ASSIGNMENT IN NCM 106 LECTURE

Jeanessa D. Quilisadio
NCM 106 LEC.

A.
1. Cervical Cancer can be prevented by vaccination of HPV, have Pap smear regularly and eat healthy foods and have proper hygiene.
She will likely experience to have pain radiating to buttocks and legs, weight loss and anemia.
2. The previous result of the patient’s pap smear (mild CIN present) which happened 2 years ago
3. The condition of Lucille poor prognosis was her diagnosed of HPV that developed to invasive Cervical cancer stage 1B.
4. Since the patient has already undergone a surgery, she will experience an Impaired Urinary elimination.
5. Encourage to have annual exam regularly, eat healthy foods and teach proper hygiene.

1. Abnormal vaginal bleeding. The nurse should assess for foreign bodies, signs of trauma, products of conception, & vaginal or
cervical discharge. Uterine size & surface contour, adnexal mass or tenderness, & cervical motion tenderness should be noted.
2. Nursing Health History
a. Biographic Data: Lucille, 40, Female
b. Chief Complain/Reason for visit: vaginal bleeding; scheduled radical hysterectomy with pelvic lymphadenectomy for patient’s
cervical cancer
c. History of Illness:
 Present: Vaginal Bleeding, cervical cancer stage 1b
 Past: Human Papilloma Virus

NURSING SCIENTIFIC OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

DIAGNOSIS RATIONALE (INTERVENTIONS)
 CUES (NURSING
DIAGNOSIS)
Complained *Sexual When cancer After 4hrs. Of  Listen to comments  Sexual concerns are After 4hrs. Of nursin
of vagina dysfunction r/t cells continue nursing intervention of the patient and often disguised as intervention the pati
bleeding disease process to grow and the patient will be SO. Provide an open humor and/or offhand will beable to identif
after coitus. due to CIN metastasize in able to identify and honest remarks. satisfying/acceptable
secondary to different parts satisfying/acceptable environment during sexual practices and
HPV of the body sexual practices and discussions. some alternative wa
system some alternative  Assess patient’s or  May have of dealing with sexu
especially in ways of dealing with SO’s information misinformation or expression.
blood vessels; sexual expression. regarding sexual misconceptions that
it can impede anatomy and function can affect adjustment.
blood and effects of
circulation and surgical procedure.
can cause  Encourage patient to
vaginal share thoughts and  Open communication
bleeding. concerns with can identify areas of
partner. agreement and
problems and promote
discussion and
resolution.
 CUES NURSING SCIENTIFIC OBJECTIVES INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS RATIONALE (INTERVENTIONS)
(NURSING
DIAGNOSIS)
Complained Impaired Dysfunction in After 8 hours of *Encourage fluid intake *To help maintain renal After 8 hours of nurs
about having urinary urine nursing function, prevent infection & intervention the patie
difficulties in elimination due elimination due intervention the formation of urinary stones. able to empty the
voiding to radical to surgical patient will be bladder regularly and
hysterectomy manipulation able to empty the *Assist with developing toileting *If patient is cognitively intact completely
bladder regularly routines as appropriate. & physically capable of self-
and completely toileting, bladder training,
timed voiding, & habit
retraining may be beneficial

*Check frequently for bladder *To reduce the risk of infection

distention & observe for over-flow &/or autonomic hyperreflexia

*Provide routine voiding *Promotes relaxation of

measures: privacy, normal perineal muscles & may
position, running water in the facilitate voiding efforts.
sink, pouring warm water
over the perineum.

*Note voiding pattern and *May indicate urinary

monitor urinary output. retention if voiding frequently
in small and insufficient
amounts

CUES NURSING SCIENTIFIC OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

DIAGNOSIS RATIONALE (INTERVENTIONS)
(NURSING
DIAGNOSIS)
Situational low *Development After x hours of  Provide an open  Promotes sharing of After x hours of nurs
self-esteem r/t of a negative nursing environment for the beliefs and values about intervention the patie
alteration in perception of intervention the patient to discuss concerns a sensitive subject, and able to verbalize
body image self-worth in patient will be about sexuality. identifies acceptance of self in
due to surgery. response to a able to verbalize misconceptions or situation and adaptat
current acceptance of self myths that may to change in body/se
situation in situation and interfere with image.
adaptation to adjustment to the
change in situation.
body/self-image.  Ascertain individual  Helpful to build on
strengths and identify strengths already
previous positive coping available for the patient
behaviors. to use in coping with
the current situation.
 Provide accurate  Provides opportunity
information, reinforcing for patient to question
information previously and assimilate
given. information.
CUES NURSING SCIENTIFIC OBJECTIVES INTERVENTIONS RATIONALE EVALUATION
DIAGNOSIS RATIONALE (INTERVENTIONS)
(NURSING
DIAGNOSIS)
*Risk for *Vulnerable to *After x hours of *After x hours of
ineffective a decrease in nursing *Monitor vital signs; palpate *obtain baseline data nursing intervention
tissue blood intervention the peripheral pulses, & note capillary patient has verbalize
perforation r/t circulation to patient will be refill; assess urinary output & understanding of risk
radical the periphery, able to verbalize characteristics. Evaluate changes in factors or condition
hysterectomy which may understanding of mentation
compromise risk factors or
health condition. *Note patient’s nutritional & fluid *Protein-malnutrition & weight
status loss make ischemic tissues
more prone to breakdown.
Dehydration reduces blood
volume & compromises
peripheral circulation

*Inspect lower extremities for skin *Often accompany diminished

texture, skin breaks, ulcerations peripheral circulation

*Assess motor & sensory function *Problems with ambulation;

hypersensitivity; or loss of
sensation, numbness, & tingling
are changes that can indicate
neurovascular dysfunction or
limb ischemia

*Avoid high-Fowler’s
position & pressure under the *Creates vascular stasis by
knees or crossing of legs. increasing pelvic congestion &
pooling of blood in the
extremities, potentiating the
risk of thrombus formation.
*Assist & instruct in foot &
leg exercises & ambulate as *Movement enhances
 soon as able. circulation and prevents stasis
complications.

DISCHARGE PLAN

 Take your medicines exactly as directed. Use pain relievers as needed so you can be up and moving around. Don't stay in bed.
 Plan rest breaks to avoid shortness of breath.
 Do the coughing and deep breathing exercises you learned in the hospital.
 Increase your activity slowly. Start with short walks on a level surface.
 Avoid over exertion. Rest when needed
 Limit stair climbing to once or twice a day. Slow down & stop to rest every few steps.
When to see your Doctor:
 Fever of 38°C or higher, or as directed by your healthcare provider
 Chills
 Increase in the amount of vaginal discharge, or changes in discharge
 Vaginal bleeding that soaks more than 1 pad over several hours.
 Pain or burning when you urinate
 Worsening belly (abdominal) pain
 Pain that's not relieved by medicine
 Redness, swelling, increased pain, or drainage around any incisions
 Nausea or vomiting
 New redness, pain, swelling, or warmth in your leg(s) or arm(s)