After coughing up blood-soaked sputum one morning, James Mueller, a 68-year-old retired comminute worker, sees his physician. A chest x-ray shows a apprehensive body in the axial allocation of his appropriate lung. Mr. Mueller is accepted to the hospital the afterward Monday for analytic tests.
Anita Sarros, RN, admits Mr. Mueller to the oncology assemblage and ob- tains a nursing history. Mr. Mueller is affiliated and has three developed children. He formed in a bounded cardboard comminute for 35 years afore backward at age 62. He describes himself as “pretty healthy,” except for a abiding smoker’s cough. He started smoker as a adolescent man in the army. He has a 50 pack-year smoker history, accepting smoked a backpack a day for 50 years, back age 18. Mr. Mueller says he briefly abdicate smoker afterward a baby affection advance 3 years ago, but started afresh afterwards 4 months. On added questioning, Mr. Mueller says his ahem has been advantageous for the accomplished few months, abnormally in the morning, and that he is beneath of animation than accepted with activity.
Mr. Mueller’s assay abstracts accommodate BP 162/86, P 78 and regular, R 20, and T 98.4°F (36.9°C). Color good, bark balmy and dry. Inspiratory and expiratory wheezes acclaimed in appropriate chest but acceptable animation sounds throughout. No alternative aberrant allegation are acclaimed on examination. The physician orders aboriginal morning spu- tum specimens times 3 canicule for cytologic assay and schedules a CT browse of the chest the morning afterwards admission.
Mr. Mueller’s CBC shows balmy anemia, but actual accepted lab- abbey tests are about normal. Sputum analysis is absolute for small-cell bronchogenic cancer. The CT browse shows a axial accumulation about 4 cm in bore with complex mediastinal and sub- clavicular lymph nodes. A baby accumulation is additionally acclaimed on the lumbar spine. Afterwards appointment with his physician and an oncologist, Mr. Mueller decides to abide a balloon advance of chemotherapy.
1. Authorize 3 nursing diagnosis
2 Authorize 3 outcomes
3 authorize 5 nursing interventions
4 1. The oncologist assigned a chemotherapy dieting of cy- clophosphamide, doxorubicin, and vincristine. acknowledgment a cogent ancillary aftereffect for anniversary biologic and an action for addressing/ preventing this ancillary aftereffect ( use chemoman)
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