Republic of the Philippines

Central Mindanao University

University Town, Musuan, Maramag, Bukidnon
COLLEGE OF NURSING

HEALTH PARTNER OUTPUT (SENIOR CITIZEN AND ELDERLY WITH CHRONIC

PROBLEMS)

PANCREATIC CANCER

PREPARED BY:
LOUIE JOHN C. ABILA

FANNY LUDZ Q. SAGPANG RN, MSN, MBA

CLINICAL INSTRUCTOR

OCTOBER 2018
 I. Introduction
Pancreatic Cancer
The pancreas is a six- to eight-inch long, slipper shaped gland located in the
abdomen. It lies behind the stomach, within a loop formed by the small intestine. Other
nearby organs includes the gallbladder, spleen, and liver. The pancreas has a wide end
(head), a narrow end(tail), and a middle section (body). A healthy pancreas is important
for normal food digestion and also plays a critical role in the body's metabolic processes.
The pancreas has two main functions, and each are performed by distinct types of tissue.
The exocrine tissue makes up the vast majority of the gland and secretes fluids into the
other organs of the digestive system. The endocrine tissue secretes hormones (like
insulin) that are circulated in the bloodstream, and these substances control how the body
stores and uses nutrients. The exocrine tissue of the pancreas produces pancreatic
(digestive) juices. These juices contain several enzymes that help break down proteins
and fatty foods. The exocrine pancreas forms an intricate system of channels or ducts,
which are tubular structures that carry pancreatic juices to the small intestine where they
are used for digestion.
Pancreatic tumors are classified as either exocrine or endocrine tumors depending
on which type of tissue they arise from within the gland. Ninety-five percent of pancreatic
cancers occur in the tissues of the exocrine pancreas. Ductal adenocarcinomas arise in
the cells that line the ducts of the exocrine pancreas and account for 80% to 90% of all
tumors of the pancreas. Unless specified, nearly all reports on pancreatic cancer refer to
ductal adenocarcinomas. Less common types of pancreatic exocrine tumors include
acinar cell carcinoma, cystic tumors that are typically benign but may become cancerous,
and papillary tumors that grow within the pancreatic ducts. Pancreatoblastoma is a very
rare disease that primarily affects young children. Two-thirds of pancreatic tumors occur
in the head of the pancreas, and tumor growth in this area can lead to the obstruction of
the nearby common bile duct that empties bile fluid into the small intestine. When bile
cannot be passed into the intestine, patients may develop yellowing of the skin and eyes
(jaundice) due to the buildup of bilirubin (a component of bile) in the blood stream. Tumor
blockage of bile or pancreatic ducts may also cause digestive problems since these fluids
contain critical enzymes in the digestive process. Depending on their size, pancreatic
tumors may cause abdominal pain by pressing on the surrounding nerves. Because of its
location deep within the abdomen, pancreatic cancer often remains undetected until it
has spread to other organs such as the liver or lung. Pancreatic cancer tends to rapidly
spread to other organs, even when the primary (original) tumor is relatively small.
Sign and Symptoms
 Pancreatic cancer is sometimes called a "silent killer" because early
pancreatic cancer often does not cause symptoms, and the later symptoms
are usually nonspecific and varied. Therefore, pancreatic cancer is often not
diagnosed until it is advanced. Common symptoms include:
  Pain in the upper abdomen that typically radiates to the back (seen in
carcinoma of the body or tail of the pancreas)
 Loss of appetite and/or nausea and vomiting
 Significant weight loss
 Painless jaundice (yellow skin/eyes, dark urine) when a cancer of the head
of the pancreas (about 60% of cases) obstructs the common bile duct as it
runs through the pancreas. This may also cause pale-colored stool and
steatorrhea.
 Trousseau sign, in which blood clots form spontaneously in the portal blood
vessels, the deep veins of the extremities, or the superficial veins anywhere
on the body, is sometimes associated with pancreatic cancer.
 Diabetes mellitus, or elevated blood sugar levels. Many patients with
pancreatic cancer develop diabetes months to even years before they are
diagnosed with pancreatic cancer, suggesting new onset diabetes in an
elderly individual may be an early warning sign of pancreatic cancer.
 Clinical depression has been reported in association with pancreatic
cancer, sometimes presenting before the cancer is diagnosed. However,
the mechanism for this association is not known

