Your patient is a 52-year-old male with a history of smoking and alcohol abuse. He presents to the ED with complaints of “my skin looks yellow, my stomach hurts, and I feel nauseous”. He is taken to CT and a tumor near the pancreas is observed. It appears to be blocking the common bile duct. Develop a plan of care for the patient. Use the attached concept map. 

Pathophysiology: The patient is diagnosed with pancreatic cancer, which is a malignant neoplasm that arises from the pancreatic tissue. The tumor appears to be blocking the common bile duct, causing a backup of bile in the liver, leading to cholestasis and elevated bilirubin levels. The cancer may also invade surrounding structures, including blood vessels, nerves, and adjacent organs, leading to metastasis.

Clinical Manifestations: Subjective Data:

• Complaints of yellow skin and eyes (Jaundice)
• Abdominal pain
• Nausea and vomiting
• Loss of appetite and weight loss Objective Data:
• Yellow skin, sclera, and mucous membranes
• Dark urine and light-colored stools
• Abdominal tenderness and distension
• Elevated bilirubin levels
• Elevated liver enzymes
• Obstructive jaundice

Nursing Diagnosis:

1. Risk for Imbalanced Nutrition: Less Than Body Requirements related to decreased appetite and nausea evidenced by weight loss and poor dietary intake.
2. Acute Pain related to abdominal distension and pancreatic cancer evidenced by patient’s report of abdominal pain.

Nursing Interventions:

1. Monitor the patient’s nutritional status and intake, including fluid and electrolyte balance, daily weights, and calorie count.
2. Encourage small, frequent, high-calorie meals and snacks that are easy to digest and appetizing.
3. Administer antiemetic medications as prescribed to manage nausea and vomiting.
4. Refer to a dietitian for dietary counseling and education.
5. Assess the patient’s pain level using a pain scale and evaluate pain characteristics and location.
6. Administer pain medications as prescribed, including non-pharmacologic interventions, such as relaxation techniques.
7. Provide comfort measures such as positioning, heat or cold therapy, and distractions.
8. Collaborate with the healthcare team to address the underlying cause of pain.

Goals:

1. Patient will maintain a stable weight and have adequate intake of essential nutrients within 5 days.
2. Patient’s pain will be reduced by 50% within 24 hours.

In conclusion, developing a plan of care for a patient with pancreatic cancer involves addressing the underlying pathophysiology, identifying clinical manifestations, and creating nursing diagnoses with appropriate interventions and goals. By providing comprehensive care, the nurse can help improve the patient’s quality of life and manage symptoms associated with the disease.