Discussion on a 65-year-old patient colon resection for a cancerous tumor

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Ellen Watson is a 65-year-old white woman who just had a colon resection for a cancerous tumor. The surgeon ordered a morphine PCA pump to control the pain. Mrs. Watson has severe arthritis in her hands and lower back. She is on a daily NSAID to control the pain related to the arthritis. Her daughter Marie is staying with her during the hospitalization because Mrs. Watson is a widow. Mrs. Watson has not had surgery before, so she is not sure what to expect. She is upset about the diagnosis of cancer. Lana Bridges is a student nurse assigned to care for Mrs. Watson. She is in her last clinical rotation and will be administering all medications with her instructor’s supervision.

1. Lana goes in to meet Mrs. Watson, and Mrs. Watson is holding her abdomen and is restless. She is pale. Lana asks Mrs. Watson to rate her pain on a scale of 1 to 10 with 10 being the worst pain you could have. Mrs. Watson tells Lana that it is a 9. Lana checks the PCA pump and notices that Mrs. Watson has not been pushing the button for medication delivery. What should Lana do to alleviate the pain?

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Answer (10 points):

Rationale (10 points):

Discussion on a 65-year-old patient who just had a colon resection for a cancerous tumor

2. Mrs. Watson tells Lana that she is worried about getting addicted to the morphine because she has heard that it can happen. How should Lana respond?

A. “Don’t worry. The cancer prevents you from becoming addicted.”

B. “It is okay. Because you have severe pain, the medication is necessary. There is little chance of addiction.”

C. “That is a valid worry. I wouldn’t want to become addicted.”

D. “My cousin was addicted to pain killers when he had cancer.”

Answer (10 points):

Rationale (10 points):

Discussion on a 65-year-old patient who just had a colon resection for a cancerous tumor

3. Lana is developing Mrs. Watson’s care plan. She wants to add more interventions and not just deliver pain medication. What are some other nursing actions that would be helpful to Mrs. Watson? (Select all that apply.)

A. Relaxation techniques

B. Distractions such as music

C. Cold or heat applications

D. Massage

Answer (2 points each):

Rationale (10 points):

4. Lana is assigned to Mrs. Watson 2 days later. While she is in the room, Mrs. Watson tells Lana that she is afraid of the cancer because there is always so much pain associated with it. She asks Lana how they treat cancer pain. How should Lana respond to this question?

Answer (10 points):

Rationale (10 points):

Discussion on a 65-year-old patient who just had a colon resection for a cancerous tumor

5. Visit the American Pain Society website (www.ampainsoc.org), access the resources page (http://americanpainsociety.org/education/resources), and report three facts new to them about pain management or resources.

Fact One (3 points)
Fact Two (3 Points)
Fact Three (3 points)

6. How can knowledge gained from the new facts about pain management improve nursing practice (14 points)?

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