Problem
ADULT/PEDIATRIC - CANCER TREATMENT You are working 7PM-730AM on an oncology service of a university medical center with a pediatric/adolescent/adult population. The staff working with you includes an experienced oncology RN, an experienced RN who has completed orientation to oncology, 3 PCTs (Patient Care Technicians) and a nursing student. Interns and residents (oncology) are on call. The patient assignment is as follows: 420D AC 66 year old male Adm. Dx: Colon cancer (Stage 2) - received chemotherapy last week in the outpatient cancer center. Hosp. day 2, admitted for diarrhea and dehydration PMH: Colon resection 2 months ago Soc. Hx: Married, lives with wife and 3 children (20 yrs, 18 yrs and 12 yrs); Wt: 62.7 kg; Employed, owns home, health insurance, occasional alcohol intake, non-smoker Report: Port-a-cath CVC in place - site clean/dry FOLFOX protocol (5-FU, leucovorin and oxaliplatin) last week Bland diet, unable to tolerate Antiemetics and anti-diarrheals PRN D5 ½ NS w/20 mEq KCL @ 100 mL/hr Morning labs: RBCs - 3.8, Hgb 12, Hct 38, WBCs 4, Platelets 99 Stool culture negative for C-diff .
• Identify at least 3 criteria related to primary diagnosis and interventions that could delay discharge.
• Include evidence based strategies utilized to prevent these complications (with references)