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
North American Nursing Diagnosis Association
was established in 1982
First joint meeting of the NANDA, NIC and NOC
held in 1997
NANDA became NANDA International in 2002
Nursing diagnoses define the knowledge of
professional nursing
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.
NOC Outcomes
Comfort Level
Effectiveness of Medication
Pain Tolerance
Pain Level
Goals/Evaluation Criteria
Within a period of 1 hour after an oral pain medication,
Debbie will:
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
NIC Interventions
Pain Management
Analgesic Administration
Environmental Management
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
.
Alligood, M. R. (2010). Nursing Theory Utilization and Application (4 ed.).
Maryland Heights, Missouri: Mosby Elsevier.
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.
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.
References
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.
NANDA. (2011). Diagnosis Development. Retrieved November 3, 2011, from NANDA
International: http://www.nanda.org/DiagnosisDevelopment.aspx
NANDA. (2011). NANDA International History: 1990-1999. Retrieved November 3, 2011,
from NANDA International: http://www.nanda.org/AboutUs/History/1990to1999.aspx
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/inde
x.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