Nursing 211

N211: Health Differences Across the Lifespan I of 148 Anxiety related to diagnosis of cancer Pain related to surgical removal of lesion High risk for ineffective management of therapeutic regimen related to insufficient knowledge of treatment regime and post-treatment management. Nursing Interventions Include instruction of self-examination in a full-length mirror; use of sunscreen, instruct clients to avoid sun lamps and tanning. Instruct patient to wear protective clothing such as long sleeves, pants and hats. Instruct patient to avoid unnecessary exposure to the sun during the day, especially between the hours of 10:00am and 3:00pm. Refer to support groups and resource agencies such as The American Cancer Society. Administer analgesics as ordered. Instruct patient regarding alternate pain relief measures such as distraction, guided imagery, or deep breathing techniques. Review post-procedure instructions with client and family to include: do not remove any scabs by pulling or soaking; the scab must be allowed to dry and fall off; do not put any nonprescription medication on the area; contact physician if there is continued bleeding, if the scab comes off and there is bleeding or if fever and chills occur. Gastric Cancer (Stomach Cancer) is a malignancy characterized by a mass or ulcerating lesion that penetrates several tissue layers. Gastric cancer is caused by degenerative changes in gastric ulcers. Men are two times more frequently affected than women; individuals with a diet high in starch, with few fresh vegetables and fruits are also affected. Stomach cancers have a high morbidity and mortality rate. The malignancies are common in African American, Japanese and Latinos. Chronic inflammation of the stomach and hereditary appear to be contributing factors. Associated factors attributed to the cause of stomach cancer in H. pylori bacteria and pernicious anemia; chronic ingestion of toxins such as foods preserved with nitrates. Another factor is a diet low in fruits and vegetables. Nursing Assessment Includes anorexia, indigestion, dyspepsia, weight loss, abdominal pain, anemia, nausea, vomiting and constipation. Diagnostics include complete blood count, serum chemistries, upper endoscopy series, CT scan, MRI, bone and liver radionuclide scans and stool for occult blood. Nursing Diagnosis • Altered nutrition, less than body requirements, related to malignancy and treatments • Pain related to disease process and surgical interventions • Fatigue relate to the effects of radiation/chemotherapy ©2012 Achieve Page 95