A. Explain how your own perceptions about quality of life and health promotion might affect your care for a dying patient with a lingering illness such as cancer. My perceptions about quality of life would and have affected my care of dying patients. I have been asked in numerous situations for my opinion from a patient or family member and my answer is generally the same. You should do what you think is best for the patient. Take yourself out of the equation. How would your loved one want to spend their remaining time? If you believe that aggressive treatment will restore a quality of life that your loved one will be happy with, pursue it. There are no wrong choices if your heart is in the right place and you hold with highest regard what is best for the patient. Benefit of treatment should outweigh the burdens associated with it. I believe the dying patient should have a peaceful, comfortable environment surrounded by the people and things that they love. Decisions about the plan of care should involve the patient. It is time to put differences aside and focus on the patient’s needs and wishes. Death should not be purposefully prolonged by the family against the patient’s wishes. It should be a time to reflect on one’s life, family, memories, accomplishments and joys. It is a time to finish unfinished business and say goodbye. The family would be encouraged to overcome their personal apprehension regarding visiting with a dying patient. The family would be encouraged not to let their personal problems play a role in the patient’s end of life care. My thoughts on quality of life would affect my care of a dying patient in several ways. I would encourage the patient to make decisions regarding their plan of care. The family would be encouraged to support the decisions of the patient. I would encourage the family to focus on the patient and come together as a unit to support the patient’s wishes and needs. The family would be encouraged to honor the patient’s wishes if the patient became unable to voice their wishes. The patient and family would be encouraged to communicate regarding their good memories together. I would encourage a peaceful environment free of conflict. Suggestions to family would include: cooking the patient’s favorite foods and providing family photos or videos for the family to watch with the patient.
B.Discuss three strategies that you could use in the Thomas’s situation to improve the quality of life for Mrs. Thomas’s and her husband during this illness. 1.Patient to define quality of life. Discuss with Mrs. Thomas and her husband openly and honestly regarding what they perceive will add quality to her life. Define patient’s final wishes, how she wishes to be cared for and what she defines as her physical and emotional needs. 2.Patient to regain control. Involve patient in developing a patient-specific plan of care. Teach patient that she is in control of the plan of care with regard to her needs and wishes. Teach caregiver to communicate needs to health care professionals as needed. 3. Minimize stress. Assist Mrs. Thomas in identifying actual and potential stressors. Identify the contributing factors to the patient’s stress level. Encourage Mrs. Thomas to verbalize her feelings. Provide reassurance and comfort. Ask Mrs. Thomas to talk about coping strategies that worked for her in the past. Identify need for external resources such as counseling to the patient and family. Assist Mrs. Thomas to develop a list of activities that will divert her attention from worry.
C.Create a holistic nursing action plan appropriate for managing Mrs. Thomas’s care at home. Problem / Related to|As Evidenced by:|Goal:|Interventions:|
Pain related to Cancer|Patient reports of pain increasing.Patient spends the day in bed crying.Patient worried that she will become addicted to pain medications.Patient concerned about her...