II. ANATOMY AND PHYSIOLOGY

The pancreas is part of the digestive system. It lies in the upper half of the
abdomen, well above the tummy button (navel), on a level with the V where the ribs meet
at the front. It’s deep inside the abdomen, lying just in front of the spine. It is about 15cm
(6 inches) long. The large rounded section on the right-hand side of the body is called the
head of the pancreas, the middle part is known as the body of the pancreas and the
narrow part on the left-hand side of the body is called the tail of the pancreas. The head
of the pancreas lies next to the first part of the small intestine, which is called the
duodenum. The pancreas is an elongated, tapered organ located across the back of the
abdomen, behind the stomach. The right side of the organ (called the head) is the widest
part of the organ and lies in the curve of the duodenum (the first section of the small
intestine). The tapered left side extends slightly upward (called the body of the pancreas)
and ends near the spleen (called the tail). The pancreas is made up of two types of tissue:
Exocrine tissue. The exocrine tissue secretes digestive enzymes. These enzymes are
secreted into a network of ducts that join the main pancreatic duct, which runs the length
of the pancreas. Endocrine tissue-The endocrine tissue, which consists of the islets of
Langerhans, secretes hormones into the bloodstream.
Functions of the pancreas:
The pancreas has digestive and hormonal functions:
The enzymes secreted by the exocrine tissue in the pancreas help break down
carbohydrates, fats, proteins, and acids in the duodenum. These enzymes travel down
the pancreatic duct into the bile duct in an inactive form. When they enter the duodenum,
they are activated. The exocrine tissue also secretes a bicarbonate to neutralize stomach
acid in the duodenum. The hormones secreted by the endocrine tissue in the pancreas
are insulin and glucagon(which regulate the level of glucose in the blood), and
somatostatin (which prevents the release of the other two hormones).
The position of the pancreas
The pancreas produces a fluid which helps to digest food (pancreatic juice) and a
hormone which enables the body to use sugars and store fats (insulin). The digestive
juices produced by the pancreas flow down a tube (the pancreatic duct) into the
duodenum. The bile duct drains bile from the liver, into the duodenum, and joins the
pancreatic duct at the sphincter of Oddi just as it enters the duodenum. The position of
the pancreas.
III. THEORETICAL FRAMEWORK

Florence Nightingale Environmental Theory´

Nightingale is viewed as the mother of modern nursing. She synthesized
information gathered in many of her life experiences to assist her in the development of
modern nursing. Her contribution to the nursing profession was her Environmental
Theory´ in which the nurses role is to place the client in the best position for nature to act
upon him, thus encouraging healing. Nightingale viewed the manipulation of the physical
environment as a major component of nursing care. She identified ventilation and warmth,
light, noise, variety, bed and bedding, cleanliness of the rooms and walls, and nutrition
as major areas of the environment the nurse could control. When one or more aspects of
the environment are out of balance, the client must use increased energy to counter the
environmental stress. These stresses drain the client of energy needed for healing. These
aspects of physical environment are also influenced by the social and psychological
environment of the individual.
I as a student nurse and part of the medical field, has the role of providing nursing
care with the help of the institutions and personnel involve to cure the illness and lower
down the factors causing the patient’s disease with the help of Nightingale’s
Environmental Theory.
Biographical Data

PATIENT’S PROFILE

Patient’s Name: Maria G. Bagamasbad

Age: 65 years old
Birthday: May 18, 1954
Sex: female
Birth place: Iloilo Paviya
Civil Status: Married
Address: Purok- 4 Poblacion Valencia City Bukidnon
height:
Educational Attainment: College Graduate
Weight: 49 kg
Occupation: Government Employee Retiree
Nationality: Filipino
Religion: Roman Catholic

Vital Signs:

