Reference no: EM133438659
Case Study
CW is a 56 year old married woman with two grown children who lives with her husband in Las Vegas, Nevada. She has smoked 2 packs of cigarettes a day for 40 years and has recently been experiencing a 10 lb weight loss over a 2-month period, a cough with hemoptysis, and SOB with walking short distances of 30 feet. Her PMH includes a hysterectomy and choleycystectomy. She works as a bar tender part time at Binion's casino. She has health insurance through her husband who is a dealer at the Mirage.
CW goes in to see her primary care provider for her cough and SOB and a chest - x-ray is ordered. The x-ray shows a large left pleural effusion for which she is admitted to the hospital for and undergoes a thoracentesis and full lab workup. A pathology report on the workup indicates squamous cell CA. Other lab reports are unremarkable.
Questions:
The plan for CW now is to undergo surgery to shrink the tumor (debulking), followed by 8 weeks of outpatient radiation therapy, possibly followed by a short course of chemotherapy.
You are the RN taking care of CW today.
The doctor has just left the hospital room with CW after explaining everything so fast that it made YOUR head spin.
When you approach the patient she just looks at you and says, "What'd the Dr. just say?" How will you explain this complicated treatment approach to your patient in terms that she can understand?
Your patient is concerned that her husband will need to stay away from her during her course of treatment. What will your response be? How will you go on to explain this radiation process to her?
Two weeks later you are taking care of CW again for a repeat thoracentesis and c/o SOB and fatigue. She is so happy to see a familiar face and feels comforted in your care.
She states that "the radiation is ok" except that it makes her "nauseous afterward". What can you discuss with her that will address this?
What information can you give CW related to her fatigue?