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Cervix Cancer, Nursing goal - Coggle Diagram
Cervix Cancer
Nursing Care Plan
Diaarhea related to side effect of radiotherapy RT
Supportive data
The patient has diarrhea
Nursing activity
Provide the patient to eat cooked food for prevent diarrhea
Provide medicine is Imodiumx1 prn follow doctors orders for prevent diarrhea
Assess sign and symptoms of diarrhea
Assess side effect of Imodium such as nausea vomiting, dry mouth, drowsiness
Patient and relative activities
Provide to eat cooked food for prevent diarrhea
Observers side effect of Imodium such as nausea vomiting, dry mounth and drowsiness
Evaluation criteria
Patient didn’t defecate the liquid
Patients can defecate normally
Analysis
Radiation in the pubis area affects the small intestine, colon and rectum, especially the small intestine. which is sensitive to radiation reduce the absorption of food more bowel movements may cause patients with anorexia, nausea, abdominal pain, diarrhea, flatulence or pain in the rectum.
Evaluation
Unable to assess
Electrolytes imbalance
Analysis
Potassium is an electrolyte in the body. Most of them are inside cells. It is important in regulating the functions of many body systems, including water and mineral balance. acid-base balance in the body contraction of muscles, intestines, nervous system function and normalize heart function since potassium plays a role in the formation of action potential hypokalaemia Hypokalemia is a serum potassium level of less than 3.5 mmol/L (normal is 3.5-5.1 mmol/L. The most common cause of hypokalemia is urinary and gastrointestinal loss. such as vomiting, diarrhea, malnutrition
Cloride lower than normal may show that may be caused by drinking too much water, from vomiting, caused by abnormalities of hormone excretion of water from the body.
Nursing goal
Evaluation criteria
3.Vital sign are normal
Temperature 36.5-37.4 C
BP ≤140/90 mmHg
PR 60-100 bpm
RR 16-20 bpm
O2sat 95-100%
1.Electrolyte imbalance
Chloride 98-107 mmol/L
Potassium 3.5-5.1 mmol/L
2.No sign and symptoms of electrolyte imbalance such as nausea vomiting, fatigue, sweating.
4.Intake-Output balance
To maintain electrolyte imbalance
Nursing activities
Observers intake output to measure amount to loss of electrolyte
Assess sign and symptoms of electrolyte imbalance such as nausea vomiting, fatigue, sweating
Assess vital sign every 4 hours
Patient and relative activities
Observers sign and symptoms such as nausea vomiting, fatigue, sweating
Observers the amount of urinate and defecate
Supportive data
The result of Electrolyte imbalance, potassium 3.3 mmol/Lis low and chloride 97 mmol L is low
Evaluation
Unable to assess
Patient need knowledge of radiotherapy RT
Supportive data
The first time of patient for radiotherapy
Evaluation criteria
Patients can answer questions of after radiotherapy
Analysis
radiotherapy used to treat cancer It uses high-energy radiation to area the cancer cells to destroy the cancer cells
Nursing goal
The patient has knowledgeable of radiotherapy
Nursing activity
General health care after receiving radiation therapy
Should eat nutritious foods, high in vitamins, high protein, easily digestible such as meat, fish, milk, eggs, animal liver, legumes, vegetables and fruits to keep the body healthy.
Drink at least 2000-3000 cc of water a day. Water helps keep the body hydrated and dissipates heat from the body
Maintain general cleanliness of the body from head to toe for patients undergoing radiation therapy will be weak and have low immunity If the body is dirty, it can easily cause complications.
excretion of waste from the body If you have constipation or diarrhea, inform your doctor. or nurse know
Sleep relaxation, you should sleep at least 6-8 hours a day. If you can't sleep, tell your doctor or nurse.
Exercise according to the condition of the body and do it regularly will help the body to be strong and circulation of better blood
If headache body pain or have any unusual symptoms such as fatigue, loss of appetite, sore mouth, sore throat, difficulty swallowing, and skin inflammation, inform your doctor or nurse for help.
Should make your mind comfortable Find hobbies to do, such as reading, listening to the radio, watching TV, and talking to others.
Patients are required to undergo laboratory tests, including CBC, once a week. to assess health conditions during radiation therapy
Caring for the skin in the irradiated area
Patients receiving radiation to the head region there may be hair loss, should not wash your hair, seek advice from a nurse. Before using hair oil or hair products or wax on the irradiated area If your head feels itchy, you may use apply olive oil for hair loss symptoms. Hair will grow again after 2-3 months of treatment has ended.
Avoid exposure to strong sunlight. or direct exposure to the irradiated area with heat or cold Should wear a loose hat or open an umbrella.
Patients who received radiation therapy to the throat Skin may be red, dry, tight, itchy, dark, and scaly, or burst into a wound. Do not rub, peel, scratch, and wear loose, soft clothing made from natural fibers. To reduce skin friction, nails should be cut. Keep it short to prevent scratching.
