•Nutrition:

–White bread, potatoes, pasta, peeled rice, semolina, bananas (rich in potassium), grated apples, cottage cheese, boiled eggs, oatmeal, porridge, maize (corn), dry pastry, black tea

–Eat easily digestible, salty meals and drink plenty

–Foodstuffs to be avoided with diarrhea: wholemeal bread and cereals, nuts, chips, fried, greasy food, raw fruit and vegetables, fruit juice, dried fruit, broccoli, onions, cabbage, hot spices

–Several small meals per day

•Psychological factors:

–Diarrhea, for the patient, is often highly unpleasant. Sensitive action with respect for privacy and sense of shame

•Anal hygiene:

–Due to diarrhea, the skin is very tender. Therefore, attention should be paid to soft, possibly moistened toilet paper

–Use of cream and baths with chamomile, as well as local anesthetic ointments may be helpful

–Where there is pain at around the anus (irritated skin): after every bowel movement, clean anus with warm water, followed by careful dabbing; warm baths also ease the discomfort. Use soft toilet paper; possibly ointment around anus. Check for ulcerations or blood in stool beforehand

19.2.7Neuropathy

Some chemotherapeutic agents may cause disruption of nerve and muscle function. (especially vincristine, vinblastine, and cisplatin)

19.2.7.1 Symptoms

• Tingling (especially in fingers), pins and needles, numbness, muscular pain, muscle weakness in hands and feet (difficulty with walking on toes and heels; foot drop), impairment of fine motor control (particularly of hands) and sensation in hands and feet, unsteady gait, muscle cramps

• Changes are usually reversible

19.2.7.2 Prophylactic Care

• None

19.2.7.3 Treatment

•Dose reduction or interruption of treatment, use of alternative therapeutics

•Promotion of sensation and fine motor activity by means of ergotherapy

•Use of walking aids and devices