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University of Southern Philippines Foundation

Salinas Drive, Lahug, Cebu City


College of Nursing

KAPOSIS SARCOMA

Burdago, Queenie B.
BSN IV

Introduction:
Kaposi's sarcoma (KS) is a type of cancer that mainly
affects the skin , mouth , and lymph nodes -- infectionfighting glands -- but can also affect other organs such
as the lungs and gastrointestinal tract. KS was once
rare, only affecting older men of Eastern European or
Mediterranean background, young African men, or
people who had organ transplants. HIV(human
immunodeficiency virus) infection has now become
the most common cause of Kaposi's sarcoma. Types of
Kaposis Sarcoma are Classic Kaposi's sarcoma (KS) rare; progresses slowly over years and tends to affect
elderly men of Mediterranean or Jewish origin.Endemic
or African KS - affects young adult men who live near
the African equator and have a normal immune
system. Reported to occur in up to 9% of Ugandan
men. In some, KS can be aggressive with rapid spread.

Children can also be affected with a form that


invades the lymphatics and lymph nodes but not
the skin. This is associated with spread to other
organs and is usually fatal.Transplant-related or
acquired KS - associated with rapid
dissemination.Epidemic KS - occurrence of KS in
patients infected with HIV.Non-epidemic KS occurs in homosexual men who do not have HIV,
and lesions tend to affect arms, legs and
genitalia. It characteristically has a slow
progression.Recurrent KS.

Due to weakened immune systems, people with HIV are more likely to develop
certain cancers. AIDS (acquired immunodeficiency syndrome) is a later stage of HIV
infection where most severe cases of KS occur. Surprisingly, though, KS of the skin
can also occur earlier in infection. It is a sign the immune system is being
suppressed. The good news is that anti-HIV drugs have caused an 80% to 90% drop
in the rate of KS cases since the beginning of the AIDS epidemic. Also treating the
virus itself is the best way to treat KS, especially early on.

Researchers have discovered that Kaposi's sarcoma is caused by aherpes virus,


called Human Herpes Virus 8 (HHV-8). Affecting eight times more men than women,
Kaposi's sarcoma may spread through sexual contact. However, this is not known for
certain. Keeping your immune system strong with antiretroviral therapy (called
HAART) is the best-known way to prevent Kaposi's sarcoma.

Kaposi's sarcoma creates tumors below skin surfaces and in membranes of


the mouth, nose, anus, or eyes. It can spread to the lungs, liver, stomach, intestines,
or lymph nodes. This involves a process called angiogenesis, where tiny
new blood vessels form.

General Information and Patients Profile


Name:
Age:
Sex:
Civil Status:
Address:
Occupation:
Nationality:
Religion:
Date and Time of Admission:

P.P
26 years old
Male
Single
Mabolo, Cebu City
Businessman
Filipino
Roman Catholic
November 9, 2015 @ 9:00 am

Ward and Bed number:


Admitting Diagnosis:
Name of Hospital:
Chief Complaints:

Kaposis Sarcoma
Vicente Sotto Memorial Medical
Center
Purple lesions on both legs, the
right periorbital region, trunk, and
oral mucosa that are extremely
very painful

Pertinent Nursing Health History


History of Present Illness:
A case of patient P.P 26-year-old HIV-positive male. The patient
reported new onset of purple lesions on both legs, the right
periorbital region, trunk, and oral mucosa for the past month and
was given a diagnosis of Kaposi sarcoma (KS).
Previous Hospitalization:
His 3rd admission in this institution.
Family History:
No known history of any type of diseases.
History of substances abuse:
Not engaged in using any drugs.
Medical History:
No known allergy.

Developmental Task
Patient P.P is 26 years old and fell under the 6th
stage of Erik Eriksons Psychosocial
Development: Young Adulthood -- 19 to 40 years.
Intimacy vs. Isolation

Major Question: "Will I be loved or will I be


alone?"

Basic Virtue: Love


Important Event(s): Romantic Relationships

In this stage, the most important events are love


relationships. Intimacy refers to one's ability to relate to
another human being on a deep, personal level. An
individual who has not developed a sense of identity
usually will fear committed relationship and may retreat
into isolation. It is important to mention that having a
sexual relationship does not indicate intimacy. People can
be sexually intimate without being committed and open
with another. True intimacy requires personal
commitment. However, mutual satisfaction will increase
the closeness of people in a true intimate relationship.
The young adult must develop intimate relationships with
others. Not resolving this conflict leaves the young adult
feeling isolated. The young adult must be willing to be
open and committed to another individual.

