Palliative Management of Cancer Fatigue

This assignment delves into the complex issue of fatigue in cancer patients, emphasizing its multifaceted impact on physical, emotional, and cognitive well-being. It highlights the importance of palliative care in managing fatigue, exploring various strategies to alleviate symptoms and improve quality of life. The document emphasizes the role of nurses in providing holistic care, addressing not only physical needs but also psychosocial and spiritual concerns. It underscores the need for empathy, communication, and tailored interventions to support both patients and their families.

Running Head: SOPHIAS SENARIO PALLIATIVE CARE
Sophias senario palliative care
Name of the Student
Name of the University
Author Note

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Introduction
The assignment deals with the case study of Sophie, a 47-year-old woman living with
metastatic breast cancer. She was admitted to the palliative care unit after the worsening of the
symptoms. In response to the case study the assignment discusses the role of the palliative care
nurse for Sophie in conduct a comprehensive health assessment management plan. It includes the
use of patient history in assessment, use of physical examination in assessment, the priorities of
management. The discussion and the clinical decision-making pertaining to the case study is
supported with the relevant literature.
Patient history in assessment
The palliative care nurses must be well versed with the significance of taking the new
patient history for documentation. Based on the literature evidence, the nurse must initially
gather information as per the type of tumor. The nurse must obtain the relevant breast cancer
focused history. The history of the present illness may include onset, location, duration,
characteristics of the signs and symptoms (Schacht et al., 2014). It should also include the
Sophie’s aggravating and relieving factors. The nurse must document the details of the
temporality of the presenting sign or symptoms. Further, the type of medication that was
administered to her is also necessary to gain a perspective on the current illness symptoms and to
rule out side effects (Bower et al., 2014). For instance, the use of MS Contin 120mg BD and
morphine (Ordine) elixir 40mg PRN for breakthrough pain It is necessary to well establish the
story of the cancer diagnosis of Sophie as a palliative care nurse. The nurse must then determine
the appropriate manner of diagnosis pertaining to that type of tumor. The nurse must collect data

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on the extent of the diagnosis process that has been conducted to date. Based on the diagnosis the
nurse can make decision on the care plan to be designed.
According to Swartz (2014), there is a great impact of the social and the family life on the
illness and the coping mechanism of the patent. Therefore, the nurse must ask the patient to retell
her story even if it is emotionally difficult. It will give the nurse some perspective on the
emotional trauma of cancer diagnosis. It will help obtain information on the family support
received by Sophie, level of social inclusion. In case of Sophie, a strong family support was
observed. As she was working, she had adequate social connectedness. As the patient retells her
story, the patient and family, competence is observed in respect to dealing with the health care
system (Pandey & Nguyen, 2017). Sophie has strong support of her husband and her two teenage
sons. The patient’s details indicate of high level of resilience in the distress of illness. However,
there is a great potential for distress considering her worsening of symptoms. Further, there is a
great role of the genetics in the cancer. Family history of cancer is the aggravating factor. Sophie
as per the history shows positive coping strategies. She is engaged in meditation and yoga and
the same can be used as strength to encourage her during palliative care.
In conclusion, collecting the patient history is useful to provide the patient centered care
in the palliative care unit. The care plan may involve the use of routine such as playing of music
or anything related to Mozart as it is Sophie’s favourite. During care process, Sophie can be
given the peppermint tea to relieve her nausea. Further, the history is useful to design the care
plan as per the tastes and preferences of Sophie and her family.

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Physical examination in assessment
The nurse must perform physical examination that is specific for the metastatic breast
cancer. The first part of the physical examination would be to look and observe. One need not
start with stethoscope to examine the respiratory and cardiovascular system. Valuable
information can be obtained by examining the skin, facies, gait, colouration, handshake and
personal hygiene. It is possible to detect the endocrine disorders, as they are immediately
apparent (Zhang et al., 2015). Even if several physical exams have been completed during the
diagnostic process, the nurse must once again perform the head-to-toe exam. As the patient
embarks on the cancer therapy it will serve as a baseline physical exam. Further, evaluation for
the metastatic disease can be triggered completely changing the staging, subsequent treatment,
and prognosis (Pandey & Nguyen, 2017).
The physical examination of Sophie includes breast examination (for lumps). It may
include monitoring the skin tethering, nipple inversion, dilated inversion, ulceration, mammary
paget disease, and edema. The nurse must identify the lumps hardness, irregularity, focal
modularity, asymmetry with other breast, and assess fixation to muscle by moving the lump in
the line of the pectoral muscle fibers. The patient bracing her arms against her hips can do it
(Lahart et al., 2015).
The physical examination may also include auscultation of heart, and examination of the
respiratory system, abdomen, examining lumps, and obtaining of the neurological history.
Further, the palliative care nurse must be able to demonstrate her competence at the orthopaedic
examination. It may include back examination, hip history, neurological examination of the
lower limbs for knee, hip history, shoulder examination, and assessment of the ankle injuries.
Other physical examination may include monitoring of Sophie for swollen joints. Further

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examination may include Sophie’s peripheral pulses, ENT examination, and mental state
examination (Lahart et al., 2015). Once the examination is over the nurse must collate the
history and the physical examination information and present it as oral and written presentations.
Management plan
Patient and the family education on the care is essential to avoid aggravation of the
illness. The management plan for the Sophie in the palliative care unit includes psychosocial and
spiritual domains. The nurse must consider the patient’s and the family member’s preferences
and value them (Wiener et al., 2015). Establishing therapeutic relationship with Sophie will help
her gain positive experiences and make differences to the life of the patient. Demonstrating
empathy and sensitivity is necessary as the suffering of the patients can be lessened. It will help
relieve the pain, respond to treatment, lessen anxiety, and developing hope. The nurse must
manage the patients to prevent stigmatisation. The nurse will encourage Sophie to communicate
with the patient (Zimmermann et al., 2014). The nurse will demonstrate the exercises to increase
the patient’s mobility and physical injury. Further, the nurse must enhance the self-care, and self-
efficacy behaviour to increase coping with illness (Zhang et al., 2015).
Conclusion
Any kind of cancer is the debilitating symptom. It is multifactorial in nature including
cognitive, emotional and physical aspects. Therefore, there is a need of Palliative management of
fatigue.

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