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rd\ql\li4031\sb5\sl-218\slmult0 \up0 \expndtw-4\charscalex100 Pasadena City Coll
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ursing Management of Patient with Ovarian Cancer \par\pard\qj \li1166\ri3762\sb3
9\sl-440\slmult0\fi574 \up0 \expndtw-1\charscalex100 H.S., a 57 year old female
with a medical history of hypertension and chronic kidney \line \up0 \expndtw-3\

charscalex100 disease, was diagnosed with a Stage IIIB clear cell carcinoma of t
he ovary and had surgery in\par\pard\sect\sectd\sbknone\cols2\colno1\colw9045\co
lsr160\colno2\colw2895\colsr160\ql \li1166\sb191\sl-218\slmult0 \up0 \expndtw-1\
charscalex100 April of 2007. When the patient began to have physical discomfort,
an exploratory lapartomy\par\pard\qj \li1166\ri594\sb39\sl-440\slmult0 \up0 \ex
pndtw-1\charscalex100 was performed. A pelvic mass had developed post peritoneal
chemotherapy. The patient had \up0 \expndtw-1\charscalex100 surgery to remove t
he intraperitoneal port, pelvic mass fluid drainage and pelvic biopsy. Often \up
0 \expndtw-1\charscalex100 patients with cancer develop cachexia and should be a
ssessed for adequate nutritional intake. \up0 \expndtw-2\charscalex100 Martin (2
006) states that \up0 \expndtw-2\charscalex100 one of the greatest challenges fo
r a woman with ovarian cancer is\par\pard\qj \li1166\ri575\sb2\sl-439\slmult0 \u
p0 \expndtw-1\charscalex100 malnutrition: she may have little appetite as a resu
lt of treatment of advancing disease, causing \up0 \expndtw-2\charscalex100 her
to lose weight.\par\pard\ql \li4255\sb184\sl-218\slmult0 \up0 \expndtw-2\charsca
lex100 Pathophysiology\par\pard\ql \li1166\ri572\sb40\sl-440\slmult0\fi574 \up0
\expndtw-1\charscalex100 The symptoms of ovarian cancer are vague and the causes
may be related to several \up0 \expndtw-1\charscalex100 factors. As Bohnenkamp
(2007) has explained, one or more risk factors may increase the \line \up0 \exp
ndtw-1\charscalex100 likelihood of developing ovarian cancer, but their presence
does not guarantee the cancer will \up0 \expndtw-1\charscalex100 occur. Martin
(2006) claimed that the most significant risk is a positive family history of th
e \up0 \expndtw-1\charscalex100 disease; it is present in about 10% of women wit
h the disease. Although it is not known if H.S. \up0 \expndtw-2\charscalex100 ha
d a history of ovarian cancer in her family, Ignatavicius (2006) noted that othe
r risk factors \up0 \expndtw-1\charscalex100 include being over the age of 40, f
amily history, diabetes mellitus, null parity, being under 30 \up0 \expndtw-1\ch
arscalex100 years of age at first pregnancy, breast cancer, colorectal cancer, i
nfertility, and BRCA1 or \line \up0 \expndtw-1\charscalex100 BRCA2 gene mutation
s. Martin (2006) found that 70% of women with ovarian cancer had \up0 \expndtw-2
\charscalex100 symptoms for 3 months or longer before diagnosis; H.S. states her
symptoms were present for \up0 \expndtw-2\charscalex100 two years, which is why
her ovarian cancer had advanced.\par\pard\column \ql \li9205\sb0\sl-149\slmult0
\par\pard\ql \li20\sb83\sl-149\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosup
ersub\cf2\f3\fs13 Comment [CS1]: \ul0\nosupersub\cf3\f4\fs13 Introduces who the
patient is\par\pard\qj \li20\ri279\sb2\sl-146\slmult0 \up0 \expndtw-1\charscalex
100 (57 year old female) and what the problem is (cell \up0 \expndtw-1\charscale
x100 carcinoma)\par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\
sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\
sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\
sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\
sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\
sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li20\ri196\
sb144\sl-147\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs13 C
omment [CS2]: \ul0\nosupersub\cf3\f4\fs13 Makes an argument for the \up0 \expndt
w-1\charscalex100 paper: the most important thing to focus on for this \up0 \ex
