This Case Study Introduces You to Aleki Tupuola - Medical Science Assignment Help

Assignment Task:

Task:

CASE STUDY SCENARIO
Background

This case study introduces you to Aleki Tupuola, a 42yo man married to Donna for the last 15 years. Born in Australia to Samoan parents, Aleki was raised in Brisbane amongst his large, churchgoing family. A heavy drinker in his youth, Aleki settled down once he was married, and lives on the Sunshine Coast where he has worked as a housepainter. Aleki and Donna have three children – son Jayden (14yo), daughter Sophie (10yo) and their ‘surprise baby’, son Fetu (18 months old). Aleki’s mother is now in her early 70s, and his father died three years ago from complications of diabetes. Aleki is one of six children, all still living in and around SE Queensland. Donna’s parents live in Townsville, and she is very close to her sister Kaylee who lives in Rockhampton. Diagnosis and prognosis A year ago, Aleki presented to hospital with constant, severe ache over his right upper quadrant, unrelated to movement, with occasional sharp spasms of epigastric pain. He had persistent nausea, loss of appetite, and weight loss. He believed he had a duodenal ulcer, as two of his brothers also had them. Upon further investigation, Aleki was found to have Stage III exocrine pancreatic cancer. He underwent a Whipple’s procedure followed later by chemotherapy. He has been unable to work since and although he is paid a pension, the financial strain has been great, as Donna only has part time work whilst looking after Fetu at home. With mild but persistent pain and low-grade nausea over the months that followed, further investigation showed that Aleki’s cancer had spread to his liver, now designated as Stage IV. Aleki and Donna were told by his oncologist last week that he has a prognosis of ‘perhaps three months’. He and Donna have told their extended families, and the two older children. Donna has been appointed his Enduring Power of Attorney for health matters and, with their GP’s help, completed an Advance Care Plan. Presentation Aleki has been admitted to the oncology unit with rapid exacerbation of pain, nausea and yellowed sclera. His abdomen is a little swollen. He is very weak, with very poor sleep at night; he is saying that his father ‘died like this’. Donna is visibly distressed when she visits Aleki and looks exhausted. Jayden and Sophie have visited a couple of times too, but Fetu has not seen his father in hospital. Aleki’s current medication is:
• Oxycontin 60mg bd
• Oxycodone 10-20mg prn - averages 4 doses a day with reducing benefit
• Dexamethasone 2mg daily • Pantoprazole 40mg daily
• Coloxyl and Senna 2-4 tablets at night
• Metoclopramide 10mg tds • Ondansetron 4mg prn
• Temazepam 20mg nocte
Donna and Aleki are adamant he should return home for the remaining time he has left.
3 Instructions: •
Create a new document to address the questions below.
• Please number your answers to correspond to the numbering of these questions
• Don’t write out or cut and paste the questions onto your answers.
• The total word count is 1600 words. As a guide, each answer should be around 330 words however there is flexibility in this, and it is the total word count that will be counted by the markers. It is essential, however, that each question is answered comprehensively.
• As illustrated in the rubric:

o 30% of the total mark for Assessment Task 2 is allocated for the questions related to Clinical Assessment;
o 30% of the total mark for Assessment Task 2 is allocated for the questions related to Care Management;
o 20% of the total mark for Assessment Task 2 is allocated for critical appraisal and integration of sources; and,
o 20% of the total mark for Assessment Task 2 is allocated for academic communication, appropriate referencing, and academic integrity.
Part One: Clinical Assessment
1. What is the likely trajectory of Aleki’s illness? You can use a diagram to illustrate. Explain the 5-year life expectancy of someone with Stage IV exocrine pancreatic cancer.
2. Consider your approach to the assessment of Aleki’s pain. What type of pain/s does he describe? What elements of his pain should you assess? What assessment tool/s might be helpful to assess his pain experience?
3. Social assessment: identify three key issues in Aleki and Donna’s social world that are influencing their experience. How could you explore these with them?
Part Two: Care Management
4. Who might the members of the multidisciplinary team be for Aleki and his family during his hospitalisation? Explain how their roles address the care needs identified during assessment.
5. Discuss the management of Aleki’s pain. Explain what pharmacological and non-pharmacological strategies might be effective.
6. A family conference is held. Explain how a discussion of goals of care could inform Aleki’s discharge and care at home.
Reference List (not included in the word count) This must include all references that are cited in this Assessment Task

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