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Debriefing Guide Gerontology Case, Part 1 Julia Morales and Lucy Grey

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Debriefing Guide Gerontology Case, Part 1 Julia Morales and Lucy Grey PCC/I What appropriate assessments were made to help you decide what interventions Julia Morales and Lucy Grey needed? The home assessment helped a great deal to make sure that we supplied all the necessary equipment to take care of the patient. Also, assessing Lucy’s ability to take care of Julia is important as I have mentioned above. During this time the patient should be comfortable, fed and hydrated, on top of managing pain and supplying oxygen. PCC/I What appropriate strategies could be implemented to empower Julia Morales and Lucy Grey in the management of Julia’s care? I believe just offering them support and encouragement will be a great tool that will allow them to accept the changes and give them the time they will need to be together. Im glad that Julia is going to be at home with family for her final moments. EBP What potential problems does Julia Morales face if the symptoms of her disease progression are not recognized and if actions are not initiated in a timely manner? The most important things to notice in order to keep Julia comfortable is maintaining her oxygen levels so that breathing will not be as hard, and keeping her pain under control. T&C/I What is the role of the home health/hospice interprofessional team, and what is the importance of teamwork and collaboration in the case of Julia Morales and Lucy Grey? The role of home health/hospice is to provide Julia with pain medication so that she is comfortable. They are also involved with the family’s well being offering support and referring them to resources to help them with coping both while Julia is alive and after her death. What potential environmental/safety hazards need to be assessed in the home care setting? It is important to assess all areas of the home for walking hazards like extension cords in the walkway, it is also important to check the bathroom and for grab bars, non-slick tubs or showers and a over the commode toilet that can also be a bedside commode when Julia is not able to walk to the bathroom. Keep all walkways well lit and make sure nothing is on the floor, including

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Debriefing Guide
Gerontology Case, Part
1 Julia Morales and Lucy
Grey


Julia and Lucy debrief complete parts
1_2_3.
Julia Morales and Lucy Grey, Part 1

Guided Reflection Questions
Opening Questions
How did the simulated experience of Julia Morales and Lucy Grey’s case make you feel?

I felt sad for Julia and her family, but understood Julia’s decision. I would have made the same choice if
I was her. It was hard to watch her son try to talk her out of it. Lucy is a supportive partner and I could
tell that she would miss her greatly but put Julias needs before her own.

What nursing actions did you feel were appropriate within this scenario?

As a hospice nurse, it was my duty to come out to the house and assess Julia to obtain a baseline of
vitals and a head to toe assessment. Doing this allows the nurse to be aware of any changes that may
occur. It was important to teach Julia and Lucy about her medications for pain, how to administer it and
how often since Lucy would be administering the medication. It is important to have Lucy explain back
to me that she understood the teaching about all meds. For example knowing how to properly apply the
fentanyl patch, rotating sites every s days. I would assess the house for safety and make sure that a
bedside commode would be delievered to the home as they stated its hard for Julia to make her way to
the restroom and Lucy is unable to lift her on and off the toilet. I would then explain that we are there
to keep Julia comfortable, and give support to her and her family.

Scenario Analysis Questions*
PCC What priority problem(s) did you identify for Julia Morales and Lucy Grey?

Lucy stated that she is unable to assist Julia on/off the toilet, this presents a safety issue so it was
decided that Julia would require a bedside commode to keep next to the bed. It is important to make
sure that Julia is having regular bowel movements since the morphine can cause constipation, she is
taking Colace as well to help with this.

PCC/ What teaching measures and what other members of the health care team should be
included T&C/I in the home health nurse visit for Julia Morales and Lucy Grey?
Julia will need a CNA to come and assist with bathing so Lucy does not have to struggle with
doing that on her own. The family and Julia will need a strong support system to assist them in
navigating through this difficult time, especially when death draws near. It may also benefit
them to have a chaplain from their church come and talk to them and offer spiritual support.

, Debriefing Guide
Gerontology Case, Part
1 Julia Morales and Lucy
Grey
PCC What potential barriers might Julia Morales and Lucy Grey encounter that would hinder
active participation in Julia’s care?

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