Xyrelle Gambaloza

BSN1-F



LABORATORY ACTIVITY 6: NURSING CARE PLAN



CASE SCENARIO: COVID-19 with CANCER as COMORBIDITY 

This is the case of a 67-year-old African-American male client who recently is

diagnosed of multiple myeloma. Now on his 4th cycle of chemotherapy with the use of
cyclophosphamide (immunosuppresant, antineoplastic), the client decides to see his
oncologist regarding flu-like symptoms that include fever, sore throat and dry cough.
Due to the rising cases of the pandemic COVID-19, he expresses that his current
immunosuppression due to the effects of chemotherapy, might have led to a possibility
of acquiring the disease more than anyone else. 



Unfortunately, the swab taken from him days ago confirms the presence of
COVID-19. While there is no current treatment or vaccine available and still waiting for
clinical trials to show promising results in the future, the client and his family have been
so stressed not only about the disease itself but the recommended national health
guidelines that the family needs to comply. 



Due to the current guidelines of chemotherapy for COVID-19, there is a decision
to delay the 4th cycle of chemotherapy while the client is monitored for respiratory
distress, immune system boosting, and adequate bedrest. Fortunately, the client is
well, no progression of symptoms, resolving fever and without respiratory
complications. The client will be needed two (2) more consecutive swabs before he will
be allowed to be discharged, as agreed by his oncologist.
ASSESSMENT NURSING SCIENTIFIC OBJECTIVES NURSING RATIONALE EXPECTED
RATIONALE
DIAGNOSIS INTERVENTIONS OUTCOME

Manifest the ff: 
 Risk for Short term:
 Independent
 Independent
 Short term:

-Exposure to infection related After 2 hours of -Monitor vital signs -High temperature -After 2 hours of
disease especially fever. may indicate
outbreak
 to compromised nursing Manage infections
 nursing
-Fever
 host defenses
interventions, hyperthermia. Use 
 interventions,
-Immunosuppre the patient will appropriate therapy 
 the patient shall
ssion
 have a decrease
for elevated 

have a

 temperature to 

in temperature maintain 
 decreased in


from an initial normothermia and 
 temperature
May manifest
reduce metabolic 

the ff:
 temperature. 
 from an initial
needs.
 

-Chills and 
 temperature.


 -With the onset of
sweats

Long term: -Observe and report infection the 

-Shortness of
After 2-3 weeks signs of infection immune system is Long term:
breathe

such as redness, activated and signs
-Fast heart rate
 of nursing After 2-3 weeks
warmth, and of infection appear.

-Pain and
interventions, discharge.
 
 of nursing
discomfort
the patient will 
 
 interventions,

 

be free from -Protective isolation the patient shall
infection. -Place patient in is established to  be free from
protective isolation if protect the person infection.

patient is at very at risk from

high risk.
 pathogens.






 -Adequate rest can
-Encourage reduce stress and
adequate rest to boost the immune
bolster the immune system.

system.





Dependent Dependent

-Administer or teach -Antibiotic agents
use of antimicrobial are either toxic to
(antibiotic) drugs as the pathogen or
ordered. retard the
pathogen's growth.











ASSESSMENT NURSING SCIENTIFIC OBJECTIVES NURSING RATIONALE EXPECTED
RATIONALE
DIAGNOSIS INTERVENTIONS OUTCOME

Interdependent
 Interdependent

-Note and report -Laboratory values
laboratory values are correlated with
(e.g., white blood client's history and
cell count and physical
differential, serum examination to
protein, serum provide a global
albumin, and view of the client's
cultures)
 immune function

 and nutritional

 status and develop

 an appropriate plan

 of care for the

 diagnosis

 (Lehmann, 1991)


 


 

-Encourage a -Immune function is
balanced diet, affected by protein
emphasizing intake (especially
proteins to feed the arginine); the
immune system. balance between
omega-6 and
omega-3 fatty acid
intake; and
adequate amounts
of vitamins A, C,
and E and the
minerals zinc and
iron. A deficiency of
these nutrients puts
the client at an
increased risk of
infection (Lehmann,
1991).