NRSG370 - Patrick Brady Case Study - Clinical Reasoning Cycle - Palliative Care - Medication - Nursing Assessment Answer

NRSG370 - Patrick Brady Case Study - Clinical Reasoning Cycle - Nursing Assessment Answer

Assessment Task:

Purpose

The case study is designed to allow students the opportunity to demonstrate the synthesis of theory and experience acquired In previous and concurrent units while exploring a specific nursing context. Students are expected to demonstrate prioritisation and management of care needs using the Clhical Reasoning Cycle.

Task

Students will complete a case study which discusses the provision of ethical, legal. evidence-based. holistic person-centred care including the establishment of realistic and relevant goals through the theoretical examination of a particular nursing specialty case study using the Clinical Reasoning Cycle.

Case Study

NRSG370 Assessment task 3: Case study —Palliative Care 

Patrick Brady, 70 years old, end-stage prostatic cancer and metastatic bone cancer in the lower back and hip. He lives in his own home with his wife, and his two adult children live close by. Over a 6-week period, Patrick noticed his bladder function was changing. He had frequent trips to the bathroom, a weak stream and some increasing constipation. He ignored these symptoms until his back and hip started to be quite painful, so he then consulted his local GP. 

After diagnostic tests to rule out reversible causes, Patrick's GP referred him to a specialist to follow up diagnostic tests and procedures. Patrick had a TURP immediately to relieve his bladder symptoms and to collect prostate biopsies and he also had a complete bone scan. He was diagnosed with advanced prostate cancer with bone metastases (in his hip and spine). He immediately commenced chemotherapy then radiotherapy and started hormonal therapy. However, after 6 months, it was noted that the treatment had not been effective. Patrick decided he wanted to stop all treatment and enjoy the remaining months of his life with his wife at home and in his garden.

Past history: Patrick has hypercholesterolemia, GORD and has otherwise been a healthy and fit man. In the last 2 weeks, Patrick has lost weight and has experienced increased nausea and fatigue and he now requires incontinence pads. His pain worsens despite pain management measures and his wife and son report that they are concerned and they seem distressed. They tell you that Patrick does not want to be drowsy from pain relief. As the palliative care nurse, you note that Patrick has deteriorated and he is in much greater pain than when you last saw him. 

Patrick's medication:

• Movicol 1 sachet BD

• Acimax 20mg daily • Atorvastatin Calcium 40mg daily

• Metoclopramide 10mg TDS a half hour before meals

• Morphine oral suspension 5 mg PRN QID

• MS Contin SR 60mg D 

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