NRS 410 Grand Canyon Week 1 Discussion: Case Scenario of Mrs G

Discussion: Case Scenario of Mrs G

The case scenario provided will be used to answer the discussion questions that follow. Case Scenario

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.Discussion: Case Scenario of Mrs G

Subjective Data

Complains of pain and heaviness in her leg.
States she cannot bear weight on her leg and has been in bed for 3 days.
Lives alone and has not had anyone to help her with meals.

Objective Data

Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
Left leg red from knee to ankle
Calf measurement on left 3 in > than right
Temperature: 38.9 degrees C
Height: 160 cm; Weight: 83.7 kg

Laboratory Results

WBC 18.3 x 10″ / L; 80% neutrophils, 12% bands
Wound culture: Staphylococcus aureus

Critical Thinking Questions

What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.Discussion: Case Scenario of Mrs G

Approach to Cancer Care Sample Approach

Pathology and Nursing Management of Client’s Health

Approach to Cancer

Cancer is a malignant neoplasm that can affect individuals of any ethnic background, age, occupation, and social economic status. Some of the common factors that contribute to the high mortality rate are consumption of alcohol, tobacco smoking, occupational exposures to asbestos and radiation among others. Genetic factors are also proven to be a contributing factor to mortality rates. Early detection of cancer can lead to good outcomes (Artherholt, 2012).

Diagnosis of Cancer

There is no proven test that is used to diagnose cancer despite having various types and forms of cancer. There are however several basic diagnostic procedures and tools that are used to assist in recognizing, determining and monitoring the treatment of cancer. The first step of diagnosing cancer is reviewing the personal history of the patient and family health history then a physical exam is obtained. The second step is laboratory testing of various specimens like stool, blood, urine or other bodily fluids that can help in recognizing any deviances in normal values. Laboratory testing is a basic tool used to help in directing more diagnostic tests that show different types of cancer. An abnormal laboratory is therefore not a certain sign of cancer (Carelle, 2002). Tumor markers are substances that are produced to show high levels of cancerous conditions. This is however not always the case as these tumor markers can also be produced by normal and non-cancerous cells of the body at beginning cancerous conditions. Tumor marker measurements are therefore used along with other tests the likes of biopsies in the treatment of cancer throughout the entire duration. Nowadays there are various technological ways of determining the presence of a tumor in the body. They include ultrasounds, magnetic resonance imaging (MRI), x-rays, positron emission tomography (PET) scans and computerized tomography (CT) scans. A biopsy is the most common and effective test used in diagnosing cancer together with the above technological techniques. A biopsy is a procedure which involves removal of a sample of organ tissue in question and then analyzed by a pathologist using a microscope to check the presence of cancerous cells. Biopsy samples are collected using endoscopic tools, aspiration needle to withdraw fluid or through surgery.

Staging of cancer

Cancer is staged after diagnosis of cancer. Staging of cancer helps in determining the chances of survival, determining the best treatment method to be used, recognizing clinical trial options as well as understanding cancer better. Staging of cancer is determined by tumor size and extent of tumors, lymph node involvement, the location of the original tumor and presence or absence of distant metastasis.

The most common and effective method of staging cancer is the TNM classification system. This classification system should always be updated at least 6-8 months as the understanding of cancer continues to advance. Letter T, represent the size and extent of primary tumor, N represents the number of regional lymph nodes that have cancer and M refers to whether the tumor has spread to other body parts (Kroschinsky, 2017). If letter X is seen after T, N, or M, this is an indication that the category is unmeasurable. If number 0 follows T, N or M, then the category can’t be found.

Clinical staging assesses the extent of cancer through results obtained from imaging tests such as X-rays and scans, physical exams and tumor biopsies. Other results tests can also be used such as blood tests. Clinical stage helps in determining the best treatment to be used as well as comparing how treatment responds to different treatment. Another method of staging cancer is pathologic staging also known as the surgical stage of cancer. This stage depends on the results obtained from previous exams and tests mentioned above or through what is learned about cancer during surgery. The surgery is done to remove cancer or nearby lymph nodes. The surgery may also be conducted to determine the extent of cancer in the body and take out tissue samples. Pathologic stages differ from clinical staging especially when the surgery indicates that cancer has spread in the body more than it was expected. Pathologic stage helps the health care team to obtain vital information to be used in predicting treatment outcomes and response.

