Nursing care process for a patient with primary Ewing's Sarcoma of the dorsal spine in the Emergency Department of the Institute of Neoplastic Diseases

Abstract

The present study is the result of the application of the nursing care process to a patient with a medical diagnosis of primary Ewing's Sarcoma of the dorsal spine, in the Emergency Department of a Neoplastic Diseases Hospital, patient identified as A.J.F.G. During the 2 days in which nursing care was provided, 11 nursing diagnoses were identified, of which 5 were prioritized: acute pain; deterioration of physical mobility; deterioration of skin integrity; nutritional imbalance; lower than body needs and anxiety. The general objectives proposed were: patient will reduce pain, patient will be mobilized in bed, patient will recover skin integrity, patient will present adequate nutrition and patient will reduce anxiety. The method used in the analytical descriptive case study; as a result it was obtained: The objectives achieved were: patient presented decrease in acute pain after the administration of treatment indicated during the shift, patient is mobilized in bed with support, and the objectives partially achieved were: patient in the process of recovery of skin integrity, patient in the process of adequate nutritional balance, patient in the process of decreasing anxiety. The following conclusions were reached: Regarding the first diagnosis, the objective was achieved through observation, use of the VAS scale, treatment is administered, patient rests. Regarding the second diagnosis, the patient presents nutritional imbalance for which long-term care and management is necessary, a follow-up plan should be implemented with the support of the Nutrition and Social Service department through appointments to clinics and home visits made by nursing staff, as this service is not available at INEN. Regarding the third diagnosis, there is no evidence of signs of infection, intravenous insertion catheter care is performed, change of lines according to the service protocol, antibiotic treatment is administered as indicated, the caregiver identifies signs and symptoms of infection and uses the hand-washing technique. Regarding the fourth diagnosis, the objective is partially achieved due to the presence of LPP between III and II degree, treatment and long-term care is required, the mother is instructed on how to cure the LPP at home, achieving participation and learning. In reference to the fifth diagnosis, the patient is mobilized every 2 to 3 hours with the help of the family member, hydrocellular patches are placed in areas at risk of LPP, the patient tolerates and collaborates.