T: 36.0 degree celcius

PR: 83 bpm
RR: 19cpm
BP: 130/80
DATE: SEPTEMBER 15, 2018
HEAD TO TOE PHYSICAL ASSESSMENT
GENERAL
INTEGUMENTARY SYSTEM
(SKIN, HAIR, NAILS, APPENDAGES)
HEENT
(HEAD, EYES, NOSE, EARS,THROAT)
CARDIOVASCULAR SYSTEM
(CENTRAL & PERIPHERAL)
RESPIRATORY SYSTEM
GASTROINTESTINAL SYSYTEM
URINARY SYSTEM
The client appears weak, clean, responsive and
cooperative, have long-term memory, and the patient
is oriented to time, person and place.
The client has poor skin turgor, the hair are evenly
distributed and there are plenty of white hairs noted
the nails are clean but pale and also to her both feet
and also the she has yellow skin (jaundice) noted.
Normal, Good capillary refill, Skin is warm dry and
intact color.
There is no problem with her head, eyes, nose, ears,
and throat. In second visit the client’s eyes has turn to
yellow. Normal symmetrically, scalp clean without
lesion, no dandruff, No earache, deafness, tinnitus, no
vertigo or discharge, No diplopia, itching, dry eyes, eye
pain or photophobia, orbits normal, Normal membrane
pink and moist. Throat is Flexible. Normal pulsations,
no palpable thyromegaly, no palpable Lymph nodes,
trachea central, no JVD, Normal lips, Buccal mucosa is
dry, Normal looking teeth and gums.
There is no problem with her cardiovascular and her
pulse is 80 beats per minute, the veins are visible, no
Tachycardia. Normal S1, S2 No murmurs.
There is no problem with her respiration and her
respiration is 19 cycles per minute. She has no asthma
or other respiratory problems. Normal contour of the
chest with symmetrical motion. Clear to auscultation
bilaterally, No dyspnea, No pleural rub.
Upon assessment the patient weight is 49 kg, and in
second assessment is the client losses 4 pound and the
patient has a loss of appetite, abdominal pain. No
Scars, Hypoactive bowels sound, 4 quadrants. Pt is very
tender in the right upper quadrant and mid
epigastrium, she is complaining of tenderness all over
her back and abdomen. Murphyis negative.
During assessment the patient has a catheter on her
part where the pancreas is located and the color of
urine is dark colored urine and its about 300 ml of
urine. The patient stated that she only drinks a water
for about 4 glasses each day
 The client has weak muscle because the client is old
MUSCULOSKELETAL SYSTEM and her age of 65 years old. And the client has poor
muscle tone. No pedal edema Peripheral pulses normal
negative joint swelling.

The client is weak and can’t work on her activities.

NUEROMUSCULAR SYSTEM Sensation is intact, Cranial nerves II – XII intact

She has no sexual intercourse with her husband

REPRODUCTIVE SYSYTEM because her uterus is been removed in the past, and
also with her aged is 65.

GROWTH AND DEVELOPMENT

Age 65+ (older adulthood)- Although the average life expectancy is 79 for females and
72 for males, older adulthood can easily extend 20 years or more beyond these figures.
As older adults age, most report increasing health problems. Even so, only about 5
percent of adults over age 65 and 25 percent of those over age 85 live in nursing
homes, foster care (where elderly people live with a family licensed by the state to care
for aging adults), or other long‐term care facilities. With medical advances and
continued improvements in health‐care delivery, the older population is expected to
increase in its numbers and report better health.

Although most older adults have at least one chronic health problem, such ailments
need not pose limitations on activities well into the adults' 80s and beyond. The most
common medical concerns during older adulthood are arthritis and rheumatism, cancer,
cataracts of the eyes, dental problems, diabetes, hearing and vision problems, heart
disease, hypertension, and orthopedic injuries. Because the elderly are at greater risk
of losing their balance and falling, hip fractures and breakages are particularly common
and dangerous in this age group.

Daniel Levinson depicts the late adulthood period as those years that encompass age
65 and beyond. Other developmental psychologists further divide later adulthood into
young‐old (ages 65–85) and old‐old (ages 85 and beyond) stages.Today, 13 percent
of the population is over the age of 65, compared with 3 percent at the beginning of this
century. This dramatic increase in the demographics of older adulthood has given rise
to the discipline of gerontology, or the study of old age and aging. Gerontologists are
particularly interested in confronting ageism, or prejudice and discrimination against
older adults.Aging inevitably means physical decline, some of which may be due to
lifestyle, such as poor diet and lack of exercise, rather than illness or the aging process.
Energy reserves dwindle. Cells decay. Muscle mass decreases. The immune system
is no longer as capable as it once was in guarding against disease. Body systems and
organs, such as the heart and lungs, become less efficient. Overall, regardless of
people's best hopes and efforts, aging translates into decline. Even so, the speed at
which people age, as well as how aging affects their outlook on life, varies from person
to person. In older adulthood, people experience both gains and losses. For instance,
while energy is lost, the ability to conserve energy is gained. Age also brings
understanding, patience, experience, and wisdom—qualities that improve life
regardless of the physical changes that may occur.

