Discussion: Treating Patients in Specialized Areas of Care

Discussion: Treating Patients in Specialized Areas of Care

When treating frail elder patients in specialized areas of care, there are various dynamics that might impact patient care plans. From questions about potential outcomes, benefits of treatment, and quality of life to factors such as personal values, families, culture, and religion, decision making can be difficult for patients and their families. As the advanced practice nurse, you must support them through this process.

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For this Discussion, you examine the following case studies and consider how you might address the needs of the patients and their families.

Case Study 1

Mr. Wiggins is a 78-year-old African American male with chronic kidney disease, which requires dialysis. The etiology of his renal disease was multifactorial—long-standing uncontrolled HTN and DM nephropathy. He has been on hemodialysis for the past 10 years and has done relatively well. Four weeks ago, he had a major CVA and is minimally responsive. His condition is not expected to change, and the family is having a difficult time with his recent health changes. Advanced directives were discussed with them, and his wife is a durable power of attorney for his health care. The wife hates to see her husband this way and understands this is not how he would want to go on, but their children and many of the family members (his brothers and sisters) think the patient will return to himself. They want everything done in terms of life support measures—full code status. His family wanted a feeding tube placed, and he is now receiving 24-hour tube feedings. You are the NP caring for Mr. Wiggins. You have known and cared for him and his wife for several years. The wife pulls you aside, shares her dilemma, and asks you to make the decision regarding continuing medical care/support for her husband. How will you respond?

Discussion: Treating Patients in Specialized Areas of Care

To prepare:

• Select one of the three case studies. Reflect on the provided patient information.
• Think about potential outcomes for the patient in the case study you selected.
• Consider how care, treatment, and/or support might be facilitated for the patient. Reflect on how you might also address the needs of the family.

By Day 3

Post an explanation of potential outcomes of the patient in the case study you selected. Then, explain how care, treatment, and/or support may be facilitated for the patient. Include how you might address the needs of the patient’s family as well.

Discussion: Treating Patients in Specialized Areas of Care