And nurses who keep up-to-date with the latest guidelines, trends and community resources can help patients prevent serious complications from these illnesses and improve quality of life.
Screenings play a big role in cancer prevention. What nurses need to understand is how much screening recommendations vary from woman to woman, according to Rose Ali, RN, ANP-BC, MSN, OCN, nurse practitioner in the gynecological survivorship program at Memorial Sloan-Kettering Cancer Center, New York City.
The guidelines recommend, for example, most women start having mammograms at age 40; that is, unless they have strong family history of breast cancer. For a patient who has a family history with a first-degree relative with breast cancer at a younger age, screenings should start earlier and might include mammograms along with an ultrasound and an MRI.
Depending on what a family or personal history reveals, nurses should encourage women with a strong family history of cancer to get a genetic work-up. Screening recommendations may be different from those without genetic risk, according to Ali.
Nurses can and should access cancer guidelines regularly, because recommendations change. One recent addition to the guidelines answers the common question about whether females who received the human papilloma virus vaccine still need to get Pap smears every two to three years. They do, according to Ali, who explained there are more than 100 types of HPV, and the vaccine protects against four.
Exercise is proven to prevent cancer and promote wellness in women with and without cancer histories. For example, endometrial cancer is correlated to obesity, and weight control can reduce that risk, according to Ali.
For cancer patients, exercise and eating healthy foods helps them regain wellness, Ali said. Nurses consistently should encourage these patients to do any type of exercise, from walking to joining a gym.
Women who are recovering after cancer treatment should exercise at least three times a week for 30 minutes each day, with the goal of reaching the recommended exercise guidelines for the general population, which is at least 30 minutes a day, five days a week, according to Ali.
As patient advocates, nurses should encourage smoking cessation. Smoking, Ali said, has direct ties to many types of cancers, including cervical cancer, and smoking cessation can reverse Pap smear abnormalities.
Diabetes is one of the few chronic diseases that does not have to get worse, according to Autumn Dempsey, RN, CDE, program coordinator, Center for Diabetes Education, Monmouth Medical Center, Long Branch, N.J.
"We can manage diabetes, stop it in its tracks and avoid complications. If [patients] have complications, we can prevent them from getting worse. You can live a long, healthy life with diabetes," Dempsey said.
Nurses encounter many patients with the disease and should understand it and be aware of patientsí specific needs. Dempsey suggests nurses attend a diabetes education program or one-on-one session with a patient and diabetes educator. In these sessions, nurses can learn about current guidelines for nutritional management and glucose monitoring, as well as goals of outpatient care. Being active, eating right and managing weight are foundations for staying well and preventing the disease.
Dempsey recommends American Diabetes Association guidelines, which for exercise include a minimum of 30 minutes, usually five days a week.
Controlling the disease is important for wellness and prevention of other dangerous conditions.
"Having especially uncontrolled diabetes can put one at higher risk for vascular disease, kidney disease, retinopathy, neuropathy, gingivitis [periodontal disease], tooth decay and tooth loss. It can affect every system if not controlled," Dempsey said.
Nurses also should know that women who have heart disease, hypertension or high cholesterol are at higher risk for diabetes, according to Dempsey.
Regardless of the setting in which they work, nurses can offer diabetes patients information and encouragement.
"Diabetes is a hard disease to manage, so just telling patients they are doing a good job or made the right choice on their menu [is helpful]," she said.
One of the bigger challenges with women and heart disease is knowing that their symptoms might differ from those of men, according to Elizabeth S. Haag, RN, MPA, CCRP, research nurse manager, St. Francis Hospital, Roslyn, N.Y.
"The location of chest pain may not be the classic mid center and radiating to the left arm. It could be, in fact, something that starts out in the back or jaw," Haag said.
Getting the word out about symptom recognition is important considering more women die from cardiovascular disease than all cancers combined, according to Madhavi Kadiyala, MD, assistant director of cardiac CT and MRI and staff echocardiologist at St. Francis.
More than 40% of women with heart attacks do not experience any chest pain. Commonly a woman having a heart attack may feel unusually tired, have disturbed sleep or feel short of breath, Kadiyala said.
"Studies show that women present to the doctor much later than men. When someone is having a heart attack, time is muscle. The longer you wait, the more heart muscle is lost," Kadiyala said.
Preventing and managing heart disease involves adhering to the classic triad of lifestyle, exercise and healthy eating, Haag said.
Stress also plays a role, according to Katherine McGrath, RN, BS, CCRP, research nurse specialist at St. Francis.
"Womenís stress levels seem to be as high as menís now," McGrath said. "And stress is an important contributor for heart disease. The nurses here offer workshops for their patients to help with stress, conflict and anger management [and more]."
Ultimately, nurses should encourage patients to know their numbers, including blood pressure and cholesterol. "Make sure you have these things checked. And if you need medication, make sure you take it and know what itís for," Haag said. •
Lisette Hilton is a freelance writer.
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