pndtw-1\charscalex100 patient is malnutrition\par\pard\qj \li9205\sb0\sl-147\slm
ult0 \par\pard\qj \li9205\sb0\sl-147\slmult0 \par\pard\qj \li9205\sb0\sl-147\slm
ult0 \par\pard\qj \li9205\sb0\sl-147\slmult0 \par\pard\qj \li9205\sb0\sl-147\slm
ult0 \par\pard\qj \li9205\sb0\sl-147\slmult0 \par\pard\qj \li9205\sb0\sl-147\slm
ult0 \par\pard\qj \li9205\sb0\sl-147\slmult0 \par\pard\qj \li20\ri182\sb143\sl-1
47\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs13 Comment [CS
3]: \ul0\nosupersub\cf3\f4\fs13 Notice that all in-text citations \up0 \expndtw1\charscalex100 use PAST TENSE (ex. \u8220?explained\u8221?) or PRESENT \up0 \ex
pndtw-1\charscalex100 PERFECTIVE (ex. \u8220?has explained\u8221?)\par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \

li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \


li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \
li20\ri360\sb14\sl-146\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2
\f3\fs13 Comment [CS4]: \ul0\nosupersub\cf3\f4\fs13 Shows what may cause the \li
ne \up0 \expndtw-1\charscalex100 disease, and why that is relevant for the patie
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}}\par\pard\sect\sectd\fs24\paperw12240\paperh15840\pard\sb0\sl-240{\bkmkstart P

g3}{\bkmkend Pg3}\par\pard\li4611\sb0\sl-218\slmult0\par\pard\li4611\sb0\sl-218\
slmult0\par\pard\li4611\sb0\sl-218\slmult0\par\pard\li4611\sb0\sl-218\slmult0\pa
r\pard\li4611\sb0\sl-218\slmult0\par\pard\li4611\sb0\sl-218\slmult0\par\pard\li4
611\sb0\sl-218\slmult0\par\pard\li4611\sb0\sl-218\slmult0\par\pard\li4611\sb207\
sl-218\slmult0\fi2212 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs19
Nursing Management 3\par\pard\li4611\sb0\sl-218\slmult0\par\pard\li4611\sb140\sl
-218\slmult0\fi0 \up0 \expndtw-2\charscalex100 History\par\pard\ql \li1741\sb217
\sl-218\slmult0 \up0 \expndtw-2\charscalex100 H.S., a 57 year old female, has a
medical history of hypertension and chronic kidney \par\pard\qj \li1166\ri3534\s
b39\sl-440\slmult0\fi0 \up0 \expndtw-3\charscalex100 disease. She was diagnosed
with Stage IIIB clear cell carcinoma of the ovary and had surgery in \line \up0
\expndtw-4\charscalex100 April of 2007. \up0 \expndtw-3\charscalex100 The patien
t had 18 cycles of peritoneal and intravenous chemotherapy and had an \line \up0
\expndtw-3\charscalex100 excellent response with C-125 that reached a low of 10
. After completion of chemotherapy, the \line \up0 \expndtw-3\charscalex100 pati
ent was readmitted 11/15/2007 for removal of a pelvic mass status post peritonea
l\par\pard\sect\sectd\sbknone\cols2\colno1\colw9045\colsr160\colno2\colw2895\col
sr160\ql \li1166\sb191\sl-218\slmult0 \up0 \expndtw-1\charscalex100 chemotherapy
. The pelvic mass was simple cyst structure with displayed the bladder bilateral
ly.\par\pard\qj \li1166\ri501\sb40\sl-440\slmult0 \up0 \expndtw-1\charscalex100
The patient elected for removal of the peritoneal port and a lapartomy with biop
sies to ascertain \up0 \expndtw-2\charscalex100 the nature of the abdominal cyst
, which was benign.\par\pard\ql \li3765\sb185\sl-218\slmult0 \up0 \expndtw-2\cha
rscalex100 Nursing Physical Assessment\par\pard\ql \li1166\sb0\sl-218\slmult0 \p
ar\pard\ql \li1741\sb4\sl-218\slmult0 \up0 \expndtw-2\charscalex100 H.S. was ale
rt and oriented to person, place and time. \up0 \expndtw-2\charscalex100 The pat
ient\u8217?s temperature was 98.0\par\pard\qj \li1166\ri581\sb39\sl-440\slmult0
\up0 \expndtw-1\charscalex100 F, pulse rate was 74, respirations were 18, blood
pressure was 126/66, oxygen saturation on \line \up0 \expndtw-1\charscalex100 ro
om air was 98%, apical pulse was 74, lungs were clear, and the patient stated he
r pain level \line \up0 \expndtw-1\charscalex100 was 5. The patient has an IV he
plock in her right jugular. The patient\u8217?s skin was warm and dry \line \up0
\expndtw-1\charscalex100 with a moderate bilateral hand grip. The patient\u8217
?s surgical incision was from the umbilicus to \line \up0 \expndtw-1\charscalex1
