Identify what management strategies

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Reference no: EM133918064

Question

Mrs. Paul is a 48-year-old woman dying of end-stage liver disease and chronic renal failure. She is fatigued and has experienced significant weight loss, despite significant edema. She was diagnosed with colon cancer three years ago.

Mrs. Paul's family is very upset and wants aggressive interventions done to help improve her appetite, curb her weight loss (she has lost 18 pounds in the last 4 weeks), and prevent nausea/vomiting. Her physician believes that one of the contributing factors to her fatigue is that her hemoglobin and hematocrit are very low. So, she has received 4 units of packed red blood cells over the past 2 weeks. The patient states that the fatigue continues, despite the blood transfusions. She has intractable nausea/vomiting and, as a result, she is frequently admitted to the hospital. As the advanced practice nurse (APN) on the medicine unit, you are consulted to address these frequent hospitalizations. As you assess these admissions, you learn that the staff is very upset when caring for this family. Neither the patient's attending family physician nor the oncologist have taken an active role in discussing palliative care with the patient or the family. One of the staff nurses confided in you, "This family and patient deserve better-someone needs to be truthful with them, so they know that their loved one is dying."

Based on your assessments, identify what management strategies you would use. What issues would you want to discuss with the interdisciplinary team?

Reference no: EM133918064

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