Erikson believed that having a fully formed


sense of self (established during the identity
versus confusion stage) is essential to being
able to form intimate relationships. Studies have
demonstrated that those with a poor sense of
self tend to have less committed relationships
and are more likely to suffer emotional isolation,
loneliness, and depression. Erikson believed it
was vital that people develop close, committed
relationships with other people.

GORDONS FUNCTIONAL HEALTH


PATTERNS
HEALTH
PERCEPTION
& HEALTH
MAINTENANC
E

BEFORE HOSPITALIZATION:Importante jud naku


akong health kay batan.on pa kaayo ko, lisod kaayo
magkasakit ron panahona as verbalized by the patient.
DURING HOSPITALIZATION:Patient participated in any
nurse instructions, to go home immediately. Follow all
the nurse instructions during his hospitalization.

NUTRITION &
METABOLISM
PATTERN

BEFORE HOSPITALIZATION:Mokaon man ko ug bisan


unsa labi na utan ug isda kay maayo man sa lawas ug
mu inom 6-8 nga basong tubig adlaw2x as verbalized
by the patientDURING HOSPITALIZATION:Patient is on
(DAT) Diet as tolerated.

ELIMINATION
PATTERN

BEFORE HOSPITALIZATION:Patient stated the he


frequently urinates 6-8 time/day and defecates 1 time a
day.DURING HOSPITALIZATION:During the clients
hospital stay, he voids usually 3-6 times a day and
defecates once a day without experiencing discomforts;
usually morning.

ACTIVITYEXERCISE
PATTERN

BEFORE HOSPITALIZATION:Dali ra kaayo ko kapoyon


ug hangakon dayon akong ginhawa as verbalized by
the patient. DURING HOSPITALIZATION: Always
sleeping and sometimes has a quick chat with his
mother.

SEXUALITYREPRODUCTI
ON PATTERN

He is single. Was engaged in sex at the age of 21


years old. Have a good relationship with his family.

SLEEP-REST
PATTERN

BEFORE HOSPITALIZATION:Puts self to sleep by


texting friends and doing internet surfing. Sleeps 6-8
hours daily.DURING HOSPITALIZATION:During
patients stay at the hospital he was not able to sleep
properly. Can sleep 5-6 hours daily.

COGNITIVEPERCEPTUAL
PATTERN

Speech clear without slur and stutter. Follows verbal


cues. Express ideas and feelings clearly and
concisely. Stated he can recall past events. Patient is
able to see without any help of visual aid. Patient has
no problem with perception.

ROLE AND
Patient has a good relationship towards own family.
RELATIONSHI
P
SELF
PERCEPTION
SELF
CONCEPT

Describes self as a normal person. Friendly person,


loves to socialize with friends.

COPINGSTRESS
TOLERANCE

Cope up with stress by managing a little business.

VALUES

Patient believe in God.

Physical Assessment:
Skin, Hair and Nail

(11-11-15 Day 1)

Inspection: Skin is fair, warm to touch, purple lesions,


range in size from a few millimeters.
Hair is a little bit oily and shiny.
Nails is a bit dirty and long, poor grooming noted.
(11-12-15 Day 2)
Inspection: Skin is fair, warm to touch, purple lesions,
range in size from a few millimeters.
Hair is a little bit oily and shiny.
Nails is a bit dirty and long, poor grooming noted.
(11-13-15 Day 3)
Inspection: Skin is fair, warm to touch, purple lesions,
range in size from a few millimeters.
Hair is clean & groomed.
Nails are short noted.

u Head and neck

(11-11-15 Day 1)

Inspection and palpation:


Enlarged lymph nodes.
(11-12-15 Day 2)
Inspection and palpation:
Modestly enlarged lymph nodes.
(11-13-15 Day 3)
Inspection and palpation:
Modestly enlarged lymph nodes.
u Eyes

(11-11-15 Day 1)

Inspection:
Pupils are equal and round, reactive to light and
accommodation.
(11-12-15 Day 2)
Inspection:
Pupils are equal and round, reactive to light and
accommodation.

(11-13-15 Day 3)
Inspection:
Pupils are equal and round, reactive to light and
accommodation noted.
Ears
15 Day 1)
Tympanic membranes are clear, Land marks are
noted upon inspection.
(11-12-15 Day 2)
Tympanic membranes are clear.
(11-13-15 Day 3)
Tympanic membranes are clear.

