Pain and dyspnea control in cancer patients of an urgency setting: nursing intervention results

ABSTRACT BACKGROUND AND OBJECTIVES: To outline best practices guidelines to control pain and dyspnea of cancer patients in an urgency setting. CONTENTS: PI[C]O question, with resource to EBSCO (Medline with Full Text, CINAHL, Plus with Full Text, British Nursing Index), retrospectively from September 2009 to 2014 and guidelines issued by reference entities: Oncology Nursing Society (2011), National Comprehensive Cancer Network (2011; 2014) and Cancer Care Ontario (2010), with a total of 15 articles. The first stage for adequate symptoms control is systematized evaluation. Pharmacological pain control should comply with the modified analgesic ladder of the World Health Organization, including titration, equianalgesia, opioid rotation, administration route, difficult to control painful conditions and adverse effects control. Oxygen therapy and noninvasive ventilation are control modalities of some situations of dyspnea, where the use of diuretics, bronchodilators, steroids, benzodiazepines and strong opioids are effective strategies. Non-pharmacological measures: psycho-emotional support, hypnosis, counseling/training/instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation equally improve health gains. CONCLUSION: Cancer pain and dyspnea control require comprehensive and multimodal approach. Implications for nursing practice: best practice guidelines developed based on scientific evidence may support clinical decision-making with better quality, safety and effectiveness.