HLTENN010 Apply Palliative Approach in Nursing Practice: Case

This document provides a comprehensive solution to a case study concerning the application of a palliative approach in nursing practice (HLTENN010). It addresses various aspects of patient care, including pain assessment and management, ethical considerations, communication techniques, and legal responsibilities in end-of-life care. The solution covers topics such as the use of Universal Pain Assessment Tools, appropriate medication, psychosocial support for the patient's family, and management strategies for respiratory distress and malignant wounds. It also delves into the enrolled nurse's role in providing quality care, respecting patient rights, and offering bereavement support to the family. The analysis emphasizes the importance of adhering to organizational policies, maintaining patient dignity, and ensuring accurate information is shared with family members, while also addressing the ethical implications of advanced care planning.

Apply Palliative approach in
Nursing Practice

Table of Contents
QUESTION 01.................................................................................................................................4
QUESTION 02.................................................................................................................................4
QUESTION 03.................................................................................................................................4
QUESTION 04.................................................................................................................................4
QUESTION 05.................................................................................................................................5
QUESTION 06.................................................................................................................................5
QUESTION 07.................................................................................................................................5
QUESTION 08.................................................................................................................................6
QUESTION 09.................................................................................................................................6
QUESTION 10.................................................................................................................................6
QUESTION 11.................................................................................................................................7
QUESTION 12.................................................................................................................................7
QUESTION 13.................................................................................................................................7
QUESTION 14.................................................................................................................................7
QUESTION 15.................................................................................................................................8
QUESTION 16.................................................................................................................................8
QUESTION 17.................................................................................................................................8
QUESTION 18.................................................................................................................................8
QUESTION 19.................................................................................................................................9
QUESTION 20.................................................................................................................................9

QUESTION 01
A. This pain can be assessed by Universal Pain Assessment Tools (UPAT). This can enable
clinicians to consult for the specialised pain management team and can lead to early intervention.
Ramesh should have provided better care and medication to reduce the pain.
B. Ramesh should have provided Non-opoids drugs like acetaminophen which could have
provided some relief. Using of nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen
should also be helpful. There should also provide more comfort to the patient.
C. Prescribed drugs should be analysed and after determining which drug is more suitable for
Ramesh for improving his condition. There is need to get the pharmacological effect of each
prescribed drugs which helps to address the medication induced constipation.
QUESTION 02
Ramesh have several needs which includes pain relief and other comfort to get rid of
diseases and to perform different activities to perform better role. As an EN, there is need to
provide better care and support for the Patient. This should have effective and allows to provide
improvement in Ramesh health. This should be respected by providing care and fulfil patient
needs effectively. This can be fulfilling by taking care of individual that can help through
supporting in performing daily activity that have positive impact to fulfil the needs of patient.
QUESTION 03
Enrolled nurse have the role to provide better care and support that can help patient to get
better and effective treatment services to patient. Palliative care should be delivered that can help
patient to get better improvement in individual that can have high impact on the patient health.
While planning palliative care there is need to follow the roles and responsibilities effectively
because there is chance of risk of life for the patient in which roles and responsibilities have the
ability to decrease the effect of pain and other health related issues to minimise and provide
better care and support to improve the quality of life. Working with roles and responsibility can
help to improve health effectively.
QUESTION 04
Psychosocial impact of palliative care providers and influence individual to provide better
care to the patient. This can be effective and allow patient's wife and family to provide better

support and confidence about better care and support. This can also provide feeling of
confidence about the care and lead to provide condensates for the patient health. Family can feel
better and able to sleep peacefully without getting worry and anxiety about the patient care. This
is effective and provides relief from getting tired while providing care to patient. This can ensure
about the better care and support.
QUESTION 05
When Ramesh's daughter approached to Enrolled nurse, in such situation, there is need to
support her belief and agree with her beliefs. This can help to support her for getting better and
effective response. This can support her emotionally to get better and feel more confident about
treatment of her father in right hand. There is also need to make her calm and take in her
confidence that can help her to get better and effective feelings. Enrolled nurse should focus on
providing better support and care to the patient in order to control the emergency situation
effectively. EN should also make Ramesh's daughter comfortable by telling her to prey and go
for her beliefs and left it on the healthcare professionals.
QUESTION 06
Stress management and emotional control are two of the communication techniques can
provide supportive environment which can be highly effective to communicate with Ramesh and
his family member. Stress management can reduce the intensity of the family thinking and
provide some hope and positive aspect. Emotional support can be effective to ensure confidence
about better care and support. This can be highly effective and allow to make them understand
with better response. Emotional and medical support can be also helpful and effectively provide
supportive environment to Ramesh’s and his family in this crucial moment of life. There is also
need to take care of the comfort that is necessary to provide some relief from pain and other
illness.
QUESTION 07
There are various signs which implies about the sign of dying in the scenario. This
includes decrease in the health condition. There was also sign of decreasing in the heart rate of
patient. Blood pressure was also declining along with higher declination in the respiratory rate.
There was observation about Ramesh that he was less responsive, making unusual noises while
breathing, only vocalizing, moving all his limbs which seems to be declining in the health. It is

