Background: A 36year old Caucasian male who is a construction worker presented to his physician's office complaining of several moles on his scalp and face that were “changing.” The client noticed a color change on the moles and states "they've increased in size". The borders on the facial moles are irregular. In addition; he states "the mole on his scalp is the worst". One half does not look equal to the other half. The client states "the moles are very bothersome and they itch a lot". Social History: Client did not finish high school; he has worked mediocre jobs since dropping out of school. The client is a poor historian and he can't say with certainty if he has a family cancer history. The client thinks that cancer means a death sentence when his physician shared his diagnosis of melanoma. Patient/ Family Centered Goals:
I. Patient/ Family will have understanding of the treatments given for the disease by being able to recognize the complications that may occur II. Patient/ Family will be able decide on strategies that will aid in coping with anxiety/stress that may occur when being diagnosed/ or being close to someone diagnosed with cancer III. Patient/ Family will understand the importance of maintaining a balanced diet IV. Patient/ Family will be able to recognize the signs & symptoms of infection Teaching Plan:
1. Patient teaching will take place when the patient is most awake and free of any medications that may affect their ability to learn/ observe the information being given. Patient will also express willingness to learn. 2. Family members that are going to be assisting in caring for the patient will be notified of the teaching ahead of time so they may be available to attend. 3. Patient/ Family will demonstrate their understanding by performing any techniques taught 4. Patient/ Family will be given a pretest and posttest to help demonstrate their understanding of the knowledge given as well as informational handouts to take home 5. The information given will be in their language of choice. 6. Patient/ Family will be allowed appropriate time to ask questions
i. Skin cancer Overview: Skin cancer is the most common form of cancer. It is an abnormal growth of skin cells. It can be caused by too much exposure to sunlight, which is its main cause. Other causes include tanning lamps & beds and being exposed to toxic substances. There are three major types of skin cancer and where your cancer begins determines its type and the treatment options. It can begin in squamous cells ( cells on the outer surface of your skin/ the skins inner lining), basal cells (cells which produce new skin cells), and melanocytes (produce the pigment that gives skin color). There are different treatments from removal of the growth to chemotherapy. Tools: Nurse will speak in a clear understandable tone. The nurse will allow time for any questions to provide clarification. Evaluation: Patient/ Family will be able to relay to the nurse their understanding of skin cancer by stating how it is caused and the different options for treatment. ii. Skin Cancer Treatments & their Complications/ Side Effects: There are different ways to treat skin cancer. It just depends on the type diagnosed. Small superficial skin cancers may be removed by a skin biopsy (removal of growth), freezing (freeze cancer and as it thaws it sloughs off), or laser therapy (light beam destroys the growth). These treatments have little to no side effects. It may only cause some bleeding or scarring. Chemotherapy and radiotherapy are other options. Chemotherapy is when the physician uses a combination of drugs to kill off the cancer. Side effects include: bone marrow suppression, nausea, vomiting, fatigue and loss of hair. Patient is also at risk for toxic effects to the heart, lungs, and kidneys. Radiotherapy is the use of radiation to kill off cancer cells and prevent more from...
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