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E CARE CHECKLIST The Patient With Gastric Cannar With Gastric and Duodenal Disorders 1281 son Case Study for NUR 2110 Cancer Diagnosis/Surgery: Harold is a 54 year old male with complaints of constipation, abdominal cramping and ribbon- like stools x 2 months. His primary care physician referred him to a gastro-enterologist who ordered a colonoscopy. Biopsies were taken during the colonoscopy which showed a 8 cm tumor in the descending colon., with 4/10 lymph nodes positive for malignancy. The pathology report showed an adenocarcinoma of the colon. A CT scan was performed which showed multiple areas of metastasis in the liver and lungs. Harold is scheduled for a partial colectomy to remove the tumor and insertion of a port-a cath for chemotherapy. He may have a temporary colostomy. You are doing his pre-operative teaching. LIST With Gastric cancer W Gana Duodenales 1281 12. What patient teaching is important right now? 13. Pick one priority teaching point and explain how you would develop a teaching plan for Harold. 14. What collaborative care is indicated, based on the CBC results? Nursing Management Continued Care: Harold has had diarrhea 5-6 times daily for 2 days. He states his mouth is too sore to eat much of anything and he is very tired and dizzy. Urine output last shift was 250 mL and dark yellow. His VS are as follows: BP 80/48, P 130 and irregular, RR 28, T102.8. Blood cultures were drawn. A chemistry panel was done and results are as follows: Na: 148 meq/L CI: 118 K: 3.2 meg/L CO2:37 BUN: 32 Cr 2.3 15. What is your priority nursing diagnosis? 16. What are your priority interventions at this time, based on the above clinical data? Explain why you chose these as priority for this particular patient.
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