Park Bong Soo The cancer patient Park Bong
Park Bong Soo The cancer patient
Park Bong Soo 81 year old middle class Korean-American 5’ 6” tall and 110 lbs Happily married to Park Min-Young Lives with his wife and his 46 year old daughter, Park Min. Ja Migrated to the US in his early 20 s with his wife to build a better future for his family in Somerset, Colorado. Park Bong Soo worked as a coal miner until he retired. Park Bong Soo has been recently diagnosed with lung cancer.
Admitting/primary Diagnosis: Shortness of breath • O 2 saturation: 89% • Chest pain when cough • Tired • Weight loss, little appetite (lost ~20 lbs from last checkup 5 months ago) Secondary Diagnosis: Lung Cancer
Surgical Interventions and/or Diagnostic Tests • Administration of oxygen via nasal cannula • Full blood panel • Low WBC count • Lung X-ray • Abnormal spot seen • MRI • Small Cell Lung Cancer • Biopsy • Malignant
History of Present Health Concern • Past Smoker • Smoked cigarettes for 50 years; quit when he was 72 • Still occasionally smokes a cigar • Retired coal miner • Worked in the coal mines for 50 years, being constantly exposed to smoke and other natural hazardous chemicals
Past Health History • Throat Cancer • Park Bong Soo has been in remission from his throat cancer for seven years • Tracheostomy • Secondary to his throat cancer—a surgical airway was implanted during Park Bong Soo’s throat cancer treatment when the tumor in his throat was compromising his airway
Current Orders • Bath • Activity -Ask patient what he prefers/feels up to? Bed bath or regular full bath. May prefer bed bath due to his risk of falling and respiratory distress and low O 2 levels. (at least until he builds up his endurance. ) -Up with assistance, fall risk so needs gait belt. When ready transition to letting him carry O 2 tank while walking with cane and assistance. Up and moving 3 x’s a day. • Diet -Normal healthy diet until start of chemotherapy. • Bathroom -Bedside urinal and commode may be used with assistance.
Top Three Priority Problems • Bathing self-care deficit related to shortness of breath as evident by use of a cannula. • Impaired physical mobility related to shortness of breath as evident by use of a cannula. • Activity intolerance related to shortness of breath as evident by use of a cannula.
Priority Nursing Diagnosis • Activity intolerance related to shortness of breath as evident by use of a cannula.
Patient Outcome/Goal • To get patient to do activity without assistance and be able to maneuver with nasal cannula.
Nursing Interventions and Rationales • Educate the patient and family of the use and care of the nasal cannula. • Make sure patient is using nasal cannula correctly. • Continue daily activity with assistance from family when needed. • Build up endurance to get the patient able to maneuver with nasal cannula on his own.
Evaluation of Patient Outcome • Goal not met yet: • Patient is going home with a nasal cannula, but still needs occasional family assistance for daily activities.
Day # 2 • Today you are assigned to Mr. Park Bong Soo again. He is feeling more tired today after a full day with physical therapy yesterday. He remains on oxygen at 2 L. • While completing you assessment with him you note some redness around his face and ears • What is your priority nursing diagnosis? • Write a care plan based on your diagnosis?
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