Assessment and Management of Palliative Care: A Case Study of Metastatic Breast Cancer

Running head: ASSESSMENT 1 - HEALTH ASSESSMENT/MANAGEMENT
ASSESSMENT 1 - HEALTH ASSESSMENT/MANAGEMENT
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ASSESSMENT 1 - HEALTH ASSESSMENT/MANAGEMENT
This paper thus aims to highlight the assessment and management of palliative care
presented to the patient. The case study is about Sophie who has been diagnosed with
metastatic breast cancer. The patient stated that few years ago she was diagnosed with this
disease after which she had undergone surgery in order to remove the lumps. Followed by
surgery, there were episodes of radiotherapy followed by mastectomy in the left breast and
chemotherapy. However one year later, Sophie again developed a lump. Recently the cancer
has spread even further in the body of the patient. When a bone scan was conducted two
months earlier, the reports showed that the cancer has spread to her spine as well.
As seen from then given situation, Sophie is suffering now from bone metastasis,
which is one of the common site of breast cancer metastasis (Greer et al., 2013). Her
backbone is worsened having a risk of fracture. This condition might call for a pain
assessment examination (Erdek, King & Ellsworth, 2013). The medications that Sophie was
taking was to manage this pain. It has been found that Sophie could be administered with
bisphosphonates recommended by palliative consultant which can reduce pain intensity and
treat malignancy-associated hypercalcemia (Greco et al., 2014). This could also prevent or
delay onset of skeletal-related disease or treatment side effects when used with endocrine
therapy (Greco et al., 2014).
In such a condition, being a palliative nurse, assessment of the patient is required in
order to identify treatment for symptom management effectively and improve the quality of
life of the patient (Irwin et al., 2013). This prevalent situation of the patient called for a need
assessment tool to be used in the palliative care setting. By considering the needs of the
patient, if it is seen that the needs can be managed, then the care should be continued along
with reassessment (Parikh et al., 2013).This is followed by assessment of the needs of the

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ASSESSMENT 1 - HEALTH ASSESSMENT/MANAGEMENT
patient, the family and the caregiver or service provider and conducted by confirmation of
primary care approach (Kwon, 2014).
The condition Sophie is suffering from needs immediate management in terms of
pain. (Parikh et al., 2013). In this regards pain assessment chart could help to assess and
review the level of pain and it would help to introduce effective interventions to manage the
pain based on the level of pain (Bortolussi et al., 2015). The scenario shows that
pharmacologic interventions is not working out for her therefore this requires non-
pharmacologic interventions. Sophie needs to be provided with multimodal approach that
might successfully reduce symptoms and minimize side effects (Roberto et al., 2016). The
WHO Cancer Pain Ladder provides can be implemented which provides guidance on pain
medication and non-pharmacologic pain management strategies which involves patient
educational interventions and comfort therapies (Roberto et al., 2016).
In addition she could be provided complementary therapies such as mind-body
therapy such as meditation to reduce the sensation of threat (Erdek, King & Ellsworth, 2013).
In addition music therapy could be provided to reduce pain as it helps to reduce the pain by
promoting rhythmic breathing, relaxation and rest (Steins et al., 2017). She could be taught
relaxation technique such as breathing slowly and deeply to reduce pain (Bortolussi et al.,
2015). In addition, she could be recommended to join a support group where patients
suffering from acute pain is involved. It could help her to feel less alone and she could be
able to cope up with pain through the benefits of their wisdom (Erdek, King & Ellsworth,
2013). Animal assisted therapy has been found to be effective to reduce pain by reducing
emotional distress, thus bringing a cat in the family could be helpful for the patient
(Bortolussi et al., 2015). Furthermore, mental counselling could be recommended to Sophie
to avoid the negative thinking associated with her condition (Steins et al., 2017).