Help for care plan for patient with Hodgkin's Disease

  1. this was originally posted in the thread, "online careplan website????" in the nursing student assistant forum. i am creating this thread to answer the ops question. before i get deluged with requests to do the homework assignments of other students, let me qualify this by saying that i have had e-mail communications with the op and decided to present this in it's own thread so that others could also benefit from seeing my work.
    Quote from pressured
    hi there..im ezra a nursing student 3rd year from the philippines..i have this assignment of making 5 nursing diagnosis for patients with hodgkins disease...can you please help me? ireally need help..im pathetic..please..thanks..and i also need nursing interventions..please reply..i would really appreciate it..just send it to my email via my profile page or send me a private message (pm)...thanks a lot...

    we have no patient..we are just told to write 5 nursing diagnosis for a patient with hodgkins disease..we must write actual nursing diagnosis not potential...yes we are using nanda...thanks for the reply...god bless..please help me im realy desperate
    hi, pressured!

    all writing of care plans follows the nursing process. the practical application of the steps in the nursing (written care plan) process are:
    1. assessment
    2. nursing diagnosis
    3. planning
    4. implementation
    5. evaluation
    in this particular case, there is no actual patient. this is a case study and this patient doesn't really exist. to satisfy the first step of the care planning process, which is the assessment of the patient, you need to go to sources and learn about hodgkin's disease. you are looking for the symptoms of this illness. a symptom is an objective observation or a subjective perception of the patient. in this particular situation you will only have objective data that you obtain from references that you have read. here are links to several online sites where you can find information about hodgkin's disease:
    there are a lot of symptoms, but these are the ones i've chosen to work with:
    • unexplained fevers with temps over 38 degrees c
    • unexplained weight loss of 10% with adequate food intake
    • drenching night sweats
    • pruritis (itching)
    • fatigue
    • cough
    • shortness of breath
    • chest pain
    these symptoms are needed to validate the nursing diagnoses that will be used. these are also the problems that will be addressed and treated by the nurse through nursing interventions.


    next order of business is to develop nursing diagnoses. you need five. there is the potential for many more, particularly once treatment is started. under each i've listed several nursing interventions. if you check nursing references you should be able to find more.
    1. ineffective airway clearance r/t physical obstruction by tumor aeb shortness of breath and cough

    outcome/goal: patient will have a patent airway at all times.

    nursing interventions:
    monitor the rate and character of patient's respirations.
    keep the head of the bed elevated 30 to 45 degrees to facilitate patient's breathing efforts.
    if there is likelihood of sputum production, teach patient how to deep breathe and cough to help clear the airway.
    observe the color, volume and odor of any sputum produced.
    provide emotional support when the patient is short of breath.

    2. imbalanced nutrition: less than body requirements r/t increased metabolic demands of neoplastic process aeb loss of 10% of body weight with adequate food intake

    outcome/goal: bring patient's weight back up to normal range for age

    nursing interventions:
    weigh weekly and record.
    monitor food intake and compare with a food guide pyramid to determine any omitted food groups.
    offer small meals at frequent intervals throughout the day to help deal with fatigue of eating.
    make regular physical inspections of patient's oral structures and monitor for inflammation or infection secondary to his/her compromised immune system.
    for children, offer finger foods that are easy for them to eat.
    offer high protein supplements between meals.

    3. hyperthermia r/t suppressed the immune system aeb fevers over 38 degrees celsius, night sweats and fatigue

    outcome/goal: patient's temperature will remain at or below 38 degrees celsius.

    nursing interventions:
    monitor patient's temperature at least every 4 hours, or as per hospital policy, or if patient is having chills.
    assist the patient with bathing and changing into clean, dry clothing after an episode of diaphoresis due to fatigue.
    encourage and instruct patient to drink fluids to replace fluid losses from diaphoresis and prevent dehydration.
    assist the patient with adls as necessary due to fatigue.
    collaborative intervention: give antipyretics as per the doctor's order to help with reducing the fever.

    4. impaired comfort: pruritis r/t inflammation in tissues aeb itching

    outcome/goal: patient will state his/her itching is relieved.

    nursing interventions:
    use soap sparingly if the skin is already dry.
    apply cool compresses on the itching skin or have patient sit in cool bath water for relief.
    applying compresses of starch solutions, such as oatmeal, may help relieve itching.
    keep fingernails short to prevent damage to skin from scratching.
    keep pruritic areas open to air.
    collaborative intervention: ask doctor for medication to relieve the itching.

    5. chronic pain r/t presence of tumor aeb chest pain

    outcome/goal: patient will be able to perform normal adls at a tolerable level of pain.

    nursing interventions:
    assess the patient's level of pain using a numerical pain rating scale or a face pain rating scale.
    if patient is young and cannot accurately report pain, document and observe for behaviors that may indicate the presence of pain.
    assess and document the location, intensity and any activity that acerbates the pain.
    plan for patient to perform adls around those times when the patient experiences greatest comfort from pain.
    collaborative intervention: ask doctor for medication to relieve the pain.
    you will find information about the nursing process and in writing care plans at these threads on the allnurses student nurses forums:
    http://allnurses.com/forums/f205/hea...ms-145091.html - health assessment resources, techniques, and forms (in nursing student assistance forum)
    http://allnurses.com/forums/f205/des...ns-170689.html - desperately need help with careplans (in nursing student assistance forum)
    http://allnurses.com/forums/f50/care...-121128-7.html - careplans help please! (with the r\t and aeb) (in general nursing student discussion forum)

    please join the other students on these student forums on allnurses. you will find many students who have the same problems with care plans that you do.
    http://allnurses.com/forums/f205/ - nursing student assistance forums
    http://allnurses.com/forums/f50/ - the general nursing student discussion forum

    welcome to allnurses!
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