Case Study, Chapter 15, Oncology: Nursing Management in Cancer Care

1. Emanuel Jones, 60 years of age, is male patient diagnosed with small cell carcinoma. He underwent surgery in the past to remove the left lower lobe of his lung. He is receiving chemotherapy. Two weeks before a round of chemotherapy, a complete blood count with differential, and a renal and metabolic profile are obtained for the patient. The patient presents to the oncology clinic for chemotherapy with a temperature of 101°F. Further assessment reveals decreased breath sounds in the right base of the right lung, and a productive cough expectorating green colored mucus. The patient is short of breath and has a pulse oximetry reading that is SaO2 of 85% on room air. The patient has a history of benign prostate hypertrophy (BPH) and has complaints of urinary frequency and burning upon urination. The patient is admitted to the oncology unit in the hospital. The oncologist orders the following: blood, sputum, and urine cultures; and a chest x-ray. An x-ray of the kidneys, ureters, bladder (KUB) is ordered. An arterial blood gas (ABG) on room air, CBC with differential, and renal and metabolic profile are ordered. Oxygen is ordered to begin with nasal cannula at 2 L/min and titrate to keep SaO2 greater than 90%. A broad-spectrum antibiotic, levofloxacin 500 mg in 100 mL of NS is ordered to be administered IV over 60 minutes once daily. 

1. After examining the physician orders, in what sequence should the nurse provide the care to the patient admitted to the hospital? Give the rationale for the sequence chosen.
2. On what areas should the nurse focus the assessment to detect potential complications for Mr. Jones?
3. What patient education does Mr. Jones need from the nurse to help prevent the reoccurrence of an infection and to get treatment for an infection promptly?

2. The oncology clinical nurse specialist (CNS) is asked to develop a staff development program for registered nurses who will be administering chemotherapeutic agents. Because the nurses will be administering a variety of chemotherapeutic drugs to oncology patients, the CNS plans on presenting an overview of agents, classifications, and special precautions related to the safe handling and administration of these drugs. 

1. What does the CNS describe as the goals of chemotherapy?
2. How should the CNS respond to the following question: “Why do patients require rounds of chemotherapeutic drugs, including different drugs and varying intervals?”
3. In teaching about the administration of chemotherapeutic agents, what signs of extravasation should the nurse include?
4. What clinical manifestations of myelosuppression, secondary to chemotherapy administration, should the CNS include in this program?

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Case Study, Chapter 17, Preoperative Nursing Management

1. Joan Arnold, 67 years of age, is a female patient who underwent a coronary angiogram that diagnosed severe coronary artery disease in three of her coronary arteries, the left anterior descending, the left circumflex, and the right coronary artery. She is scheduled for a coronary artery bypass graft operation tomorrow. The nurse provides patient education for Mrs. Arnold and her husband, which includes watching a hospital video on the operation, the intensive care environment, what to expect after the surgery, the recovery period, and cardiac rehabilitation. The video also covered the importance of coughing and deep breathing, using an incentive spirometer, splinting, early ambulation, pain medication, and how to position oneself safely. The video stressed the importance of not rolling onto the side that the chest tube may be in place postoperatively. The video also discussed the preoperative preparation. The nurse also provided a booklet on the subject material. The nurse had a session with the patient and her husband to assess their understanding and to answer any questions they may have had. 

1. What specific preoperative nursing measures should the nurse review with the patient to help decrease the risk for postoperative complications?
2. Explain the role of the nurse when implementing the immediate preoperative preparation the day before surgery and the morning of the surgery?

2. The nurse in a gynecology clinic is completing preoperative teaching for a patient scheduled for an abdominal hysterectomy next week. The patient states that she is currently taking 325 mg of aspirin daily for chronic joint pain, along with a multivitamin. The patient has type 2 diabetes; she closely monitors her blood glucose levels. Currently, she is taking an oral hypoglycemic agent. The nurse advises her to ask the anesthesiologist whether she should take this medication the morning of surgery. 

1. The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action?
2. Why is it important to assess the patient for use of herbal products prior to surgery?

c.The patient asks how surgery could affect her blood glucose; how should the nurse respond?

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Please review the grading rubrics.Also attach some student works to read,I don’t have a book for this work.Please Read the works and make my own

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You are an RN working in an Urgent Care. Below is just a brief history of a client with information limited on purpose to encourage you to utilize your critical thinking skills.

Subjective information: Miranda is a 26-year-old female who presents to the office with the complaint of diarrhea for 6 days. She states she has lost 8 pounds in one week. She is not currently taking any medications. She has tried over-the-counter remedies for the treatment of her diarrhea with minimal improvement. She is generally healthy with only a sinus and bladder infection on occasion.

Objective information: She does not have a temperature, BP is 102/60, Pulse is 98, and her bowel sounds are present in all quadrants and are hyperactive. Her abdomen is soft and mildly tender.

In a 2-3 page paper, answer the following questions. Include, at minimum, two peer reviewed sources (in-text citation), and provide a Reference page (not included in the page count) using APA Editorial format.

1. What is the pathogenesis of diarrhea?
2. Describe the different mechanisms of diarrhea (osmotic, secretory and motility).
3. With the limited information provided, what additional information would you like to obtain from her history and physical to help direct your care plan? Describe why obtaining this information would be helpful in leading you to a nursing diagnosis.
4. What infectious or inflammatory conditions could she be suffering from?

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Case Study 

Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken him.

Question

Considering Mr. P’s condition and circumstance, write an essay of 750-1000 words that includes the following:

· Describe your approach to care.

· Recommend a treatment plan.

· Describe a method for providing both the patient and family with education and explain your rationale.

· Provide a teaching plan (avoid using terminology that the patient and family may not understand). 

Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, You are required to submit this assignment to Turnitin 

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