NRS-460 Benchmark – Case Study: Timothy Smith – Hospice/Palliative Care
Directions: Based on the information given in the case study, formulate a conclusion based on your evaluation and complete the Critical Thinking assignment as instructed below.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the complex management of disease, the clinical manifestations and associated treatment protocols, and how they impact patients across the life span. The purpose of this assignment is to navigate patient needs associated with cognitive and physical decline while demonstrating effective communication and compassionate care.
PART I: Health History and Medical Information
Evaluate the health history and medical information for Timothy Smith, presented below.
Upon discharge from the hospital, Mr. Smith had a successful recovery with home health and outpatient therapy. At the end of his home health journey, Timothy was mobile with a walker and his cognitive abilities had significantly improved. He continued his physical and cognitive therapies to better his mobility on the left leg and address his ongoing PTSD and depression.
After 5 years of successful physical and cognitive therapy, Mr. Smith began to see a decline in his activities of daily living (ADL) and began refusing to attend checkups. At this time, his mother was his primary care giver. She has been diagnosed with terminal cancer.
Mr. Smith’s decline continued to progress. His mother, who was his primary support, passed away, and he does not have a secondary support. He has been dragging his left leg due to decreased mobility, which has led to the development of an infected friction wound on the left foot. After no-showing three appointments with the psychiatrist, Mr. Smith showed up looking disheveled, had a positive drug screen, and seemed to be dealing with his cognition issues outside of the medical field. Due to the accident and decrease in cognition, he isn’t able to comprehend his health needs. Due to immobility and progressive leg weakness, the provider ordered a vascular study of bilateral lower extremities. The study identified thrombus in the left popliteal vein. The patient reports shortness of breath despite no fever, which led to a chest x-ray being completed, showing no noticeable changes.
Laboratory Tests and Vitals:
1. Neurocognitive test – Montreal Cognitive Assessment (MoCA)
2. Vascular study showed a thrombus in the left popliteal vein.
3. Patient is experiencing shortness of breath despite clear chest x-ray.
4. SpO2: 84% on room air
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
Clinical Assessment and Interventions Answer the following questions based on Mr. Smith’s |
|
Discuss the conditions that could be causing Mr. Smith’s |
|
Identify possible interventions that would be needed to |
|
Prioritize three to five additional interventions that |
|
Building Rapport Through Respect, Compassion, and Establishing caring relationships is vital for the |
|
Discuss the steps needed to build rapport and mutual |
|
Explain the strategies that would be useful when |
|
Effective Communication Caring for patients with complex needs requires the |
|
When communicating with Mr. Smith, identify which of |
|
Emotional intelligence helps us maintain an awareness |
|
Psychosocial and Spiritual Considerations Providing holistic nursing care for the patient with |
|
Given the patient’s current situation, discuss ways in |
|
Hospice/Palliative Care Management You are assigned as the nurse case manager for Mr. |
|
Explain the difference between hospice and palliative |
|
Develop a plan to address Mr. Smith’s needs including |
|
Identify two care team members who you would need to |
|
Community Resources and Support Network Appropriate resources and a support network are |
|
Discuss the options that are still available to provide |
|
Suppose this patient was a part of your community. What |
|
References (Please include working hyperlinks.)
|