You are an AGACNP practicing as an oncology nurse practitioner ✓ Solved

You are an AGACNP practicing as an oncology nurse practitioner on a 20-bed inpatient oncology unit at a tertiary care center. You are tasked with admitting a patient with a chief complaint of an acute oncologic disease state (Lymphomas). Summarize the pathology, etiology, modifiable and nonmodifiable risk factors, pertinent signs and symptoms, diagnostics, treatment regimens to include both pharmacological and nonpharmacological, and nutritional approaches for lymphomas.

Cancer and the associated side effects of cancer treatments are often devastating and exhausting for both patients and their families. Discuss the patient-centered, family-inclusive, and Christian-oriented approach that you will use in your future practice when working with cancer patients. Include your approach to revealing a new diagnosis, respecting nontraditional or alternative treatment regimens, adhering to a patient's wishes for nontreatment, palliation, and end-of-life care.

You are an AGACNP practicing as a hospitalist nurse practitioner in a 200-bed community hospital. You have pulmonology and critical care consultant teams available, as well as a 15-bed critical care unit. You are tasked with admitting a patient with a chief complaint of an acute pulmonology state (Pulmonary Fibrosis). Summarize pathology, etiology, modifiable and nonmodifiable risk factors, pertinent signs and symptoms, diagnostics, treatment regimens to include both pharmacological and nonpharmacological, and nutritional approaches for pulmonary fibrosis.

Compare and contrast BIPAP and CPAP as pulmonary interventions.

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The role of an Acute Care Nurse Practitioner (AGACNP) in oncology is crucial, especially when faced with complex conditions such as lymphomas. Understanding lymphomas involves exploring their pathology, etiology, risk factors, symptoms, diagnostics, and treatment options. Lymphomas are cancers that originate in the lymphatic system, specifically in lymphocytes (NCCN, 2022). There are two main types: Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL). The etiology of lymphomas includes genetic mutations, immune system dysfunction, and environmental factors. Modifiable risk factors are limited but may include certain infections like Epstein-Barr virus and lifestyle choices such as smoking, while nonmodifiable factors include age and family history (Chihara et al., 2020; Rugo et al., 2021).

Common signs and symptoms of lymphomas include swollen lymph nodes, fever, night sweats, weight loss, and fatigue. Diagnostic tools typically involve imaging studies, biopsies, and blood tests that check for lymphoma markers and organ function (Swerdlow et al., 2016). Treatment regimens vary based on the type and stage of lymphoma but generally include chemotherapy, radiation therapy, immune therapy, and targeted therapies. Nonpharmacological approaches such as physical therapy and nutritional support play an integral role in management. For instance, a balanced diet can help patients tolerate treatments and maintain their strength (GANS, 2020).

In addressing the holistic aspects of cancer treatment, a patient-centered, family-inclusive, and Christian-oriented approach is essential. Communication remains fundamental in revealing diagnoses and discussing treatment options. One must respectfully consider patients' wishes, including their choices for alternative treatments, the desire for palliative care, and end-of-life decisions. For example, cultivating an atmosphere where patients feel comfortable voicing their concerns or non-treatment preferences can enhance the therapeutic alliance (Ferrell et al., 2017).

In my future practice, I envision using compassionate dialogue facilitated by active listening and empathy, allowing me to tune into the emotional and spiritual needs of both patients and their families. Respecting nontraditional treatments can demonstrate openness and respect for individual beliefs. Establishing interdisciplinary teams can ensure that both traditional and nontraditional methods are available for patients while also equipping the team to manage expectations and outcomes more holistically (Carlson et al., 2016).

On the other hand, transitioning to pulmonology, understanding pulmonary fibrosis (PF) is vital for AGACNPs working in hospital settings. PF is characterized by progressive lung scarring, leading to stiffening and reduced lung capacity. Etiologically, PF can arise from idiopathic factors or be associated with environmental exposures to asbestos and certain medications (Liu et al., 2021). Modifiable risk factors primarily involve occupational exposures, while nonmodifiable risks include genetics and advanced age.

Symptoms of PF consist of persistent dry cough, shortness of breath, and fatigue, often culminating in respiratory failure in advanced stages. Diagnostic strategies include high-resolution computed tomography (HRCT) scans and lung function tests that assess the degree of impairment (Swigris et al., 2018). Treatment regimens can include antifibrotic medications, corticosteroids, and pulmonary rehabilitation, alongside nutritional interventions to optimize patients’ nutritional intake and support their overall health (Brown et al., 2019).

Furthermore, when addressing respiratory interventions, comparing BIPAP (Bilevel Positive Airway Pressure) and CPAP (Continuous Positive Airway Pressure) is essential. Both therapies aim to enhance ventilation; however, BIPAP allows for different pressure settings during inhalation and exhalation, which can be more comfortable for patients with advanced pulmonary conditions (Kheir et al., 2020). In contrast, CPAP delivers a consistent pressure throughout, mainly used for obstructive sleep apnea. Their selection often depends on a patient's specific needs and response to therapy.

In conclusion, as AGACNPs, our approach to complex patients, such as those with lymphomas or pulmonary fibrosis, should be holistic, integrating evidence-based practices, patient-centered communication, and adaptability to individual patient needs and preferences. Emphasizing the interconnectedness of physical, emotional, and spiritual aspects of health is paramount in delivering high-quality care.

References

• Brown, K. K., et al. (2019). Nutritional support in pulmonary fibrosis. Respiratory Medicine.
• Carlson, L. E., et al. (2016). The role of interdisciplinary teams in cancer care. Cancer.
• Chihara, D., et al. (2020). Epidemiology of lymphoma. Journal of Clinical Oncology.
• Ferrell, B. R., et al. (2017). Patient-centered communication in cancer care. Journal of Oncology Practice.
• GANS, P. (2020). The impact of nutrition on recovery in oncology. Clinical Nutrition.
• Kheir, F., et al. (2020). BIPAP vs CPAP in respiratory failure management. Chest.
• Liu, Y., et al. (2021). Environmental factors and pulmonary fibrosis. European Respiratory Journal.
• NCCN. (2022). Lymphoma treatment guidelines. National Comprehensive Cancer Network.
• Rugo, H. S., et al. (2021). Advances in lymphoma management. Hematology.
• Swigris, J. J., et al. (2018). Diagnostic evaluation of pulmonary fibrosis. Archives of Internal Medicine.