00 suprapubic with staples and was intact with no erythema. The patient\u8217?s
bowel sounds \up0 \expndtw-2\charscalex100 were\par\pard\qj \li1166\ri649\sb1\sl
-439\slmult0 \up0 \expndtw-1\charscalex100 hypoactive and stated no bowel moveme
nt today but had passed flatus. The urine output from \line \up0 \expndtw-1\char
scalex100 0600-0800 was 200ml. The patient was on a liquid diet starting 11/06/2
007 and changed to a \line \up0 \expndtw-1\charscalex100 regular diet on 11/08/2
007. The patient ate 70% of her breakfast and stated she did not have\par\pard\q
l \li1166\ri519\sb1\sl-440\slmult0 \up0 \expndtw-1\charscalex100 much of an appe
tite. H.S. appeared frail and thin with some general weakness. The patient\u8217
?s \up0 \expndtw-1\charscalex100 height was 5\u8217?7\u8221? (1.70m) and her wei
ght was 105 lbs (47.7 kg). The patient was ambulatory and \up0 \expndtw-1\charsc
alex100 was able to perform independent activities of daily living. The patient
used the incentive\par\pard\ql \li1166\sb184\sl-218\slmult0 \up0 \expndtw-2\char
scalex100 spirometer ten times an hour as instructed by physician.\par\pard\colu
mn \ql \li9205\sb0\sl-149\slmult0 \par\pard\ql \li20\sb84\sl-149\slmult0 \up0 \e
xpndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs13 Comment [CS5]: \ul0\nosupersu
b\cf3\f4\fs13 Gives specific dates and\par\pard\ql \li20\sb0\sl-146\slmult0 \up0
\expndtw-1\charscalex100 treatment information\par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s
lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s

lmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\s


lmult0 \par\pard\qj \li20\ri381\sb15\sl-146\slmult0 \up0 \expndtw-1\charscalex10
0 \ul0\nosupersub\cf2\f3\fs13 Comment [CS6]: \ul0\nosupersub\cf3\f4\fs13 Lists t
he numbers for each \up0 \expndtw-1\charscalex100 health measurement\par\pard\qj
\li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj
\li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj
\li20\ri125\sb5\sl-146\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf
2\f3\fs13 Comment [CS7]: \ul0\nosupersub\cf3\f4\fs13 Notice that past tense is u
sed to \up0 \expndtw-1\charscalex100 describe the patient (NOT present tense)
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}}\par\pard\sect\sectd\fs24\paperw12240\paperh15840\pard\sb0\sl-240{\bkmkstart P
g4}{\bkmkend Pg4}\par\pard\li4184\sb0\sl-218\slmult0\par\pard\li4184\sb0\sl-218\
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Nursing Management 4\par\pard\li4184\sb0\sl-218\slmult0\par\pard\li4184\sb140\sl
-218\slmult0\fi0 \up0 \expndtw-2\charscalex100 Related treatments\par\pard\ql \l
i1741\sb217\sl-218\slmult0 \up0 \expndtw-1\charscalex100 The patient has no alle
rgies to latex, iodine, or adhesives and is using an abdominal \par\pard\qj \li1
166\ri3553\sb39\sl-440\slmult0\fi0 \up0 \expndtw-3\charscalex100 binder for supp
ort. The patient has an IV heplock in her right jugular vein due to chemotherapy
. \line \up0 \expndtw-1\charscalex100 As Ignatavicius (2006) has noted, insertio
n sites must be chosen carefully after consideration of \line \up0 \expndtw-1\ch
arscalex100 skin integrity, vein condition, and activities of daily living. Igna
tavicius (2006) also has stated \line \up0 \expndtw-1\charscalex100 that IV ther
apy involves the entire vascular system or multiple systems. Access to other sit
es for \line \up0 \expndtw-3\charscalex100 IV insertion was not available due to
damage occurring from chemotherapy. The patient was \line \up0 \expndtw-3\chars
calex100 ambulatory and used the incentive spirometer ten times every hour as or
dered by physician. The \line \up0 \expndtw-1\charscalex100 patient stated her p
ain level is a 5. According to Ignatavicius (2006), the Numeric Pain Distress \l
ine \up0 \expndtw-2\charscalex100 Scale of 0-10 has zero to 4 being no pain, 5 t
o 9 being distressing pain, and 10 being unbearable \line \up0 \expndtw-3\charsc
alex100 pain. The patient was taking pain medication of Motrin 600mg as needed.
