7.+Cognitive+Impairment


 * Cognitive Impairment **

One in every three people in the United States are expected to be diagnosed with cancer in their lifetime, and more than half of those diagnosed will require chemotherapy as part of their treatment regimen (National Cancer Institute, 2009). Chemotherapy is the mainstay of treatment for various cancer types, and although survival is greatly increased with its use, it can also cause many adverse effects during and following treatment. Cognitive impairment, commonly referred to as ‘chemo brain', is one of the most frequently reported post-chemotherapy symptoms among breast cancer survivors. Cognitive impairment may cause changes in memory, communication, expressive and receptive, and many other cognitive abilities may be affected. Cognitive impairment following chemotherapy treatment comes as surprise to many cancer survivors. Many cancer patients that become survivors think that they will return to normal once the cancer is gone only to find out post chemotherapy treatment they are experiencing lingering effects that interfere with their cognitive function. They begin to experience things that interfere with their day-to-day life. Things such as working, connecting with others and completing simple tasks can become very difficult for this person. It is important for us as nurses to educate on things that can help them manage and cope with these new changes they are experiencing.
 * CLINICAL SIGNS/MANISFESTATIONS **
 * Problems with short term memory
 * Forgetting details of recent events
 * Difficulty concentrating on a single task
 * Confusing dates and appointments
 * Difficulty focusing on a single task
 * Fumbling for the right word or phrase
 * Feeling mentally slower than usual
 * Difficulty carrying out day to day tasks
 * Ways to Help: **
 * Establish a daily routine and keep the same schedule each day.
 * Create an organized environment that is free of clutter.
 * When you need to complete tasks that require concentration, try to minimize distractions.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Work and read in a quiet, uncluttered environment.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Make a checklist, or a “to-do” list, of daily chores, errands and important things to remember (e.g., grocery list, medication schedules).
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Write your appointments in a calendar
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Carry a personal organizer and/or notebook with you.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Place post-it notes around your house and workplace, or leave yourself voice mail messages as reminders.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">To sharpen your memory, try to learn a new skill, take a class, or do crossword puzzles (Sodoku puzzles) or other games
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Get plenty of sleep, exercise regularly, [|maintain a proper diet], and [|manage your stress].
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Keep a daily journal to track changes in your thinking, memory and behavior, including when symptoms began, what time of day they occur, and what influences them throughout the day. Share this information with your doctor.
 * <span style="font-family: 'Times New Roman',serif; font-size: 12px;">Share your experiences with others (e.g., friends, family, other cancer survivors).

<span style="font-family: Andalus,serif; font-size: 16px;">-BELOW: This video shows: Many women who undergo chemotherapy for breast cancer describe unsettling changes to the memory and concentration. Researchers at the University of Michigan Comprehensive Cancer Center say this phenomenon is very real, and have even given it a name: “Chemo brain” []

[|**http://www.oncolink.org/resources/article.cfm?c=16&s=59&ss=224&id=1057**]
 * <span style="color: #7030a0; font-family: Andalus,serif; font-size: 16px;">Oncology nurses **<span style="font-family: Andalus,serif; font-size: 16px;"> can play an integral role for patients who experience CICI. Nurses are key participants in screening and assessment, discussing proposed treatment options and current knowledge, as well as validating patients' symptoms and concerns and helping them find ways to cope with CICI (Evens &Eschiti, 2009). Although CICI is a common side effect in patients receiving chemotherapy, its exact cause is unknown. Because of this, it is difficult to determine management strategies for patients experiencing this symptom. However, understanding how CICI can affect a patient's ability to make complex decisions and carry out his/her daily responsibilities (career, family life, etc) allows the oncology nurse to become a patient advocate.
 * <span style="font-family: Andalus,serif; font-size: 16px;">REFERENCES **
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