Nursing Diagnosis.

Introduction.

Mary S. was a beautiful woman with a great sense of humour. She was 64 years old at the time when she got admitted for lung cancer stage IV. Her health started deteriorating after the discovery of a tumour in an x-ray operated on her chest in 1998. She experienced various challenges such as Pneumonia, fatigue and sore throat. Later, in the year 2000, her condition worsened, and she got transferred to a cancer centre. In the new health facility where she got moved, nurses administered various therapies. The therapies they conducted focused on managing stress to improve the quality of Mary’s life (Ferrell and Coyle, 2006). However, she died while undergoing the care. Thus, below is an illustration of the patient’s database and the nursing diagnosis care plan.

Patient Database.

General information (Doenges et al., 2016).

Name:   Mary S. Age: 64             Date of Birth: May 1936                         Gender: Female 

Admission Date: 2, September, 2000        Time: 8.00 a.m.                              From: Wales

Reason for Admission: Stage IV Lung Cancer

Source of Information:  Laboratory test Results Reliability:  4

 Subjective report.

Ability to participate in activities: Weak Leisure time activities: 

Listening to gospel music            Activity level: low Changes in Strength: Rapid reduction History challenges: Pneumonia, fatigue and sore throat               Feelings: Anxiety, Insomnia, Fatigue and Pain.          Development factors: Age appropriate.

Objective exhibits.

Stress levels: High Symptoms: Depression, Anxiety, Insomnia, Fatigue, Peripheral neuropathy, Dyspnea.

Aid: Management of stress levels to improve the quality of life.

Nursing Plan of Care
Assessment	Planning	Implementation	Evaluation
Nursing Diagnosis: Stress Related to: the patient appeared worried, depressed and needed family support.  As Evidenced by: The patient could not actively participate in responding to the questions asked.  Objective: The patient required strategies that would help her in overcoming stress. One, the patient needed to participate in Neurofeedback and Biofeedback training. This strategy enables the patient to be able to gain conscious that would allow her to control different functions of the body such as a heartbeat. Also, the patient needed to participate in exercises to ensure she becomes active (Fawzy et al., 1990). Also, the patient should have a conducive environment for stress management.	Short term goals  Check on the mood of the patient for about 45 minutes.  Engage the patient in oral questions, and note her ability to answer, for about 30 minutes Long term goals. Engage the patient in activities that would enhance assessing her consciousness, for about 12 hours. Interact with the patient. Involve her in interactions that would ensure that she laughs and have a smile.	The mood of the patient suggests that she needs therapy. Rationale: Engage the patient in doing exercises to help in transforming her mood.  The results show that the patient was not active while answering the questions. Rationale: There is a need to make the patient comfortable, by ensuring a conducive environment.  Also, the results show that during the interactions, the patient appeared unconscious.  Rationale: the nurse should have applied Neurofeedback and Biofeedback training, to help the patient in gaining consciousness.	Even though, the nurses assisted the patient in participating in various activities and provided her with a conducive environment, the patient died, since she did not understand the impact of the events.

Conclusion.

The above information provides the various strategies for diagnosing stress among patients. For instance, the nursing diagnosis care plan for Mary indicates that the nurse needed to check the patient’s mood and engage the patient in various activities. The strategies were to enable the nurse to assess the consciousness and also note the level of activeness of the patient. The findings would then assist the nurse in applying appropriate methods that would help in solving the problems. Additionally, the above information shows that a nurse would need to evaluate the patient after diagnosis. In this case, the nurses found out that, even though they applied the appropriate strategies, the patient died since she could not understand the impacts of the activities they engaged her in doing. 

Reference List.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nursing diagnosis manual: planning, individualising, and documenting client care. FA Davis.

Fawzy, F. I., Cousins, N., Fawzy, N. W., Kemeny, M. E., Elashoff, R., & Morton, D. (1990). A structured psychiatric intervention for cancer patients: I. Changes over time in methods of coping and affective disturbance. Archives of General Psychiatry, 47(8), 720-725.Ferrell, B. and Coyle, N. Textbook of palliative care. (2006) pp. 4