- Acute Pain related to tumour growth and Inflammatory process as evidenced by positioning to ease pain and report of activity changes
- Death Anxiety related to anticipation of the outcome of the disease process
Awareness of imminent death as evidenced by expresses fear of premature death and reports negative thoughts related to death and dying - Risk for Infection related to immunosuppression and Invasive treatment procedures as evidenced by infection
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviours | Acute Pain related to tumour growth and Inflammatory process as evidenced by positioning to ease pain and report of activity changes | The patient will report a decrease in pain The patient will implement two strategies to ease pain | 1. Encourage the patient to use nonpharmacologic pain relief interventions. Massage, meditation, heat, and other diversional activities promote relaxation and pain relief. 2. Administer pain relief medications as needed. Opioids and NSAIDs may be prescribed to help manage pain in patients with cancer. 3. Educate the patient about the pain management plan. Improved control of pain is achieved when the patient has a better understanding of the nature of the pain, its causes, and treatment. 4. Offer resources for coping with the psychological impacts of pain. Cancer pain affects all aspects of the patient’s well-being. Cognitive behavioral strategies can help the patient with coping with discomfort and other unpleasant effects of pain. 5. Encourage complementary therapies if not contraindicated. Complementary therapies like acupuncture, yoga, aromatherapy, and hypnotherapy can help relieve pain without the adverse effects of medication. | The patient reported decreased in pain The patient implemented two strategies to ease pain |
| Subjective data: Feeling nervous -Verbalizing a sense of impending danger -Difficulty controlling one’s worrying Objective data: -Restlessness and tense appearance -Tachycardia -Tachypnoea -Hyperventilation -Diaphoresis -Trembling/tremors -Weakness or tiredness | Death Anxiety related to anticipation of the outcome of the disease process Awareness of imminent death as evidenced by expresses fear of premature death and reports negative thoughts related to death and dying | The patient will express feelings about death and its effects and seek help in coping The patient will express acceptance of their prognosis | 1. Encourage the patient to verbalize thoughts and feelings. Acknowledging the patient’s feelings and emotions about the cancer diagnosis and imminent death enhances trust and a therapeutic relationship. Oncology nurses are often a support system for patients as they undergo cancer treatments. 2. Educate the patient about the stages of grief. The grieving process is important to help frame and identify one’s feelings. Understanding the grieving process will reinforce the normality of feelings experienced by the patient after a cancer diagnosis, allowing them to deal with grieving more efficiently. 3. Encourage family members to be involved in patient care. A reliable support system will help the patient feel less isolated. Encourage the patient to lean on their friends and family for support. 4. Refer to grief counselling. Counsellor’s and spiritual advisors can assist the patient with their feelings of anxiety and anticipatory grieving. | The patient expressed feelings about death and its effects and seek help in coping The patient expressed acceptance of their prognosis |
| Subjective data: Verbalizes about infectious wound in the body Objective data: -Disease process -Fever -Inflammation -Infection -Invasive procedures | Risk for Infection related to immunosuppression and Invasive treatment procedures as evidenced by infection | The patient will identify and initiate interventions that can help reduce the risk of infection The patient will be free from any signs of infection | 1. Encourage infection control measures. Frequent hand washing protects the patient from infection. Screening visitors and placing the patient in isolation will help reduce the risk of airborne and droplet infections. 2. Remain home when possible. Patients with cancer should reduce their interaction with lots of people such as in stores or restaurants. When venturing out for necessary appointments or errands, a mask should be worn to reduce the transmission of diseases. 3. Provide adequate rest periods but remain active. Patients with cancer experience fatigue and weakness due to the effects of the disease and its treatment. Ensuring that the patient has adequate rest periods reduces the incidence of fatigue while adequate exercise can prevent the loss of muscle function and support healthy immune function. 4. Alert the healthcare team to signs of infection. A cold or flu virus can be detrimental to a patient with cancer. Ensure the patient knows to alert the healthcare team to any symptoms such as a fever, cough, chills, sore throat, or mouth sores. 5. Maintain asepsis of invasive lines. Patients may have PICC lines, implanted ports, or urinary catheters. Maintain sterile technique when changing a PICC dressing or accessing a port to prevent introducing bacteria. Clean urinary catheters daily and discontinue once appropriate. | The patient identified and initiated interventions that can help reduce the risk of infection The patient reported free from signs of infection |