Harding, M., Roberts, D., Reinisch, C., Hagler, D., Kwong, J. Lewis's Medical-Surgical Nursing
Palliative Care at End of Life
Patient Profile
B.B., a 79-year-old woman, is brought to the emergency department by an ambulance. B.B. is reporting
shortness of breath and feeling hot and sweaty. She was diagnosed with stage IV cervical cancer 2
months ago and decided not to have any treatment. Her husband died 1 year ago, and she has been
living alone since that time. In the 2 months since her diagnosis, she has been cleaning out her house,
donating things to charity, and giving her daughters family photo albums and jewelry. Her daughters
have continued trying to get her to have chemotherapy, but B.B. refuses. They would check B.B. every
morning and night and said that she had been getting weaker in the past week. Today they found B.B.
lying in bed, short of breath and diaphoretic, and called an ambulance.
Subjective Data
States she can’t catch her breath
States she wants to go home and says, “I don’t want to die in the hospital”
Daughters appear upset and angry and tell their mother that she needs to be in the hospital to
get better
Has a history of hypertension and osteoarthritis
Objective Data
Blood pressure 100/60, pulse 96, respirations 28, temperature 101.4°F
5’4”, 100 lb, BMI 17.1 kg/m 2
Oxygen saturation 88% on room air
Labored respirations
Crackles in bilateral bases of lungs
Discussion Questions
1. From the data provided, which stage of grieving is B.B. in?
-B.B is in the acceptance stage. She is in this stage because she has been cleaning out her
house, donating things to charity and giving her daughters family photo albums and jewelry.
She also refused to have chemotherapy. At this point B.B has accepted death.
2. Patients and families often struggle with many decisions during terminal illness. What are some
decisions that patients can make about their end-of-life wishes?
-They can make the decision of the person they want to make the decisions for them when
they can’t, the kind of treatment they want or don’t want, how comfortable they want to be,
how they want people to treat them, and how what they want their loved ones to know.
3. What legal documents are available to guide B.B.’s daughters in making decisions about B.B.’s
care should she become unable to make her own decisions?
-Living will, trust, power of attorney, healthcare power of attorney, letter of intent and five
wishes.
This study source was downloaded by 100000850872992 from CourseHero.com on 03-04-2023 23:53:09 GMT -06:00
https://www.coursehero.com/file/59143422/Palliative-Care-at-End-of-Life-Case-Studydocx/
Palliative Care at End of Life
Patient Profile
B.B., a 79-year-old woman, is brought to the emergency department by an ambulance. B.B. is reporting
shortness of breath and feeling hot and sweaty. She was diagnosed with stage IV cervical cancer 2
months ago and decided not to have any treatment. Her husband died 1 year ago, and she has been
living alone since that time. In the 2 months since her diagnosis, she has been cleaning out her house,
donating things to charity, and giving her daughters family photo albums and jewelry. Her daughters
have continued trying to get her to have chemotherapy, but B.B. refuses. They would check B.B. every
morning and night and said that she had been getting weaker in the past week. Today they found B.B.
lying in bed, short of breath and diaphoretic, and called an ambulance.
Subjective Data
States she can’t catch her breath
States she wants to go home and says, “I don’t want to die in the hospital”
Daughters appear upset and angry and tell their mother that she needs to be in the hospital to
get better
Has a history of hypertension and osteoarthritis
Objective Data
Blood pressure 100/60, pulse 96, respirations 28, temperature 101.4°F
5’4”, 100 lb, BMI 17.1 kg/m 2
Oxygen saturation 88% on room air
Labored respirations
Crackles in bilateral bases of lungs
Discussion Questions
1. From the data provided, which stage of grieving is B.B. in?
-B.B is in the acceptance stage. She is in this stage because she has been cleaning out her
house, donating things to charity and giving her daughters family photo albums and jewelry.
She also refused to have chemotherapy. At this point B.B has accepted death.
2. Patients and families often struggle with many decisions during terminal illness. What are some
decisions that patients can make about their end-of-life wishes?
-They can make the decision of the person they want to make the decisions for them when
they can’t, the kind of treatment they want or don’t want, how comfortable they want to be,
how they want people to treat them, and how what they want their loved ones to know.
3. What legal documents are available to guide B.B.’s daughters in making decisions about B.B.’s
care should she become unable to make her own decisions?
-Living will, trust, power of attorney, healthcare power of attorney, letter of intent and five
wishes.
This study source was downloaded by 100000850872992 from CourseHero.com on 03-04-2023 23:53:09 GMT -06:00
https://www.coursehero.com/file/59143422/Palliative-Care-at-End-of-Life-Case-Studydocx/
