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Data cluster 1: The first data cluster collected from the analysis of Frankley’s case scenario includes ‘Shortness of breath, he feels like choking due to breathing difficulty, he is unable to bring up her secretions’. These data cluster defines sensory perception of client. Due to breathing difficulty, his cognitive patterns are affected as he is restless and he feels like choking. The data clusters resembles Gordon’s ‘cognitive-perceptual pattern’ (Gordon, 2014). This pattern helped to identify physiological problem in patient and need to prioritize physiological problems related to breathing difficulty and cough first.
Data cluster 2: The second data cluster collected from the analysis of Frankley’s case scenario includes ‘Wants to lose weight, but loves eating, Frankley is worried that he leaves alone and he also shouts on the nurse, he is very distraught and crying’. The data collected in this set define Frankley’s skill related to coping with diseases and management of illness. ‘Wanting to lose weight, shouting at nurse and worried about being alone’ suggest that client has poor coping skills. The data cluster is similar to Gordon’s coping-stress tolerance pattern as it defines patient’s coping patterns in the patients (Gordon, 2014). Frankley’s data suggest that the pattern is dysfunctional and he has negative coping style.
Data cluster 3: The third data cluster collected from the analysis of Frankley’s case scenario includes ‘He has the intention to lose weight, but no intention to control her eating habits smoking is a weakness , ‘I don’t plan on quitting’, ‘Eating an entire pizza with coke’. The above data sets clearly exemplified what plans Frankley has regarding improving his health and being healthy. Poor focus on quitting smoking and improving eating habits suggest that he has poor perception about health and well-being. It represents Gordon’s health perception-health management patterns (Gordon, 2014). The pattern is dysfunctional for the patient.
Data cluster 4: The fourth data cluster collected from the analysis of Frankley’s case scenario includes ‘He smokes 2 packs of cigarettes, he is obese but he does not control her eating habits, he was found to have eat an entire pizza pie and coke with his wife during hospital stay’. The data sets defines Frankley’s addiction to cigarette and that he has interest in unhealthy food items like coke and pizza. Eating those foods even during hospital stay is a weak point which suggests he is not serious about his metabolic and nutrient needs. The data resembles Gordon’s nutritional metabolic pattern (Gordon, 2014).
Data cluster 5: The fifth data cluster collected from the analysis of Frankley’s case scenario includes ‘Need ambulatory support while going to the bathroom, he states ‘Its hard for me to get around, I use sticks while walking’. This data set defines patient’s engagement in activity and leisure activity. The pattern is related to Gordon’s activity-exercise pattern and it is dysfunctional (Gordon, 2014).
Nursing diagnosis or Associated NDx:
The following nursing diagnoses have been identified for patient:
The cause of each specific nursing diagnosis as per Gordon’s pattern are as follows:
Physiological problem found in patient includes breathing problem, low pulse rate and persistent cough with problem in bringing up the secretions
Shortness of breath can increase difficulty and chest congestion can increase complication for patient. The patient can be at risk of bleeding while coughing or choking (Polanski et al., 2016).
To promote health, proving high concentration of oxygen and respiratory medications will be important. Suction secretion is also necessary to clear airway blockage (Chatwin et al. 2018).
Poor emotional states because of cancer diagnosis and inability to cope with mobility problems due to obesity
Impairment in psychosocial state can cause risk in the long term if social isolation and poor emotional state persist for long time. Patient may be at risk of developing depression (Bekh Bradley et al., 2011)
Psycho-education and counseling support is essential to improve thinking pattern and teach positive coping skills to deal with illness and other life stressors (Walker et al., 2013)
Poor intention to quit smoking and unhealthy eating habit has been identified as one of the educational problem for patient
Continuing with smoking can further cause problem for Frankeley as he is a patient diagnosed with lung cancer. People who continue to smoke after diagnosis of the cancer doubles their risk of dying (Cataldo, Dubey & Prochaska, 2010).
Smoking cessation is an integral part of treatment and encouraging patient to quit smoking is essential to provide health benefit to patient (Cataldo, Dubey & Prochaska, 2010).
To understand whether client has met the goal, the evaluation of outcome will be done by evaluating patients respiratory pattern. Other expected outcomes include:
Amato, K. A. D., Hyland, A., Reed, R., Mahoney, M. C., Marshall, J., Giovino, G., ... & Nwogu, C. (2015). Tobacco cessation may improve lung cancer patient survival. Journal of Thoracic Oncology, 10(7), 1014-1019.
Bekh Bradley, D., DeFife, J. A., Guarnaccia, C., Phifer, M. J., Fani, M. N., Ressler, K. J., & Westen, D. (2011). Emotion dysregulation and negative affect: association with psychiatric symptoms. The Journal of clinical psychiatry, 72(5), 685.
Cataldo, J. K., Dubey, S., & Prochaska, J. J. (2010). Smoking Cessation: An Integral Part of Lung Cancer Treatment. Oncology, 78(5-6), 289–301.
Chatwin, M., Toussaint, M., Gonçalves, M. R., Sheers, N., Mellies, U., Gonzales-Bermejo, J., ... & Nygren-Bonnier, M. (2018). Airway clearance techniques in neuromuscular disorders: A state of the art review. Respiratory medicine, 136, 98-110.
Gordon, M., 2014. Manual of nursing diagnosis. Jones & Bartlett Publishers.
Ignatavicius, D. D., & Workman, M. L. (2015). Medical-Surgical Nursing-E-Book: Patient-Centered Collaborative Care. Elsevier Health Sciences.
Mudd, S. S., & Sloand, E. D. (2015). Lower Respiratory Disorders. Pediatric Nurse Practitioner Certification Review Guide, 137.
Polanski, J., Jankowska-Polanska, B., Rosinczuk, J., Chabowski, M., & Szymanska-Chabowska, A. (2016). Quality of life of patients with lung cancer. OncoTargets and therapy, 9, 1023.
Walker, J., Sawhney, A., Hansen, C. H., Symeonides, S., Martin, P., Murray, G., & Sharpe, M. (2013). Treatment of depression in people with lung cancer: a systematic review. Lung Cancer, 79(1), 46-53.
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