Mrs x is a 65yr old lady.
Metastis Colonic Cancer – diagnosed 2005 (Adenocarcinoma)
Recurrence in colon,Adjacent small bowel,stomach.
Extensive Carcinometosin throughout peritoneal cavity.
Right hemicolectomy and Omentectomy – 2005.
Social & Family HX.
Retired from farming & was widowed in 91.Has 4 sons that live at home & also has 4 daughters. Never smoked & does not drink alcohol.
On my initial assessment Mrs x she had allot of physical needs. Mobilisation was poor assistance needed from bed to chair, assistance needed with all her ADL s .
Mrs x had regular intermittent abdo-pain & discomfort .
Fentenyl patch 150mg every 72 hrs
0xymorm 10mg PRN
Paraecetamol 1gm QDS
Dexamethasone 4mg OD
Mrs x suffered from nausea & vomiting.
Cyclizine 10mg subcutaneously PRN
Pantoprazole 40mg OD
Mrs had regular constipation.
Dulcalax 10mls Tds.
Mrs x had urinary retention.
U/C was inserted for monitoring and pts comfort.
Mrs x suffers oral trush - Mycocstatin 1ml QDS.
Reg mouthcare 2-4 hrs needed attending too taking sips only.
Mrs x had very restless nights –Zolpidem 5-10mg PRN
Mrs x had abdominal wound due to a breakdown of laparotomy scar with an offensive odour .Discharge coming from underlying tumour.
Dressed with metrotop to reduce odour.
Both her & her daughter very upset at details regarding the extent of her disease & progress. Finding it very difficult to come to terms with what was happening.
Symptoms express Mrs x suffering.
Fears associated with her symptoms – very restless nights (breathing will stop if i fall asleep)
Emotional distress – Family very much involved in her care esp her daughters, taking over every aspect of their mothers care, not letting her make her own decisions or express her feelings.
Mrs x suffered increased anxiety.
Terminal anguish - loss of control, not...