- Acute Pain related to effects of cancer treatment and effects of chemotherapy as evidenced by Facial expressions of pain and reports pain intensity
- Death Anxiety related to Anticipation of death and awareness of imminent death as evidenced by expresses concern about the impact of death and expresses fear of premature death
- Imbalanced Nutrition less than body Requirements related to hypermetabolism, and Insufficient pancreatic enzymes as evidenced by food intake less than recommended daily allowance (RDA) and Hyperactive bowel sounds
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns Guarding or protective behaviors | Acute Pain related to effects of cancer treatment and effects of chemotherapy as evidenced by Facial expressions of pain and reports pain intensity | Patient will report a significant reduction in pain and discomfort. Patient will utilize pharmacologic measures prescribed to control pain. | 1. Administer pain medications as indicated. Drug therapy, including long-acting oral morphine and fentanyl patches, is indicated for patients with pancreatic cancer to help reduce discomfort. 2. Evaluate the precipitating factors of breakthrough pain. Increasing pain intensity and duration that requires a higher dosage of pain medication may indicate a developing complication or progression of cancer. 3. Encourage the use of nonpharmacologic pain relief interventions. Massage, imagery, and diversional activities can help reduce anxiety, refocus attention, and relieve discomfort in patients with pancreatic cancer. Cognitive-behavioral therapy and other mental health services can teach coping strategies for managing pain sensations. 4. Assist with palliative care measures. Palliative care is not curative and focuses on managing symptoms and pain for improved quality of life. This can be achieved through surgical procedures, nutritional support, chemotherapy, and more. | Patient reported a significant reduction in pain and discomfort. Patient utilized pharmacologic measures prescribed to control pain. |
| Subjective Data: Expresses fear about death Objective Data: -Expresses fear of pain related to dying -Expresses fear of premature death -Expresses fear of the dying process -Expresses powerlessness -Expresses fear of the unknown -Expresses concern over role changes | Death Anxiety related to Anticipation of death and awareness of imminent death as evidenced by expresses concern about the impact of death and expresses fear of premature death | Patient will verbalize acceptance of their prognosis and peace with dying. Patient will identify and verbalize interventions that can help control anxiety. | 1. Acknowledge the patient’s feelings and concerns. Shock, anger, and despair are normal responses upon the initial diagnosis of pancreatic cancer. Reassure the patient that their feelings are normal and valid. 2. Educate and reinforce information about the condition, symptoms, and treatment. Knowing what to expect allows for better self-control, reduced anxiety, and adherence to the treatment regimen. 3. Encourage the patient to plan activities. Staying busy helps some patients not to focus on their anger or depression. Encourage hobbies like gardening, crafts, time in nature, or anything they are interested in. 4. Instill hope. Some medical practitioners believe hope and a positive outlook can help heal the body. The nurse can support this belief by reminding the patient to live life like they always have, practice gratitude, and participate in activities that spark joy. 5. Refer the patient to community and support groups. Peer and community groups can provide additional support for patients with pancreatic cancer. | Patient verbalized acceptance of their prognosis and peace with dying. Patient identified and verbalized interventions that can help control anxiety. |
| Subjective Data: Verbalizes about loss of appetite and increase appetite sometimes Objective Data: -Abdominal cramping -Abdominal pain -Loss of appetite -Altered taste sensation -Food intake less than recommended daily allowance (RDA) -Hyperactive bowel sounds -Diarrhea -Steatorrhea -Weight loss | Imbalanced Nutrition less than body Requirements related to hypermetabolism, and Insufficient pancreatic enzymes as evidenced by food intake less than recommended daily allowance (RDA) and Hyperactive bowel sounds | Patient will exhibit a progressive weight gain toward the desired goal. Patient will verbalize the causes of malnutrition and strategies to improve deficiencies. | 1. Administer pancreatic enzymes. If the pancreas can no longer secrete enzymes necessary for digestion, supplemental enzymes can be provided to help break down fats, carbohydrates, and protein. 2. Refer the patient to a dietitian. A dietitian is vital in planning nutritional interventions for patients with pancreatic cancer and those currently undergoing chemotherapy or radiation therapy. 3. Administer antiemetics and pain medications before meals. Pain, discomfort, nausea, and vomiting can affect the patient’s appetite. 4. Encourage the patient to avoid alcohol and fried foods. Alcoholic beverages and greasy, fried foods are to be avoided by patients with pancreatic cancer as these foods are difficult to digest and can result in diarrhea, gas, and bloating. 5. Administer enteral nutrition. Enteral nutrition is recommended over parenteral nutrition and has been shown to reduce complications, and hospital stays while increasing energy. | Patient exhibited a progressive weight gain toward the desired goal. Patient verbalized the causes of malnutrition and strategies to improve deficiencies. |