[Verified Answer]: Oncology Case Study G

Oncology Case Study G.C. is a 78-year-old widow who relies on her late husband’s Social Security income for all of her expenses. Over the past few years, G.C. has eaten less and less meat because of her financial situation and the trouble of preparing a meal “just for me.” She was diagnosed with small cell lung cancer approximately 1 year ago. She also struggles financially to buy medicines for the treatment of hypertension and arthritis. She goes to the outpatient clinic complaining that over the past 2 to 3 months she has felt increasingly tired, despite sleeping well at night. Her vital signs (VS) are 136/76, 16, 80/ She denies continues to have mild dyspnea but denies palpitations. The nurse practitioner orders blood work. G.C. chemistry panel findings are all within normal limits and a stool guaiac test result is negative. Her other results are shown in the chart. White blood cell count 7500/mmɜ Hematocrit (Hct) 27.3% Hemoglobin (Hgb) 8.3 mg/dL Platelets 151,000/mmɜ Mean corpuscular volume (MCV) 65 mmɜ Mean corpuscular hemoglobin (MCH) 31.6 pg MCH concentration (MCHC) 35.1% Red cell distribution width (RDW) 15.6% Iron (Fe) 30 mcg/dL Total iron-binding capacity (TIBC) 422 mcg/ dL Ferritin 8 mg/dL Vitamin B12 414pg/mL Folate 188 ng/mL 1. Which laboratory values are normal and which are abnormal? Explain the significance of each abnormal result. 2. Based on these results ad her history, what condition does G.C. have? 3. The physician stars G.C, on ferrous sulfate (Feosol) 325 mg orally once per day. What teaching needs to be done regarding this medication? One of your roles as you meet with her is also to help with the symptom control as her illness progresses with her small cell lung cancer. You address her pain and let her know that pain control can have a powerful effect on quality of life. 4. What interventions will you use to help her be as pain free as possible? 5. Because her advancing lung cancer will likely result in respiratory distress, which interventions should you include in her plan of care? Select all that apply. a. Perform a respiratory assessment at each visit b. Administer low-dose morphine sulfate if vital signs are adequate c. Maintain room at a warm temperature and have blankets available d. Have her space activities and rest as needed in a position of comfort e. If oxygen saturation falls below 90% on room air, begin oxygen at 2L 6. Toward the end of your visit, G.C. looks at you and says, “You know, I just really thought I had more time,” The most appropriate response is: a. “Dying is a natural process; we will help you through it.” b. “Your feelings are understandable; most people aren’t ready to die.” c. “Tell me more about what you mean when you say, ‘I thought I had more time.’” d. “No one ever really knows when it is their time, even if they don’t have cancer.” 7. You are concerned with G.C. psychological status, particularly because she is expressing feelings of grief. Write a nursing outcome addressing this issue and identify independent nursing action that you would implement to provide her emotional support.