Nursing care focuses on wound management, threats to body image and self-esteem, and prevention. Teach the patient how to care for the wound aseptically. Coordinate a consistent, standard plan so that the patient can begin to assume care for the wound. If the wound is large and infected, keep it dry and clean. If it has an odor, control the odor with odor-masking substances such as oil of cloves or balsam of Peru in the room.

Patients are often upset about the changes in their appearance. Listen to the patient's fears and anxieties and accept the patient's perception of her or his appearance. Assist the patient and significant others to have realistic expectations. Help the patient present a pleasant appearance by assisting with hair care and clothing. Some patients experience increased self-esteem when they wear their own clothing rather than hospital-issued clothing, if hospitalization is needed. If hair loss occurs during radiation, encourage the patient to wear any type of head covering that improves body image, such as baseball caps, wigs, scarves, or bandanas. If it is appropriate, arrange for the patient to interact with others who have a similar problem. If the patient has endstage disease, listen to the patient's and significant others' fears and concerns. Identify the needs of the family, and investigate mechanisms for support from the chaplain, the American Cancer Society, or a local hospice.

If the patient cannot continue with his or her present occupation, arrange for job counseling to evaluate possible occupational alternatives. Encourage the patient to avoid excessive sun exposure by using sunscreen and wearing protective clothing. Explain the necessity of examining the skin weekly or monthly for precancerous lesions and to obtain healthcare when any unusual skin changes occur.

Mirror Madness

Mirror Madness

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