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CASE STUDY 7 A 76-year old woman has just been diagnosed with breast cancer. She also has severe cardiovascular disease that limits her choices of treatment. Her oncologist has recommended a series of chemotherapy that her cardiologist believes would be fatal. Her family is urging her to do all what is recommended. The client, who is in good spirits despite her diagnosis, chooses palliative care. GUIDE QUESTION: Based on her developmental stage, how can you help the family adjust to her choice? RATIONALE: Mr. Moore is a 72 years old widower who is recovering from a fall in which he fractured his lips and underwent surgical repair 1 week ago. He will be staying with his son for 2 weeks after he is discharged from the hospital, he is eager to return to his own home. Once he is home, his son visit nightly after work, he will receive meals on wheels once a day, and a home health care attendant will visit weekly to assist him with hygienic care until he can move independently. Mr. Moore wife died 3 years ago, but he has remained independent and continued his social functions. He lives in a small single level house with his dog and cat, and he enjoys gardening. Prior to fracturing his hip he walked with his dog daily. So, you will be his home health care nurse. GUIDE QUESTION: What do you need to assess in regards to Mr. Moore’s safety and wht suggesstions can you make for enhancing his safety? RATIONALE: Mrs. Nile is 83 years of age and lives alone. She has difficulty walking and relies on a church volunteer group to deliver lunches during the week. Her fixed income limits her ability to buy food. Last week, Mrs. Niles’s 79 year old sister died. The two sisters had been very close. GUIDE QUESTION: As a home care nurse, explain the factors that might increase Mrs. Niles’s risk for infection.

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