Analysis of Case Study Scenario 2022

Running head: ANALYSIS OF CASE STUDY SCENARIO
ANALYSIS OF CASE STUDY SCENARIO
Name of the Student
Name of the University
Author’s Note:

1ANALYSIS OF CASE STUDY SCENARIO
Answer to question number 1:
Holistic assessment in the palliative care must consider the patients physical needs as well as
emotional, cultural, spiritual and psychological needs. It is vital that the nurse establish the
eagerness of the patient and in extension their families to discuss these issues beforehand. In
this scenario, the patient want only comfort care and not resuscitation. Therefore, the nurse
should focus on the comfort of the patient on the priority basis (Edwards, 2011). The nurse
should consider the following aspects during the holistic assessment of the patients:
 P - Physical need(s)
 E – Emotional need(s)
 P – Personal need(s)
 S – Social need(s)
 I – Information and communication need(s)
 C – Control and autonomy need(s)
 O– Out of hours need(s)
 L – Living with illness
 A – After care need(s) (Edwards, 2011)
Answer to question number 2:
Patho - physiology of gastric carcinoma generally occurs due to the step wise evolution of
pre- cancerous lesions. Sequential changes which are histo-pathological in nature take place
in the gastric mucosa after this stage (Jang & Kim, 2011).
The two needs for Ramesh in this scenario are:
 Relief of associated pain
 Sustenance for the patient

2ANALYSIS OF CASE STUDY SCENARIO
Answer to question number 3:
a) Pain assessment for the Ramesh would include physical examination and a detailed
history, in addition to assessment of psycho-social circumstances, and a diagnostic work up.
b) Two strategies for pain reduction of Ramesh are:
 Reduce the intensity of the pain
 Pharmacological intervention and psychological support (Abernethy et al., 2013)
c) Management of medication induced constipation:
 Increment of fluid intake
 Prescription of cathartic or laxative medication (Abernethy et al., 2013)
Answer to question number 4:
In this scenario, patient’s primary need is comfort care. The nurse should respect this and
Opioid based analgesic can be given to the patient for the reduction of pain (Caraceni et al.,
2012). The nurse also should not the patient what he is not willing to do and respect the
patient’s choice.
Answer to question number 5:
Nurse’s role in this scenario would be to reduce the suffering of the patient and address the
complexity of the patients and their respective family’s needs.
The responsibilities of the multi- disciplinary team in this scenario would be addressing the
psychological needs of the patient’s family as well as to enhance the comfort care of the
patients (Hussainy, Box, & Scholes, 2011).
Answer to question number 6:

3ANALYSIS OF CASE STUDY SCENARIO
For many families, their first significant confrontation with death is their diagnosis of a life-
threatening disease of a family member. Social burdens such as personal-time constraints,
routine disturbance, and a decreased leisure time can accentuate the physical, mental,
economic and social effect of offering support for a dying relative. They include anxiety,
depression, low self-esteem, isolation, tiredness, guilt and sorrow (Hudson et al., 2012).
Answer to question number 7:
It is essential, during palliative care and after death, to be conscious of religious or spiritual
convictions and practices an individual can have. Therefore, the nurse should allow the
patient’s daughter to perform her religious belief.
Answer to question number 8:
Two effective communication techniques during palliative care are:
1. C-L-A-S-S strategy for clinician patient interview (Kumar, D’souza, & Sisodia, 2014)
2. S-P-I-K-E-S protocol for breaking bad news (Kumar et al., 2014)
Two support services that would be approached to provide supportive environment and care
are:
1. Psycho-social support
2. Family Focused Grief Therapy (Zaider & Kissane, 2009)
Answer to question number 9:
Signs of stages of dying:
 Pain to left upper quadrant
 Making unusual breathing noises
 Losing consciousness