19. When a patient discovers that they’re terminally ill, they may get depressed or even see no reason to continue living. They may stop eating or reduce the amount of food they eat because of their anger, depression, or just ultimately feel as if nothing will help their situation. In my nutritional care, I would encourage the family to continue supporting the patient through their difficulties. They should motivate him to stay positive during these hard times. I would personally encourage the patient to remain optimistic. 3 questions I would ask is: What does he usual eat while home? Does he usually finish his meals. Being the family of this patients what wishes or concerns do you possess?
20. Unintended weight loss related to malnutrition as evidence by his usual body weight severely decreasing
Malnutrition related to his
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decreased appetite and pain while eating as evidence by his severe weight loss 21. In the first diagnosis: I would maintain the amount of calories the patient is receiving to the required 2700 kcals per day to prevent the patient from losing weight. Stabilizing his weight will be ok since, he’s at a normal weight. In the second diagnosis: I would suggest that he’s receiving atleast 2700 kcal per day. He could switch his formula from Isosource 1.2 to Pivot 1.5 to increase his caloric and protein intake. 22. No, the current nutritional support doesn’t meet the needs of the patient. I would recommend increasing his caloric intake to about 2,700 kcal per day with a minimum of atleast 135-225g of protein. 23.
Mr. Seyer’s nutritional intervention will have to occur after his surgery. They can attempt to get him off his tube feeding. He can consume soft (non-spicy foods). Avoid juice or foods with high concentrations. If necessary, he can take tube feeding through the mouth.
24. Factors you should monitor for is Mr. Seyer’s weight and fluid levels to make sure he’s weight is stabilizing and his becoming more hydrated. His lab values should me monitor to ensure they’re normalizing.
25. A side effects of radiation is dysphasia. With individuals having trouble swallowing, it would be necessary to place a feeding tube in the patient to provide the adequate nutrients that would be loss due to a lack of completely consumed meals.
26. Mr. Seyer’s weight should be monitored to make sure he doesn’t continue to suffer weight loss. Fluid, caloric intake, and protein should be monitored in order to assure adequate nutrition is being supplied. Also, his lab values such as albumin, pre-albumin, and protein should be monitored to ensure he has limited amount of muscle wasting. Lab values such as RBC, HGB, HCT, should also be monitored to prevent
anemia.
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
...concerns appropriate interventions were assigned to each one. For the priority concern of the family’s ability to cope and their risk of depression commendation and interventative questioning were the chosen interventions. For the priority concern of Gilberts care giver burnout and risk for compassion fatigue commendation and encouraging respite were chosen. The Grape family is a fitting example of the complex difficulties a family can have when they are faced with the difficulty of dealing with a chronic illness and tragedy. This paper demonstrates the importance of assessing and creating interventions for a family in a way which includes every member of the family not only the ones with complications. Raising the question should patients who are suffering from chronic illnesses better off to be treated as an individual or as a member of a functional family unit?
The first component of the MUST involves measuring the patient’s height and weight to establish their Body Mass Index (BMI). BMI is the’ relationship b...
Since the patient cannot use glycose as a form of energy for the muscle I would expect this patient to use fuels such as fatty acids and proteins.
The purpose of this essay is to explore nursing care priorities for a patient with a common health condition. A common health condition is a disease or condition which occurs most often within a population. The author has chosen scenario 3 for this essay and will describe the nursing assessment and care planning provided to a patient with Chronic Obstructive Pulmonary Disease (COPD). The WHO definition of COPD is a lung disease which has a chronic obstruction of the airways that impedes normal breathing and is not fully reversible (). According to), there are estimated to be over 3 million people in the UK with COPD. It is common in later life and there are approximately 25,000 deaths each year, with 15% of COPD being work related (The identity of the patient will remain anonymous in adherence with the Nursing and Midwifery Council, Code of Conduct on patient confidentiality (). However, the patient will be referred to as Mr B in this essay. The author has chosen the priority of eating and drinking for Mr B. Patients with COPD are at increased risk of malnutrition and nurses must make certain they screen patients and offer advice or refer as necessary (). If this priority is managed well it will have a positive effect on the other priorities (, 2012). In accordance with NICE Guideline 101 (), the treatment and care provided should consider each persons’ individual requirements and preference. Care and treatment should take into account people’s individual needs and choices. To allow people to reach informed decisions there must be good communication, supported by evidence-based practice (). This essay will provide an evidence based discussion on how care will be implemented in relation to Mr B and his eating and drin...
