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1.

Anxiety related to diagnosis of skin cancer as evidenced by expressed


concerns regarding condition, increased tension and feelings of helplessness

Review patients previous experience with cancer. Determine what the doctor has
told patient and what the client knows about his/her condition
Clarifies patients perceptions; assists in identification of fear(s) and misconceptions
based on diagnosis and experience with cancer.

Encourage patient to share thoughts and feelings.


Provides opportunity to examine realistic fears and misconceptions about diagnosis.

Provide open environment in which patient feels safe to discuss feelings or to refrain
from talking.
Helps patient feel accepted in present condition without feeling judged, and promotes
sense of dignity and control.

Maintain frequent contact with patient. Talk with and touch patient as appropriate.
Provides assurance that patient is not alone or rejected; conveys respect for and
acceptance of the person, fostering trust.

Provide accurate, consistent information regarding diagnosis and prognosis. Avoid


arguing about patients perceptions of situation.
Can reduce anxiety and enable patient to make decisions and choices based on realities.

Promote calm, quiet environment.


Facilitates rest, conserves energy, and may enhance coping abilities

Encourage patient interaction with support systems


Reduces feelings of isolation. If family support systems are not available, outside sources
may be needed immediately, (local cancer support groups).

2. Acute Pain related to surgical excision of melanoma secondary to skin


cancer

Assess quality, characteristics and severity of pain


Pain is subjective experience and must be described by the client in order to plan
effective treatment

Provide non-pharmacological measures for pain relief such as diversional


activity (watching TV)
to distract the attention towards pain and reduce tension

Encourage verbalization of feelings about pain


to reduce level of anxiety and fear

Teach the patient about the relaxation techniques like deep breathing and guided
imagery
To ease discomfort and alleviate pain

Administer analgesics as prescribed


To alleviate pain and promote comfort

3. Risk for infection related to surgical wound secondary to skin cancer

Promote good handwashing procedures by staff and visitors.


Patients and caregivers can spread infection from one part of the body to another, as well
as pick up surface pathogens; handwashing reduces these risks.

Keep area around wound clean and dry.


Wet areas can promote proliferation of bacteria which may cause infection

Emphasize personal hygiene.


Limits potential sources of infection and secondary overgrowth.

Monitor temperature.
Increase in temperature is a good indication of infection and early identification of
infectious process enables appropriate therapy to be started promptly.

Maintain or teach asepsis for dressing changes and wound care


To ensure that the surgical wound is protected from microorganisms that may cause
infection

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