You are taking care of Mr Raju who has been diagnosed with late-stage pancreas cancer. During his stay, Mr Raju complaint of severe visceral pain.

a.State the characteristics of visceral pain. (4m)

b.Discuss how are you going to assess the Mr. Raju pain. (6m)

Mr Michael , a colon cancer patient in advanced stage is admitted due to spinal cord compression. He complained of severe back pain with pain score 8/10. Doctor prescribed S/C Morphine 10mg stat and followed by Aqueous Morphine 20mg 4 hourly.

a.Explain how are you going to assess his pain. (7m)

b.Constipation is the most common side effect of morphine.

Describe your nursing interventions for constipation (3m)

a,List four (4) types of family structure (4m)

b.Explain three  (3) types of family structure in social care. (6m)

Madam Y, diagnosed with advanced cancer with spinal cord compression.

She has a weakness of the lower limb with a neurogenic

bladder and bowel. Her cancer rehabilitation goal was at the palliative

stage. She will be discharged to home and her husband will be the main carer.

a.State clinical manifestation for neurogenic bladder. (4m)

b.Describe the discharge planning for Madam Y. (6m)

Leela is a 16 year old student diagnosed with right femur osteosarcoma. He complains of pain and is unable to walk. The doctor used World Health Organization (WHO) analgesic ladder as a guide to prescribe analgesic to relief her pain.

a.State the type of pain that Leela is suffering. (1m)

b.Describe the WHO analgesic ladder (9m)

Mrs Jeeva, a breast cancer patient was admitted to the ward due to spinal cord compression. She complained of severe back pain with pain score 7/10. Doctor has prescribed S/C Morphine 10mg stat and followed by Aqueous Morphine 20mg 4 hourly.

a.Explain how are you going to assess her pain. (7m)

b.State three ( 3 ) types of pain assessment tool you would used to assess Mrs. Jeeva’s pain level. (3m)

Rehabilitation can be applied throughout the entire phase from the time of diagnosis to the terminal stage of cancer patients. Dietz (1981) has classified four rehabilitation stages for cancer patients.

a.Describe the four (4) stages of cancer rehabilitation according to Dietz (1981).(8m)

b.State two (2) objectives of oncology rehabilitation for cancer patients. (2m)

Stress is a normal physical response to events that make we feel threatened or upset our balance in some way.Anything that poses a challenge or a threat to our well-being is a stress.

a.Describe types of stresses working in oncology care setting (4m)

b.State the concept of self care in dealing with stress (6m)

1.Self care awareness

2.Self care needs

3.Self care practices

You are the nurse managing a 34 year old male patient with history of non-traumatic spinal cord injury due to a tumor at the lumbar level. He complained of hesitancy, frequency and difficulty in passing urine. There were no symptoms to suggest urinary tract infection.

a.Outline the nursing management that can be given to this patient. (6m)

b.List four (4) complications that can be occurred. (4m)