\up0 \expndtw-2\charscalex100 The physician\u8217?s \par\pard\ql \li1166\ri3470\
sb0\sl-440\slmult0 \up0 \expndtw-1\charscalex100 discharge orders were to stay o
n a low cholesterol, low fat diet and no lifting over 15 pounds. \line \up0 \exp
ndtw-3\charscalex100 Carpenito (2000) has explained that even though some people
can ingest food, they may eat an \line \up0 \expndtw-3\charscalex100 inadequate
or imbalanced quality or quantity. For instance, the diet may be insufficient p
rotein or\par\pard\sect\sectd\sbknone\cols2\colno1\colw9045\colsr160\colno2\colw
2895\colsr160\ql \li1166\sb192\sl-218\slmult0 \up0 \expndtw-2\charscalex100 exce
ssive fat content. \up0 \expndtw-1\charscalex100 Ignatavicius (2006) stated that
recent testing and management guidelines\par\pard\ql \li1166\ri385\sb40\sl-440\
slmult0 \up0 \expndtw-1\charscalex100 from the National Cholesterol Education Pr
ogram (NCEP) have a major preventive focus for \line \up0 \expndtw-1\charscalex1
00 individuals with multiple risk factors. The patient\u8217?s medications were
Ducosate Sodium - 100mg \line \up0 \expndtw-1\charscalex100 tab to promote bowel
movements; VICODIN - 5-500mg every 4 hours for pain as needed.; \line \up0 \exp

ndtw-1\charscalex100 Metroclopramide - 10mg every 6 hours for nausea and vomitin


g; and Enoxaparin injection -\line \up0 \expndtw-1\charscalex100 40mg - an antic
oagulant as a prophylactic to prevent deep vein thrombosis after surgery. Since
\line \up0 \expndtw-1\charscalex100 the patient stated that she was no longer na
useated and her pain level was a five, she chose to not \line \up0 \expndtw-1\ch
arscalex100 take metroclopramide for nausea or vicodin for pain. Because the pat
ient was up and out of bed\par\pard\column \qj \li9205\sb0\sl-146\slmult0 \par\p
ard\qj \li20\ri166\sb90\sl-146\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupe
rsub\cf2\f3\fs13 Comment [CS8]: \ul0\nosupersub\cf3\f4\fs13 Explains what treatm
ents the \line \up0 \expndtw-1\charscalex100 patient is undergoing, and why (ex.
