The holistic nursing care for high risk cholangiocarcinoma patients : case study 2 case

Abstract

This study was a case study of two cases to compare care and the process of nursing 2 cholangiocarcinoma patients and using the results of the study as a guideline for nursing practice in caring for cholangiocarcinoma patients to be more quality and effective. The results of the study found that the first case study was a middle-aged patient, have co-morbidities, namely diabetes and high blood pressure has a history of likes to eat raw food, pickled fish and raw fermented fish have severe abdominal pain , very yellow eyes. The doctor diagnosed it as Cholangiocarcinoma in the past 1 month received PTBD intubation treatment to reduce abdominal distension. The patient is aware of the disease refused surgery due to fear of surgery. Therefore, it is treated according to symptoms and patients are interested. An alternative treatment is the use of cannabis oil. To reduce pain, but because the patient has high bilirubin congestion. Therefore, hemp oil cannot be given because it will affect liver function. Patients and relatives are informed Understand the treatment approach, seek palliative care at home. The second case study was an elderly person had a comorbid disease was diabetes. One day before coming to the hospital had a stomachache, Diarrhea, nausea, and vomiting.  Able to eat less food for 4 months before having symptoms of jaundice, jaundice, loss of appetite, weight loss along with abdominal pain under the right ribcage and dark yellow urine. During his youth hard drank alcohol. Quit smoking for about 5 years, had a history of eating raw food, Raw pickled fish, fish koi, shrimp koi were a snack when drinking alcohol. The result of a CT scan was Cholangiocarcinoma. Treated by Hepatectomy (Rt.). After surgery was complication is the ventilator cannot be removed and the ventilator must be inserted for 4 days. Low potassium salt be supervised while using the ventilator received antibiotics Painkillers and medication according to the treatment plan until symptoms improve, can breathe on their own, and eat soft foods. Sold to take home with a JD tube on the abdomen. 2 more weeks to see a doctor, total 11 days hospital stay.