Learning Team Case Study

Case Scenario

Debbie, 29 years old, married with 2 teenaged

children

History – 730 pack per year smoker

Symptoms – pelvic fullness, foul-smelling vaginal

discharge

Diagnosis – Class V cervical cancer

Treatment – s/p radical hysterectomy with bilateral

salpingo-oopherectomy, needs radiation therapy

Dysfunctional voiding requires self catheterization

Tearful, anxious, believes cancer is a punishment

NANDA-I

Nursing diagnoses define the knowledge of professional nursing

NANDA became NANDA International in 2002

North American Nursing Diagnosis Association was established in 1982

First joint meeting of the NANDA, NIC and NOC held in 1997

Problems

Post operative pain and nausea

Intermittent self-catheterization at home is

essential

Concerned about her family’s future

Husband is jobless, distant, and abusive

Unaware of all available resources

Etiology

Recently admitted to oncology nursing unit for

evaluation after sensing pelvic “fullness”, and

noticing a watery, foul-smelling vaginal discharge

Infrequent physical examinations in her past

Takes oral contraceptives on a regular basis

730 pack per year smoking habit

Stage II Squamous cell carcinoma of the cervix

S/P radical hysterectomy with BSO

Waiting for her radiation therapy

Signs and Symptoms

Losing hope

Afraid of her situation

Weight loss of 21 pounds

Post operative pain and nausea

Ineffective bladder emptying

Patient takes an antibiotic, and an analgesic

depending on her tolerance

Physiological Nursing Diagnosis

Acute pain is common among cancer patients.

This is proved by various testimonies of Class V

cervical cancer patients. Acute pain results from the

activity of cancer cells and is related to the body’s

surgical interruption.

Comfort Level

Effectiveness of Medication

Pain Tolerance

Pain Level

NOC Outcomes

Goals/Evaluation Criteria

Reported pain is relieved or reduced, and scaled between 0-10

Prescribed pharmacological regimen must be followed

Do verbal processes that add relief Do some relaxation exercises that can divert one’s

attention

Within a period of 1 hour after an oral pain medication, Debbie will:

Pain Management

Analgesic Administration

Environmental Management

NIC Interventions

Psychosocial Nursing Diagnosis

Ineffective Health Maintenance is influenced

by misconceptions on health facts. Examples

are smoking habits, unplanned pregnancies,

and failure to undergo an annual check-up.

NOC Outcomes

Knowledge: Disease Process

Self Esteem

Health-Seeking Behavior

Social Support

Goals/Evaluation Criteria

Debbie will take responsibility over her own health

maintenance and monitoring

She will be asked to orally repeat her

understanding on her current situation

She would have to change her lifestyle for her own

benefit

NIC Interventions

Health System Guidance

Support System Enhancement

Discharge Planning

Teaching: Disease Process

Risk Identification

References.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2010).  Nursing Diagnosis Manual.

Planning, individualizing, and documenting client care (3rd ed.). Philadelphia: F.A.

Davis Company. 

Doenges, M. E., Moorhouse, M. F., & Murr, A. C., (2009-2011). Nursing Care

Plans: Guidelines for individualizing client care across the life span. (8th ed.). 

Philadelphia: F.A. Davis Company.

Alligood, M. R. (2010). Nursing Theory Utilization and Application (4 ed.).

Maryland Heights, Missouri: Mosby Elsevier.

NANDA. (2011). Diagnosis Development. Retrieved November 3, 2011, from NANDA

International: http://www.nanda.org/DiagnosisDevelopment.aspx

References

NANDA. (2011). NANDA International History: 1990-1999. Retrieved November 3, 2011,

from NANDA International: http://www.nanda.org/AboutUs/History/1990to1999.aspx

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2008). Nurse's Pocket Guide

Diagnoses, Prioritized Interventions, and Rationales (2nd ed.). Philadelphia: F.A.

Davis Company.

References

The University of Iowa College of Nursing. (n.d.). The University of Iowa College of

Nursing. Retrieved October 29, 2011,from The University of Iowa College of

Nursing:

http://www.nursing.uiowa.edu/excellence/nursing_knowledge/clinical_effectiveness/

index.htm

Standardized nursing language: What does it mean for nursing practice?. (2008,

January). The Online Journal of issues in Nursing, 13(1).

Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketpl ace/

ANAPeriodicals/OJIN/TableofContents/vol132008/No1Jan08/ArticlePreviou

sTopic/StandardizedNursingLanguage.aspx