diet restrictions)
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}}\par\pard\sect\sectd\fs24\paperw12240\paperh15840\pard\sb0\sl-240{\bkmkstart P
g5}{\bkmkend Pg5}\par\pard\ql \li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0
\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\s
l-218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl-21
8\slmult0 \par\pard\ql\li6824\sb196\sl-218\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs19 Nursing Management 5 \par\pard\qj \li1166\ri3615\sb
179\sl-440\slmult0 \up0 \expndtw-1\charscalex100 and walked up and down the hall
s at least three times per shift, there was a decreased chance of \up0 \expndtw2\charscalex100 deep vein thrombosis. \par\pard\ql \li4191\sb184\sl-218\slmult0
\up0 \expndtw-2\charscalex100 Nursing Care Plan \par\pard\ql \li1741\sb0\sl-218\
slmult0 \par\pard\ql\li1741\sb5\sl-218\slmult0 \up0 \expndtw-3\charscalex100 H.S
.\u8217?s nursing diagnosis is nutrition, altered: less than body requirements r
elated to \par\pard\ql \li1166\sb0\sl-218\slmult0 \par\pard\ql\li1166\sb5\sl-218
\slmult0 \up0 \expndtw-3\charscalex100 increased caloric requirements and diffic
ulty in ingesting sufficient calories secondary to cancer\par\pard\sect\sectd\sb
knone\cols2\colno1\colw9045\colsr160\colno2\colw2895\colsr160\ql \li1166\sb0\sl218\slmult0 \par\pard\ql \li1166\sb12\sl-218\slmult0 \up0 \expndtw-2\charscalex1
00 (Carpenito, 2000). According to Martin (2007), malnutrition is one of the gre
atest concerns for a\par\pard\ql \li1166\ri379\sb39\sl-440\slmult0 \up0 \expndtw
-1\charscalex100 patient with ovarian cancer. Fitch (2006) also noted that fatig
ue and anorexia are not uncommon \up0 \expndtw-1\charscalex100 side effects of b
oth chemotherapy and surgery. Patient\u8217?s appearance was frail, with dry ski
n, and \up0 \expndtw-1\charscalex100 she was underweight for her height. Her hei
ght and weight were obtained and compared to the \up0 \expndtw-2\charscalex100 B
MI. Patient\u8217?s height was 5\u8217?7\u8221? (1.70m) and her weight was 105lb
s (47.7kg). Her BMI was 16.50 \up0 \expndtw-2\charscalex100 and needs to be at l
east 19 (Christensen & Kockrow, 1999). \up0 \expndtw-2\charscalex100 The short t
erm goal is to assess\par\pard\ql \li1166\sb184\sl-218\slmult0 \up0 \expndtw-1\c
harscalex100 appetite, dietary patterns, activity levels, and knowledge of nutri
tion (Carpenito, 2000).\par\pard\ql \li1166\ri420\sb40\sl-440\slmult0\fi574 \up0
\expndtw-1\charscalex100 Nursing interventions for the patient include explaini
ng the need for adequate \line \up0 \expndtw-2\charscalex100 consumption of carb
ohydrates, fats, protein, vitamins, minerals, and fluids. Determine the \line \u

p0 \expndtw-1\charscalex100 patient\u8217?s food preferences and arrange to have


these foods provided, as appropriate. Give the \line \up0 \expndtw-1\charscalex
100 patient printed materials outlining a nutritious diet that includes a high i
ntake of complex \line \up0 \expndtw-1\charscalex100 carbohydrates and fiber wit
h a decreased intake of sugar, salt, cholesterol, total fat, and saturated \line
\up0 \expndtw-1\charscalex100 fats (Carpenito, 2000). The patient needs proper
caloric intake to reach ideal weight, which is at \line \up0 \expndtw-1\charscal
ex100 least 121 lbs. The rationale behind this is that food nutrients provide an
energy source, build \line \up0 \expndtw-2\charscalex100 tissue, and regulate m
etabolic processes (Carpenito, 2000). Even though the patient stated that \line
\up0 \expndtw-1\charscalex100 she was no longer nauseous, she complained of decr
eased appetite and was unable to finish her \line \up0 \expndtw-1\charscalex100
meals. Carpenito (2000) has claimed that an even distribution of the total daily
caloric intake \line \up0 \expndtw-1\charscalex100 throughout the day helps pre
vent gastric distention, possibly increasing appetite. If unable to\par\pard\col
