Case study background information – Rosiane Mabweni Rosiane is a 50-year-old Rwandan woman (born in the month of May) wh
Posted: Fri Jun 10, 2022 11:30 am
Case study background information – Rosiane
Mabweni
Rosiane is a 50-year-old Rwandan woman (born in the month of
May) who arrived in Australia 18 years ago as refugee. She
arrived with her husband (Lonji) and their 3 daughters (aged 12, 10
and 8 years) as refugees from Cogo where they had fled following
The Rwandan crisis in 1994.
They have settled well into Australian life; their family has
been very important to them and has now grown to include 2
grandchildren with another grandchild due in 6 months’ time
Rosiane and Lonji are practising Muslim’s (Sunni) and are both
very active in the local African community. Rosiane is currently
working 4 days per week in Lonji’s Home Cleaning business to help
meet their financial needs however this has become increasingly
challenging for her as she has recently become unwell.
She presented to her GP, Dr White, 2 months ago with increasing
fatigue, shortness of breath, mild confusion and hardening of the
Right Breast with ‘peau d’orange’ (orange dimpling) causing pain
and discomfort in her breast.
Dr White referred Rosiane to Mr Sheal, a Surgical Oncologist who
completed a full physical examination and undertook the following
investigations:
On review of all the findings Mr Sheal confirms that
Rosiane has stage 4 Advanced R) Breast Cancer with lymph, lung +
brain metastases. Mr Sheal discusses the diagnosis with
Rosiane and Lonji and explains that approaches to treatment were
now not curable but rather palliative in intent.
You are the GP Practice nurse assisting Rosiane through these
early stages of diagnosis and follow-up tests.
QUESTION 1: Discuss four
(4) key elements of a ‘palliative approach to care’ in relation to
Rosiane.
QUESTION 2: Describe how you would
complete a holistic assessment on Rosiane?
QUESTION 3: Describe the
pathophysiological changes associated with Rosiane’ s life-limiting
diagnosis.?
QUESTION 4: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
implications of implementing advanced care planning and advanced
care directives.
QUESTION 5: Discuss the state legislation,
that you reside in, relevant to Advanced Care Planning
QUESTION 6: Discuss the state legislation,
that you reside in, relevant to Advanced Care Directives.
QUESTION 7: Lonji is quite distressed at
the level of Rosiane’s deterioration and complains to you in front
of Rosiane that she doesn’t “make an effort to eat and drink to
help her stay well”. He thinks she needs to go to “hospital
for a drip” How would you explain to Lonji’s Rosiane’s hydration
and nutrition needs in line with a palliative approach to care and
her ACD?
QUESTION 8: Rosiane was referred to an
Oncologist to explore palliative options of chemotherapy. She
completed a course of IV Trastuzumab which she has been having
weekly however she says to you that she feels ‘worse not
better’. She tells you she is not going to accept further
chemotherapy treatment and she wants to talk to you about
Palliative Care. Describe what Palliative Care is and state
four (4) members of the Multidisciplinary
Palliative Care Team.
QUESTION 9: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
issues related to “request for autopsy”.
QUESTION 10: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
issues related to “organ donation”.
Mabweni
Rosiane is a 50-year-old Rwandan woman (born in the month of
May) who arrived in Australia 18 years ago as refugee. She
arrived with her husband (Lonji) and their 3 daughters (aged 12, 10
and 8 years) as refugees from Cogo where they had fled following
The Rwandan crisis in 1994.
They have settled well into Australian life; their family has
been very important to them and has now grown to include 2
grandchildren with another grandchild due in 6 months’ time
Rosiane and Lonji are practising Muslim’s (Sunni) and are both
very active in the local African community. Rosiane is currently
working 4 days per week in Lonji’s Home Cleaning business to help
meet their financial needs however this has become increasingly
challenging for her as she has recently become unwell.
She presented to her GP, Dr White, 2 months ago with increasing
fatigue, shortness of breath, mild confusion and hardening of the
Right Breast with ‘peau d’orange’ (orange dimpling) causing pain
and discomfort in her breast.
Dr White referred Rosiane to Mr Sheal, a Surgical Oncologist who
completed a full physical examination and undertook the following
investigations:
On review of all the findings Mr Sheal confirms that
Rosiane has stage 4 Advanced R) Breast Cancer with lymph, lung +
brain metastases. Mr Sheal discusses the diagnosis with
Rosiane and Lonji and explains that approaches to treatment were
now not curable but rather palliative in intent.
You are the GP Practice nurse assisting Rosiane through these
early stages of diagnosis and follow-up tests.
QUESTION 1: Discuss four
(4) key elements of a ‘palliative approach to care’ in relation to
Rosiane.
QUESTION 2: Describe how you would
complete a holistic assessment on Rosiane?
QUESTION 3: Describe the
pathophysiological changes associated with Rosiane’ s life-limiting
diagnosis.?
QUESTION 4: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
implications of implementing advanced care planning and advanced
care directives.
QUESTION 5: Discuss the state legislation,
that you reside in, relevant to Advanced Care Planning
QUESTION 6: Discuss the state legislation,
that you reside in, relevant to Advanced Care Directives.
QUESTION 7: Lonji is quite distressed at
the level of Rosiane’s deterioration and complains to you in front
of Rosiane that she doesn’t “make an effort to eat and drink to
help her stay well”. He thinks she needs to go to “hospital
for a drip” How would you explain to Lonji’s Rosiane’s hydration
and nutrition needs in line with a palliative approach to care and
her ACD?
QUESTION 8: Rosiane was referred to an
Oncologist to explore palliative options of chemotherapy. She
completed a course of IV Trastuzumab which she has been having
weekly however she says to you that she feels ‘worse not
better’. She tells you she is not going to accept further
chemotherapy treatment and she wants to talk to you about
Palliative Care. Describe what Palliative Care is and state
four (4) members of the Multidisciplinary
Palliative Care Team.
QUESTION 9: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
issues related to “request for autopsy”.
QUESTION 10: As part of a Palliative Care
approach to care discuss two (2) legal and ethical
issues related to “organ donation”.