Nursing Assignment: Palliative Care Approach and Care Priorities

This nursing assignment discusses the palliative care approach and identifies care priorities for a patient. It provides strategies to manage symptoms and improve quality of life. The care priorities identified are increased shortness of breath and social isolation. Nursing interventions include promoting clear airway passage and enhancing social interaction through community engagement programs. The assignment emphasizes the importance of holistic care for patients and their families.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

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Introduction:
The palliative care approach intends to improve the quality of life of the patients as
well as their family members who suffer from a limiting or life-threatening illness (Hui et al.,
2013). The palliative care approach offers support by envisioning relief from the painful
symptoms and making appropriate physical, psychosocial as well as spiritual support
resources available (Kelley & Morrison, 2015). The palliative care approach offers support to
the family members so as to enable to cope with the disease burden of the patient (World
Health Organization, 2014). In this paper, the case study of Mrs. Brown would be discussed
and accordingly two care priorities would be identified. Appropriate nursing strategies would
then be devised aligned to the care priorities so as to alleviate the quality of living of Mrs.
Brown as well as her family members.
Prioritizing care and devising appropriate intervention strategies:
The primary complaint of Mrs. Brown is her increased shortness of breath and
coughing symptoms. Mrs. Brown states that on account of her shortness of breath, she has not
been able to manage her activities of daily living. Also, it has resulted in her increased
dependence on her husband and she feels that she would soon become a burden for the
family. Further, she also states that she is exceedingly restricted to the bed and is extremely
fatigued. This clearly reveals that the physical health symptom has created a negative impact
on her and has deteriorated her quality of living. In addition to this, on account of her illness,
Mrs. Brown’s level of social interaction has also declined which has made her socially
withdrawn. Further, the case study also reveals that Mrs. Brown suffers from depression and
has never sought professional assistance for recovery. Therefore, on the basis of the case
study evaluation, the care priorities that can be identified would comprise of increased
shortness of breath and social isolation.

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The first care goal would therefore be to manage the symptom of shortness of breath.
The increase in the shortness of breath has resulted in limiting Mrs. Brown’s ability to
perform activities of daily living. The devised nursing goal would be achieved by the
application of appropriate nursing interventions to promote a clear airway passage. In
addition to this, the nursing goal would also comprise of demonstrating behaviours to
effectively improve airway by enhancing coughing and clearing expectorate sections. The
intervention strategy would include, assisting the patient to maintain a comfortable position.
This would be done by elevating the head of the bed and instructing the patient to lean
forward on an over-bed table or be seated at the edge of the bed. The rationale for the applied
nursing intervention can be explained as the promotion of effective respiratory function.
Research studies mention that forward positioning of the patient improves respiratory
function by making use of the gravity (Lainscak et al., 2013). Further, according to
Alexopoulos et al. (2013), forward positioning of the patient eases breathing. Also,
supporting the arms and legs with pillows helps in reducing muscle fatigue and promotes
better chest expansion. In addition to this, the patient would also be encouraged to perform
abdominal and pursed-breathing exercises. Research studies mention that pursed breathing
exercises effectively help in controlling abnormal breathing and at the same time
substantially reduced air-trapping (Alexopoulos et al., 2013; Lainscak et al., 2013). Upon
application of the discussed intervention strategies, the effectiveness of the strategies would
be evaluated so as to measure positive patient outcome. The evaluation would be done by
auscultating breath sounds and assessing the patient for air movement. This would be done in
order to measure the level of airway clearance. Also, the patient would be monitored for
ABG level and respiratory rate. A chest X- ray of the patient would also be conducted
(Alexopoulos et al., 2013). This would help in establishing a baseline for monitoring the level
of progress or deterioration of the disease and its associated complications.

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The second care goal would comprise of increasing the level of social interaction of
the patient. This would be done by encouraging the patient to participate in community
engagement programs after being discharged from the healthcare setting. The patient would
be referred to participate in a number of social support groups specifically designed for aged
individuals that target activities such as meditation and Yoga and gardening. Also, the patient
would be referred to Veteran support groups that engage patient with similar illnesses and
encourage participants to talk about their experience of dealing with the disorder. It can be
expected that this would help in improving the level of social interaction of the patient.
During the tenure of hospital stay, the spiritual preferences of the patient would be taken into
consideration and accordingly arrangements would be made so as to assist the patient with
spiritual therapy. Based on the spiritual preference of the patient, a spiritual leader would be
involved in the care process who would motivate the patient in order to promote accelerated
recovery. In addition to this, the patient would also be referred to a psychotherapist. The
rationale for the same being administration of counselling so as to promote mental wellness
and promote recovery (Connor, 2017). At the same time, the family members of the patient
would be educated about the health condition of the patient. In addition to the same, the
family members of the patient would also be counselled so as to alleviate the level of their
suffering on seeing their family member deal with a chronic illness. Also, appropriate
information about financial assistance services and psychological services would be
discussed with the family members of Mrs. Brown in order to make them aware about the
available support strategies and guide them in the decision making process (Selman et al.,
2014). Also, the family members of the patient would be actively involved across all the
stages of the treatment so as to promote a shared decision making process. This would guide
the care professionals in devising the care process according to the preferences of the patient
as well as her family members. It should be noted here that, according to Selman et al.

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(2014), family members are often unable to cope with the nature of chronic illness and are
not aware of any specific set of behavioural consideration to be used while interacting with
the patient. Negligence and dissatisfaction are normally expressed by family members on not
being able to cope with nature of illness and this subsequently increases grief and deteriorates
the quality of living of the patient. In order to avoid the scenario, specific psychosocial
education would be imparted to the family members of Mrs. Brown so as to improve the level
of communication and improve the standard of living.
Conclusion:
Hence, to conclude, it can be said that palliative care takes into consideration the
holistic needs of the patient as well as the associated family members. In case of Mrs. Brown,
two care priorities could be identified which included the physical symptom of shortness of
breath and her reduced level of patient’s interaction. The nursing strategy to manage the first
care priority would include teaching breathing exercises and maintaining the patient in a
comfortable posture. In order to increase the social interaction, Mrs. Brown would be referred
to a number of social support groups. Further, a spiritual leader would also be involved in the
care process of Mrs. Brown. Also, the psychological, psychosocial and financial concerns of
the patient would be addressed by referring to appropriate support services.

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References:
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Connor, S. R. (2017). Hospice and palliative care: The essential guide. Routledge.P.80-85
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