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.