Submitted by:

Pangarungan, Ayna S.
Section C

DAY 3: ACTIVITY # 3
ONCO Virtual Duty
All of the following are imaginary patient profile and does not describe a real person.

PATIENT # 1: COLON CANCER

PATIENT PROFILE

Name: Mr. Cohen

Sex: Male

Age: 58 year-old

Race: American

Lifestyle: Mr. Cohen is a 58-year-old American male is a smoker who worked as a plumber for almost 30 years. The

patient likes to eat red meats such as beef and pork and processed meats like hotdogs and luncheon meats.

Job: Plumber
All of the following are imaginary patient profile and does not describe a real person.
NURSING CARE PLAN
CUES NURSING DIAGNOSIS OBJECTIVES INTERVENTIONS
INDEPENDENT
Subjective: Fatigue related to altered After 8 hours of nursing  Have patient rate 
‘’I feel very weak and tired all body chemistry, side effects of interventions, the patient’s fatigue, using a numeric
the time.’’ as verbalized by pain and other medications, will report improved sense of scale, if possible, and the
time of day when it is
the patient. chemotherapy as evidenced energy.
most severe.  Frequent rest periods and
Objective: by disinterest in surroundings.  Plan care to allow for rest
 Disinterest in the periods. Schedule
surrounding activities for periods
 Lethargy when
 V/S taken as follows:  Establish realistic activity 
goals with patient.
 T: 37.3
 RR: 22 cpm  Assist with self-care 
 P: 90 needs when indicated;
 BP: 120/80 keep bed in low position,
pathways clear of
furniture; assist with
ambulation.
 Encourage patient to do 
whatever possible (self-
bathing, sitting up in
chair, walking). Increase
activity level as
individual is able.
 Monitor physiological 
response to activity
(changes in BP, heart and
respiratory rate).
RATIONALE EVALUATION
Helps in developing a plan After 8 hours of nursing
for managing fatigue. interventions, the patient was
able to report improved sense
of energy.
naps are needed to
restore and conserve
energy. Planning will allow
patient to be active during
Provides for a sense of
control and feelings of
accomplishment.
Weakness may make ADLs
difficult to complete or
place the patient at risk
for injury during activities.
Enhances strength and
stamina and enables
patient to become more
active without undue
fatigue.
Tolerance varies greatly
depending on the stage
of the disease process,
nutrition state, fluid
balance, and reaction to
therapeutic regimen.
All of the following are imaginary patient profile and does not describe a real person.

 Perform pain assessment  Poorly managed cancer

and provide pain pain can contribute to
management. fatigue.
 Provide supplemental
 Presence of anemia and
oxygen as indicated.
hypoxemia reduces
O2available for cellular
uptake and contributes to
fatigue.
COLLABORATIVE  Programmed daily
 Refer to physical or exercises and activities
occupational therapy. help patient maintain and
increase strength and
muscle tone, enhance
sense of well-being. Use
of adaptive devices may
help conserve energy.
All of the following are imaginary patient profile and does not describe a real person.

PATIENT # 2: LUNGCANCER

PATIENT PROFILE

Name: Mr. Cruz

Sex: Male

Age: 50 year-old

Race: Filipino

Lifestyle: Mr. Cruz is a 50-year-old Filipino who worked as a jeepney driver for almost 30 years. He spent a great deal

of his time driving and smoking.

Job: Jeepney driver

All of the following are imaginary patient profile and does not describe a real person.

NURSING CARE PLAN

CUES NURSING DIAGNOSIS OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

INDEPENDENT
Subjective: Impaired gas exchange After 8 hours of nursing  Note respiratory rate,  Respirations may be After 8 hours of nursing
‘’Nahihingal ako sa paghinga related to altered oxygen interventions, the patient will depth, and ease of increased as a result of interventions, the patient was
at sumasakit din dibdib ko.’’ supply as evidenced by demonstrate improved respiration. Observe for pain or as an initial able to report improved sense
use of accessory muscles, compensatory
(I’ve been experiencing cyanosis and restlessness. ventilation and adequate of energy and adequate
pursed-lip breathing, mechanism to
shortness of breath and chest oxygenation of tissues by changes in skin or mucous accommodate for the loss oxygenation of tissues by
pains) as verbalized by the ABGs within the patient’s membrane color, pallor, of lung tissue; however, ABGs within the patient’s
patient. normal range. cyanosis. increased work of normal range.
Objective: breathing and cyanosis
 Cyanosis may indicate increasing
oxygen consumption and
 Restlessness
energy expenditures
 V/S taken as follows: and/or reduced
 T: 37.1 respiratory reserve.
 RR: 25 cpm  Auscultate lungs for air  Consolidation and lack
 P: 101 movement and abnormal of air movement on the
 BP: 120/80 breath sounds. operative side are
normal in the
pneumonectomy
patient; however, the
lobectomy patient
should demonstrate
normal airflow in
remaining lobes.
 Investigate restlessness  May indicate increased
and changes in mentation hypoxia or complications
or level of consciousness. such as a mediastinal shift
in pneumonectomy
patient when
accompanied by
tachypnea, tachycardia,
and tracheal deviation.
All of the following are imaginary patient profile and does not describe a real person.