umn \ql \li9205\sb0\sl-149\slmult0 \par\pard\ql \li20\sb122\sl-149\slmult0 \up0
\expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\fs13 Comment [CS9]: \ul0\nosuper
sub\cf3\f4\fs13 States the nursing diagnosis\par\pard\ql \li20\sb0\sl-146\slmult
0 \up0 \expndtw-1\charscalex100 and backs it up with citations\par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li92
05\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li20
\ri125\sb14\sl-146\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\f3\
fs13 Comment [CS10]: \ul0\nosupersub\cf3\f4\fs13 States the nursing goal for the
\line \up0 \expndtw-1\charscalex100 patient\par\pard\ql \li9205\sb0\sl-147\slmu
lt0 \par\pard\ql \li9205\sb0\sl-147\slmult0 \par\pard\ql \li9205\sb0\sl-147\slmu
lt0 \par\pard\ql \li20\ri243\sb146\sl-147\slmult0 \up0 \expndtw-1\charscalex100
\ul0\nosupersub\cf2\f3\fs13 Comment [CS11]: \ul0\nosupersub\cf3\f4\fs13 States t
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}}\par\pard\sect\sectd\fs24\paperw12240\paperh15840\pard\sb0\sl-240{\bkmkstart P
g6}{\bkmkend Pg6}\par\pard\ql \li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0
\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\s
l-218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl218\slmult0 \par\pard\ql\li6824\sb0\sl-218\slmult0 \par\pard\ql\li6824\sb0\sl-21
8\slmult0 \par\pard\ql\li6824\sb196\sl-218\slmult0 \up0 \expndtw-2\charscalex100
\ul0\nosupersub\cf1\f2\fs19 Nursing Management 6 \par\pard\qj \li1166\ri3531\sb
179\sl-440\slmult0\fi0 \up0 \expndtw-1\charscalex100 tolerate increased food int
ake, she should be offered frequent small meals throughout the day, as \up0 \exp
ndtw-2\charscalex100 well as liquid nutritional supplements (Christensen & Kockr
ow, 1999). \up0 \expndtw-2\charscalex100 The patient was \par\pard\ql \li1166\sb
184\sl-218\slmult0 \up0 \expndtw-1\charscalex100 responsive to education regardi
ng nutrition and requested a consultation with a nutritionist on\par\pard\sect\s
ectd\sbknone\cols2\colno1\colw9045\colsr160\colno2\colw2895\colsr160\ql \li1166\
sb0\sl-218\slmult0 \par\pard\ql \li1166\sb12\sl-218\slmult0 \up0 \expndtw-2\char
scalex100 discharge.\par\pard\ql \li4185\sb0\sl-218\slmult0 \par\pard\ql \li4185
\sb5\sl-218\slmult0 \up0 \expndtw-2\charscalex100 Recommendations\par\pard\ql \l
i1166\ri558\sb39\sl-440\slmult0\fi574 \up0 \expndtw-1\charscalex100 The patient
should follow up with her physician regarding surgery and post-cancer \line \up0
\expndtw-1\charscalex100 treatment, as scheduled. The patient should also follo
w up with a nutritionist regarding her diet \up0 \expndtw-1\charscalex100 to gai
n weight. Christensen (1999) has claimed that dietary treatment should create bo
th a \line \up0 \expndtw-1\charscalex100 positive energy and a nitrogen balance
in the underweight patient, and advised that high-\line \up0 \expndtw-1\charscal
ex100 kilocalorie and high-protein diets can provide this in frequent small-volu
me meals. Martin \line \up0 \expndtw-1\charscalex100 (2007) suggested that medic
ations such as oxandrolone or megestrol be given to improve \line \up0 \expndtw1\charscalex100 appetite. She also advised supplying small, frequent meals serve
d at room temperature, as well \up0 \expndtw-2\charscalex100 the use of nutritio
nal supplements.\par\pard\ql \li1166\ri491\sb0\sl-440\slmult0\fi574 \up0 \expndt
w-2\charscalex100 Fitch (2006) has pointed out that nurses can teach patients ho
w to advocate for \up0 \expndtw-1\charscalex100 themselves with their healthcare
providers by helping them formulate and write down questions \up0 \expndtw-1\ch
arscalex100 about their treatment to bring to appointments and by encouraging th
em to bring a supportive \up0 \expndtw-2\charscalex100 person with them to their
medical appointments.\par\pard\column \ql \li9205\sb0\sl-149\slmult0 \par\pard\
ql \li20\sb122\sl-149\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf2\
f3\fs13 Comment [CS12]: \ul0\nosupersub\cf3\f4\fs13 Gives an evaluation of how\p

