Casey Sandy

Post Clinical Week 2

Dx: Esophageal Cancer

1. Application of theory to practice:

Discuss one idea from nursing theory that relates to your client. Reflect on how you
integrated this theory into practice. Alternatively, discuss a theoretical framework that assisted
you in decision-making in your practice.

Neumans model is related to a client as an open system that responds to stressors in the
environment. When the stressors breakthrough such as illness; the lines of defense will
ultimately get activated. I can relate this theory to my patient because the stressors of esophageal
cancer requires care for the patient to achieve wellness. This was achieved by proper feeding
through an enteral feeding tube. Following agency policy there are specific protocol for flushing
through the tube and administering medication through the feeding tube. When I was flushing
the tube, I maintained turbulent flow. I became familiar with the feeding tube pump, this
included a 95ml/hr automatic flush, and filling the feeding bag with varying amount of cans
(feeding formula) to the patient.

2. Identify four abnormal laboratory/diagnostic tests that one may anticipate based on the
clients diagnosis:

Elevated Lymphocytes, abnormal Potassium levels, double contrast barium swallow.

Abnormal calcium levels.

Select two of the test results above and explain the rational for conducting the test; note the
test result; compare the abnormal result with the normal range; and interpret the reason for any
abnormal values as it relates to the clients condition.

1. Lymphocytes: Elevated due to infection. Patient more susceptible to infection due to

age associated with a weaker immune system. Lab test show 4 x 109 /L, normal lab
values for lymphocytes is 1-3 x 109 /L. This abnormal lab values can be associated
with the bodys response to cancer cells, showing an increased count.
2. Elevated potassium: showing 5.2 mmol/l, the normal value is 3.6-5.2 mmol/l. This can
be elevated because of cancer related therapy, which would cause an increase in the
amount of potassium in the blood stream.

3. Choose two prescribed medications for this client and include:

1. Generic & Trade Name: Ceftriaxone, Rocefin
Classification: Cephalosporin

Reason for Medication: Infection r/t to weaker immune system, used to treat many
bacterial infections.
 Casey Sandy

Nursing Implications: Continued monitoring of CBC. Checking comfort level of patient.

2. Generic & Trade Name: Lactulose, Constulose

Classification: Laxatives

Reason for Medication: Chronic constipation,

Nursing Implications: Monitor bowel movement, assessing stomach for distention, or

firmness. Comfort of patient.