Reference no: EM133324275

For the patient scenarios, think about each of these questions:

• Who do you think should be in the Interdisciplinary TEAM ?
• Which Care Coordination Model is best for them and WHY ?
• Where they would be on the Model for Palliative Care and WHY ?

(Use the Fig. 12. 1 Model for Palliative Care in Cherry p. 226 for this activity)

#1- Meet the Client: Leo White

Leo White, a 64-year-old male, was diagnosed with Parkinson's disease 4 years ago. He has been married to his second wife, Nancy, for 10 years. Leo has 2 grown children who live out of state, and Nancy has one grown daughter who lives close by. Until recently, Leo and Nancy had always been active in the community. They attended church, played bridge, and enjoyed being with each other. Leo had been able to care for himself independently since his diagnosis, but he is now requiring more assistance with activities of daily living. He does not want to participate in any usual activities and just sits in his recliner.

# 2-Meet the Client: Terry Barnes

Terry Barnes, a 35-year-old mother of three young children, visits the healthcare clinic. She reports experiencing increasing bilateral joint pain, especially in her hands, wrists, and knees. She also reports increasing fatigue and a weight loss of 5 pounds over the last 2 months. She states she has been taking a couple of aspirins a day, but the joint pain is increasing, and she is hesitant to take more medication without a medical evaluation. She appears tense and anxious, and states that she is upset because it is becoming increasingly more difficult to do all the little things necessary to care for her three children. She states, "I'm too young to have arthritis. That's something you get when you're old." Terry's initial medical diagnosis is rheumatoid arthritis, and she is scheduled for diagnostic evaluation.

#3-Meet the Client: Charles Daniel

Charles Daniel is an 82-year-old Black male with hypertension and arthritis, who experienced a transient ischemic attack a couple of years ago. He moved in with his daughter, Sheila after his wife died several years ago. Charles' daily activities include playing golf and socializing with his friends, but for the past few months, he has been unable to play golf due to painful arthritis. Charles stays in the house and as a result, he has gained a significant amount of weight and he smokes more than usual. Sometimes Charles forgets to take his antihypertensive medication. Sheila works fulltime and she states that it is increasingly difficult to care for her father since his arthritis worsened.

#4- Meet the Client: Susan Weil

Susan Weil is a 76-year-old widowed female who lives alone in a subsidized apartment building for older adults on a fixed income. She has two grown children, a daughter and a son, who live nearby and visit often. She enjoys caring for her two grandchildren 3 days a week. Susan has a history of hypertension and osteoporosis. She has also had osteoarthritis for the last 10 years and takes one naproxen each day to manage her arthritic pain. Lately, the joint pain of her right knee has worsened making it difficult for her to care for her grandchildren.

#5- Meet the Client: Albert "AJ" Jones

Albert "AJ" Jones is a 60-year-old Black male who comes to the to the urgent care clinic adjacent to the Emergency Department (ED) at 5:35 pm (1735 ) on Friday afternoon. His gait is unsteady as he walks to the admission counter. AJ leans on the admission counter for support and he appears to have difficulty breathing. AJ states that after dinner, an hour earlier, he began to experience difficulty breathing, which increased in difficulty as he walked toward the clinic.

The receptionist notifies the ED triage nurse, and a certified nurse assistant (CNA) assists AJ into a wheelchair and transports him to the ED.

#6- Meet the Client: Mrs. Judy Sailor

Mrs. Judy Sailor is a 52-year-old Hispanic client that presents to the women's health clinic with vaginal bleeding. She is currently married with two grown children and one grandchild under the age of 5. Mrs. Sailor's last menstrual period was 2 years ago, and due to erratic health insurance, she has not had a regular well women examination for more than 8 years.

#7- Meet the Client: Judy Harrison

Judy Harrison is a 38-year-old African American female with a long history of diabetes mellitus type 2 and hypertension. She has experienced renal insufficiency for the last two years. Her current medications include an angiotensin converting enzyme inhibitor (ACEI), a diuretic, and an oral hypoglycemic agent. She reports to the nurse at the clinic that she has lost her appetite and is very fatigued. She adds that she has to get up to go to the bathroom several times during the night and has trouble catching her breath at times. Her current weight is 114 lbs. (51.7 kg). She is scheduled for diagnostic studies to evaluate for the onset of end-stage renal disease (ESRD).

#8- Meet the Client: Darrell Johnson

Darrell Johnson is a 62-year-old male who comes to the Emergency Department (ED) with a 4-day history of increased sputum production, a change in the character of sputum, increased shortness of breath, and a fever of 101° F. He has a smoking history of 2 packs a day for the past 20 years, and he smoked 1 pack a day prior to that, beginning at the age of 14. He reports that he had asthma as a child and that he has been treated with albuterol (Ventolin) inhalers from time to time as an adult. Mr. Johnson has been hospitalized twice with pneumonia; the most recent pneumonia-related hospitalization was 2 years ago.

#9- Meet the Client: Lara Fielding

Lara Fielding, a 20-year-old college student, comes to the student health center with a 4-day history of flu-like symptoms. She reports feeling increasing fatigue, thirst, and nausea over the last 24 hours. Further assessment and lab work indicate that Lara is experiencing diabetic ketoacidosis (DKA). She is transferred to an acute care facility for treatment.

#10 -Meet the Client: Jeff Dickson

Jeff Dickson is a 17-year-old male admitted to the emergency department via ambulance following a motor vehicle accident (MVA). He is accompanied by his parents and two of the three friends who were in the vehicle with him. Another friend, who was driving the vehicle, was transported to a different hospital by LifeCare Helicopter.

Upon admission, Jeff is awake, but lethargic. He responds verbally, knows his name, and recognizes his parents and friends. He has no memory of the accident that just took place. Jeff's pupils are equal, round, reactive to light, and they are 4 mm in size. He has a positive Battle's sign and has clear drainage from his nose. He reports a headache with a numerical rating of 4 on a 10-point scale. His initial medical diagnosis is a probable basilar skull fracture. He is scheduled for a CT scan of the head, and he is monitored in the emergency department until he can be transported to radiology.

#11-Meet the Client: Frank Hershey

Frank Hershey is a 60-year-old male who is brought to the Emergency Department following an automobile accident. The car Frank was driving swerved off the road into the median, where the car's front end hit a highway bridge. Frank is treated for minor injuries, and several lab tests are ordered. Frank's blood alcohol level (BAL) is .20% (0.20%), and his liver enzymes are elevated. Assessment findings include lethargy, an enlarged liver on palpation, jaundiced skin and sclera, and ascites. Frank is admitted for further evaluation with a medical diagnosis of cirrhosis. The following morning when Frank is more alert, the nurse is able to obtain a more thorough history.