had a clinical today, and i am having trouble coming up with a teaching plan that must include 5 areas of instruction....
so, the run down....
patient is a 16 y.o. female, chronic asthma and pneumonia, which led to her family md having a ct scan done. mass found in the lower right lobe. bronchoscopy lead to determining the mass needed to be removed, as the md had concerns that it was a carcinoid tumor. upon removal of the lower 1/3 of the r lung, carcinoid tumor was confirmed with biopsy. complete excision was accomplised and the mds are not anticipating a recurrence or need for follow up radiation/chemo.
patient is doing well, postoperatively, o2 sats are a 98 with no movement, and ambulation, and all vitals are wnl.
however...i feel like the patient has had some regression with self care tasks, as she tells me that she normally does her own hair, and takes care of her self at home, but in the hospital she requested mom help her with bathing, combing hair, brushing teeth, and other general self care tasks.
so, my nursing dx is....risk for delayed development related to chronic illness. but when i am in my nanda, the proposed interventions are mostly geared at children much younger than her, and interventions include promoting parents to take child in for regular health care visits (already being done), provide parents realistic expectations for attainment of growth and development milestones (which just seems unnecessary, given her age and normal development of older siblings), assessing whether parents/client may benefit from internet/electronic support groups.
to which i say....*****?? (which seems to be happening a lot in nursing school! haha!)
can anyone give me some other interventions that seem fitting for this patient? my worries are that her possibility of lots of time out of school, away from friends may leave her with the inability to keep up in school, lack of ability to obtain drivers permit/licenseure due to lack of time to practice....things of that nature.
