Need help with oncology care plan

  1. hello, need help care plans pls..

    A 7 year old in Palliative care with ALL-Acute Lymphoplatic Leukemia. She was suffering from weight loss, lethargy, fever, swollen glands, easy bruising and painful
    After diagnostic testing, that included Full blood Exam, Bone Marrow Aspirate, Lumbar Puncture and
    Chest X-ray; she was diagnosed with Acute Lymphoblastic Leukaemia.
    She has just finished a course of Chemotherapy and the doctors have told her parents that they can't
    do anything else for her. Her parents were told to take her home and enjoy the rest of the time that
    they have with her, she is 7 years old.

    She will now need to receive palliative care at home.

    1. Develop a care plan that respects her needs in relation to her lifestyle, social
    context, emotional and spiritual choices.

    So far care plan ideas I came up with:
    Fatigue related to cancer?
    Immobility related to?
    Anxiety related to poor nutrition
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    Joined: Apr '13; Posts: 1


  3. by   KelRN215
    WOW, in the real world my care plan would be "get thee child to a different doctor" because anyone who says there's nothing else they can do for ALL after one course of chemo doesn't know which end is up.

    Regardless, let's pretend this is a likely scenario.

    Is the child constipated? It doesn't say so. Is there more information you haven't provided?
    Is she anxious because of poor nutrition? That seems to be an unlikely pair.
    Is she anxious at all? There's no assessment data that automatically leads us to conclude that she is. Does she know what's going on?
    Is the child immobile? Again, your scenario does not say that she is. She may have painful joints but that does NOT mean that she is immobile. Decreased ambulation is often a presenting sign for pediatric cancers but we don't know based on the information you provided that the child is immobile.
    The child has been losing weight- so what are you going to do to address that?
    What are your goals for a child in palliative care?
    What about the parents or the siblings?
  4. by   Esme12
    HI! welcome to AN! The largest online nursing community!

    Care plans are all about the assessment.
    weight loss, lethargy, fever, swollen glands, easy bruising and painful
    What about the assessment talks about constipation?

    What are you studying in school?.....What semester are you?

    How would you develop your plan of care for a 7 year old? What about Erickson's growth and development.?Erikson's Psychosocial Stages Summary Chart

    Stage Basic Conflict Important Events Outcome
    Infancy (birth to 18 months) Trust vs. Mistrust Feeding Children develop a sense of trust when caregivers provide reliabilty, care, and affection. A lack of this will lead to mistrust.
    Early Childhood (2 to 3 years) Autonomy vs. Shame and Doubt Toilet Training Children need to develop a sense of personal control over physical skills and a sense of independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt.
    Preschool (3 to 5 years) Initiative vs. Guilt Exploration Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.
    School Age (6 to 11 years) Industry vs. Inferiority School Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.
    Adolescence (12 to 18 years) Identity vs. Role Confusion Social Relationships Teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self.
    Young Adulthood (19 to 40 years) Intimacy vs. Isolation Relationships Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.
    Middle Adulthood (40 to 65 years) Generativity vs. Stagnation Work and Parenthood Adults need to create or nurture things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world.
    Maturity(65 to death) Ego Integrity vs. Despair Reflection on Life Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and
  5. by   carlie77
    Is this the EN assignment at Navitas? which campus are you at?
  6. by   nurseprnRN
    Don't forget the family is part of this nursing plan of care. Spiritual distress, Decisional conflict, all the Coping nursing diagnoses, the Grieving diagnoses, Stress overload, Chronic sorrow ...

    You MUST use the NANDA-I 2012-2014 nursing diagnoses; you can get the book from Amazon for $29 and free two-day delivery for students. Check to see which defining characteristics meet your assessment (NOT the other way around ) and that the related factor(s) match.