Nursing Case Study: Managing Tom's Pain and Breathing Issues

The assignment discusses the nursing care provided to Tom, focusing on the essential actions taken to manage his severe pain and difficulty breathing. These actions include working together with medical professionals, pressing bells for emergency help, conducting case discussions with family members, and providing morphine and oxygen as necessary. The nurse's role in overcoming emotional challenges, communication breakdowns, and opinions from family members is also highlighted, demonstrating the importance of effective communication and teamwork in ensuring Tom's optimal care.

Nursing Case

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Identify the issues...................................................................................................................3
Establish goals........................................................................................................................4
Select a course of action.........................................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Nursing refers to a medical profession which concerned with provision of facilities
important to maintain and restore the health by attending actual requirements of patients.
Moreover, it can be described as a profession of health care sector to focus on well being of
individuals, families and communities by improving quality of life. They have a role to make an
appropriate plan of interventions with rationale, performing collaboratively with specialists,
therapists or physicians to make patient a sick person healthy (Schwartz and et. al., 2013). The
present report is based on given case of Tom whose age is 55 years surviving at last stage of his
life along with facing severe pain and problem in breathing. Actually, he is suffering from lung
cancer & multiple metastases and receiving case at terminal phase of his life. This assignment
will focus on issues in case of given patient and required to set desired goals in order to select an
appropriate course of action to improve his health position.
MAIN BODY
Identify the issues
As per given case study, Tom is suffering from lung cancer and multiple metastasis at the
age of 55 years along with facing crucial pain. It include his critical situation because of facing
extreme difficulty in breathing due to which medical specialist provide an oxygen mask to him
for 24 hours. It is necessary to take care of him very care fully along with dealing properly with
is family members including daughter; Carina and an enduring guardian; Jimmy. However, his
son, Jimmy think that they should contact with General Practitioners in order to gain advanced
care planning to make his father well being very soon. There are several issues winch are
observe by me and analysed thoroughly to examine the case of Tom and these problems are
explained further –
Communication Breakdown – This can be described as conversation among staff
members or with relatives in health care organisation is not appropriate or incomplete which
impacts negatively on outcomes relevant to patient (Kongstvedt, 2012). It is considered as a
significant cause of risks and malpractice which harms a sick individual. In context of Tom's

situation, it is necessary to make an accurate communication within nurses, doctors and other
specialists associated with his case to gain desired results. His daughter, Carina shouts as she do
not want her father to take morphine any more and asks doctors to change his medication for
reducing his pain. Moreover, it is essential for nurses to make family members understand the
importance of current medication and persuade their behaviour to cooperate with them to make
Tom well being.
Emotional Challenges – This include emotional status of family, members, relative and
known ones of patients when they observe their loving person into crucial situation. Meanwhile,
it also analysed that many times nurses or doctors even get emotional but they must remain
controlled to avoid showing their feelings among relative of sick individual (World Health
Organization, 2012). Moreover, they have a responsibility to make them morally strong and
motivate ill person to improve their will power for get well soon. As per scenario, nurse of Tom
get demotivated herself while observing deadly circumstances and discuss her situation with
superior through avoiding tense expressions among his relatives.
Opinion of family members – Here description is given about about view, opinions and
expectations of family members of patient which they expect from nurses. Common people do
not have much knowledge about medications and due to that unable to understand person behind
using the same. In case of Tom, his daughter is not in favour to further continue the present
medication of morphine which is helpful to reduce pain and difficulty in breathing. Moreover, it
is required that nurses should convey desired information to make them understand the actual
significance and gain their cooperation towards well being of patient.
Remove Oxygen Mask – This refers a negative response of Tom, as he remove his
oxygen mask while talking or answering questions of nurse which is not good for his health. As
he is not able to breathe and feeling severe pain than it is necessary for him to wear oxygen mask
in proper manner along with avoiding to remove it and take doses of morphine for decreasing
pain (Stoddart and Evans, 2017).
Establish goals
There are different types of patients having differentiated health issues and requires an
appropriate medication as per their body response to make them well being. It is necessary for
me while perusing the profession of Nursing to thoroughly analyse situation of a sick person
through examine actual signs or symptoms to render more effective as well as efficient treatment

