ANSWER TO THIS POST IN A THOUGHFUL WAY AND USE NORLANDER AS ONE OF THE REFERENCES
The most important aspect of Jane’s care is understanding what she and her family know about her prognosis and goals of care. By establishing a baseline of needs with Jane and her family, I would be able to get a better handle on what kinds of interventions I can provide for them both physically, spiritually, psychosocially, and emotionally. I would utilize the Palliative Assessment Screening Tool (PAST) to steer the questions towards Jane and her family to get a better sense of their needs. PAST is used to guide staff nurses in the early identification of the palliative care needs of their patients and helped nurses obtain referrals to a medical palliative care provider to improve patient outcomes, particularly symptoms of pain, nausea, and shortness of breath (Flaherty et al., 2018). By utilizing this tool, I would be able to pinpoint some of the areas of distress for Jane and her family and hopefully alleviate some of the issues.
There are a few physical symptoms that I would take into consideration regarding Jane’s case and would like to address with immediate interventions. First, her dyspnea should be considered. This can be a combination from her previous medical history of low ejection fraction, heart valve replacement, and pulmonary edema. In addition, she is currently being treated for pneumonia which can also be a cause of her shortness of breath. It is important to keep this symptom well-controlled since this can be a highly distressing issue and can be a major source of anxiety. Dyspnea can be one of the most distressing symptoms for both patients and their families (Norlander, 2014). By continuing her course of antibiotics for the pneumonia, and I would also implement other interventions into her care plan including head of bed elevation, opening of a window, and maybe even attaching a fan to her bedside for a feeling of fresh air. In addition, I would aid Jane in breathing techniques including purse-lip breathing to help slow her respiratory rate if she is becoming anxious. I would not immediately jump into anxiolytics for her since her hypotension and delirium could worsen.
The next physical symptoms that I would consider are her hypotension and fluid overload. Jane is at a very delicate balance with CVVHD, fluids, and dopamine infusion. Therefore, it is of the utmost importance to relay to the patient and family that this will continue to be overseen in the ICU since the patient requires close monitoring.
Jane’s spiritual, psychosocial, and emotional symptoms are also important for her and her family’s plan of care. I would first address her confusion that is being attributed to ICU psychosis, and make sure it is not an extension of the infection that she is fighting. Once better understood, I would then take steps to re-orient Jane to her baseline mental status including scheduling her timing of medications and care, including a clock or calendar in her rom providing a calming environment, and even having her family members at the bedside. As previously discussed, I would get a sense from Jane and her family of their understanding of her prognosis and how they have been coping with her frequent hospitalizations. I would assess the family’s needs based off their responses and be as transparent as I can about Jane’s condition. I would offer support for them in any way that I could and ensure them that the palliative care plan is a collaborative effort and will continue to change as Jane’s needs change.
Flaherty, C., Fox, K., McDonah, D., & Murphy, J. (2018). Palliative care screening. Clinical Journal of Oncology Nursing 22(4), E92-E96. doi: 10.1188/18.CJON.E92-E96
Norlander, L. (2014). To comfort always: A nurse’s guide to end-of-life care. (2nd ed.). Indianapolis, IN: Sigma Theta Tau International. ISBN: 9781938835506
Why Work with Us
Top Quality and Well-Researched Papers
We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.
Professional and Experienced Academic Writers
We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.
Free Unlimited Revisions
If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.
24/7 Customer Support
Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.
No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.
Admission Essays & Business Writing Help
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.
Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.