming more focused on primary care. This book provides a guide for managing the acute and chronic oncologic issues familiar to the oncology APN, but can also assist in managing general medical problems with which the APN may not be as familiar. It also serves as an excellent reference for nurses in any of various specialty areas (eg, medical oncology, surgical oncology, home care) who are seeking medical information that is not necessarily related to a patient’s cancer diagnosis or treatment.

The book’s many contributors are primarily advanced practice nurses working in a broad range of settings. An introductory chapter provides an overview of the general role of the APN in patient management. It includes an extensive discussion of the history-taking process, the components of a physical examination, diagnostic tests, interpretation of symptoms and history, differential diagnosis, treatment and management (both nonpharmacologic and pharmacologic), the referral process, and short and long-term follow-up.

Each subsequent chapter is presented in outline form and includes the following sections for each diagnosis or symptom: definition, pathophysiology, clinical features, diagnostic tests, differential diagnosis, treatment, follow-up, and referrals. In cases where the differential diagnoses are described elsewhere in the book, the reader is referred to that separate chapter. For example, if dyspnea is being evaluated, the APN can review the chapter that specifically addresses that topic, to ensure that a thorough history is taken and correct diagnostic tests are performed. If the diagnosis is pleural effusion, the APN can review the pleural effusion chapter for a more comprehensive evaluation of that diagnosis.

Following the introduction, the book is divided into sections on 11 body systems. Each of these sections includes descriptions of associated symptoms and medical diagnoses. A section entitled "Miscellaneous" contains chapters that review a variety of topics, including anxiety, breast tenderness, nipple discharge, swelling, lumps, fatigue, depression, phlebitis, human immunodeficiency virus, and the use of total parenteral nutrition.

There are 158 chapters in all, and many contain detailed tables that will be beneficial to the APN. For example, the myocardial infarction chapter includes a table on thrombolytic therapy that serves as a quick drug reference, with mechanisms of action, the advantages and disadvantages of treatment, and guidelines for administration. The APN can use this table to identify the appropriate agent for managing a particular clinical situation in a timely manner. References appear at the end of each chapter.

There are 18 appendices with useful oncologic and medical information, including antibiotic treatments, different drug categories (eg, antidepressant agents, antiemetic agents) with prescribing information, National Cancer Institute Common Toxicity Criteria, tumor markers, paraneoplastic syndromes, dermatomes, cranial nerve assessment, and dose equivalents for opioid analgesics. Additional resources are referenced in this section.

The major strength of the book is its organized, easy-to-read outline format, and the multiple tables supplementing the chapters. It would be an extremely useful reference for the traditional oncology clinical nurse specialist moving into an APN role with a primary care focus. The book can also serve as a "refresher course" on various medical conditions and as a quick comprehensive resource, not only for APNs, but for all nurses involved in caring for this patient population.

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