to them for their welfare. In context of Tom, he is not able to take proper meal and only take
small sips of fluid. Due to agitation and pain, his condition become more critical which requires
desired treatment in order to sort out his problem properly. In this situation, as a nurse I required
to be make certain accurate goals in favour of Tom for getting well soon. Some of targets in
order to taking care of selected patient are as under –
Make Effective Communication – This include to conduct an appropriate conversation
among various medical professionals who are associated care of Tom. It also include that they
are required to communicate with family members appropriately to motivate them and perform
diagnosis of patient together for solving desired health problem successfully. Moreover, nurses
or doctors should convey limited information about medication of Tom in order to make them
understand the importance along with attaining their support.
Provide appropriate medication – This refers to analyse real situation of patient in
order to render most suitable medication to them. In context of Tom, he has issues of lung cancer
and multiple metastases from long period of time. However, now his condition is very crucial as
he is suffering from severe pain and facing difficulty in breathing (Agrawal, 2015). Meanwhile,
dose of morphine should be provided to him after specific period of time to reduce his pain and
supply an appropriate amount of oxygen in terms monitor him continuously for 24 hours. In this
regard, morphine is provided in every two hours 2.5 to 5 mg.
Focus on Practical desires – This can be described as top focus on practical desires
along with avoiding emotional issues to gain an appropriate results. It include to remain practical
and put effective treatment to reduce pain and abnormal breathing of Tom in order to render
healthy living to him. Additionally, actual needs of patients as well as their family members
should be considered while making plan of action to make patient well being successfully.
Select a course of action
The course of action is an important aspect in order to remove medical threats from life
of sick person as attempts of nurses, doctors and other specialists are responsible for positive
outcomes. According to me necessary to select more effective as well as efficient medication to
solve issues of Tom including crucial ache and difficult breathing according to his age as well as
previous critical diseases. Some of essential actions which are favourable in case of Tom which
are given below –

Work together – This refers to make work together in team through coordination with
team of medical professions with relative of Tom through communicating properly. It include to
motivate family members for achieving their support to conduct diagnosis properly. Nurse of
Tom request to Tom and his relative that necessary to give small amounts of morphine which is
mandatory to control pain.
Press bells to call help – The nurse of Tom provide a pressing bell to him for calling
help in emergency situations to fulfil gain any king kind of help as well. It also involve to make
him morally strong in terms of maintaining his will power to be alive (Collins and Rocco, 2014).
Case discussion with family – This refers to make a healthy and positive discussion of
overall case to family members of Tom and convey necessity of medication to them. It is helpful
in order to gain cooperation of relatives which is supportive to provide treatment to Tom for
solving his problem of severe pain and difficult breathing through morphine & Supply of
oxygen.
Provide morphine and oxygen – This can be described as to provide required doses of
morphine in desired durations of time on regular basis without missing a single dose for Tom.
Moreover, an an appropriate supply of oxygen should be given to him for making him breathe in
comfortable manner along with kept him under observation to deal with emergencies.
CONCLUSION
The above reports is conclude that nursing is a kind of medical profession in terms of
taking care of individuals, families or communities by conducting desired diagnosis properly. It
include to determine several issues including communication breakdown, emotional challenges,
opinion of family members and remove oxygen mask which are required to be overcome by
taking several sources of action. Thus, these problems can solved by making effective
communication, work together, provide actual medication through avoiding emotions to get
better situation of given patient and make him healthy.

REFERENCES
Books and Journals
Schwartz, R. L. and et. al., 2013. Health law: cases, materials and problems. West Academic
Publishing.
Kongstvedt, P. R., 2012. Essentials of managed health care. Jones & Bartlett Publishers.
World Health Organization, 2012. Research priorities for Chagas disease, human African
trypanosomiasis and leishmaniasis. World Health Organization technical report series
(975). p.v.
Stoddart, G. L. and Evans, R. G., 2017. Producing health, consuming health care. In Why are
some people healthy and others not? (pp. 27-64). Routledge.
Agrawal, V., 2015. Security and privacy issues in wireless sensor networks for healthcare. In
Internet of Things. User-Centric IoT (pp. 223-228). Springer, Cham.
Collins, J. C. and Rocco, T. S., 2014. Disparities in healthcare for racial, ethnic, and sexual
minorities. New Directions for Adult and Continuing Education. 2014(142). pp.5-14.