 Assess patient response  Increased oxygen

to activity. Encourage rest consumption demand and
periods and limit activities stress of surgery can
to patient tolerance. result in increased
dyspnea and changes in
vital signs with activity;
however, early
mobilization is desired to
help prevent pulmonary
complications and to
obtain and maintain
respiratory and
circulatory efficiency.
Adequate rest balanced
with activity can prevent
respiratory compromise.
 Note development of  Fever within the first 24 hr
fever. after surgery is frequently
due to atelectasis.
Temperature elevation
within the 5th to 10th
postoperative day usually
indicates a wound or
systemic.
 Maintain patent airway by  Airway obstruction
positioning, suctioning, impedes ventilation,
use of airway adjuncts. impairing gas exchange.

 Reposition frequently,  Maximizes lung expansion

placing patient in sitting and drainage of
positions and supine to secretions.
side positions.  Research shows that
 Avoid positioning patient positioning patients
with a pneumonectomy following lung surgery
on the operative side; with their “good lung
instead, favor the “good down” maximizes
lung down” position. oxygenation by using
gravity to enhance blood
All of the following are imaginary patient profile and does not describe a real person.
 Encourage and assist with 
deep-breathing exercises
and pursed-lip breathing
as appropriate.
 Maintain patency of chest 
drainage system for
lobectomy, segmental or
wedge resection patient.
 Note changes in amount 
or type of chest tube
drainage.
DEPENDENT
 Administer supplemental 
oxygen via nasal cannula,
partial rebreathing mask,
or high-humidity face
mask, as indicated.
flow to the healthy lung,
thus creating the best
possible match between
ventilation and perfusion.
Promotes maximal
ventilation and
oxygenation and reduces
or prevents atelectasis.
Drains fluid from pleural
cavity to promote re-
expansion of remaining
lung segments.
Bloody drainage should
decrease in amount and
change to a more serous
composition as recovery
progresses. A sudden
increase in amount of
bloody drainage or return
to frank bleeding suggests
thoracic bleeding or
hemothorax; sudden
cessation suggests
blockage of tube,
requiring further
evaluation and
intervention.
Maximizes available
oxygen, especially while
ventilation is reduced
because of anesthetic,
depression, or pain, and
during period of
compensatory
physiological shift of
circulation to remaining
functional alveolar units.
All of the following are imaginary patient profile and does not describe a real person.

INDEPENDENT
 Assist with and encourage  Prevents or reduces
the use of incentive atelectasis and promotes
spirometer.
re-expansion of small
airways.
 Monitor and graph ABGs,  Decreasing Pao2 or
pulse oximetry readings. increasing Paco2 may
Note hemoglobin (Hb) indicate the need for
levels. ventilatory support.
Significant blood loss can
result in decreased
oxygen-carrying capacity,
reducing Pao2.
All of the following are imaginary patient profile and does not describe a real person.

PATIENT # 3: GASTRIC/STOMACH CANCER

PATIENT PROFILE

Name: Mr. Tolentino

Sex: Male

Age: 68 year-old

Race: Filipino

Lifestyle: Mr. Tolentino is a 68-year-old Filipino male who worked as a farmer for almost 35 years. As stated

by the patient, he has a low socio-economic status. He is fond of eating spicy foods and would smoke

cigarette from time to time.

Job: Farmer
All of the following are imaginary patient profile and does not describe a real person.