Aging in late adulthood profoundly affects appearance, sensation, and motor abilities.
An older adult's appearance changes as wrinkles appear and the skin becomes less
elastic and thin. Small blood vessels break beneath the surface of the skin, and warts,
skin tags, and age spots (liver spots) may form on the body. Hair thins and turns gray
as melanin decreases, and height lessens perhaps by an inch or two as bone density
decreases. The double standard of aging applies to men and women in older adulthood
just as it did in middle adulthood. Older men may still be seen as distinguished, while
older women are labeled as grandmotherly, over the hill, and past the prime of life.

During late adulthood, the senses begin to dull. With age, the lenses of the eye discolor
and become rigid, interfering with the perception of color and distance and the ability to
read. Without corrective glasses, nearly half the elderly population would be legally
blind. Hearing also diminishes, especially the ability to detect high‐pitched sounds. As
a result, the elderly may develop suspiciousness or even a mild form of paranoia—
unfounded distrustfulness—in response to not being able to hear well. They may
attribute bad intentions to those whom they believe are whispering or talking about
them, rather than correctly attributing their problems to bad hearing. Hearing problems
can be corrected with hearing aids, which are widely available. The sense of taste
remains fairly intact into old age, even though the elderly may have difficulty
distinguishing tastes within blended foods. By old age, however, the sense of smell
shows a marked decline. Both of these declines in sensation may be due to
medications, such as anti hypertensives, as well as physical changes associated with
old age. In addition to changes in appearance and the dulling of the senses, reflexes
slow and fine motor abilities continue to decrease with old age. By late adulthood, most
adults have noticed a gradual reduction in their response time to spontaneous events.
This is especially true of older adults who drive. However, many elderly are hesitant to
give up driving because the sacrifice would represent the end of their personal
autonomy and freedom.
Generally, older adults score lower overall on tests of manual dexterity than do younger
adults. Older adults may find that their fine motor skills and performance speed
decrease in some areas but not in others. For instance, an elderly lifelong pianist may
continue to exhibit incredible finger dexterity at the keyboard, but may at the same time
find that taking up needlepoint as a hobby is too difficult.

Erikson: Psychosocial Development Erikson has included older adulthood in

his psychosocial theory of human
development (Table 13-1). The
psychosocial challenge for this
developmental stage is ego integrity
versus despair. Older adults can reflect
on the events and decisions of their lives.
Individuals achieve ego integrity when
they sense that their lives have meaning
and have been worthwhile. They are
comfortable with past resolutions and do
not regret past decisions. If older adults
do not meet the challenges of aging, they
are likely to feel that life is too short.
Regrets and feelings of failure may
envelop them. Individuals may have
feelings of despair if they cannot accept
that death is part of the normal life cycle.

A self-review, which may be called life

review, can help older clients avoid
feelings of failure, depression, and
despair. By reviewing life’s events, older
adults can gain a new, more positive
perspective on the conflicts of earlier
stages. When working with older clients
in healthcare practice, you can
encourage reminiscence. Listening to
older adults describe past joys and
successes increases a person’s
satisfaction and self-esteem.
 Developmental Tasks of Later Maturity

Robert Havighurst’s Developmental Tasks

Developmental Description Passed or Failed Justification

Tasks

1. Adjusting to Older adults also Passed Our patient is

decreasing have to adjust to aware about his
physical strength decreasing health and is very
and health physical strength cooperative on the
and health. The student nurses
prevalence of who provide care
chronic and acute to him. He is
diseases increase cooperative in
in old age. Thus, away that he
older adults may follows the
be confronted with student nurses in
life situations that procedures like
are characterized removing the
by not being in catheter. Also,
perfect health, when giving meds,
serious illness he does not refuse
and dependency in taking the due
on people. meds given to
him.

2. Adjusting to A central Passed Our patient is not

retirement and developmental receiving pension
reduced income. task that but gets his
characterized the income from his
transition into old farm (banana
age is adjustment plantation) and
to retirement. The his photo studio.
period after He is a
retirement has to photographer by
be filled with new experience
projects, but is according to his
characterized by grandchildren. His
few valid cultural annual income at
guidelines. The
achievement of
 this task may be his photo studio
obstructed by the is 200,000 pesos.
management of
another task,
living in a reduced
income after
retirement.

3. Adjusting to Older adults may Passed When asked, the

death of a spouse become patient stated that
Older adults may caregivers to their his wife is already
become spouses. Some dead. He accepts
caregivers to their older adults have that he is now a
spouses. to adjust to the widow. His
death of their deceased wife's
spouses. After name is Susanna.
they have lived She died on
with a spouse for November 7, 2005
many decades, due to cancer (not
widow hood may specified). They
force older people had 9 children
to adjust to
loneliness,
moving to a
smaller place, and
learning about
business matters.

