NURS 106 Case Study—Oncologic Disorders by whq15269


									                     NURS 106 Case Study—Oncologic Disorders
                               Lung CA with Mets

Jane is a 42-yo divorced woman with adenocarcinoma of the lung with mets to the brain
& liver. She is the single mom of a 17-yo son, has experienced episodic health care, is
currently unemployed without health insurance. She has smoked 1-2 ppd x 20 yrs. Last
year she developed scapular & arm pain on the R, was Dx with adenocarcinoma of the
lung, and underwent a wedge resection of the upper R lobe of the lung. Because she has
no insurance, she did not receive FU care (chemo or radiation).

Jane developed pain in her R temple 48 hrs ago, & had a tonic-clonic seizure. She was
brought to the ED, and a CT scan revealed a large mass in the R frontal area of her brain.
She was transferred to your oncology unit post-seizure with slightly slurred speech and
intermittent bone pain. She has lost 22 pounds in the past year. She is taking
hydrocodone/acetaminophen (Lortab) for pain at home.

   1.      Jane asks you “What is happening to me?” How do you respond?
           What tests are likely to be performed to determine metastasis?

   2.      Jane is scheduled to receive 10 radiation therapy treatments to the brain.
           What information would you include in your teaching to prepare her for this?

   3.      Blood will be drawn before each treatment. What tests will be performed, and
           what is the significance of abnormal results?

After her 3rd radiation treatment, Jane is discharged on the following medications:
dexamethasone 4mg po q8h, Darvocet-N 100mg po q4h prn, Compazine 15mg po q12h
prn, temazepam 30 mg po prn.

   4.      What is the rationale for Jane receiving each medication?

   5.      Discharge teaching involves dealing with local effects of radiation therapy.
           List 3 of these & appropriate interventions to deal with them.

   2 months post-hospital discharge & follow-up therapy, Jane continues to have
   increasing symptoms of pain, anorexia & weight loss. Her son accompanied her, and
   while she is getting her blood drawn, he asks you what is going to happen to his

   6.      How would you respond to him?
           He asks what he can do to help his mother. What information can you give

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