Teaching plan for cancer pt?

Daytonite, BSN, RN · Oct 28, 2006

this is a very nice link to a twelve-page publication that was made for patients and family of those with advanced lung cancer. it lists and addresses some issues that should give you a good place to start with where to go with a teaching topic.

http://www.chestnet.org/downloads/patients/guides/lungcancer5048.pdf - advanced lung cancer: issues to consider. a patient education guide.

my mother died a few months ago from metastatic breast cancer that had spread to the lung. the end for her came very quickly. her dyspnea came on very quickly and her biggest fear was smothering. she was short of breath all the time, even with continuous oxygen turned up as high as we could get it. between the hospice nurses and myself i guess you would have to say that our teaching with her was how to save her energy, how to position herself to get the maximum from each breath and little things to do to try to relax, especially once she was medicated. despite telling her these things she would still insist on trying to do things for herself which only made her dyspnea worse. the shortness of breath is a new and scary thing to these people and they need to be educated about it.

Jtejas · Oct 28, 2006

Daytonite

That was jsut the thing I was looking for. My pt had the exact same thing. Metastic lung cancer. Died the night after I helped him. He could barely keep his breath. Eating was difficult, drinking was difficult. He had been off Morphine and a rebreather mask for awhile... Went back on the morphine w/o the rebreather and I think the morphine cause his RR to decrease to much....

Thanks

James

Daytonite, BSN, RN · Oct 29, 2006

my mom was put on roxanol (sublingual morphine) and ativan. the first time i gave her the ativan she was "out" for a whole day. scared me to death. the roxanol didn't seem to help as much even though i kept upping the dose as per the hospice nurses. the night she died (she died at home), she was begging for more of everything to help ease her breathing. poor thing got nasty with me about it too and said she was going to tell the hospice nurses i wasn't giving her enough of the medicine! she had been saying for days that her biggest fear was the shortness of breath and having trouble breathing. i doubled, tripled the roxanol and gave her 3/4 of a tablet of ativan. it took almost 3 hours before she finally settled down. i kept the head of her bed up and her oxygen at 5l. around 4am her lungs just failed her. she actually died peacefully and without any struggling for breath. initially, i worried that i might have medicated her to her death, but i don't think so. i spoke with the hospice nurse who came to pronounce her and she felt i really hadn't given her that much medication at all. i had seen the ct images of her lungs that had been done when the metastasis had been found and they looked bad to begin with. how she had any good lung tissue left to exchange oxygen and carbon dioxide is beyond me since the cancer had done a heck of a number on her lungs.