The skin at the irradiated area should be washed with clean water or soapy water that does not contain perfume and should use a towel that Softly absorbs the irradiated area. avoid scrubbing Avoid using a shower with strong water pressure when taking a shower.
Do not swim in chlorinated pools. because it will dry your skin
Do not place hot water bags ice in the irradiated area Do not cover the plaster, apply balm on the irradiated area.
If itching Do not apply talcum powder Because talcum powder is mixed with heavy metals. irritate darker skin Use pure cornstarch instead.
Use a sunscreen with SPF15 for 1 year after irradiation is complete.
Patient and relative activities
Follow : by nursing activity
Evaluation
Unable to assess
Anemia related to cervix cancer
Nursing goal
To improve patient didn’t have sign and symptoms of anemia
Supportive data
Patient has cervix cancer and Hct 27.0 % is low
Evaluation criteria
Hct is normal 37.7-53.7%
No sign and symptoms of anemia such as pale, fatigue,chest pain, tired ,low blood pressure, difficult to breath
Analysis
Bone marrow pathology from cancer spreading into the bone marrow or affecting the bone marrow from cancer treatment, increased hematopoietic damage to the spleen, renal failure, chemotherapy and radiotherapy, and anemia caused by cancer. itself called cancer-related anemia
Nursing actity
Assess sign and symptoms of anemia such as pale, fatigue, chest pain, tired , low blood pressure, shortness of breath
Assess laboratory of Hct for assessing of anemia
Encourage rest and assign activities of anemia to reduce the body's need for oxygen.
Assess vital sign every for assessing of anemia
Suggest the patient receives the necessary food for red blood cell formation, such as iron, protein, vitamin C.
Patient and relative activities
Eat foods high in iron, protein, vitamin C.
Observers sign and symptoms of anemia pale, fatigue, chest pain, tired , low blood pressure, shortness of breath if has sign an symptoms notify the nurse
Evaluation
Unable to assess
D METHOD
Nursing actity
Assess knowledge of the patient in self care at home after received radiotherapy
Provide information about taking care of yourself. When receiving radiotherapy D-METHOD
D- Diagnosis
Cervical cancer is a cancer that occurs around the cervix of a woman. There are indications that are abnormally white discharge. pus-like white discharge abnormal vaginal bleeding that is not menstrual bleeding bleeding after sex or those who are in menopause bleeding after menopause which generally do not show symptoms in the early onset of illness but will have symptoms when the cancer cells have spread
Causes of cervical cancer
Most cervical cancer is caused by infection with HPV (Human Papillomavirus) through sex. There are also other potential risk factors for cervical cancer, such as pre-cancerous uterine (CIN) cell changes, low immunity, smoking, and having multiple children.
O- Out patient
Follow doctor's appointments regularly.
M- Medications
There is no information about medications
H- Health
Promoting physical and mental rehabilitation as well as preventing various complications
E- Environment
Management the home environment is stuble for patient health such as must be kept clean and good ventilation in house because recieve radiotherapy will lower immunity may be infection easily.
T- Treatment
Radiotherapy RT and same as nursing activity, Patient need knowledge of radiotherapy RT
D- Diet
Choosing the food appropiate for the disease, avoiding or refraining from foods that are harmful to health.
Provide a chance to the patient to ask a question of radiotherapy
Assess understanding information by ask a question of radiotherapy that the patient can answer correctly 4 out of 5 question
Patient and relative activities
Follow by nursing activity
Nursing goal
Patients and relatives knowledge and understand self care at home after received radiotherapy
Evaluation criteria
Patient can answer correctly 4 out of 5 question
Present illness
July 2019 : Patient has abnormal vagina bleeding after menopause
Date 8/7/2019 : Cervical biopsy - Non-keratinizing Squamous cell CA
Date 26/8/2019 : MRI lower abdomen -Cervix mass 6.5x5x5.4 cm with involved both parametrium, closed to Rt pelvic side wall, upper 1/3 vagina involvement, Multiple diverticula at sigmoid colon and 0.8 cm. diverticulum at periampullary area, PV : IUB - normal, Vg & Cx - Hard infiltrative Cx mass 6 cm. Involved to upper vagina 1/3, Rt pelvic side wall.
Cervix cancer IIIB
Cheif complaint
Plan for radiotherapy RT (Date 11 November 2019)
Patient information
She is 59 years old, have underlying disease DM, HT, DLP, refuse allergic of drug. Body weight 50 kg, High 145 cm. Vital sign are Temperature 36.7 c, BP 135/82 mmHg, P 74 bpm, RR 18 bpm.
Physical Examination
Unable to provide information
Pathological Diagnosis
Cervix (Biopsy) : -Non-keratinizing squamous cell cinoma
Nursing goal
The patient doesn’t have diarrhea