Internal Code: MAS4073 Nursing Assignment: Lorna Hetherington is 85yrs old. She is a practising Roman Catholic and was previously a regular churchgoer and participated in social activities with a variety of people. She is married and has one daughter. Medical Condition: Lorna has breast cancer. She has undergone a total mastectomy and has received chemotherapy. However, the disease has recurred and she has not responded to any of the recommended treatments. She recently had a bout of pneumonia which has not resolved itself. She is now in the wing of the hospice of a residential facility where you work. Lorna has recently been diagnosed with Bone Metastases. She also wears a hearing aid, but forgets to switch it on so communicating is very stressful for all. Current condition: Lorna has verbalised that her pain is increasing; she is experiencing episodes of shortness of breath and progressive weakness. She has also developed a decline in her cognitive ability. Lorna Hetherington has verbally refused all medical treatment available and does not have an Advance Health Directive or a current Power of Attorney. Questions: 1. How would you demonstrate a palliative care approach when caring for this client? 2. Describe the importance of teamwork in this specialised area. 3. Who else participated in the development of the client’s nursing care plan? 4. How would you support clients and others to contribute to the care plan and identify their preferences for spiritual, cultural, needs and lifestyle options? 5. What support would you provide and relevant information to the client and their family members to prepare for the client’s death? 6. Describe the pathophysiology of Bony Metastases and potential complications. 7. Identify the risks associated the diagnosis of Bony Metastases and discuss the nursing strategies to minimise the potential risks to the client. 8. Discuss how the Enrolled Nurse would observe and assess Lorna’s pain level and management within the healthcare team. 9. Discuss the legal and ethical implications of Mrs Hetherington refusing her treatment and not having an Advanced Health Directive or Legal Power of Attorney. What are your responsibilities in relation to your ANMC competencies and scope of practice? 10. How do you maintain the client’s dignity after their death? 11. Following the confirmed death the client, the family have requested an autopsy to investigate malpractice. What advice would you give the family with regards to officially requesting an autopsy and seeking relevant information post-autopsy? 20 total views, 2 views today
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