CASESTUDYEco601235802Paula601235815Vicky601235812CONTENTSBasicinformationofthepatientTreatmentNursingcareplanBasicinformationofthepatientName:AunlamoolGender:MaleAge:48Maritalstatus:MarriedDateofhospitaladmission:15/6/2018Diagnosis：lungcancerandhemoptysisPasthistoryillness:IIIlungcancer（NSCLCT3N0M1a），SLPchemotherapyOnJune14,patienthadanintermittentlyhemoptysismorethan20timesandthevolumeofhemoptysisabout200ml.Aftercontactingtheemergencydepartment,thepatientwastakenfromthestretchertotheemergencydepartmentfortreatment.ThedoctororderedIVdropsNSS1000ml，vitalsigns:T=36.9℃,P=116bpm;R=20bpm,BP=125/82mmHg，O2saturation=94%.Pasthistory:CBC,Hb12g/Dl,Hct37.3%,WBC7780/cu.mm,Neutrophil88.4%Eosinophil1.7%Lympocyte7.8%Monocyte3.6%Basophil0%Platelet272000APTT27.80TT0.89MCV79,RDW14.8Totalprotein8.0gm/dLAlbumin4.37gm/dLGlobulin:8.7gm/dLCholesterol:173mmol/LTotalBil:0.33μmol/LDirectBil:0.15μmol/L.Laboratoryresult（EmergencyDepartment）InJune15afternoon,thepatientwastransferredtomaleward3fromtheemergencydepartmentwithgoodconsciousness.Nochestpainbuthewasworriedabouthiscondition.Patienthascoughduringnight,sleepsnotverywell.Givethepatientcontinuousoxygeninhalation.Onadmission,hisvitalsigns:T=36.7℃,P=120bpm;R=20bpm,BP=123/80mmHg，O2saturation=95%.Pasthistory:AboutNSCLCThereare2maintypesoflungcancernon-smallcelllungcancer(NSCLC)(80%-85%)smallcelllungcancer(SCLC)(80%-85%)Lungcancerisoneofthemostcommontypesofcancer，duetocancer-causingsubstances(carcinogens)intheairareinhaledandcausecelldamagethatlaterbecomescancer.Themostcommoncauseoflungcancer,byfar,issmoking.isadiseaseinwhichmalignant(cancer)cellsforminthetissuesofthelung.SquamouscellcarcinomaLargecellcarcinomaAdenocarcinomaComplications：Thecancerspreadingtootherareasofpatient'sbodyAsideeffectoftreatmentplan，likeChemotherapyHemoptysis•Hemoptysisistheexpectorationofbloodorblood-tingedsputumfromthelungsortracheobronchialtree.•Duringtheclinicalcourseofnonsmallcelllungcancer(NSCLC),20–60%ofpatientswilldevelophaemoptysis,with5–10%ofcasesconsideredsevere.•Colorandamountofbleedingisusefulinthedifferentialdiagnosisofhemoptysis.•Emergencymanagementdependsuponlocalizationofthesiteofbleedingbyroentgenogram,computerizedchesttompgraphyandbronchoscopy.Thirddayafteronadmission,heisingoodconsciousness,asmallamountofhemoptysis,intermittentcough，nochestpain,theconditionisstable,thelaboratoryresultsarestable,givethepatientthedischargeofthehospitalinaccordancewiththedoctor'sorders.Hisvitalsigns:T=36.3℃,P=108bpm;R=20bpm,BP=120/70mmHg，O2saturation=98%.CurrentconditionHomemedication:Codepect1x3CpcFluimucil200mg1x3CpcLaboratoryresultB.U.N13mg/dlCreatinine1.1mg/dlNa135mEq/LK4.2mEq/LCl97mEq/LtotalCO224mEq/LtotalCa8.7mg/dLInorganicP2.7mg/dlMg1.51mEq/Lliverfunctiontest15/6totalprotein(6.0-8.5gm/dl)8.0Albumin(3.2-5.0gm/dl)4.3Globulin(2.8-3.5gm/dl)3.7Alk.Phos(23-98U/L)69Cholesterol(150-250mg/dl)173AST(3-35U/L)14ALT(7-33U/L)13TotalBilirubin(0.2-0.1mg/dl)0.33DirectBilirubin(0-0.2mg/dl)0.15CBC,Hb10.2g/Dl,Hct32.9%,WBC5570/cu.mm,Neutrophil68.7%Eosinophil9.0%Lympocyte12.9%Monocyte8.3%Basophil1%Platelet260000MCV80.2RDW80.2LaboratoryresultTreatmentOnO2cannula3L/minNPONSS1000mlintravenous80ml/hTransamine500mgintravenousq6hrHomemedication:Codepect1x3CpcFluimucil200mg1x3CpcTreatmentTreatmentTransamin500mgintravenousq6hrTreatmentHomemedication:NursingcareplanImpair...