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
In her paper entitled "Euthanasia," Phillipa Foot notes that euthanasia should be thought of as "inducing or otherwise opting for death for the sake of the one who is to die" (MI, 8). In Moral Matters, Jan Narveson argues, successfully I think, that given moral grounds for suicide, voluntary euthanasia is morally acceptable (at least, in principle). Daniel Callahan, on the other hand, in his "When Self-Determination Runs Amok," counters that the traditional pro-(active) euthanasia arguments concerning self-determination, the distinction between killing and allowing to die, and the skepticism about harmful consequences for society, are flawed. I do not think Callahan's reasoning establishes that euthanasia is indeed morally wrong and legally impossible, and I will attempt to show that.
disease that Stephen Hawking has) 5 years ago. This is a condition that destroys motor nerves, making control of movement impossible, while the mind is virtually unaffected. People with motor neurone disease normally die within 4 years of diagnosis from suffocation due to the inability of the inspiratory muscles to contract. The woman's condition has steadily declined. She is not expected to live through the month, and is worried about the pain that she will face in her final hours. She asks her doctor to give her diamorphine for pain if she begins to suffocate or choke. This will lessen her pain, but it will also hasten her death. About a week later, she falls very ill, and is having trouble breathing.
Introduction This lab will evaluate the body composition of the subject. This lab includes measuring BMI, girths of the body, skin folds, and hydrostatic weighing. BMI or body mass index is important to measure because it categorize degree of obesity of the subject.(Adams and Beams 273) As BMI and the degree in obesity increase so to does the risk of chronic disease. These disease include hypertension, diabetes, coronary heart disease, and metabolic syndrome. In this lab girths around the body will be measured and put into ratios.(Adams and Beams 281)
There are several clues that hint on what could be going on with James’ nutritional status according to his physical assessment. It is clear that James has oral health issues, because it states that he is having trouble chewing and swallowing, and his tongue is also sore. Based on the oral health chapter, I believe that he could be experiencing xerostomia – otherwise known as dry mouth. Xerostomia can be a side effect of many medications, and James is taking several different medications (Bernstein & Munoz, 2016). Such oral problems might persuade James to not eat as much food, due to it being a difficult and painful experience. This could be another factor playing into his
they measured the patient's height, weight (first asked them to answer and then compared weight from six months ago to now) (Correia & Ravasco, n.d., 2014)
Assisted Suicide. Pain. That's all he feels most days. No matter how many pills they give him.
Assisted suicide brings up one of the biggest moral debates currently circulating in America. Physician assisted suicide allows a patient to be informed, including counseling about and prescribing lethal doses of drugs, and allowed to decide, with the help of a doctor, to commit suicide. There are so many questions about assisted suicide and no clear answers. Should assisted suicide be allowed only for the terminally ill, or for everyone? What does it actually mean to assist in a suicide? What will the consequences of legalizing assisted suicide be? What protection will there be to protect innocent people? Is it (morally) right or wrong? Those who are considered “pro-death”, believe that being able to choose how one dies is one’s own right.
" ... I didn't do it to end the life. I did it to end the suffering the patient is going through. The patient is obviously suffering. What's a doctor supposed to do, turn his back?
Context as well as process is important. Communication difficulties include lack of involvement of the patient in discussions, inadequate provision of information to the patient and family, and the physician's discomfort in sharing information, particularly about prognosis. Individualised assessment of needs and expectations is recommended as few characteristics of the patient predict his or her need for information. Information about prognosis should respect individual coping styles of patients and relatives and has been reported as important to families of patients in palliative care. A qualitative study of informal caregivers of patients with terminal cancer recommended an individualised approach to address needs for information about the illness and