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Palliative care improves quality of life of patient and families who face life threatening disease, by provide pain and symptom relief, spiritual, psychosocial support to diagnosis to end of life, In most of world, majority of cancer patient are in advances stages of cancer when first seen by medical professional. For them, only factual treatment option is pain relief and palliative care. Effective approaches to palliative care are available to improve quality of life for cancer patient. Cancer pain release is diffusion of the world health organization global communication program for improve cancer pain control and palliative and supportive care (World Health Organization, 2011). Lung cancer is a disease which consists of uncontrolled cell growth in tissues of the lung. This growth may lead to metastasis, which is the invasion of adjacent tissue and infiltration beyond the lungs. The vast majority of primary lung cancers are carcinomas of the lung, derived from epithelial cells. Lung cancer, the most common cause of cancer-related death in men and women, is responsible for 1.3 million deaths worldwide annually, as of 2004.The most common symptoms are shortness of breath (WIKIPEDIA,2011).
Which nursing problem does lennart have?
Pain and Irritation upon draining of tubes.
Nausea and diarrhea.
Loss of energy.
Loss of appetite.
Eelevated blood pressure
How would you prioritize his problem?
Pain and irritation upon draining tube
Loss of appetite
Loss of energy
Eelevated blood pressure
NURSING CARE PLAN
Objective data: he has an elevated blood pressure and diabetes.
Subjective data: diarrhea. Nausea, pain.
Take medical history. Patient complained of abdominal pain, bowel movement cramping. Increased frequency of stool, increased frequency of bowel sounds loose, liquid stools, diarrhea. Assess onset and patterns of diarrhea Assess and identify individual stress factors and coping behaviors. Assist thorough diagnosis including neurologic and psycho logic Assess patient’s attitude toward pain.
.Discuss with patient, family and other medical team the treatment and medical
Diagnosis: diarrhea, pain, nausea related to lung cancer.
Observe and record frequency, characteristic, amount, time of day, and precipitating factors related to occurrence of diarrhea
Observe pain associated with episodes
Observe nausea and vomiting.
Every day make blood test for diabetes and give medication and give diabetes food. Give treatment to hypertension and cheek blood pressure and give low salt food advice patient make exercises every day.
Auscultate abdomen for presence, location, and characteristic of bowel sounds observe for associated factors such as fever / chills, abdominal pain / cramping .Determine diet and nutritional status. Review drug intake. Determine recent exposure to different / foreign environment, change in drinking water, food intake and illness of other. Note concurrent illnesses, treatment, food and drug allergic, lactose intravenous and therapy side effects. Eliminate: relaxation techniques to decrease stress / anxiety. Provide for changes in dietary intake to avoid diarrhea. Limit caffeine and high fiber foods, avoid milk and dairy products. Recommended change in drug therapy as appropriate (eg. Antacid) Assess baseline hydration, note postural hypotension, tachycardia, skin cracks, and condition of mucous membranes. Review laboratory work. Administer drugs as indicated to decrease gastrointestinal motility and minimize fluid losses. Administer IVF as indicated. Maintain skin integrity (ointment skin as needed) .Promote returns to normal bowel functioning:
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Increase oral fluid intake and return to normal diet with assist from his family members. Give medication as ordered, for example to decrease motility and to absorb water and explain that to the patient and to his family. Patient maintains normal bowel function with good hydration. Understanding of causative factors and rationale for treatment regimen .Demonstrates appropriate behavior to assist with resolution of causative factors like proper food preparation or avoidance of irritating. Verbalization of pain upon draining of tube Distraction behavior (moaning, crying, pacing, seeking out other people or activities, restlessness .Autonomic responses like diaphoresis , blood pressure and pulse changes . Papillary dilatation increased or decreased respiratory rate. Pain, Alleviate patient from pain, Provide comfort while draining of tube Explain procedure to the patient and family and when it hurt to reduce concern of the unknown .Nursing priority: assess etiology / precipitating and contributory factor.
Determine possible pathophiysiologic / psycho logic causes of pain eg( inflammation , thrombosis ,grief ,fear and anxiety )
Nursing priority: evaluate patientâ€™s response to pain.
Observe patients walk, how patient holds body, sits ,facial expression ,cool finger tips / toes , which can mean constricted useless .
Determine pain characteristics; dull, throbbing, constant , sharp ,intermittent Assess for referred pain. Monitor vital signs as usually it increase in acute pain, Review patients previous experience with pain.
Nursing priority assist patient to explore methods for alleviation and control of pain: Instruct patient to report pain as soon as it begins ,encourage verbalization of feelings about the pain ,provide quiet environment , calm , activities . provide comfort measures ( eg. Back rub , change of position , use of heat or cold if indicated ) and encourage his family to do it .encourage relaxation exercise with the use of individualized tapes ( eg. Music and instructional ) .encourage to use diversirnal activities ( eg, TV ,radio and socialization ) ,assist in treatment of the cause of pain and evaluate effectiveness .encourage rest to prevent fatigue ,identify ways of avoiding or minimizing pain ,review ways to lessen pain ,discuss with significant others ways in which they can assist patient and can reduce precipitating factors that may cause or increase pain .
Patient reports that he is relieved from pain.
He follows prescribed pharmacologic regimen.
Verbalizes methods that provide relief .
Demonstrate use of relaxation skills and dimensional activities.
Cancer patient has severe pain the nurse should be observer this pain and give medicine and attention to case of spiritual psychical through palliative care.
Cancer patient need to support from teamwork and family is the source of light and hope of the patient, I think support depend on family. Teamwork is foundation palliative care and everywhere cooperative teamwork will outcome become high for palliative care. Communication is contact the most powerful factor in palliative care causes it is a point of communication between teamwork and family and between patient, teamwork, good communication is the secret success palliative care.
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