NURSING CARE PLAN

CUES NURSING DIAGNOSIS OBJECTIVES INTERVENTIONS RATIONALE EVALUATION

COLLABORATIVE
Subjective: Impaired Nutrition Less Than After 2 weeks of nursing  Ascertain healthy body  Experts like a dietician can After 2 weeks of nursing
‘’Konti na lang po ang Body Requirements related to interventions, the patient will: weight for age and height. determine nitrogen interventions, the patient was
nakakain ko ngayon.’’ (I’ve anorexia and difficulty eating.  Verbalize and Refer to a dietitian for balance as a measure of able to:
complete nutrition the nutritional status of
been eating very little these demonstrate selection of  Verbalize and
assessment and methods the patient. A negative
past few days) as verbalized food or meals that will for nutritional support. nitrogen balance may demonstrate selection of
by the patient. achieve a cessation of mean protein food or meals that will
weight loss. malnutrition. The achieve a cessation of
Objective:  Have weight within 10% dietician can also weight loss.
 Weight loss of ideal body weight. determine the patient’s  Have weight within 10%
daily requirements of
 Poor muscle tone of ideal body weight.
specific nutrients to
 Difficulty swallowing promote sufficient
 V/S taken as follows: INDEPENDENT nutritional intake.
 T: 37.1  Set appropriate short-  Patients may lose concern
 RR: 17 cpm term and long-term goals. in addressing this
 P: 59 dilemma without realistic
 BP: 90/60 short-term goals.
 Provide a pleasant
environment.  A pleasing atmosphere
helps in decreasing stress
and is more favorable to
eating.
 Promote proper  Elevating the head of bed
positioning. 30 degrees aids in
swallowing and reduces
risk for aspiration with
eating.
 Provide good oral hygiene  Oral hygiene has a
and dentition. positive effect on appetite
and on the taste of food.
Dentures need to be
All of the following are imaginary patient profile and does not describe a real person.
 If patient lacks strength,
 Nursing assistance with
schedule rest periods
before meals and open
packages and cut up food
for patient.
 Provide companionship 
during mealtime.
 Consider the use of 
natural seasoning for
patients with changes in
their sense of taste; if not
contraindicated.
 Consider six small 
nutrient-dense meals
instead of three larger
meals daily to lessen the
feeling of fullness.
COLLABORATIVE
 For patients with 
impaired swallowing,
coordinate with a speech
therapist for evaluation
and instruction.
clean, fit comfortably, and
be in the patient’s mouth
to encourage eating.
activities of daily living
(ADLs) will conserve the
patient’s energy for
activities the patient
values. Patients who take
longer than one hour to
complete a meal may
require assistance.
Attention to the social
perspectives of eating is
important in both hospital
and home settings.
Seasoning may improve
the flavor of the foods and
attract eating.
Eating small, frequent
meals lessens the feeling
of fullness and decreases
the stimulus to vomit.
Adjustments of the
thickness and consistency
of foods to improve
nutritional intake may be
provided by a speech
therapist.
All of the following are imaginary patient profile and does not describe a real person.

INDEPENDENT  Patients with liver disease

 Determine time of day often have their largest
when the patient’s appetite at breakfast
appetite is at peak. Offer
time.
highest calorie meal at
that time.  Patients with specific
 Encourage family ethnic or religious
members to bring food preferences or
from home to the restrictions may not
hospital. consider foods from the
hospital.
COLLABORATIVE
 Such supplements can be
 Offer high protein
supplements based on used to increase calories
individual needs and and protein without
capabilities. conflict with voluntary
food intake.
 Offer liquid energy  Energy supplementation
supplements.
has been shown to
produce weight gain and
reduce falls in frail elderly
living in the community.
 Discourage caffeinated or  These beverages will
carbonated beverages. decrease hunger and lead
to early satiety.
 Keep a high index of
 Impaired immunity is a
suspicion of malnutrition
as a causative factor in critical adjunct factor in
infections. malnutrition-associated
infections in all age
groups.
 Consider the possible  Nutritional support may
need for enteral or be recommended for
parenteral nutritional patients who are unable
support with the patient, to maintain nutritional
family, and caregiver, as
intake by the oral route. If
appropriate.
All of the following are imaginary patient profile and does not describe a real person.
 Validate the patient’s 
feelings regarding the
impact of current lifestyle,
finances, and
transportation on ability
to obtain nutritious food.
gastrointestinal tract is
functioning well, enteral
tube feedings are
indicated. For those who
cannot tolerate enteral
feedings, parenteral
nutrition is
recommended.
Validation lets the patient
know that the nurse has
heard and understands
what was said, and it
promotes the nurse-
patient relationship.