Question

The RN is developing a plan of care for a 35-year-old female, newly diagnosed with breast cancer. Assessment findings include: the patient is teary and states, “I haven’t been sleeping since the diagnosis.” The patient doesn’t make eye contact, has difficulty sitting still and her voice is trembling. Her mucous membranes are dry and she says she has not had an appetite. She says, “I don’t know if I am going to need surgery to remove my breasts. I don’t know how it will make me feel or look”. • Develop a 3-part actual nursing diagnostic statement, related to therapeutic communication, stress and adaptation OR patient teaching. Use the patient data in the scenario, including the problem, etiology and symptoms. • Develop a patient specific, measurable outcome with a time-frame, appropriate for your chosen diagnosis and this patient. • Explain why this diagnosis is a priority for this patient.

Answer 1

Nursing Management:

Breast Cancer:

Breast cancer is the most common malignancy in women as a cancer death. A women finds a lump in the breasts which may be benign or malignant.

Etiology: The cause of breast cancer is unknown.Eventhough genetic, hormonal. or biochemical factors are involved.

Symptoms: Most breats cancers present as painless, nontender, hard, irregular shaped, nonmobile masses. Heat and erythema of the breast skin may be related to inflammation but may also indicate inflamatory carcinoma. If a tumor is suspected on the basis of the physical findings, a diagnostic mammogram is indicated. Also,Fine needle aspiration, biopsy is performed.

Treatment: Radiation therapy, Systemic chemotherapy, Surgical excision of breast(infected) - mastectomy

Nursing care plan:

Encourage client to express her feelings and fears with family members and seek assistance from the psyco oncology service, if appropriate.

1. The nursing diagnosis expressed as Imbalanced nutrition : Less than body requirements related to loss of appetite.

Intervention: Encourage to take healthy diet.,Provide oral hygiene, Prevent nausea vomiting if present.

2. Nursing diagnosis related to loss of sleep

Intervention: Encourage patient to be optimistic, Consult a pysologist for better relaxation, Encourage to do some yoga practices.

3.. Nursing diagnosis of Disturbed body image related to impending changes in breast and sexuality may be appropriate.

Interventions: Assess coping strategies, encourage selfcare activities, Explain possible body image concerns after discharge, discuss strategies to improve body image.

4. Nursing diagnosis may be expressed as Ineffctive individual coping and compromised family coping related to diagnosis of cancer and surgical changes of breast.

Interventions: Asses the clients coping ability and concerns. Do not rush the assessment. Identigy the coping mechanisms usually used by the client and her significant others. Use positive, growth producing coping and to avoid disabling coping.