Learning Team Case Study

Debbie, 29 years old, married with 2 teenaged children History – 730 pack per year smoker Symptoms – pelvic fullness, foul-smelling vaginal discharge Diagnosis – Class V cervical cancer Treatment – s/p radical hysterectomy with bilateral salpingo-oopherectomy, needs radiation therapy Dysfunctional voiding requires self catheterization Tearful, anxious, believes cancer is a punishment

NANDA-I Nursing diagnoses define the knowledge of professional nursing NANDA became NANDA International in 2002 North American Nursing Diagnosis Association was established in 1982 First joint meeting of the NANDA, NIC and NOC held in 1997

Problems Post operative pain and nausea Intermittent self-catheterization at home is essential Concerned about her family’s future Husband is jobless, distant, and abusive Unaware of all available resources

Etiology Recently admitted to oncology nursing unit for evaluation after sensing pelvic “fullness”, and noticing a watery, foul-smelling vaginal discharge Infrequent physical examinations in her past Takes oral contraceptives on a regular basis 730 pack per year smoking habit Stage II Squamous cell carcinoma of the cervix S/P radical hysterectomy with BSO Waiting for her radiation therapy

Signs and Symptoms Losing hope Afraid of her situation Weight loss of 21 pounds Post operative pain and nausea Ineffective bladder emptying Patient takes an antibiotic, and an analgesic depending on her tolerance

Acute pain is common among cancer patients. This is proved by various testimonies of Class V cervical cancer patients. Acute pain results from the activity of cancer cells and is related to the body’s surgical interruption.

Comfort Level Effectiveness of Medication Pain Tolerance Pain Level

Reported pain is relieved or reduced, and scaled between 0-10 Prescribed pharmacological regimen must be followed Do verbal processes that add relief Do some relaxation exercises that can divert one’s attention Within a period of 1 hour after an oral pain medication, Debbie will:

Pain Management Analgesic Administration Environmental Management

Psychosocial Nursing Diagnosis Ineffective Health Maintenance is influenced by misconceptions on health facts. Examples are smoking habits, unplanned pregnancies, and failure to undergo an annual check-up.

Knowledge: Disease Process Self Esteem Health-Seeking Behavior Social Support

Debbie will take responsibility over her own health maintenance and monitoring She will be asked to orally repeat her understanding on her current situation She would have to change her lifestyle for her own benefit

Health System Guidance Support System Enhancement Discharge Planning Teaching: Disease Process Risk Identification

. Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2010). Nursing Diagnosis Manual. Planning, individualizing, and documenting client care (3rd ed.). Philadelphia: F.A. Davis Company. Doenges, M. E., Moorhouse, M. F., & Murr, A. C., ( ). Nursing Care Plans: Guidelines for individualizing client care across the life span. (8 th ed.). Philadelphia: F.A. Davis Company. Alligood, M. R. (2010). Nursing Theory Utilization and Application (4 ed.). Maryland Heights, Missouri: Mosby Elsevier.

NANDA. (2011). Diagnosis Development. Retrieved November 3, 2011, from NANDA International: NANDA. (2011). NANDA International History: Retrieved November 3, 2011, from NANDA International: Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2008). Nurse's Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (2nd ed.). Philadelphia: F.A. Davis Company.

The University of Iowa College of Nursing. (n.d.). The University of Iowa College of Nursing. Retrieved October 29, 2011,from The University of Iowa College of Nursing: x.htm Standardized nursing language: What does it mean for nursing practice?. (2008, January). The Online Journal of issues in Nursing, 13(1). Retrieved from ace/ANAPeriodicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviou sTopic/StandardizedNursingLanguage.aspx