NUR272: End-of-life Care: Assessment Task 2 – INSTRUCTIONS - Medical Science Assignment Help

NUR272 End-of-life Care: Assessment Task 2 – INSTRUCTIONS

The care needs of patients receiving palliative and end-of-life care can be complex and require careful care assessment and management, regardless of the setting. At times, this care is very challenging, and nurses must demonstrate knowledge and skills their responses. In turn, this can mean nurses are placed under specific kinds of stress, and it is essential to have strategies for self-care in place.

In Assessment Task 2, you will prepare a 2000-word written assignment that demonstrates your skills in assessment and person-centred care planning, your understanding of the particular challenges of palliative and end-of-life care, and your insights into self-care strategies.

To do this, you will answer a series of questions relating to a case study scenario that is presented in four parts. All questions are drawn from aspects of the Learning Materials, although you will need to access additional resources for specific information in some questions. All questions relate directly to at least one Rubric criterion.

Follow these steps to undertake Task 2 – read them through carefully before you start:

• You must use the template provided below. DO NOT ALTER THE CASE STUDY INFORMATION OR QUESTIONS.
• The words provided in the template are not part of the total word count. This document, without any answers, is 1427 words, so your final submission will read about 3427 words, plus Reference List.
• Read through the Case Study excerpts and consider carefully what it tells you about the scenario.
• Using what you have learned from the Learning Materials and the range of sources in the peer-reviewed literature, textbooks and credible websites, provide your answer as clearly as you can with appropriate citation.
• Remember to use at least 1 citation (reference) for each answer.
• The word count for your answers is for guidance only – the total word count is what will be assessed.
• The Reference List must include all references that are cited in this Assessment Task. APA7 Style must be used for in-text citations and formatting the Reference List. The Reference List is NOT included in the total word count
• Submit your template as a Word document for assessment.

Case Study – 1) Background and Assessment

Carol is 43 years of age, living on small acreage in the rural hinterland of the Sunshine Coast near Nambour, with her husband Tim (50yo), their son Simon (17yo) and daughter Penny (12yo) who are both secondary school students.Although Carol was born and raised in Brisbane, she settled in the district when she met Tim, a local.

Carol was initially diagnosed with bowel cancer 10 years ago after a sustained period of alternating constipation and diarrhoea, and weight loss after the birth of Penny. A colonoscopy at that time showed that multiple adenomatouspolyps had become malignant. At this time, Penny’s mother mentioned that her mother had died many years earlier from ‘something in her bowels’. Carol underwent a partial colectomy and chemotherapy, and has kept good health since, with annual screening.

However, a year ago after some pain and nausea, with breathlessness on exertion, Carol was found to have metastases in her liver and lungs. Further chemotherapy appeared to slow the progress of her disease at that time. Now, Carol is now in the advanced stages of her illness and has been given a prognosis of ‘a few months.’ She reports constant low to medium abdominal pain, especially in the right upper quadrant; she remains breathless with little exertion and generalised weakness. Carol reports erratic bowel habits, where she is mostly constipated.

Tim continues to work at his job in town, as well as maintain the acreage. Simon and Penny have continued to go to school, although both of them have had their parents called to the school following some behavioural incidents with other students.

Questions

1. What is the likely trajectory of Carol’s illness? 

2. From your assessment, what type of pain is most likely with Carol’s disease? What are the characteristics of pain that must be included in your assessment? 

3. What are the elements of assessing Carol’s constipation? Approx. 150 words

4. What are some of the concerns the family might be experiencing? How could you assess these? 

Case Study – 2) Managing the impact of illness

Your assessment of Carol has identified a range of symptom management needs in pain, breathlessness, fatigue and constipation. You are now aware of family dynamics that can impact upon the experience of Carol and her family. As her illness progresses, Carol’s need for support will increase in a range of ways.

Questions

5. What are the domains of care that can be addressed through palliative and end-of-life care? 

6. What pain management plan could be put in place for Carol? 

7. What constipation management plan could be put in place for Carol?

8. Thinking about the domains of care, which are broader than nursing practice, what kinds of strategies might address the family’s needs? 

Case Study – 3) Challenges in providing care

Tim is struggling to meet the demands of his job and maintenance of the property, which has chooks and a pair of goats roaming on it, as well as large expanses of lawn. He finds there are just not enough hours in the day given the extra requirements of caring for Carol, going into town for shopping and medication, and running the kids to school and sports.

Tim and Carol are both determined that she should remain at home during her final illness and, if possible, die at home in a place they and the kids love so much. Simon, though, is unhappy at the idea of his mother’s death happening in the house. Penny is alternating between being withdrawn from her mother or fussing over her.

Questions

9. Carol and her family would be considered to be subject to an inequity in health care. What is it? How would it impact upon their care and support?

10. What might the impact of Tim’s experience be on Carol’s illness experience?

11. What do you think Simon and Penny are experiencing? What could be helpful to support them? 

12. Thinking about the Compassionate Communities model in Week 8, what strategies might help the family as Carol’s illness progresses? 

Case Study – 4) Need for self-care

Judy is a 38yo RN providing end-of-life care at home for Carol and supporting her family as her death approaches. At times, Judy finds it difficult to manage Carol’s symptoms; she struggles to figure out the best way to support Tim who looks completely exhausted; Simon has started staying at his friends’ home a lot rather than being at home; and Penny has become very withdrawn and tearful.

Judy has found providing care for Carol quite distressing at times, and often finds herself in tears when she is at home with her own family, including her partner and their three teenage children.

Questions

13. What are some of the most prevalent stressors of PEoLC nursing? 

14. What aspects of this particular caregiving experience might be impacting upon Judy? 

15. How could Judy assess her self-care needs? 

16. What are some evidence-based, self-care strategies that Judy could use? Why are they important in nursing practice?

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