(11-11visible, cerumen

Mouth, Throat, and Nose

(11-11-15 Day 1)

Inspection:
Positive bleeding. Hard palate lesions
Throat is pink, redness and exudate.
Swelling in nasal mucosa upon inspection.
(11-12-15 Day 2)
Inspection:
Positive bleeding. Hard palate lesions
Throat is pink.
Reduce swelling in nasal mucosa upon
(11-13-15 Day 3)
Inspection:
Minimize bleeding. Hard palate lesions
Throat is pink noted.
Thorax and Lungs
Inspect, Palpate, and auscultate:
Increased in anteroposterior diameter.
Lung sounds are clear bilaterally.
(11-12-15 Day 2)
Inspect, Palpate, and auscultate:
Increased in anteroposterior diameter.

inspection.

(11-11-15 Day 1)

Heart

(11-11-15 Day 1)

Normal heart sound upon auscultation, and within


blood pressure.
(11-12-15 Day 2)
Normal heart sound upon auscultation, and within
blood pressure.
(11-13-15 Day 3)
Normal heart sound upon auscultation, and within
normal blood pressure.
Peripheral Vascular
Negative bilateral edema.
Normal reflexes noted.
(11-12-15 Day 2)
Negative bilateral edema.
Normal reflexes noted.
(11-13-15 Day 3)
Negative bilateral edema.
Normal reflexes noted.

(11-11-15 Day 1)

normal
normal

Abdomen
(11-11-15 Day 1)
Normal peristalsis and muscle tone, motility.
(11-12-15 Day 2)
Normal peristalsis and muscle tone, motility.
(11-13-15 Day 3)
Normal peristalsis and muscle tone, motility
noted.

Anatomy & Physiology

The skin is the largest organ of the body, with a total area of about
20 square feet. The skin protects us from microbes and the
elements, helps regulate body temperature, and permits the
sensations of touch, heat, and cold.

Skin has three layers:

The epidermis, the outermost layer of skin, provides a waterproof


barrier and creates our skin tone.

The dermis, beneath the epidermis, contains tough connective


tissue, hair follicles, and sweat glands.

The deeper subcutaneous tissue (hypodermis) is made of fat and


connective tissue.

The skins color is created by special cells


called melanocytes, which produce the
pigment melanin. Melanocytes are located
in the epidermis.

Mouth - The upper opening of the digestive tract,


beginning with the lips and containing the teeth,
gums, and tongue. Foodstuffs are broken down
mechanically in the mouth by chewing and saliva
is added as a lubricant. Saliva contains amylase,
an enzyme that digests starch. Any opening or
aperture in the body. The mouth in both senses
of the word is also called the os, the Latin word
for an opening, or mouth. The o in os is
pronounced as in hope. The genitive form of os
is oris from which comes the word oral.

A lymph node is an oval-shaped organ of


the lymphatic system, distributed widely
throughout the body including
the armpit andstomach and linked by lymphatic
vessels. Lymph nodes are major sites of B, T,
and other immune cells. Lymph nodes are
important for the proper functioning of
the immune system, acting as filters for foreign
particles and cancer cells. Lymph nodes do not
deal withtoxicity, which is primarily dealt with by
the liver and kidneys.

Lymph nodes also have clinical significance. They


become inflamed or enlarged in various infections and diseases
which may range from trivial throat infections, to lifethreatening cancers. The condition of the lymph nodes is very
important in cancer staging, which decides the treatment to be used,
and determines the prognosis. When swollen, inflamed or enlarged,
lymph nodes can be hard, firm or tender.

Lymph nodes are bean or oval shaped and range in size from a few
millimeters to about 12 cm long.Each lymph node is surrounded by
a fibrous capsule, and inside the lymph node the fibrous capsule
extends to form trabeculae. The substance of the lymph node is
divided into the outer cortex and the inner medulla. The cortex is
continuous around the medulla except at the hilum, where the
medulla comes in direct contact with the hilum.

Thin reticular fibers and elastin form a supporting


meshwork called a reticular network inside the
node. White blood cells (leukocytes), the most prominent
ones being lymphocytes, are tightly packed in the follicles
(B cells) and the cortex (T cells). Elsewhere in the node,
there are only occasional leucocytes. As part of the
reticular network there are follicular dendritic cells in the B
cell follicle andfibroblastic reticular cells in the T cell
cortex. The reticular network not only provides the
structural support, but also the surface for adhesion of
the dendritic cells, macrophages and lymphocytes. It
allows exchange of material with blood through the high
endothelial venules and provides the growth and
regulatory factors necessary for activation and maturation
of immune cells.