1. Listen to the patient’s fears and concerns, and offer reassurance when appropriate.
2. Encourage the patient to use relaxation techniques to promote comfort during the diagnostic procedures.
3. Monitor the patient’s response to therapy through frequent Pap tests and cone biopsies as ordered.
4. Watch for complications related to therapy by listening to and observing the patient.
5. Monitor laboratory studies and obtain frequent vital signs.
6. Understand the treatment regimen and verbalize the need for adequate fluid and nutritional intake to promote tissue healing.
7. Explain any surgical or therapeutic procedure to the patient, including what to expect both before and after the procedure.
8. Review the possible complications of the type therapy ordered.
9. Remind the patient to watch for and report uncomfortable adverse reactions.
10. Reassure the patient that this disease and its treatment shouldn’t radically alter her lifestyle or prohibit sexual intimacy.
11. Explain the importance of complying with follow up visits to the gynecologist and oncologist.

1. Establish and maintain a patent airway as needed.
2. Administer supplemental oxygen as ordered.
3. Position the patient to promote pulmonary drainage and prevent upper airway obstruction.
4. Avoid placing the patient in the prone position as well as hyperextending his neck.
5. Suction secretions from the airway as necessary to prevent hypoxia and vasodilation from carbon dioxide accumulation.
6. Monitor pulse oximetry levels and arterial blood gas level as ordered. Use these levels as a guide to determine appropriate needs for supplemental oxygen.
7. Prepare the patient for emergency craniotomy, if indicated.
8. If surgery can’t be performed immediately, institute aneurysm precautions to minimize the risk of rebleeding and to avoid increasing the patient’s intracranial pressure.
9. Administer hydralazine or another antihypertensive agent as ordered.
10. Turn the patient often. Encourage deep breathing and leg movement.
11. Apply elastic stockings or compression boots to the patient’s legs to reduce the risk of deep vein thrombosis.
12. Give fluids as ordered and monitor I.V. infusions to avoid overhydration, which may increase ICP.
13. If the patient has facial weakness, assist him during meals; assess his gag reflex and place the food in the unaffected side of his mouth.
14. Implement a bowel elimination program based on previous habits.
15. Raise the bed’s side rails to protect the patient from injury.
16. Provide emotional support to the patient and his family.

1. Administer mild analgesics as needed.
2. Encourage the patient to express her concerns.
3. Have her perform as much self-care, as her immobility and pain allow.
4. Provide her adequate time to perform these activities at her own pace.
5. Monitor the effectiveness of analgesics and other forms of therapy used to relieve the patient’s discomfort.
6. Regularly assess the patient’s degree of physical mobility.
7. Teach the patient how to apply splint. Advise her not to make it too tight.
8. Show her how to remove splint to perform gentle range-of-motion exercises.
9. Advise the patient to occasionally exercise her hands in warm water.
10. If the patient is using a sling, tell her to move it several times a day to exercise her elbow and shoulder.
11. Review prescribed medication regimen. Emphasize that drug therapy may require 2 to 4 weeks before maximum effect is achieved.

1. Administer oxygen by face mask or artificial airway to ensure adequate oxygenation of tissues.
2. Adjust the oxygen flow rate to higher or lower level, as blood gas measurements indicate.
3. Administer an osmotic diuretic, such as mannitol, if ordered to increase renal blood flow and urine output.
4. Never flex the patient’s “ballooned” leg at the hip because this may displace or fracture catheter.
5. To ease emotional stress, allow frequent rest periods as possible.
6. Allow family members to visit and comfort the patient as much as possible.
7. Monitor and record blood pressure, pulse, respiratory rate, and peripheral pulse every 1 to 5 minutes until the patient stabilizes.
8. Record hemodynamic pressure readings every 15 minutes.
9. Monitor ABG values, complete blood count, and electrolyte levels.
10. During therapy assess skin color and temperature and note any changes. Cold and clammy skin may be a sign of continuing peripheral vascular constriction, indicating progressive shock.

