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Focus on early detection and management of symptoms and the prevention of complications. Interventions depend on the stage of the disease process. If the patient is newly diagnosed, patient teaching becomes important because of the patient's knowledge deficit. If the patient has severe symptoms that interfere with the ability to perform daily functions, strategies to maintain rest and conserve energy become important. If the patient is a surgical candidate, preoperative and postoperative management are the priority.

During periods of activity intolerance, encourage the patient to maintain bedrest and to allow full assistance with hygiene activities. Provide a bedside commode rather than a bedpan to decrease energy expenditure during voiding. Encourage the patient to keep the head of the bed elevated to at least 30 degrees. Support both arms with pillows to ease breathing and to augment chest excursion. Explore with the patient preferred diversionary activities, such as reading, watching television, needlework, listening to the radio, or quiet visitation with friends and family. Monitor the number of visitors to ensure that the patient is not overfatigued.

Encourage the patient and family to discuss their fears about the progress of the symptoms or the possibility of surgery. Answer questions honestly, provide accurate information, and allow the patient and significant others time to digest information before adding additional content. If the patient needs surgical intervention, evaluate the patient's home situation to determine if additional home assistance will be needed after discharge.

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