Catherine is a 35 year old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116lbs). She is 165 cm (5ft 5in) tall. Catherine has a history of recurrent cervical cancer for which she had a hysterectomy 4 months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2 weeks postoperatively, during which she tolerated clear liquids only. An intravenous drip of 10% glucose and 45% normal saline was ordered to supplement fluids and kcal. This week she developed peritonitis and has had a fever with a maximum temperature of 39 C (102 F) over the past 24 hours. Her weight has dropped to 41 kg (90lbs); drainage from the fistulas has become odorous. The patient was placed in isolation today and was advised by her physician that he intended to start her on total parenteral nutrition (TPN) and conduct some more tests to determine her progress.
Questions for Analysis:
Why did Catherine develop nausea and anorexia during chemotherapy? What are the implications of this for recovery? Outline a plan for evaluating and controlling nausea and vomiting in patients undergoing chemotherapy.
The development of nausea and anorexia during chemotherapy are due :
Chemotherapy induced nausea and vomiting can be classified as acute (occurring within 24 hours of therapy), delayed (persisting for 6–7 days after therapy), or anticipatory (occurring prior to chemotherapy administration). The occurance of vomiting is influenced by the emetogenic potential of the administered chemotherapy, patient variables.The emetogenic potential of the drugs depends on the chosen cytotoxic agent, the dose given, and the administration schedule.
Evaluate and contol nausea and vomiting in patients with chemotherapy
1. Check for the degree of dehydration
2. Check the amount of food intake
3. Evaluate the cleanliness of the surroundings:
4. Check for the ways of Distraction during chemotheapy:
Catherine is a 35 year old mother of three young children. She was admitted to the...
Catherine is a 35 year old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116lbs). She is 165 cm (5ft 5in) tall. Catherine has a history of recurrent cervical cancer for which she had a hysterectomy 4 months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2...
Catherine is a 35 year old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116lbs). She is 165 cm (5ft 5in) tall. Catherine has a history of recurrent cervical cancer for which she had a hysterectomy 4 months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2...
Catherine is a 35 year old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116lbs). She is 165 cm (5ft 5in) tall. Catherine has a history of recurrent cervical cancer for which she had a hysterectomy 4 months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2...
Catherine is a 35 year old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116lbs). She is 165 cm (5ft 5in) tall. Catherine has a history of recurrent cervical cancer for which she had a hysterectomy 4 months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2...
Carmine is a 34-year-old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116 bs). She is 165 cm (5 ft 5 in) tall. Carmine has a history of recurrent cervical cancer for which she had a hysterectomy four months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again Her fistulas continued to drain for...
Carmine is a 34-year-old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116 lbs). She is 165 cm (5 ft 5 in) tall. Carmine has a history of recurrent cervical cancer for which she had a hysterectomy four months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for...
Catherine Garber is a 42-year-old office manager admitted to the hospital’s intensive care unit. She was first seen in the emergency department with severe edema, headache, nausea and vomiting, and a rapid heart rate. She reported an inability to pass more than minimal amounts of urine in the past two days. Her son, who drove her to the emergency department, reported that she had missed work for several days and seemed confused and unusually tired. Laboratory tests revealed elevated serum...
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