1. Observe standard precautions.
2. Provide a nonirritating mouthwash to loosen tenacious secretions and a soft toothbrush to avoid irritation.
3. Relieve mouth discomfort with a topical anesthetic, such as lidocaine at least 1 hour before meals.
4. Apply cornstarch, nystatin powder, or dry padding in intertriginous areas of obese patients to prevent irritation and candidal growth.
5. Record dates of I.V. catheter insertion and replace the catheter according to hospital policy to prevent phlebitis.
6. Provide appropriate supportive care for patient’s with systemic infections.
7. Prepare to give blood transfusions if ordered and if the patient has low platelet count.
8. Frequently check the vital signs of a patient with systemic infection.
9. If you note a vaginal discharge, document the color and amount.
10. Carefully monitor intake and output and potassium levels while the patient is receiving medications.
11. If the patient has renal involvement, carefully monitor blood urea nitrogen, serum creatinine, and urine
12. Assess the patient with candidiasis for underlying systemic causes, such as diabetes mellitus, infection, or immune dysfunction.
13. Demonstrate comprehensive oral hygiene practices, and have the patient perform a return demonstration.
14. Recommend that the patient use alkaline mouth care products because increased acidity promotes candidal growth.
15. Tell the patient who’s using nystatin solution to swish it around in his mouth for several minutes before swallowing.
16. Suggest a soft diet for the patient with severe dysphagia.

1. Answer the patients questions and encourage him and his family to express their concerns about the illness.
2. As needed, perform chest physiotherapy, including postural drainage and chest percussion and vibration for involved lobes several times daily.
3. Make sure the patient receives adequate fluids (at least 3 liters per day) to loosen secretions.
4. Schedule respiratory therapy for the patient at least 1 hour before or after meals.
5. Provide mouth care after bronchodilator inhalation therapy.
6. Encourage daily activity and provide diversional activities as appropriate.
7. To conserve the patient’s energy and prevent fatigue, help him to alternate periods of rest and activity.
8. Administer medications as ordered and note the patient’s response to them.
9. Assess the patient for changes in baseline respiratory function.
10. Evaluate sputum quality and quantity, restlessness, increased tachypnea, and altered breath sounds. Report changes immediately.
11. Monitor the patient’s weight by weighing him three times weekly. Assess for edema.
12. Evaluate the patient’s nutritional status regularly.
13. Watch the patient for signs and symptoms of respiratory infection, such as fever, increased cough and sputum production, and purulent sputum.
14. Advise the patient to avoid crowds and people with known infections and obtain influenza and pneumococcus immunizations.

1. Provide supportive care and help the patient adjust to the lifestyle changes that irreversible lung damage necessitates.
2. Administer antibiotics, as ordered, and record the patient’s response to this medication.
3. Give oxygen as needed.
4. Perform chest physiotherapy, including postural drainage and chest percussion for involved lobes, several times per day, especially in the early morning and before bedtime.
5. Provide a warm, quiet, comfortable environment. Also help the patient to alternate rest and activity periods.
6. Give the patient well balanced, high calorie meals.
7. Offer small, frequent meals or nutritional supplements.
8. Make sure the patient receives adequate hydration to help thin secretions and promote easier removal.
9. Give frequent mouth care to remove foul-smelling sputum.
10. Provide the patient with tissues and waxed bag in which to dispose contaminated tissues.
11. Monitor the patient’s respiratory rate and pattern regularly.
12. Assess gas exchange by monitoring ABG values as ordered.
13. Observe the patient’s breath sounds and sputum production for changes that might indicate a respiratory infection or worsening condition.

1. Always evaluate the patient’s feelings about her illness and determine her level of knowledge and expectations.
2. Administer analgesics for pain as needed.
3. Perform comfort measures to promote relaxation and to relieve anxiety.
4. If immobility develops late in the disease, prevent complications by frequently repositioning the patient, using a convoluted foam mattress.
5. Provide skin care particularly in bony prominences.
6. Provide measures to relive adverse effects of treatment.
7. Instruct the patient or caregiver how to manage adverse effects of treatment.
8. Watch for treatment complications, such as nausea, vomiting, anorexia, leucopenia, thrombocytopenia, gastrointestinal ulceration, and bleeding.
9. Monitor patient’s weight and nutritional intake for evidence of malnutrition.
10. Inspect the skin for redness, irritation, and skin breakdown if immobility occurs.
11. In late disease, monitor the patient’s pain level and the efficacy of administered analgesics and non-pharmacologic measures.
12. Assess the patient’s and family’s ability to cope, especially if the cancer is terminal.