Palliative Care at End-of-Life Patient Profile B.B., a79-year-old female, is brought to the emergency department by anambulance. B.B. is complaining of shortness of breath and feelinghot and sweaty. She was diagnosed with stage IV cervical cancer twomonths ago and decided not to have any treatment. Her husband dieda year ago and she has been living alone since that time. In thetwo months since her diagnosis, she has been cleaning out herhouse, donating things to charity, and giving her daughters familyphoto albums and jewelry. Her daughters have continued trying toget her to have chemotherapy, but B.B. refuses. They would check onB.B. every morning and night, and said that she had been gettingweaker in the last week. Today they found B.B. lying in bed, shortof breath and diaphoretic, and called an ambulance. Subjective DataStates she can’t catch her breath States she wants to go home andsays “I don’t want to die in the hospital” Daughters appear upsetand angry and tell their mother that she needs to be in thehospital to get better No advance directives or living will Has ahistory of hypertension and osteoarthritis Objective Data Bloodpressure 100/60, pulse 96, respirations 28, temperature 101.4° F5’4”, 100 lb., BMI 17.1 kg/m2 Oxygen saturation 88% on room airLabored respirations Crackles in bilateral bases of lung Answer thefollowing case study questions thoroughly and cite resourcesappropriately in APA format From the data provided, which stage ofgrieving is B.B. in? Patients and families often struggle with manydecisions during terminal illness. What are some decisions thatpatients can make about their end-of-life wishes? What legaldocuments are available to guide B.B.’s daughters in makingdecisions about B.B.’s care should she become unable to make herown decisions? How do nurses deal with families and patients whenthey don’t agree on treatment options?
What are some options available to B.B. so that she can becomfortable and able to die at home?
What are the criteria for admittance to a hospice program?
As the time of death nears for B.B., what physicalmanifestations should B.B.’s daughters be told to expect as normalsigns of approaching death?
Providing care for patients and families at the end of life canbe both rewarding and challenging.
It is important for you to be aware of how grief affects youpersonally and to alleviate your stress. What are someinterventions that can help you alleviate your stress from caringfor patients at the end of life?
