Question

END-OF-LIFE ISSUES You are the home health nurse who has been seeing Phyllis Court, who has a diagnosis lung cancer for approximately one year. Her provider recently told her that her cancer was no longer treatable; the focus of treatment will change from curative measures to symptom relief. She is confused and somewhat angry with her provider. She vapuely remembers the term palliative care when discussing her situation with the provider but does not know what this means. Ms. Court confides that she always felt she might survive her illness but has never formally written down her wishes concering what types of treatment she would or would not want to have. You advise her to complete an advance directive or living will Ms. Court states she is confused and has mixed feelings about her health care wishes right now. She asks. "If I fill out this form, can I change my mind down the road? Revised 1/20

concept map on end of life issues

Answer 1

1. Nursing diagnosis - Greif related to the anticipatory loss .

#. Nursing interventions :-

- Encouraging the patient to accept the reality .

- Providing psychological and emotional support

- Involving family members in patient care

- Providing assistance in daily activities and encourages to be independent

- Making the patient busy in some activities so that he does not think about it .

#. Positive outcome - patient acceptance of the reality

#. Evaluation :

- Patient accepted the reality and tries to live the life fully with the family .

2. Nursing diagnosis - Shortness of breath related to progression of disease .

#. Nursing interventions :-

- Assess the vitals of the patient ( Temperature, RR - 26bpm , BP - 130/94, HR- 94bpm , SPO2-85%)

- Monitor the breathing pattern of the patient

- Providing oxygen therapy as per the physicians order

- Raise the head end of the patient ( semi -fowlers position ) .

- Use of incentive spirometry to keep the lungs inflated

- Teaching deep breathing exercises to the patient

#. Positive outcome - Patient has relief in his Shortness of breath .

#. Evaluation - On re-evaluation after interventions , patient's SPO2 - 93%, RR - 19bpm.