case study 15

  Case Study, Chapter 15, Oncology: Nursing Management in Cancer Care 1. Emanuel Jones, 60 years of age, is hardy unrepining diagnosed delay fine cell carcinoma. He underwent surgery in the elapsed to abstract the left inferior lobe of his lung. He is receiving chemotherapy. Two weeks antecedently a circular of chemotherapy, a consummate class enumerate delay divergential, and a renal and metabolic feature are obtained for the unrepining. The unrepining presents to the oncology clinic for chemotherapy delay a region of 101°F. Further duty reveals decreased inspiration sounds in the direct infamous of the direct lung, and a efficient cough expectorating green colored mucus. The unrepining is brief of inspiration and has a pulse oximetry lection that is SaO2 of 85% on compass air. The unrepining has a truth of kind prostate hypertrophy (BPH) and has complaints of urinary abundance and beaming upon urination. The unrepining is admitted to the oncology part in the hospital. The oncologist subserviency the subjoined: class, sputum, and urine cultures; and a chest x-ray. An x-ray of the kidneys, ureters, bladder (KUB) is ordered. An arterial class gas (ABG) on compass air, CBC delay divergential, and renal and metabolic feature are ordered. Oxygen is ordered to initiate delay nasal cannula at 2 L/min and titrate to preserve SaO2 important than 90%. A broad-spectrum antibiotic, levofloxacin 500 mg in 100 mL of NS is ordered to be administered IV balance 60 minutes uninterruptedly daily.  After examining the physician subserviency, in what progression should the nourish arrange the wariness to the unrepining admitted to the hospital? Give the rationale for the progression selected. On what areas should the nourish nucleus the duty to unmask possible complications for Mr. Jones? What unrepining direction does Mr. Jones deficiency from the nourish to aid anticipate the reoccurrence of an taint and to get treatment for an taint quickly? 2. The oncology clinical nourish properist (CNS) is asked to expand a staff expandment program for registered nourishs who gain be administering chemotherapeutic agents. Because the nourishs gain be administering a miscellany of chemotherapeutic drugs to oncology unrepinings, the CNS plans on presenting an balanceview of agents, classifications, and proper precautions allied to the secured handling and government of these drugs.  What does the CNS draw as the goals of chemotherapy? How should the CNS accord to the subjoined question: “Why do unrepinings demand circulars of chemotherapeutic drugs, including divergent drugs and varying intervals?” In education encircling the government of chemotherapeutic agents, what signs of extravasation should the nourish embody? What clinical manifestations of myelosuppression, minor to chemotherapy government, should the CNS embody in this program?