Help with care plan

[Ishb1]

I Really have a hard time with care plans I am trying to get this practice one done but again I am stuck, can you guys please help me out and give me any tips for the future.

So far this is what I got

ineffective family coping related to family disorganization and role changes evidenced by not engaging with Mr. X. Intervention to establish rapport and acknowledge difficulty of the situation for the family to possibly assist them with accepting what is happening.

i don't know if activity intolerance would be a good one as he is on bed rest and is not interested in talking

please help me:)

Q3. A patient, Mr. X, a 66 year old male, is under your care on the unit today. He has been diagnosed as end stage pancreatic cancer and is on palliative care. His oxygen saturation on room air is 90%, R=26 and shallow, T=37, P=52, B/P is 90/50. He is beginning to show mottled areas on his extremities. He does not want to engage in conversation with you saying only that he feels his time is near”. You notice that his family is in the room does not appear to be engaging with the patient. As a nurse you want to ensure that Mr. X is provided with compassionate and humane care.

Document your nursing care plan for this offender including your assessment, plan, implementation of your plan and evaluation.

[jadelpn, LPN, EMT-B]

First off, take complete comfort in the fact that more than likely, after schooling, you will never have to write another care plan. These are usually started by RN's and followed by LPNs. (At least in acute care, LTC may be different, but ANYWHO....) HAHA. Comic relief.....

Every patient has to be assessed for fall risk, skin risk, pain management. Palliative care patients need to be assessed for spiritual distress. Patients usually need a discharge care plan, but if the plan is to keep Mr. X hospitalized until his passing, then a "alteration in health care" can address hospice consult needs.

Good luck!!

[bluegeegoo2, LPN]

...Does anyone else feel the urge to apply O2 and start Ativan and MS04? By his statement of "my time is near" there's likely anxiety on his part (also evidenced by increased respirations) and likely that of the family who may be in denial of his condition. Poor oxygen perfusion a.e.b. mottling and also the increased respirations.

I was taught to assess and care plan all abnormal findings. Such as the mottling, increased and shallow respirations, voicing of being aware death is imminent, is he not talking d/t pain? Fear? Both? Does the family and pt need educating on the end of life process? Risk of impaired skin integrity d/t immobilization, poor oral intake, unable to perform own ADL's, etc. Does he and the family require a spiritual leader? There's plenty more options, but that's what came up off the top of my head. Hope that helps and best of luck. :)