Complications and side effects of cancer treatment

Complications of cancer depend on the affected part of the body. Some of the common complications include fatigue, difficulty in swallowing, changes in bladder habits, weight gain or loss, persistent cough, persistent indigestion, and unexpected fevers among others.

Commonly used cancer treatment include radiation therapy, chemotherapy, and surgery. This treatment is accompanied by side effects that often affect patient’s ability to comply with treatments or make treatment less effective than they could be. Neutropenia is a common side effect after chemotherapy treatment (Ko, 2002). Neutropenia decreases the number of white blood cells in the body which are the main defense against germs. Chemotherapy drugs kill all fast-growing cells in the body including healthy white blood cells and cancer cells. Patients who have less white blood cells to fight infection are likely to be more affected. Washing hands often is the most recommended way of lowering the chances of getting neutropenia side effects. Another way of preventing this infection is by consulting a doctor especially when one notices any other signs of infection such as fever.

Lymphedema is another side effect that occurs when lymph nodes are removed during surgery or when lymph nodes are damaged by radiation treatment thus blocking the lymph fluid from draining properly. The blocked lymph fluid then builds up in the skin thus making that part of the body to swell. Cancer patients are recommended to inform the doctor when they notice such body swellings. There is a specialist who can be able to drain the lymph nodes manually. Alternatively, the patients can be recommended to exercise or wear tight-fitting garments that will help in managing lymphedema.

The aim of chemotherapy drugs is to kill all growing cells in the body which means they are also capable of destroying hair roots. Some patients end up losing all hair in the body including eyebrows, pubic hairs, armpit hair, and eyelashes. The hair may, however, grow again after 3 to 10 months after the last treatment. Radiation can also lead to hair loss although it only affects the exposed areas. There is no proven effective treatment for hair loss however treatments such as cooling caps helps in keeping more of the hair from falling out (Mourtzakis, 2008). The cooling cap is fitted in the patients head to keep the scalp cool before, during and after chemotherapy treatment. The effectiveness of the cooling cap is determined by the kind of chemotherapy one receives. Most cancer patients prefer to shave their hair before it starts falling out. Others choose to wear hats, scarfs or wigs during chemotherapy treatment.

Some cancer patients’ experiences nausea and vomiting just from thinking about cancer treatment. Nausea can be managed byways such as taking ginger and drinking plenty of water. Others techniques include acupuncture and hypnosis. Other side effects of treatment include trouble eating, depression, decreased sex drive, tiredness, hearing loss, skin changes, and nail changes.

Methods to lessen physical and psychological effects

Encouraging exercise program especially during radiation therapy can help in improving signs and symptoms as well as mental and physical health of the patient. During therapy, a patient is recommended to walk around to help in maintaining his or her fitness. A medical practitioner is required during the exercise to address any complication that can occur. Most patients including healthy individuals believe that no one can survive from cancer. It is therefore important for cancer patients to be taught on how to relax and deal with the situation thus lessening psychological and physical effects. This technique is referred to as a relaxation method which involves diaphragm breathing and guided imagery (Murray, 2013). The patient is encouraged to only think of the good moment in his or her life. The patients are also educated to enable them to clearly understand and accept their condition hence reducing anxiety. They are educated on what type of cancer they are having and why it is necessary for them to change their lifestyle. This relieves dilemmas concerning cancer as well as reducing psychological disturbances. Other techniques that can help in lessening physical and psychological effects include emotional and social support, medications for depression or anxiety, training in stress management and early distress screening.

References

Artherholt, S. B., & Fann, J. R. (2012). Psychosocial care in cancer. Current psychiatry reports, 14(1), 23-29.s

Carelle, N., Piotto, E., Bellanger, A., Germanaud, J., Thuillier, A., & Khayat, D. (2002). Changing patient perceptions of the side effects of cancer chemotherapy. Cancer, 95(1), 155-163.

