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Symptom Management:

Symptom Management

Side Effects of Treatment
Side Effects of Chemotherapy
Pain
Fatigue
Appetite Loss
Bladder Disturbances
Incontinence - Urinary
Bleeding
Constipation
Diarrhea
Dryness of the Mouth
Fluid and Electrolyte Imbalances
Hypercalcemia
Flu-like Syndrome
Hair Loss
Infection
Anemia
Itching
Lymphedema
Menopausal Symptoms
Nausea & Vomiting
Neurological Disturbances
Spinal Cord Compression
Peritoneal Effusions
Shortness of Breath
Skin Conditions
Sleep Problems (Insomnia/Oversleeping)
Sore Mouth
Swallowing
Bone Metastases
Coping
Anxiety
Depression
Grief
Sexuality Issues
Sexual Dysfunction
Bleeding

Symptom and Description Bleeding occurs when blood escapes from a blood vessel. Bleeding can happen anywhere in your body. It can happen as an open cut, nose bleed, or bleeding hemorrhoid, or it may occur inside your body, such as in your stomach, lung, brain, or bladder. Slow bleeding can have little effect or can make you tired, weak, and short of breath. Sudden bleeding can cause severe weakness, dizziness, and pain.

Bleeding most often occurs in the person who has cancer when platelets (cells and the blood that help stop bleeding) are low. This may be a problem for people with leukemias or other tumors involving the bone marrow, as well as for those receiving chemotherapy or radiation therapy.

The risk of bleeding increases with infection, especially when the platelets are low or are dropping quickly.

Learning Needs You will need to learn the signs and symptoms of bleeding and what to report to your doctor. The signs and symptoms of bleeding may be obvious, as with a nose bleed, or more subtle. You should report any of the following signs of bleeding to your doctor.

  • Skin: A fine red rash that looks like pinpoint dots, usually appearing on the feet and legs; increased bruising
  • Eyes: Bleeding in to the whites of the eyes, inability to see normally
  • Mouth and nose: Blood blisters, blood oozing from gums, blood-tinged saliva, bleeding mouth sores, nose bleeds
  • Digestive system: Blood in vomitus, blood in stools, black tarry stools
  • Urination/genitals: Blood in urine, pain or burning on urination, cramping, and frequency; vaginal bleeding
  • Other: Severe headaches; increased weakness; difficulty waking up; pain in joints and muscles

Prevention Your skin and the lining of your mouth are protective barriers for your body. Keeping them clean and free of debris is important in decreasing infection and risk for bleeding.

1. Skin:

  • Bathe and clean the perineal (crotch) area daily
  • Use skin lotion to prevent dryness and breaks in skin
  • Protect skin from cuts and scrapes and sharp objects
  • Shave using an electric razor
  • Trim and cut nails
  • Avoid falling and contact sports

2. Mouth care:

  • Cleanse your mouth after each meal and before bedtime
  • Use a soft-bristle toothbrush
  • If your platelets are low, you may need to use toothettes, or swabs, instead of a toothbrush
  • Use mouthwash that does not contain alcohol, which can be drying

3. Digestive system:

  • Promote normal bowel patterns, avoiding straining and constipation
  • Use stool softeners or laxatives
  • Maintain proper diet and exercise
  • Avoid rectal suppositories and enemas
  • Avoid taking rectal temperatures

Management

  • If bleeding does occur, stay calm; sit or lie down
  • If bleeding is external, such as a cut, wound, or nose bleed, apply pressure for at least 10 to 15 minutes
  • If bleeding is on a leg or arm, raise the limb above your heart
  • Use an ice pack for 5 to 10 minutes to help slow the bleeding
  • If oral bleeding occurs, increase the frequency of mouth care
  • If blood is in vomitus, take your prescribed antiemetics, antacids, or medications to decrease acid in the stomach; avoid spicy or acidic foods and caffeine
  • If blood is in urine, increase fluids; note color and amount of urine for reporting to your doctor
  • If bleeding vaginally, note if the bleeding is heavy or abnormal and the size of clots; do not use tampons; keep track of how many sanitary napkins are used for reporting to your doctor

Follow-up Notify your nurse and/or physician if any of the following occur:

  • Blood in stool, urine, or vomitus
  • Unusually heavy vaginal bleeding (or any bleeding if you are past menopause)
  • Blood in sputum, shortness of breath, or problems breathing
  • Dizziness, severe headaches, or changes in mental status
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2004 2nd Cancer Opinion USA