Answer Happy

Tuesday. -5 Engage Fundamentals End of Life may 3 Clinical Judgment Case Study with Concept Map Case study The nurse who works in a hospice facility is caring for Matias Perez, a 78-year-old man with cancer who is receiving hospice care and is expected to die within the next couple of weeks. At least one of Matias's family members is present with him most of the time. The client suffers chronic pain from the cancer spreading, and the pain is managed with a combination of opioid analgesics, positioning, and occasionally massage. Matias's pain is increasingly intense, and the opioids used are causing Matias to sleep more than he would like. The client expresses a desire to be awake and talking with his family as much as possible. Matias reported a pain level of 8 out of 10 on the pain scale but refuses pain medication. His grandchildren are planning to visit within the next hour and he wants to be awake to talk with them. He asks the nurse to pray with him for relief from the pain while his grandchildren are visiting. The client further states that he has not been a religious man most of his life but always considered himself spiritual. Jacob asks the nurse to have the hospital's pastor come visit with him the next day. The nurse assists the client with bathing, bathing, dressing, and shaving prior to the grandchildren's visit. The nurse helps the client change to a comfortable position and leaves him to visit with his family. Assessment Questions 1. Identify the relevant subjective and objective assessment information related to the client's condition and place the findings in the assessment data box below. (Recognizing Cues; Assessment) 2. Based upon assessment information, identify and prioritize the top 3 client problems. Write one client problem in each of the Client Problem boxes below. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning) 3. Below each client problem, determine and enter the relevant assessment information that supports the identified client problem. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning) 4. Identify important nursing interventions that should be taken to address each client problem and enter them in the related intervention box for the associated client problem. (Take Action; Implementation)
ENGAGE FUNDAMENTALS CLINICAL JUDGMENT CASE STUDY WITH CONCEPT MAP Discussion Questions Educators may choose to instruct students to include relevant information identified during the discussion questions into the concept map. Discuss special considerations to be made for clients from diverse backgrounds. (Recognize Cues: Assessment) a. Pediatric client b. Clients from diverse backgrounds (i.e. age, culture, socioeconomic status) 2. Identify potential client problems. (Analyze Cues; Analysis) a. Instruct students to provide a rationale for their choices. 3. Discuss nursing interventions to address the identified potential client problems. (Generate Solutions; Planning) a. Instruct students to provide a rationale for their choices. 4. Discuss the desired client outcomes related to the performed interventions identified in the concept map as well as for potential client problems. (Generate Solutions; Planning) a. Discuss client responses that demonstrate an improvement of the client problem b. Identify client responses that indicate worsening of the client condition. (Generate Solutions, Planning) 5. Discuss safety considerations that should be included when planning care for this client (i.e. fall risk). (Generate Solutions; Planning) 6. Identify client education the nurse should provide for this client (ie, diet, activity, ADLs). (Take Action; Implementation) Discuss client outcomes you would anticipate based on the performed nursing interventions (.e. improved SPO2 with raising head of bed, increasing amount of oxygen being delivered). Identify how achievement of client outcomes would be evaluated. (Evaluate Outcomes; Evaluation) 7. Discuss ways to modify or revise the plan of care when client outcomes are not met. (Evaluate Outcomes; Evaluation)