Question

THIS IS NURSING 454 UMSON: PATHOPHYSIOLOGY

A 45-year-old person was brought to the emergency department (ED) by ambulance after collapsing at work. Coworkers report she had been "fine" all morning but then had problems speaking and "suddenly collapsed." When EMS arrived, she was breathing on her own, speech was garbled, and she did not move her right side. BP was 176/90 when she arrived in the ED. Total elapsed time from first symptom is 23 minutes.  

This patient continued to deteriorate rapidly despite appropriate care. Within three hours, she had had a GCS of 5. CT scan revealed massive cerebral edema that did not respond to treatment. Serial EEGs have demonstrated progressive slowing of brain activity. Days have passed without improvement. During a meeting with the care team and family, the physician reported that she had experienced massive and irreparable cerebral injury. The family shared that the patient "would not want to be kept alive like this." The family have asked that care priorities be changed to comfort measures only. She has been placed on hospice services.  

Create a comprehensive plan of care to meet the patient and family needs for end of life care now that she has been placed on hospice care.

Answer 1

A comprehensive care plan for the end of life situation includes caring for a patient suffering from pain and other disability and family from emotional sickness due to dying patients. As nurses responsible to find outpatient symptoms to alleviate their symptoms and professional colloboration in various needs make patients comfort and family to adopt and understand with cope and illness.
Nursing care plan:-
- Control pain and patient associated symptoms
-Determine the level of impairment and its progress
- Perform neurological assessment and physical examination and monitor patient vital signs and intake and output continuously.
-Assess patient family emotional conditions and behavioral response and understanding capacity.
-fulfill the patient and family's spiritual and cultural needs for a sense of peace.
-Involve family in the care plan and provide counseling and psychological support to avoid distress.
-Interprofessional care for various needs for the patient makes collaborative care that increases patient and family trusting relationships.
-Make informed consent and care when providing care for the patient.
-Oxygen therapy and medication administration and various care for the patient to avoid risk and harm should be monitored in the patient chart.
-make active listening and communication
-Reinforce education on disease process and treatment.
-Avoid external environmental stimuli like extra noise, lighting should be avoided to make comfort.
-spiritual care for terminally ill patient help to overcome the severe fear, anxiety, and depression, it empowers them with grief and loss meaning.