A A Comprehensive Nursing Care Approach for a Child with Osteosarcoma and Pulmonary Metastasis: A Case Study
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Abstract
Background: Osteosarcoma is a serious pediatric malignancy that may result in substantial physical, psychological, developmental, and social consequences. Children with advanced disease may require multimodal treatment while experiencing pain, impaired mobility, treatment-related adverse effects, and disruption of education and social participation.
Case Presentation: This case study described an 8-year-old Thai girl with osteosarcoma of the left distal femur with pulmonary metastasis. She had previously undergone wide excision with proximal tibial reconstruction and was admitted for her 13th chemotherapy treatment. During hospitalization, imaging demonstrated progression of multiple calcified pulmonary nodules and metastatic involvement of the thoracic spine, followed by T6–T8 laminectomy.
Methods: A descriptive single-case study was conducted using a predefined episode of care from August 2021 to November 2022. Data were obtained through triangulation of the clinical record, nursing documentation, laboratory and imaging results, treatment records, direct nursing observation, and caregiver-reported information. Data were organized chronologically and interpreted descriptively across physical, functional, developmental, psychosocial, and family-care domains.
Nursing Management and Outcomes: Nursing care focused on chemotherapy safety, infection prevention, postoperative care, pain management, nutrition, mobility, developmental needs, psychosocial support, and family participation. The child completed chemotherapy, and pain improved with multimodal management. The caregiver actively participated in care, and the mother’s stress score decreased from 4 to 3.
Conclusion: Comprehensive, family-centered nursing care addressed the child’s physical, developmental, psychosocial, and family needs beyond chemotherapy treatment.
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