4. Establishing an The development Passed Our patient is a

explicit affiliation of a large part of member of PHIC
with one's aged the population and a
group into old age is congregation of
historically recent Jehovah's
phenomenon to witnesses in
modern cities. Panabo City.
Thus, According to him,
advancements they have
understanding of 7congregations in
the aging process Panabo and it is
may lead to composed of
identifying further 100members per
 developmental
tasks associated
with gains and
purposeful lives
for adults.
5. Meeting social Older people Passed
and civil might accumulate
obligations knowledge about
life, and thus may
contribute to the
development of
younger people
and the society
6. Establishing Oder adults are Passed
satisfactory generally
physical living challenged to
arrangements create positive
esense of their
lives as a whole.
The feeling that
life has order and
meaning results in
happiness
congregation. In
their
congregation,
their focus is on
teaching the good
news of Jehovah.
He also
mentioned that he
has friends of the
same age group
namely Helson
Daclan who
delivers meds and
Oscar Emier.
Our patient tells
stories about his
childhood life to
his grandchildren.
He shares
experiences to
them which
served as a guide
and lesson.
Our patient lives
in a subdivision in
a Panabo City
together with his
daughter.
According to him,
his daughter is
the only one who
is not married
among his
children. All eight
had their own
families
nonetheless he

Eric Erikson’s Developmental Task
Integrity vs. Despair
sometimes would
visit them.
Erikson felt that much of life is
preparing for the middle adulthood
stage and the last stage recovering
from it. Perhaps that is because as
older adults we can often look back on
our lives with happiness and are
contented, feeling fulfilled with a deep
sense that life has meaning and we've
made contribution to life, a feeling
Erikson called integrity. On the other
hand, some adults may reach this
stage and despair at their experiences
and perceived failure. Our patient
achieved happiness and contentment
in his life based on his actions and
speeches. He is faithful and devoted to
his religion. When asked what his
principle in life he said is, “Mamatay
man kun buhi, mapabilin kay
Jehovah”. He is ready to accept death
completely and he has shared his
experiences to his beloved
grandchildren. Even though he
accepted death fully but his faith and
love for his worshipped God never
changed.
GORDON’S FFUNCTIONAL HEALTH PATTERN

I.HEALTH PERCEPTION-MANAGEMENT PATTERN

usual health status: weak

tobacco use: None
alcohol use: None
immunization history: Complete
regular breast exam: every month
recent surgery: Hysterectomy (removal of uterus)

NOTE:

II. NUTRIRIONAL METABOLIC PATTERN

Weight: 49kg loss: 4 pounds gain: none
Appetite Description:
Good: Fair: Poor: poor
Food Intolerance: None
Dietary restrictions: None
Usual food intake: Foods that are available
Fluid intake: Water
Food likes/dislikes: None
PROBLEMS: Nausea, Vomiting
Swallowing: None Chewing: None Digestion:
Breastfeeding:(freq. Prob. Belief. Concerns)

III. ELIMINATION PATTERN:

Bowel Habits: every day

Characteristics:
-color: yellow, sometimes green
-consistency: Small like goats stool
-constipation: Sometimes
-Diarrhea: Sometimes
Voiding pattern: Sometimes when the clients eat a lot
Pain: none

IV. ACTIVITY-EXERCISE PATTERN

Occupation: retired employee in city hall
Daily Activities: none
 Morning-
 Afternoon-
 Evening-
Hobbies: watching tv
Exercises: none
Medical conditions that limit activities: Pancreatic cancer
V. SLEEP-REST PATTERN
Usual sleep habits: 8 pm to 6 am
Hours of sleep: 10 hours
Hours of nap: 2 hours
Sleep problems: can’t sleep properly because she has a catheter on her body
where the pancreas is located.
Methods to promote sleep: Relax and Calm

VI. COGNITIVE-PERCEPTUAL PATTERN

Pain: None
Location: None
Intesnsity: None pain scale: None
Educational level: College graduate
Sensory Status:
 Vision- She has no problem with her vision.
 Hearing- She has no problem with her hearing.
 Language- She has no problem with her language.
 Memory- She has no problem with her memory.

