Park Bong Soo The cancer patient

Park Bong Soo 81 year old middle class Korean-American 5’6” tall and 110 lbs Happily married to Park Min-Young Lives with his wife and his 46 year old daughter, Park Min-Ja Migrated to the US in his early 20s with his wife to build a better future for his family in Somerset, Colorado. Park Bong Soo worked as a coal miner until he retired. Park Bong Soo has been recently diagnosed with lung cancer.

Admitting/primary Diagnosis: Shortness of breath O2 saturation: 89% Chest pain when cough Tired Weight loss, little appetite (lost ~20lbs from last checkup 5 months ago) Secondary Diagnosis: Lung Cancer

Surgical Interventions and/or Diagnostic Tests Administration of oxygen via nasal cannula Full blood panel Low WBC count Lung X-ray Abnormal spot seen MRI Small Cell Lung Cancer Biopsy Malignant

History of Present Health Concern Past Smoker Smoked cigarettes for 50 years; quit when he was 72 Still occasionally smokes a cigar Retired coal miner Worked in the coal mines for 50 years, being constantly exposed to smoke and other natural hazardous chemicals

Past Health History Throat Cancer Tracheostomy Park Bong Soo has been in remission from his throat cancer for seven years Tracheostomy Secondary to his throat cancer—a surgical airway was implanted during Park Bong Soo’s throat cancer treatment when the tumor in his throat was compromising his airway

Current Orders Bath Diet Activity Bathroom -Ask patient what he prefers/feels up to? Bed bath or regular full bath. May prefer bed bath due to his risk of falling and respiratory distress and low O2 levels. (at least until he builds up his endurance.) Diet -Normal healthy diet until start of chemotherapy. Activity -Up with assistance, fall risk so needs gait belt. When ready transition to letting him carry O2 tank while walking with cane and assistance. Up and moving 3x’s a day. Bathroom -Bedside urinal and commode may be used with assistance.

Top Three Priority Problems Bathing self-care deficit related to shortness of breath as evident by use of a cannula. Impaired physical mobility related to shortness of breath as evident by use of a cannula. Activity intolerance related to shortness of breath as evident by use of a cannula.

Priority Nursing Diagnosis Activity intolerance related to shortness of breath as evident by use of a cannula.

Patient Outcome/Goal To get patient to do activity without assistance and be able to maneuver with nasal cannula.

Nursing Interventions and Rationales Educate the patient and family of the use and care of the nasal cannula. Make sure patient is using nasal cannula correctly. Continue daily activity with assistance from family when needed. Build up endurance to get the patient able to maneuver with nasal cannula on his own.

Evaluation of Patient Outcome Goal not met yet: Patient is going home with a nasal cannula, but still needs occasional family assistance for daily activities.

Day # 2 Today you are assigned to Mr. Park Bong Soo again. He is feeling more tired today after a full day with physical therapy yesterday. He remains on oxygen at 2L. While completing you assessment with him you note some redness around his face and ears What is your priority nursing diagnosis? Write a care plan based on your diagnosis?