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Independent

Two of the most important priorities are to enhance gas exchange and to maintain the patient's comfort. Institute pulmonary care on a routine basis. Patients with a smoking history may take longer to recover normal lung function after surgery. Encourage the patient to turn, cough, and breathe deeply at least every 2 hours. Show the patient how to use diaphragmatic breathing techniques and how to splint the incision. Teach the patient how to use an incentive spirometer to improve gas exchange. Ask the patient to describe the degree of pain on a scale of 1 to 10. Instruct the patient on nonpharmacologic methods for pain relief. If the patient is receiving analgesia that is insufficient to relieve the pain, notify the physician.

552 Kidney Cancer

Patients and their significant others are dealing with stressors that cause extreme anxiety and fear. Spend time each day discussing their concerns, being honest about the patient's chances for recovery. If the patient experiences an unusual degree of spiritual distress, refer to a chaplain or clinical nurse specialist. The diagnosis of kidney cancer is life-threatening, and the patient may need to work through the issues associated with a serious disease.

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