Martha Rogers Case Study with Answers Mrs. P.

, a 56 year old female is admitted to the hospital with irretractable nausea and vomiting post chemotherapy and radiation. Symptoms include tachycardia with heart rates from 100-160's, nausea and vomiting, dehydration with headache and fatigue. She is complaining of generalized pain and weakness with a focus on a headache. Mrs. P. is surrounded by multiple family members and several small children who appear to be well meaning, but are coughing, sneezing, and talking loudly. Mrs. P is unfortunately placed in a semi-private room with a roommate who is eating Mexican food for lunch and laughing watching the loudly tuned TV. The nurse administers IVP narcotics for her pain and headache and an IVP antiemetic, but Mrs. P continues to complain of headache. Questions 1) Considering Rogers' Theory of Unitary Human beings where Rogers states "nurses are in constant mutual process with those for whom they care and have opportunities to pattern the environment for change" what immediate interventions could be initiated for Mrs. P? 2) Using Rogers' theory, what non-pharmacologic interventions could be utilized for pain management? 3) In what ways can the nurse alter the way care is provided during the shift in order to promote improvement in symptoms and provide a calming environment? 4) What can the nurse do so that family and visitors can help Mrs. P recover more quickly? 5) What can the nurse do help Mrs. P increase her appetite and help control nausea and vomiting? Answers 1) Immediate change in environment. If the patient has a headache it would be beneficial to remove loud noises. If the patient is nauseated facilitation of removal foul/obnoxious smells could aid in reduction of symptoms. Checking into the availability of private room to produce a calming atmosphere that ensures a noise reduction and provide a better environment for healing. 2) Calm quiet environment. Nursing can utilize comforting therapeutic touch, guided imagery or massage therapy. 3) Limit interruptions to Mrs. P's rest by grouping tasks together, for example, give medications and take vital signs together instead of separately. Limit the number of visitors until acute symptoms have improved and patient is ready to visit. Lower lights or turn them off, offer music to help distract and drown out noise in hallway, keep door closed, and warm blankets/cool compresses as needed. 4) The nurse needs to educate the family & visitors on chemotherapy and its effects. Hand washing being most important. Educate the reasoning that every visitor who is sick in anyway must stay home so the patient does not become more ill.

5) After getting the patient into a private room, the nurse can identify what foods the patient enjoys. The nurse should also encourage the patient to try small and frequent meals.