Medical-Surgical Nursing 8th Edition by Donna Ignatavicius , Linda Workman

Exercise 1

W. is an 80-year-old woman who has undergone exploratory surgery for an acute bowel obstruction. She had been relatively healthy, although growing more frail in recent years, and recently began to need home oxygen intermittently for chronic lung disease. Persistent abdominal pain and vomiting brought her to the emergency department. She lives alone in an assisted-living apartment near her daughter Joan, who provides some additional assistance with grocery shopping, bill paying, etc. Mrs. W. has just been admitted to the ICU after surgery, where she is expected to remain intubated and mechanically ventilated overnight. The surgeon and Mrs. W.'s daughter are talking outside of her room. You join the conversation in time to hear the surgeon explain that a large, disseminated cancer was found as the cause of the obstruction; he removed as much as he could but was not able to resect all of the cancer. Joan responds, "I was afraid of this. Whatever you do, don't tell my mother it was cancer-she'll never be able to cope with that. Please, just tell her that it was a benign tumor and you took it out." The surgeon looks uncertain but nods and then leaves the bedside. Joan turns to you and says, "Tell the other nurses- nobody can say it was cancer."
What, if anything, should you say to Joan at this point?
It is now the next day. As expected, Mrs. W. has remained stable through the night and has been successfully extubated. She is still somewhat sleepy and has not asked any questions about her surgery. When Joan comes in to visit, she pulls you aside and says, "No one told her about the cancer, right?"