Kroschinsky, F., Stölzel, F., von Bonin, S., Beutel, G., Kochanek, M., Kiehl, M., & Schellongowski, P. (2017). New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management. Critical care, 21(1), 89.

Ko, C., & Chaudhry, S. (2002). The need for a multidisciplinary approach to cancer care. Journal of Surgical Research, 105(1), 53-57.

Mourtzakis, M., Prado, C. M., Lieffers, J. R., Reiman, T., McCargar, L. J., & Baracos, V. E.(2008). A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. Applied Physiology, Nutrition, and Metabolism, 33(5), 997-1006.

Murray, S. A., Kendall, M., Boyd, K., & Sheikh, A. (2013). Illness trajectories and palliative care. International Perspectives on Public Health and Palliative Care, 30, 2017-19.Discussion: Case Scenario of Mrs G

MORE INFO

Approach to Cancer Care

Introduction

Cancer care is based on your stage of cancer and your overall health. The most important thing you can do for your own recovery is to stay well-hydrated. Your doctor may recommend a variety of treatments to help you get through this difficult time. For many cancers, treatment involves surgery, radiation therapy or hormone therapy. Some types of cancer are treated with drugs that interfere with the growth or spread of cancer cells.”

Cancer care is based on your stage of cancer and your overall health.

Cancer care is based on your stage of cancer and your overall health. In general, the earlier you are diagnosed with cancer and the more advanced it is at diagnosis, the more likely you have a better chance of survival.

Stage 1: Early stage disease represents an early sign that something may be wrong in your body but does not yet require treatment. If you’re diagnosed with early-stage cancer, there are several things you should know about how to manage this type of disease so that it doesn’t grow or spread (metastasize). You can use treatments like chemotherapy alone or together with radiation therapy as needed depending on which type works best for each patient based on their unique needs.

Stage 2: Intermediate stage means there is evidence that cancer has grown but hasn’t invaded nearby tissues yet; however, these patients still need regular checkups because they’re still at risk for new growths later down the road due to lack of proper treatment options available today! It’s important not only because life expectancy isn’t guaranteed but also because some people find comfort knowing what symptoms might occur during each stage.”

The most important thing you can do for your own recovery is to stay well-hydrated.

Your body needs water and electrolytes in order to function properly. If you are not drinking enough liquids, it will be much harder for your body to fight off infection and disease, as well as recover from surgery or chemotherapy treatments. You should also eat foods that are high in water content (such as fruits), since this helps keep everything hydrated throughout the day!

Your doctor may recommend a variety of treatments to help you get through this difficult time.

Your doctor will likely recommend a variety of treatments to help you get through this difficult time. The first step is to make sure that you’re getting the best care possible, which means choosing a doctor who has specialized training in cancer care and has received extensive training on how to treat it.

Your doctor will explain what each treatment involves and why it might be necessary for your health. For example:

Radiation therapy gives high doses of radiation to kill cancer cells while leaving normal cells unaffected
Chemotherapy drugs stop the growth of new tumors by killing off existing ones

For many cancers, treatment involves surgery, radiation therapy or hormone therapy.

Surgery is often used to remove the cancer. Radiation therapy destroys cancer cells by exposing them to high-energy rays that damage their DNA and cause them to die. Hormone therapy suppresses hormones that stimulate the growth of tumor cells in certain types of breast, prostate and colon cancers.

Some types of cancer are treated with drugs that interfere with the growth or spread of cancer cells.

Some types of cancer are treated with drugs that interfere with the growth or spread of cancer cells. Cancer drugs may be injected into the body (intravenously), taken by mouth, administered through a vein, or given through an inhaler.

Combining medical care with support services can improve your quality of life

Combining medical care with support services can improve your quality of life.
A positive attitude is essential to improving your quality of life.
Focus on what you can control, such as staying positive for yourself and your family, friends and colleagues.

Conclusion

In summary, the key to good cancer care is a team of doctors, nurses and specialists who work together to design an individualized plan for you. It’s important that you trust your doctor with all of your health decisions and follow their instructions as closely as possible. You also need to be aware of what treatments are available, how they work and when they might be most effective in helping you cope with your cancer diagnosis (or recurrence).

Nursing Worker

Discussion: Case Scenario of Mrs G