VII. SELF PERCERTION AND SELF-CONCEPT PATTERN

During assessment the patient appears: weak, neat, cooperative and responsive and
also oriented to time and place and person.
Perception about hospitalization: She is nervous on her in and out hospitalization
Fears about current situation: Fear of Death

VIII. ROLE-RELATIONSHIP PATTERN

Married: Yes Single: no
No. Of children: five (5)
Recent admission that cause changes in family role: Last month
The client is limit on her activities

IX. SEXUALITY AND REPRODUCTIVE:

Date of LMP: none

Birth control methods: none
History of vaginal discharges/lesions: none
Satisfied with sexual relationships: none
Type of Delivery: none

X. COPING-STRESS TOLERANCE PATTERN

Stressful/Traumatic events in past: she has a surgery in the past

Rate unusual handling of stress: stress in handling the situation specially right now
having pancreatic cancer
Coping mechanism: Watching Televison
Primary way to deal with stress: avoid thinking of the problem

XI. VALUE-BELIEF PATTERN

Religion: Roman Catholic

Satisfied with your life has been developing: Yes
Religious restrictions: None
Religious beliefs helped you deal problems in the past: Yes
DATE: SEPTEMBER 15, 2018
Problems Identified
Nutrition We know that the cancer may affect the
functionality of your pancreas, which may
affect your ability to digest food properly.
Pancreatic insufficiency is the inability of
the pancreas to make or secrete the
enzymes needed for digestion. Having an
insufficient amount of pancreatic
enzymes can cause digestive issues and
is a very common problem for pancreatic
cancer patients. The client has a problem
in her nutrition especially she has a poor
appetite, lesser food intake and her
weight losses for about 4 pounds.
Body Functioning The client has a problem in body
functioning like she experience many
signs and symptoms such as back pain,
nausea, vomiting, abdominal pain,
darkening of stool, dark-colored urine and
her skin is yellowish (Jaundice). And also
unexplained weight loss, and has a
catheter on her part of her abdomen that
is located in the part of pancreas.

Date: September 22, 2018

Problems Identified
Nutrition We know that the cancer may affect the
functionality of your pancreas, which may
affect your ability to digest food properly.
Pancreatic insufficiency is the inability of
the pancreas to make or secrete the
enzymes needed for digestion. Having an
insufficient amount of pancreatic
enzymes can cause digestive issues and
is a very common problem for pancreatic
cancer patients. The client has a problem
in her nutrition especially she has a poor
 appetite, lesser food intake and
unexplained weight loss.
Body Functioning The client has a problem in body
functioning like she experience many
signs and symptoms such as back pain,
nausea, vomiting, abdominal pain,
darkening of stool, dark-colored urine and
her skin is yellowish (Jaundice). And also
unexplained weight loss, and has a
catheter on her part of her abdomen that
is located in the part of pancreas.

Date: September 30,2018

Problems Identified
Nutrition We know that the cancer may affect the
functionality of your pancreas, which may
affect your ability to digest food properly.
Pancreatic insufficiency is the inability of
the pancreas to make or secrete the
enzymes needed for digestion. Having an
insufficient amount of pancreatic
enzymes can cause digestive issues and
is a very common problem for pancreatic
cancer patients. The client has a problem
in her nutrition especially she has a poor
appetite, lesser food intake and
unexplained weight loss.
Body Functioning The client has a problem in body
functioning like she experience many
signs and symptoms such as back pain,
nausea, vomiting, abdominal pain,
darkening of stool, dark-colored urine and
her skin is yellowish (Jaundice). And also
unexplained weight loss, and has a
catheter on her part of her abdomen that
is located in the part of pancreas.
Nursing Diagnosis and Interventions
 Evaluation
In this case study, we were able to assess the client properly and gain baseline
data by building rapport with the client and his significant others. We have formulated the
correct diagnosis based from the thorough assessment done to the client. And based
from it we were able plan the actions that are to be done through the problem which has
been addressed and found through the assessment. We have been able to give the
appropriate nursing interventions with efficiency and observance to the 11 core
competencies and able to achieve the expected outcomes and gain a positive response
from the client with the interventions done. The client understand the instructions given
about taking the maintenance properly and the client resume daily activities which aides
in achieving and maintaining an optimum level of wellness and heath. The clients follow
on the proper drinking pattern, client have follow-up check up to monitor her condition.
The client to eat foods less in fat and sodium and also the client to increase oral fluid
intake.
 Reflection
First of all I’m so glad because I finish this requirement all by myself and it is really
overwhelming and it’s nice to hear that I finish it all. Based on this activity I’ve learned a
lot about caring for a client that is an elderly 65 years old who is suffering from pancreatic
cancer. Providing health teaching, lectures about her condition every visit and also
rendering nursing procedures that is appropriate to her condition.