important to share the accurate information about the patient to the family. This is the legal
perspective that family member has the right to know about the patient's real condition. This is
legal concern that healthcare professional should delivery the correct and accurate information to
the family member about patient's health condition.
QUESTION 08
Ramesh health condition was not good and was dying due to declining health due to
presence of stage IV adenocarcinoma of the stomach. There was continuous decline in his health
which includes decline in body temperature, respiratory rate, heart rate, blood pressure etc. To
follow the standard guidelines, it is important to provide the correct information about the patient
physiology about the health should be provided to his family member. This is the rights of the
patient family that enable to deliver the information to Ramesh's family member. This can be
effective and following of policy to right to know about the information regarding cause of death
and the declining condition of patient.
QUESTION 09
About 12:00, it was observed that there is declination in Ramesh health which was not
good and get less responsive which indicates to the sign of getting respiratory distress. He was
also not able to swallow sip of water which was there due to respiratory distress. This was not
good and created difficulties in swallowing for the Ramesh. There are several management
strategies which allows to decline the stress which includes make feel more comfort with using
of medication which allows to reduce and provide relief from pain. It was needed to provide
medicine which contain iron like ferrous fumarate, ferrous fluconate or ferrous sulfate etc. This
can be more effective in case of ACD.
QUESTION 10
There is need to take care of proper sanitisation. This can be effective and can provide
better response to manage the malignant wound of Ramesh. It is essential to focus on the
removing of visible derbies and devitalised tissue, removing dressing residue and through
reducing contamination. This strategy can be effective and can be used as the non-healing wound
management strategy. This allows to provide better response and can focus to manage the
situation in better way.

QUESTION 11
There is decline in the health of Ramesh which provides the information about the
deterioration according to ACP. There is sign of declining in the respiratory rate and the heart
rate. This is the vital sign for the health deterioration in Ramesh. According to guidelines, there
should be improvement in the quality of life which can be there due to provide better care that
can help to improve the quality of life. But due to not getting the improvement and decreasing in
blood pressure, heart rate, respiratory rate which shows the sign of deterioration. These sign
should be reported to the registered nurse at the right time when this happened.
QUESTION 12
While delivering the healthcare support, there is need to provide the quality of care to the
patient even after knowing that patient is not going to well after this. This can provide respect
and able to maintain dignity of person while delivering care. There is also need to provide care
and give best to save the life and try to provide comfort and not to get suffer to the patient. There
should be taken care that patient should not suffer more and should ensure that delivered care
with quality. This can help to get better and effectively maintaining the dignity of person when
care is provided to the patient in their end of life stages and after the death.
QUESTION 13
Ramesh refused to eat breakfast which was patient's right. Enrolled nurse should have
made him take breakfast which was needed while taking care of patient good health. This was
the ethical issues that Ramesh refused to take breakfast which was needed to take for the health
improvement. This was the ethical issues for the enrolled nurse because, there was need to
ensure about the proper care which includes to get ensure that patient should take breakfast.
Ramesh wife is the appropriate person to discuss about this issue according to organisational
policies where individual nearest relative or family is the right person to inform about this.
QUESTION 14
There are the legal responsibilities of EN when any patient dies who was there under the
care of enrolled nurse. In this, enrolled nurse should take care to fulfil all the documented work
and should take care of confidentiality which is necessary to follow for providing respect and to
maintain dignity of died patient. It is the responsibility of enrolled nurse to ensure about the
preparation for family viewing and should arrange transportation to funeral home or the morgue.

There should also determining the disposition of patient's belongings. They should also show
their consent and make comfort and support their family and friends.
QUESTION 15
There is need to ensure about the death of patient after this, it is important to inform to
the family member who are with patient. There is standard procedure which includes informing
patient's family and related scenario. Then arranging and preparing dead body for viewing
through patient family and arrange the transportation to take body to concern place. These
process should be done effectively by respecting patient along with dignity. There is need to
follow the cultural and religious method that cannot hurt patient's family sentiment.
QUESTION 16
This is the care provide to the family member and relative who have lost their family.
There is need to provide support to the family and help to provide the bereaved individual which
can help in to deal with the grave and provide emotional and support when individual loss the
loved one. Ramesh daughter needs this support because she was the one who feel very bad and
continue weeping for her father. There are some of the resources includes providing support to
her daughter.
QUESTION 17
In this, there is need to provide emotional support by showing empathy which can be very
helpful in delivering support to the people and allow to get better and effective support to the
Ramesh family and his daughter. There is needs to provide care and support to family and
Ramesh daughter. In this, there is need to complete all the legal procedures which should be
there for effective procedures.
QUESTION 18
There is need to take some rest after some interval. This can help to feel better and allow
to get relax and restore own self. This can be highly effective to get better and work further.
There is need to after serving patient, there should take some relax by getting little nap or talking
with person or loved one. This can provide better feeling and can help to sustain social and
emotional well-being.

QUESTION 19
The two ethical implications of the advanced care planning and the advanced care
directives includes an approach which is generally based on a case that encourages a patient’s
autonomy to make the ethical decisions. To support congruence among the individuals and
switch the decision makers in order to boost the supported decision making. As the autonomy is
basically an individual's right for themselves to make proper decisions as well as show their
beliefs. As the ACP supports the autonomy and an individual's right to control the medical
decision making. This includes the stages such as identification and elucidation of the relevant
considerations, explicate and utilize the ethical beliefs and so on.
QUESTION 20
In order to encourage Carolyn it they must mention her that in a nursing profession there are
lot of things through which a nurse will go through. For nurses they should take everything a
positive manner and should follow their prime duty for they are appointed. A debriefing in a
particular workplace is quite important as it is an essential plan of action which is used for
learning from their imperfectness and also enhancing their presentations. The main function of
the debriefing is basically to identify the aspects of the team performance which should be well.
Their discussion then mainly concentrating on regulating the various possibilities for enhancing
at an individual's level, team level as well as the systems level.