Problem Cues/ Need Physiologic Deficit Disturbed Body mage Cues Objective !hair loss !

not loo"ing or touching the head !change in ability to estimate s#atial relationshi# of body to environment !change in social involvement Subjective !verbali$ation of feelings that reflect an altered vie% of one&s body in a##earance !fear of rejection or of reaction by others

Nursing Diagnosis Disturbed body image' hair loss related to chemothera#y

Scientific Basis (air loss is a common side effect of chemothera#y treatment) t generally starts to ha##en a fe% %ee"s after chemothera#y starts) *or most #eo#le+ regro%th b egins not long after chemothera#y has ended) Not all #eo#le %ill lose their hair to chemothera#y+ ho%ever) Cancer cells divide at a high mitotic rate+ meaning they divide ,uic"ly !! much more than most of the cells in our body) Chemothera#y drugs %or" by targeting these ra#idly dividing cells) Some cells in our bodies do

Objectives of Care After - days of nursing care+ the child %ill verbali$e #ositive feelings about himself)

Nursing Actions .)Discuss and revie% the structure and function of the hair and develo#ment of hair loss) /)(ave the child identify the meaning of his a##earance and hair loss) 0)(ave the child e1#ress feelings and thoughts about self+ a##earance and hair loss) ncor#orate the use of thera#eutic #lay)

Rationale .)Revie%ing and clarifying aid in learning and strengthen understanding) /) dentifying the meaning assists in determining the degree of its #ossible im#act on the child) 0)Sharing of feelings and concerns #ermits a safe outlet for emotions and also aids in highlighting the child&s a%areness of #ossible im#act on body image) 3hera#eutic #lay allo%s the child to understand that hair loss is tem#orary) 2)Reinforcement aids in clarifying

2)Reinforce %ith the child that

!negative feelings about body

ra#idly divide+ li"e our hair follicle cells and the cells in the lining of our stomach and digestive tract) Chemothera#y drugs sim#le cannot tell the difference bet%een these normal+ ra#idly dividing cells and cancer cells+ so the drug attac" these cells as %ell)

hair is lost by brea"ing off at the s"in surface) Remind child that the hair %ill gro% bac" because the root is not damaged) -)Assist the child %ith suggestions+ such as the use of colorful ca#s+ to minimi$e the a##earance of the hair loss)

any misconce#tions+ hel#ing the child understand that hair loss is tem#orary) -)5inimi$ing the a##earance of the hair loss may hel# the child co#e better %ith the event and #ossibly enhance feelings of self! esteem and normalcy) 4) ncluding the child&s friends in these measures hel#s to decrease the child&s feelings of being different and alone)

4) nclude a fe% of the child&s close friends as a##ro#riate in discussion and suggestions)