PATHOPHYSIOLOGY

PATIENT’S DATA

 NICOLE REYES
 42 YRS.OLD
 FEMALE

SIGNIFICANT DATA
DIAGNOSTIC TEST
 COMPLAINT OF SEVERE DOB
 SWELLING ON HER RIGHT  CHEST X-RAY
BREAST,DISCHARGED AND  BREAST EXAMINATION
CRUSTING ON NIPPLE  MRI
 V/S: 150/90, RR 40, SPO2 88%,  MAMMOGRAM
TEMP: 36.5 C
 ON EXAMINATION, THE PHYSICIAN
NOTE THAT HER BREAST FEEL
NODULAR BUT WITH DISCRETE
MASSES T-3 >5 CMS, N-3, M-1.
OTHER FINDINGS INCLUDE MEDICATIONS
EVIDENCE OF INFLAMMATION, W/
AXILLARY NODE ENLARGED.  DOXORUBICIN
 THORAX ASSESSMENT AS (ADRIAMYCIN)
FOLLOWS: DECREASED CHEST  EPIRUBICIN (ELLENCE)
MOVEMENT, STONE DULLNESS TO  PACLITAXEL (TAXOL)
PERCUSSION, DIMINISHED  CARBOPLATIN
BREATH SOUNDS, DECREASED (PARAPLATIN)
RESONANCE AND FREMITUS, +
PLEURAL FRICTION RUB AND
MEDICAL DIAGNOSIS EGOPHONY,
BREAST CANCER STAGE III,  SHE RELATES THAT SHE IS A
PNEUMONIA, COVID 19-SUSPECT “HEAVY COFFEE DRINKER” AND IS
UNDER A GREAT DEAL OF STRESS
IN HER JOB
 THE MASS WAS NOTICED 5 YEARS
AGO WITH NO CONSULTATION WAS
MEDICAL AND SURGICAL HISTORY MADE DUE FINANCIAL
THE MASS WAS NOTICED 5 YEARS AGO WITH CONSTRAINT.
NO CONSULTATION WAS MADE DUE  SHE REPORTS THAT A MATERNAL
FINANCIAL CONSTRAINT. AUNT DIED OF BREAST CANCER.
 FEAR RELATED TO SITUATIONAL RISK FOR SKIN INTEGRITY RELATED INEFFECTIVE BREATHING PATTERN

DIAGNOSIS
DIAGNOSIS

NURSING

DIAGNOSIS
NURSING

CRISIS AS EVIDENCED BY

NURSING
TO EFFECTS OF RADIATION AND RELATED TO SEVERE DIFFICULTY OF
EXPRESSED CONCERNDUE CHEMOTHERAPY BREATHING AS EVIDENCED BY
FINANCIAL CONSTRAINT. HOOKED TO O2 INHALATION AT 5 LPM
VIA FACE MASK.

SIGNS AND
SYMPTOMS
BREAST CANCER STAGE III
 DYSPNEA, TACHYPNEA
 ENCOURAGE PATIENT
 ABNORMAL BREATH SOUNDS
TO SHARE THOUGHTS

SIGNS AND
SYMPTOMS
(RHONCHI, BRONCHIAL LUNG
AND FEELINGS.
SOUNDS, EGOPHONY)
 REVIEW PATIENT’S
 ASSESS DENTAL HEALTH  CHANGES IN RATE, DEPTH OF
AND SO’S PREVIOUS
AND ORAL HYGIENE RESPIRATIONS
EXPERIENCE WITH
CANCER. PERIODICALLY.
 PERMIT  DISCUSS WITH PATIENT
EXPRESSIONS OF AREAS NEEDING
IMPROVEMENT AND
INTERVENTIONS

INTERVENTIONS

ANGER, FEAR,
DESPAIR WITHOUT DEMONSTRATE METHODS
 PLACE PATIENT WITH PROPER
CONFRONTATION. FOR GOOD ORAL CARE.
BODY ALIGNMENT FOR MAXIMUM
GIVE INFORMATION  INSTRUCT REGARDING
BREATHING PATTERN.
THAT FEELINGS ARE DIETARY CHANGES: AVOID
 MAINTAIN A CLEAR AIRWAY BY

INTERVENTIONS
NORMAL AND ARE TO HOT OR SPICY FOODS,
ENCOURAGING PATIENT TO
BE APPROPRIATELY ACIDIC JUICES; SUGGEST
MOBILIZE OWN SECRETIONS WITH
EXPRESSED. USE OF STRAW; INGEST
SUCCESSFUL COUGHING.
 EXPLAIN THE SOFT OR BLENDERIZED
 ASSESS AND RECORD
RECOMMENDED FOODS, POPSICLES, AND
ICE CREAM AS TOLERATED. RESPIRATORY RATE AND DEPTH
TREATMENT, ITS
AT LEAST EVERY 4 HOURS.
PURPOSE, AND  ENCOURAGE FLUID INTAKE
AS INDIVIDUALLY  OBSERVE FOR BREATHING
POTENTIAL SIDE PATTERNS.
EFFECTS. HELP TOLERATED.
PATIENT PREPARE
FOR TREATMENTS.

THE PATIENT WILL MAINTAINS AN

EFFECTIVE BREATHING PATTERN, AS
EXPECTED
OUTCOME
THE PATIENT WILL DEMONSTRATE USE
EXPECTED
EXPECTED

OUTCOME
OUTCOME

THE PATIENT WILL VERBALIZE EVIDENCED BY RELAXED BREATHING AT

OF EFFECTIVE COPING MECHANISMS
UNDERSTANDING OF CAUSATIVE FACTORS. NORMAL RATE AND DEPTH AND
AND ACTIVE PARTICIPATION IN
ABSENCE OF DYSPNEA.
TREATMENT REGIMEN.