A65-year-old male was admitted for evaluation of pain on swallowing and a sore throat that has persisted for the past year. the discomfort has not changed with the use of various over the counter cold remedies. the client has lost weight due to a decrease in appetite and difficulty swallowing. he has smoked 3 packs of cigarettes a day for 40 years. a laryngoscopy showed a subglottic mass. the client had a total laryngectomy with a tracheostomy to manage laryngeal cancer. he also has a nasogastric tube in place.
you will be providing care for this client during his first 72 hours after surgery.
a. select one nanda-i nursing diagnosis and describe why it is a priority for this client.
b. what is the cause or related factor for this nanda-i nursing diagnosis?
c. identify an outcome for this nanda-i nursing diagnosis. the outcome must be patient-centered and measurable.
d. identify two (2) nursing interventions that will this client achieve the outcome.
e. describe how each intervention will the patient achieve the outcome.

Mr rogers is 2 days postoperative of a thoracotomy of removal of a malignant mass in his left chest. his pain is being managed via epidural catheter with morphine. as the nurse assumes care of mr rogers, he is alert and fully oriented and states that his current pain is 2 on a 1 -to-10 scale. his vital signs are 37.8-92-12, 138/82. what are benefits of epidural versus systemic administration of opioids? the nurse monitors mr roger’s respiratory status and vital signs every 2 hours. what is the rationale for this frequent assessments? the nurse monitors mr rogers for what other complications of epidural anelgesis?

A10-year-old girl suffered from a rare malignancy in her brain and around her spinal cord. she had surgery, and most of the tumor mass was removed, but residual tumor remained in the brain and around the spinal cord. the girl's doctors informed her parents that chemotherapy and radiation were possible treatment options but could cause serious problems such as sepsis, a permanent loss of iq and stature, and even death. the parents wished to proceed with the therapy. while their child was undergoing aggressive chemotherapy and radiation, the parents did independent research and read of several drugs being administered for cancer in other states that were unapproved by the federal drug administration (fda) and were illegal in their home state but were touted by physicians using them as miracle cures." furthermore, one of the girl's doctors released the girl's medical records to another physician to get a "second opinion" without informing the parents. this particular physician is a member of the same country club as the parents. he happens to share facts from the medical records with other members who end up telling the girl's parents. the couple sued their child's physician for failure to disclose alternative treatments, thus depriving them of informed consent. the couples also sued the child's physician for sharing their daughter's records in violation of the girl's privacy. how should the court rule in both cases? did the child's physician involved follow the law? did he act ethically in either situation? explain your answer. under the doctrine of informed consent, should a physician be responsible for informing patients of all treatment options, even if some of the treatments are illegal or not yet proven effective?

Anurse is caring for a client who has diabetes mellitus and is taking pioglitazone. the nurse should plan to monitor the client for which of the following adverse effects? a. tinnitus b. insomnia c. fluid retention d. orthostatic hypotension