Basal Cell Epithelioma2

8/4/2019 Basal Cell Epithelioma2

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A slow- growing, destructive skin tumor,basal cell epithelioma or carcinoma usuallyoccurs in persons older than age-40; itsmore prevalent in blond, fair skinned menand is most common malignant tumor

affecting white.


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Changes in Epidermal basal cells candiminish maturation andkeratinization.Continuing division of basalcells leads to mass formation. The threetypes are nodular ulcerative lesion,superficial basal cell epithelioma and

sclerosing basal cell epithelioma.


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Arsenic ingestionBurnsImmunosuppressionProlonged sun exposure ( most common)Radiation exposureVaccination (rare)


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Occur most commonly on the face,particularly the forehead, eyelid marginsand nasolabial folds.early lesions: small, smooth, pinkish, andtranslucent papules; telangiectatic vesselcrossing the surface; occasionally

pigmented.later lesions: center depressed; bordersfirm and elevated.


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Results in ulceration and local invasion (known as rodent ulcers; rarely metastasizebut if untreated , can spread to vital areasand become infected; can cause massivehemorrhage if they invade large bloodvessels).


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Numerous; commonly on chest and back.Oval or irregularly shaped, lightly pigmented

plaques, with sharply defined, sligthly

elevated threadlike borders.Appears scaly with small atrophic areas incenter that resembles psoriasis or eczema;usually chronic, but dont tent to invade other

areas.Related to ingestion of or exposure to arsenic

containing compunds.


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Irradiation is used if the tumor location requires it orif the patient is elderly or debilitaded and might notwithstand surgery.

Cryotherapy with liquid nitrogen freezes and kills thecells.

Chemosurgey may be necessary for persistent orrecurrent lesions. Chemosurgery consist ofperiodic applications of a fixative paste (such as

zinc chloride) and subsequent removal of fixedpathologic tissue. Treatment continues until thetumor has been completely removed.


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Instruct the patiet to eat small frequent smallmeals that are high in protein. Suggesteggnog, pureed foods, or liquid protein

supplement if the lesins has invaded the oralcavity and is causing eating problems.Tell the patient to prevent the disease from

recurring, he needs to avoid excessive sun

exposure and use a strong sunscreen orsunshade to protect his skin from damage byultraviolet rays.


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Advise patient to relieve local inflammationfrom tropical flourouracil with coolcompresses or corticosteriod ointment.

Advise patient with noduloulcerative basalcell epithelioma to wash his face gentlywhen ulcerations and crusting occur;

scrubbing too vigorously may causebleeding.


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Waxy, sclerotic, yellow to white plaqueswithout distinct borbers occuring on thehead and the neck that looks like smallpatches of scleroderma.


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Incisional or excisional biopsy and histologicstudy may help to determine the tumortype and histologic subtype.


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Curettage and electrodesiccation offer goodcosmetic results for small lesions.

Tropical Flourouracil is commonly use for

superficial lesions. This medicationproduces mark irritation or inflammation inthe evolved tissue but no systemic effects

Microscopicalltrolled surgical excisioncarefully removes recurrent lesions, skingrafting may be required.


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and calorieintake.

Promote earlymobility.Provideposition

changes

Teach patientto practiceaseptictechnique forcleansing,

medicatinglesions.

Teach patientthe importanceof need foradequatenutritional food

intake.

Advise patientto avoid directsun exposureof affectedarea.

to promotewellness

measure topromotewellness.

n : 107

Hematocrit0.29

Segmenters: 0.72

Lymphocytes: 0.19

Creatinine:135


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CUES/NDXprovidepositionchanges

GOAL OFOBJECTIVE

NURSINGINTERVENTION

RATIONALE

IMPLEMENTATION

EVALUATION

SUBJECTIVE::may sugat sabukol ni inahobjective:LesionImflammedneck

particularlyaround theaffected area.Poor skinturgor.On ngtfeeding.Dry lips

At the endof healthteachingclent will beable to:1. verbalize

understanding ofrecencondition

2. Identify itsnature andcomplication.3.utilizetreatment canbe done.

encourageclient toexpressthought freely.

To advise thepatient to

follow doctorsorderreligiously.

Assist patientin comfortableposition.

Inspectwounds daily

to identifycausative factors.

To promotecontinous

healing andassess thedegree ofimpairment.

To avoidaspiration andminimize

Impairmentpromote

Helpedclientexpressedthoughtsandfeelings.

Administered NGTfeeding.

Advised toregiously

Patienthaveverbalizedrecentconditionfreely.

Client haveidentifiedpreventivemeasuresfor causinginfection.


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NAME OFDRUG

MECHANISMOF ACTION

INDICATION/CONTAINDICATION

SIDEEFFECTS

NURSINGRESPONSIBILITIES

Brand name:

Genericname:Co amoxiclav

Classification:anti bacterial /anti biotic

Dosage:1.2mgs

Route:Intravenous

An AntibioticIn the class of

Drugs calledPinicillin itfights bacteriastapinfections itpreventbacterial cellwall synthesisduringreplication

Used primarilyfor the

treatmentOf infectiondue tobacterialagentinfections ofthe respiratorytractSkin structure,paranasalsinuses, otitismedia,sinusitis or

Dizziness,fatigue

,insomnia skinrashes, itchyeyes, fine ordry mouth,abnormaltastesensation,diarrhea,rectalbleeding

AdvanceEffect :

Always the 10rigths. Rights

of patient,drugs,dosage,route,frequency

Advised pt. toReportimmediatelyany unusalmanifestationof the adverseeffect after

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Basal Cell Epithelioma2