Question

1. You are meeting with Sandra and John during their second visit to the Cancer Center. You notice that Sandra is well groomed and not disheveled as she was during the last visit. John and Sandra were able to sit down and talk to one another about various treatment options. They are here today to finalize their decision. Although Sandra appears calm today, John is worried about her emotional status and the impact caring for him during treatments will have. Discuss the various stressors that need to be considered when evaluating their situation. 2. John is now in the Cancer Center for his third dose of the first round of chemotherapy. He had a strong reaction to the medications, and his white count dropped so low that he was unable to take the next dose of chemotherapy. Although John feels good physically and understands the reasons for holding the next round, Sandra is convinced that the treatment is not working. When you meet with Sandra you notice that she is talking fast, can't concentrate, and is crying. She has a friend with her, and the friend tells you that Sandra did not understand what the oncologist said. When he said that we need to skip this week's dose, Sandra interpreted it as we have to skip the chemotherapy. Which nursing diagnoses might apply to this situation? 3. John has completed his first round of chemotherapy. His blood chemistries look good, and on scan the tumor is decreased. He is now resting and will begin the second round of chemotherapy. Sandra is still fearful, but she is sleeping and eating well. She still has difficulty meeting with the doctors and understanding the treatments and impact they have on John's level of health. She says that, when she listens to the doctor, “I feel like I'm watching someone else and really don't hear or remember many details.” Which approach would be the best to take in planning for Sandra?

Answer 1

1. The various stressors that need to be considered while evaluating their situation are like every individual whether it be a wife, husband ,father or mother have about cancer treatment ,the same were the stressors for Sandra and John.

These were :-

- side effects of chemotherapy

- disease will be completely treated or not

- will there be any chances of relapse

- will he be able to tolerate chemotherapy

- what will be the duration of the treatment

- how much financial need will be there

- will he be able to lead a normal life ,do their work ,child care etc

- what all precautions has to be taken while taking care of him .

2. Nursing diagnosis of this situation is - Deficient knowledge related to the disease condition and treatment method .

3. Sandra is anxious about her husband's disease condition ,she needs a therapeutic approach. Firstly ,encourage her to express her concerns and doubts regarding the disease condition and then use a open question approach to explain about the disease , different treatment options ,about medications, side effects etc in a simple language so that she is able to understand everything easily