Palliative Nursing Care Case Study 2022

Assessment Task 3: Case Study
Introduction
Palliative nursing care is a vital part of nursing practice. Palliative nursing care is considered
to be reducing the pain and promote the comfort for the dying patient. Emotional support,
family and patient centered care are also an essential part of the palliative nursing care. Mr.
Patrick Brady is a 70 years old male, suffering from end-stage prostatic cancer. The
metastasis of cancer to neighboring organs, hip and bone cause unbearable pain. The nurse
caring for Mr. Patrick needs to plan the palliative care using clinical reasoning cycle. The
clinical reasoning cycle is composed of eight stages that help the health professional to ensure
evidence-based nursing care. This assessment helps to consider the patient’s situation, collect
and process the objective and subjective data, identify and prioritize the nursing problems,
establish the goals, implementation of nursing intervention, evaluation, and refection.
Consider the patient situation
Mr. Brady is suffering from end-stage prostatic cancer and metastatic bone cancer in the
lower back and hip. Patrick was not showing the sign of recovery after the chemotherapy,
radiotherapy and hormonal therapy treatments for about six months. He decided to stop all
the treatments and enjoy the rest of the days in his home and garden. Presently, Patrick lost
weight and experiencing increased nausea and fatigue. He needs more incontinence pads and
his pain is worsening and he is clinically deteriorating. Patrick needs palliative nursing that
supports him to alleviate the signs and symptoms of the end stage of cancer.
Collect and process the information

Mr. Patrick's past medical history shows that he has hypercholesterolemia and GORD. His
present medical condition shows that he is suffering from end-stage prostatic cancer and
metastatic bone cancer in the lower back and hip. Over 6 week period there was an altered
bladder function associated with constipation (Leppert et al. 2016). Due to increased pain,
Patrick consulted the GP. Investigations are done to rule out the diagnosis. His bladder
symptoms are relieved with TURP and prostate biopsy was done. He was diagnosed with
advanced prostate cancer with bone metastasis. The metastasis to his hip and spine was
discovered. Immediately chemotherapy, radiotherapy, and hormonal therapy were started. He
was on the therapies for six months and identified that the treatment was not effective. Patrick
wanted to stop all the treatment and enjoy the rest of his days in his home with his family.
Mr. Patrick needs palliative nursing care both physically and emotionally (Sanford, Greene,
& Carroll, 2013). The nurse involved in the nursing care of Patrick should concern about the
pain that increases day by day. Prostate cancer presses the nerves in the region and causes
pain which increases as the cancer cells grow and add more pressure on the nerves.
Metastasis of cancer to the hip and back causes pain in the bones (Mustafa et al.
2016).Hormonal therapy is also one of the causes of the pain as it is the side effect of the
therapy. Patrick is experiencing incontinence which is due to the metastasis of cancer to the
bladder and urethra causes incontinence. He is losing weight due to nausea and loss of
appetite, the common symptoms of any kind of cancer. His condition is deteriorating and he
is in need of palliative care, emotional and spiritual support.
Identifying the problem
Mr. Patrick is the dying patient who is in need of end of life care. The nursing problems
identified in the case of Patrick are chronic pain that is related to the disease condition and its

complication, Nutritional deficit due to disease condition and psychological issue and Need
of emotional and spiritual support.
 Chronic Pain
Chronic pain is common in end-stage prostate cancer which is due to the metastasis of the
malignant to the bones and the neighboring organs. Chronic pain is considered to be the high
priority nursing problem because pain affects the patient both physically and emotionally.
Mr. Patrick wanted to enjoy his remaining days with his family; the chronic pain would be
the hindrance for the last wish of the patient. So, the nurse needs to set goals to reduce
chronic pain and promote comfort for the patient. Malignant tumor presses the nerves and the
adjacent organs which cause the pain in the cancer patients (Green, & Hart-Johnson, 2010) In
the case of Patrick; he is in the end stage of prostate cancer which refers to the metastasis of
cancer to the bones of hip and back. The nurse needs to be aware of the cause for chronic
pain which helps to plan the goals and nursing interventions to alleviate pain (Leppert et al.
2016).
 Nutritional deficit
Mr. Patrick had weight loss and the eating pattern is altered due to the complications of the
disease condition. The nutritional deficit is considered to be the high priority of nursing care
because one of the causes for the clinical deterioration of the patient is the nutritional deficit.
Palliative care is always concerned about the suffering of the patient. But, the study of
Bazzan (2013) states that nutritional support is essential in palliative care. He suggests that
nutritional support helps to sustain the quality of life in palliative care. The present condition