Nursing Diagnosis: Spiritual Distress R/T mis-communication between staff and patient S/T language and cultural barrierGoal: Spiritual need will be met. Objective(s)：Obtain rosary and pray.Intervention: Obtain rosary from Chapel.Evaluation: Obtained rosary and prayed the rosary in Cajun French with patient.Patient resting quietly and comfortable at end of shift.

Ms. Mary is an 88 year old "Cajun" female who is widowed and retired. She was diagnosed with metastatic colon cancer and her prognosis is poor; Speaks "Cajun French" only. Focused Assessment:Palliative care needs: Physical,Psychosocial and Spiritual Comfort

SPIRITUALITY and CULTURECatholic, CajunPhysicial met with the family and patient last eventing regrading her poor prognosis. The staff nurse also eported that since the family left last eveningm the patient is restless, and picking at the sheets, mumbling the same thing over and over, which the staff nurse could not understand. Assessment: Speaking Cajun French with student nurse and searching for her rosary which patient lost in her bed sheets on the prior evening.

OXYGENATION/PERFUSIONAssessment - Awake, alert and orientedto person, place and time. Pulse Ox 96%c/o dyspnea with minimal exertionOrders-Oxygen 2LPM per NC prn

COMFORT/HYGIENEassessment - pt. c/o of abdominalaching pain which has improvedsince starting MS Contin yesterday. Orderd - Palliative Care - MS Contin 60 mg po every 12 hours.

SAFETY Assessment bed lowest position,side rail up x 4, call bell inreach; Turn every 2 hours; No pressure ulcers noted Orders - DNR status

NUTRITIONAssessment - decreased appetiteOrders - Diet as tolerated.Ensure I can po tid

ELIMINATIONAssessment - I>O voiding approximately 500cc's of fark yellow urine per day:LBM 0 1 day agoOrders -

PSYCHOSOCIALElder with good family support. Patient states"I lived a good life." c/o feeling anxious attimeOrders -

ACTIVITYAssessment -Transfers tochair with maxassist tid for mealsand doesnot ambulate.Orders - Activityad lib