Topic 5 DQ 3
MOVIE CHARACTER PRESENTATION: “MY SISTER’S KEEPER” BY: JAMIE FALLIGAN AUGUST 19, 2018 NRS-434VN
OVERVIEW OF PRESENTATION ➢Summary of the disease Acute Promyelocytic Leukemia ➢Functional Health Pattern Assessment (FHP) of the client; movie character “Kate” ➢Observed health patterns of the client ➢Nursing diagnosis including interventions ➢Available resources MEET THE CLIENT ➢Name: Kate Fitzgerald ➢Age: 15 ➢Diagnosed with acute promyelocytic leukemia at age 2. ➢Sister, Anna, was conceived with the intent of becoming a genetic match for Kate. FUNCTIONAL ASSESSMENTS ➢ Health Perception/Health Management • Client is aware she has APL that will eventual result in her death • Current health issues include frequent epistaxis, bruising, vomiting, anemia, neutropenia, and fatigue • To maintain health, client takes prescribed medications and avoids those with acute illnesses due her immunocompromised state ➢ Nutrition/Metabolic • Client is underweight • Intake is less than recommended requirements due to decreased appetite and nausea caused by chemotherapy treatments ➢ Pattern of Elimination • Reports diarrhea due to current chemotherapy treatment • Current renal failure resulting in minimal urination ASSESSMENT CONTINUED ➢ Pattern of Activity/Exercise • No active exercise program and minimal activity due to fatigue, shortness of breath, and bone pain ➢ Conceptual/Perceptual Pattern • Client is currently in the 9th grade • Normal mental and sensory functions • Experiences joint and bone pain with activity ➢ Pattern of Sleep and Rest • Sleeps >8 hours each night • Takes frequent naps and rest periods frequently throughout the day ASSESSMENT COMPLETE ➢Pattern of Coping and Stress Tolerance • Client copes by keeping a daily diary and discussing feelings with her parents • Discusses illness with other cancer patients during her chemotherapy sessions, which helps her cope ➢Pattern of Values and Beliefs • Feels that everyone should live life to their fullest • No religious affiliation • Supportive family and friends ANALYSIS OF HEALTH ASSESSMENT ➢Normal assessment findings • Role/Relationship Pattern • Pattern of Coping and Stress Tolerance ➢Abnormal or risk-based findings • Nutrition/Metabolic Pattern • Pattern of Elimination ADDITIONAL OBSERVATIONS ➢ Cultural • American ➢ Geographical • Lives with her family in Rhode Island ➢ Religious • No specific religious affiliation ➢ Ethnic • Caucasian ➢ Spiritual • Shows alleviation of fear and loneliness during her last days of life. NURSING CONSIDERATIONS ➢ Nursing Diagnosis • Risk for Infection related to Neutropenia Secondary to Chemotherapy ➢ Interventions • Encourage a well-balanced diet • Teach measures for prevention of infection, such as proper hand washing and avoiding those with infectious illnesses • Educate patient and family members on signs of infection, including elevated temperature, cough, sore throat, mouth sores, and any area that appears to be infected ➢ Resources • CancerCare • Leukemia Research Foundation CONCLUSION ➢Acute promyelocytic leukemia (APL) presents similarly in children and adults. ➢Previously considered a highly lethal form of leukemia, APL is now the most curable subtype of adult acute myeloid leukemia (AML). ➢Rapid treatment is key to a positive outcome. ➢Today, cure rates can be as high as 98% if diagnosed and treated rapidly. REFERENCES ➢CancerCare. 2012. About us. Retrieved from http://www.cancercare.org/about ➢Clark, P. A., Drain, M., & Malone, M. P. (2003). Addressing patients’ emotional and spiritual needs. Joint Commission Journal on Quality and Safety, 29(12), 659-670. Retrieved from https://doi.org/10.1016/S1549-3741(03)29078-X ➢Colón, Y. (2017). Ethnic diversity and cultural competency in cancer care. Oncology Issues, 22(5), 28-31. Retrieved from https://doi.org/10.1080/10463356.2007.11883357 REFERENCES ➢ Leukemia Research Foundation. 2018. About us. Retrieved from http://leukemia-research.org/ ➢ St. Jude Children’s Research Hospital. (2018). Leukemias: Acute promyelocytic leukemia (APL). Retrieved from https://www.stjude.org/disease/acute-promyelocyticleukemia.html?vgnextoid=9c0c061585f70110VgnVCM1000001e0215acRC ➢ Walker, D., & Held-Warmkessel, J. (2010). Acute promyelocytic leukemia: An overview with implications for oncology nurses. Clinical Journal Of Oncology Nursing, 14(6), 747-759. doi:10.1188/10.CJON.747-759.
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