The patient described in this case scenario is Emanuel Jones, a 60-year-old male who has been diagnosed with small cell carcinoma. He has previously undergone surgery to remove the left lower lobe of his lung and is currently receiving chemotherapy. Two weeks before his next round of chemotherapy, routine laboratory tests were performed, including a complete blood count with differential and a renal and metabolic profile. At his visit to the oncology clinic, he presents with a fever of 101°F and further assessment reveals decreased breath sounds in the right base of the right lung, a productive cough with green-colored mucus, and shortness of breath. His pulse oximetry reading is 85% on room air, indicating poor oxygen saturation. Additionally, the patient has a history of benign prostate hypertrophy (BPH) and complains of urinary frequency and burning upon urination.
Based on the patient’s symptoms and examination findings, the decision is made to admit him to the oncology unit in the hospital. The oncologist orders several investigations to further evaluate his condition. These include blood, sputum, and urine cultures to identify any potential infections. A chest x-ray is also ordered to assess the lung pathology. In addition, an x-ray of the kidneys, ureters, and bladder (KUB) is ordered to evaluate the patient’s urinary symptoms. Furthermore, an arterial blood gas (ABG) on room air, a CBC with differential, and a renal and metabolic profile are ordered to assess the patient’s overall health status.
In order to address the patient’s low oxygen saturation, supplemental oxygen is prescribed. The initial oxygen delivery method selected is nasal cannula at a flow rate of 2 L/min, with the goal of maintaining the patient’s oxygen saturation (SaO2) above 90%. This is a conservative approach, as higher flow rates or alternative oxygen delivery devices might be required if the patient’s oxygenation does not improve adequately.
Antibiotic therapy is also initiated due to the patient’s clinical presentation and suspicion of a possible respiratory infection. Levofloxacin, a broad-spectrum antibiotic effective against a wide range of bacteria, is selected for treatment. It is administered intravenously over 60 minutes once daily, with a dose of 500 mg diluted in 100 mL of normal saline solution (NS). The choice of levofloxacin is based on its proven efficacy against common respiratory pathogens and its suitability for intravenous administration.
In another aspect of oncology care, the oncology clinical nurse specialist (CNS) is tasked with developing a staff development program for registered nurses who will be responsible for administering chemotherapeutic agents to oncology patients. The CNS plans to provide an overview of various chemotherapeutic agents, their classifications, and the special precautions required for their safe handling and administration. This program will equip the nurses with the necessary knowledge and skills to administer chemotherapy safely, reducing the risk of drug errors or adverse events.
Overall, this case highlights the importance of a comprehensive approach to patient care in oncology. From accurate diagnosis and effective treatment selection to appropriate supportive measures and staff education, a multidisciplinary approach is critical to optimize outcomes for patients undergoing cancer treatment.
