Palliative Care - Case Study Example

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This is a case study of a 78 year old male who was brought into the (ER) emergency room by the emergency medical services after being found down and altered. The report describes the clinical picture of the patient…
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Download file to see previous pages The report then discusses the case in light of current medical practice in the field of palliative care and applies the ACE model in the design and implementation of the palliative care plan of the patient. Palliative care for the elderly is a critical healthcare service whose objective is to improve the quality of life of the elderly. Although a lot has been done in terms of research initiatives, and education of healthcare providers, the quality of healthcare is yet to reach the desired standards (Jerant, Azari, Nesbitt, & Meyers, 2004). In many instances, design of care provision often overlooks the elderly who in fact have the greatest need for the care due to the complex nature of their needs. Despite this, palliative care is progressively being incorporating the elderly in the design of care and has played a major role in alleviating pain and distressing symptoms thereby gaining wide acceptance as a recognized specialty of nursing (Becker, 2009). Palliative care and nursing are also closely intertwined and the knowledge and skills required are applicable across the nursing profession. It is therefore critical that nurses acquire critical skills and knowledge that would enable them to conduct research and apply current evidence based practice guidelines in palliative care delivery. This report will be based on a case study of a 78 year old man brought into the ER after being found down and altered by a friend....
On physical examination, the heart rate was in the 110’s and improved to 130 and then to 140’s systolic with fluid resuscitation. On further examination; the patient is noted to be cachetic, and malnourished. He was alert, oriented, awake and talking. The mucous membranes were very dry. He had tachycardia with inspiratory rales on the right upper lobe of the lung. The abdomen was non distended and non tender. His laboratory results revealed a white blood cell count 16.1 with a left shift, the sodium concentration was 128, the creatinine level was 2.0, and lactate at 5.1. His chest x ray was clear and the head CT scan of the head revealed moderate hypoattenuation of the white matter. The patient has evidence of having an acute kidney injury and hyponatremia. The patient displays evidence of failure to thrive. The initial diagnosis made included altered mental status, acute kidney injury, failure to thrive, malnourishment, starvation, weight loss, history of alcohol abuse, severe chronic obstructive pulmonary disease, dehydration, and hyponatemia, The condition of the patient was determined to be critical and he was admitted into the medical intensive care unit. While in the MICU, the patient complained of increasing cough, difficulty swallowing and abdominal pain. On auscultation of the lungs, there were scattered rhonchi across the lung fields both posterior and anterior. The patient grimaced on palpation of the abdomen and had a productive cough. The bowel sounds were hyperactive and the abdominal x-ray revealed a large amount of stool within the rectosigmoid colon. There were also several air filled loops in the mid to upper abdomen. The mucosal lining appeared thickened and distorted. The x-ray of the chest ...Download file to see next pagesRead More
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