Lucy S. is a 64-year-old-german woman admitted to a home care agency for care related to end-stage cardiac disease and renal failure. She has complained of chronic generalized chest pain, frequent cramps in her legs, and worsening arthritis pain related to her immobility. The home care nurse has been in contact with Lucy's physician almost daily for the past week and her analgesics have been steadily increased with little pain relief but an increase in nausea, constipation and sedation. The nurse feels frustrated as she observes Lucy declining rapidly with worsening depression, withdrawal and weeping. Lucy's neighbor has noticed that her lights are left on 24 hours a day and the nurse has noticed that Lucy has several rosaries and pray books now at her bedside. Lucy has refused referral to hospice by the home care nurse has requested a team conference with assistance from the local hospice affiliated with the home care agency.
1) The disciplines should be included in the case conference are primary care physician like cardiac specialist and renal specialist and psychologist and physician member of hospice and physical therapist and home care agency representative and religious spiritual guide. 2)The additional assessment the nurse obtain is statistics about end of life care , and barriers to end of life planning and discussions like patients lack of knowledge about treatment options and limited access to health care and legal professionals who could assist in advance care planning and death denfying ethos in western society and chronic illnesses and end of life care like focued previously related to cancer patients and uncertainty about when dealth will occur in chronic illnesses, and ways to initiate end of life care conversation while avoiding negative connotations, additional assessments like assess orientation and obtain a values history and allow patient to talk about death and fears and assess acceptance to death and assess lucys end life of life preferences and assess lucy S. cultural beliefs and assess about religious beliefs and assess knowledge about hospice care and assess if lucy S. has family and assess lucyS willigness for an aide or housekeeper, and how can lucy pain and suffering best be treated.
Lucy S. is a 64-year-old-german woman admitted to a home care agency for care related to...
Lucy S. is a 64-year-old-german woman admitted to a home care agency for care related to end-stage cardiac disease and renal failure. She has complained of chronic generalized chest pain, frequent cramps in her legs, and worsening arthritis pain related to her immobility. The home care nurse has been in contact with Lucy's physician almost daily for the past week and her analgesics have been steadily increased with little pain relief but an increase in nausea, constipation and sedation. The...
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You are assigned to care for a 65-year-old woman admitted last evening with a recent history of cellulitis and a 3-day history of persistent vomiting and diarrhea. She takes no medications at home, other than a daily multivitamin. Her weight on admission was 153 pounds. The patient states her original weight is 165 pounds (75 kg). The nurse notes that the patient’s mucous membranes and skin are dry. Vital signs are temperature 99.8° F, pulse 112, respirations 32, and blood...
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