ar\pard\ql \li20\sb0\sl-147\slmult0 \up0 \expndtw-1\charscalex100 effective the


intervention was\par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0
\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0
\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0
\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0
\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0
\sl-146\slmult0 \par\pard\qj \li20\ri358\sb7\sl-146\slmult0 \up0 \expndtw-1\char
scalex100 \ul0\nosupersub\cf2\f3\fs13 Comment [CS13]: \ul0\nosupersub\cf3\f4\fs1
3 Explains what the patient \line \up0 \expndtw-1\charscalex100 should do next (
after the nursing intervention)\par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li9205\sb0\sl-146\slmult0 \par\pard\qj \li9205\sb0\sl-146\slmult0 \par\pard
\qj \li20\ri259\sb17\sl-146\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersu
b\cf2\f3\fs13 Comment [CS14]: \ul0\nosupersub\cf3\f4\fs13 Gives a suggestion for
how \up0 \expndtw-1\charscalex100 nurses can deal with patients in the future
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}}\par\pard\sect\sectd\fs24\paperw12240\paperh15840\pard\sb0\sl-240{\bkmkstart P
g7}{\bkmkend Pg7}\par\pard\li4472\sb0\sl-218\slmult0\par\pard\li4472\sb0\sl-218\
slmult0\par\pard\li4472\sb0\sl-218\slmult0\par\pard\li4472\sb0\sl-218\slmult0\pa
r\pard\li4472\sb0\sl-218\slmult0\par\pard\li4472\sb0\sl-218\slmult0\par\pard\li4
472\sb0\sl-218\slmult0\par\pard\li4472\sb0\sl-218\slmult0\par\pard\li4472\sb207\
sl-218\slmult0\fi2351 \up0 \expndtw-2\charscalex100 \ul0\nosupersub\cf1\f2\fs19
Nursing Management 7\par\pard\li4472\sb0\sl-218\slmult0\par\pard\li4472\sb140\sl
-218\slmult0\fi0 \up0 \expndtw-2\charscalex100 References\par\pard\qj \li1166\ri
4028\sb33\sl-440\slmult0\tx1741 \up0 \expndtw-1\charscalex100 Bohnenkamp, S., Le
Baron, V., & Yoder, L. (2007). The medical-surgical nurse\u8217?s guide to \line
\tab \up0 \expndtw-2\charscalex100 cancer: Part I. \ul0\nosupersub\cf4\f5\fs19 M
edsurg Nursing\ul0\nosupersub\cf1\f2\fs19 , \ul0\nosupersub\cf4\f5\fs19 16\ul0\n
osupersub\cf1\f2\fs19 (4), p.259-265. \par\pard\ql \li1166\sb184\sl-218\slmult0
\up0 \expndtw-3\charscalex100 Christensen, B., & Kockrow, E. (1999). \ul0\nosupe
rsub\cf4\f5\fs19 Foundations of nursing\ul0\nosupersub\cf1\f2\fs19 (3\ul0\super
\cf3\f4\fs19 rd\ul0\nosupersub\cf1\f2\fs19 ed.). St. Louis: Mosby. \par\pard\ql
\li1166\sb0\sl-218\slmult0 \par\pard\ql\li1166\sb5\sl-218\slmult0 \up0 \expndtw
-2\charscalex100 Fitch, M., & Turner, F. Ovarian Cancer. (2006). \ul0\nosupersub
\cf4\f5\fs19 Canadian Nurse, 102\ul0\nosupersub\cf1\f2\fs19 (1), p. 18-19. \par\
pard\qj \li1166\ri3621\sb39\sl-440\slmult0\tx1741 \up0 \expndtw-1\charscalex100
Ignatavicius, D., & Workman, M. (2006). \ul0\nosupersub\cf4\f5\fs19 Medical-surg
ica nursing\ul0\nosupersub\cf1\f2\fs19 (5\ul0\super\cf3\f4\fs19 th\ul0\nosupers
ub\cf1\f2\fs19 ed.). St. Louis: Elsevier \line\tab \up0 \expndtw-2\charscalex10
0 Saunders. \par\pard\qj \li1166\ri3497\sb0\sl-440\slmult0\tx1741 \up0 \expndtw2\charscalex100 Martin, V. (2006). Shining a light on ovarian cancer, the hidden
tumor. \ul0\nosupersub\cf4\f5\fs19 Nursing Made Incredibly \line\tab \up0 \expn
dtw-2\charscalex100 Easy\ul0\nosupersub\cf1\f2\fs19 , \ul0\nosupersub\cf4\f5\fs1
9 4\ul0\nosupersub\cf1\f2\fs19 (6), p.28-37. \par\pard\ql \li1166\sb0\sl-440\slm
ult0 \par\pard\ql\li1166\ri3484\sb440\sl-440\slmult0 \up0 \expndtw-2\charscalex1
00 \ul0\nosupersub\cf5\f6\fs19 Note: This paper received 18/20 points. 1 point
was deducted for missing key intervention \line \up0 \expndtw-2\charscalex100 a
reas and patient data. 1 point was deducted for problems with APA formatting,
although \line \up0 \expndtw-3\charscalex100 these problems have been corrected
in this version (so there are no APA errors in this \line \up0 \expndtw-4\charsc
alex100 version).
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