Question

UNIT 3 Concepts and Challenges in Patient Management 384 CRITICAL THINKING EXERCISES 1 pa A 63-year-old man previously treated for stage Ill prostate cancer with HDR brachytherapy and androgen deprivation therapy returns to the cancer center for a follow- up visit. While you are assessing his vital signs, he tells you that he has been having back pain for the last 3 weeks that he attributes to sleeping on an old mattress. What are the pri- orities to include in your nursing assessment of this patient? Identify the diagnostic procedures that you anticipate will be required to further evaluate this patient's back pain. What are your priorities for care of this patient? 2 An 80-year-old woman, who lives alone, was just recently diagnosed with stage IV colon cancer. She is being discharged from the hospital following a palliative colon resection. What will be the focus of educating this patient for self-care? Describe at least three age-related implications that will be important to consider. What type of referrals might be appropriate for this woman? 3 ebp You are caring for a 32-year-old woman who is a breast cancer survivor. The patient takes tamoxifen 20 mg orally once daily and this will continue for the next 5 years. Are there any preventive measures that should be considered to address survivorship needs? What is the evidence for these interventions and education that you identified? How strong is that evidence, and what criteria did you use to assess the strength of that evidence? REFERENCES *Asterisk indicates nursing research. **Double asterisk indicates classic reference.

Answer 1

2. A 80-year-old women is discharged after palliative care colon resection surgery, the things to consider during patient education at discharge for self-care are as follows-

Include write-ups, pictures and videos to educate the patient regarding the reference for obtaining support, equipment and independence for self-care.

Recommend increased fluid intake during warm weather, this will help in maintaining normal colon function and prevent dehydration.

Instruct possible reasons to decrease salt intake, as salt can increase the output and risk dehydration and results in patient inconvenience.

Discuss the symptoms of electrolyte depletion that include nausea, anorexia, abdominal cramps, faintness, bloating and decreased sensation in arms and legs.

Indicate importance of chewing food well and taking fluids with meals that reduces risk of bowel obstruction.

Avoid food with source of carbonated drinks, beer, cabbages, onions, fish and seasoned food.

Instruct regarding sleep disturbances, anorexia and loss of interest as a part of homecoming depression.

Counsel regarding use of appropriate medication.

The age related considerations important in this case would be-

Instructing the patient to take adequate fluids and fluids between the meals to avoid bowel obstruction, as old age may result in improper deglutination and digestion of food products.

Recommending help and assistance if the patient is living alone.

Minimize the intake of nausea initiating food items and increase the routine social activities to prevent depression and isolation.

Some referrals for this women would include-

a referral to palliative care community home where she would be cared for and provided a palliative care services with proper assistance.

(please create individual order for other questions)