Assist with my hospice home visit homework
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Assist with my hospice home visit homework
Anne McMillan is 80 years old and is terminally ill with metastatic breast cancer. She has been a widow for 5 years and has three daughters and two sons. All of her children are married with kids of their own, except one son who is handicapped and lives with Anne. Anne is too weak to care for herself and is moving in with her youngest daughter. Her daughter’s house is a colonial with all bedrooms upstairs. There is a first-floor bathroom.
During her first visit, the hospice nurse talks with Anne and her daughter and explains what hospice is all about. The nurse then admits Anne into the hospice program and begins her initial assessment. Anne’s primary physical complaints are back pain and constipation. She is still eating and drinking regularly.
The nurse immediately recognizes that Anne will need a hospital bed. Anne already has a walker, but the nurse informed Anne and her daughter that they could have a bedside commode if needed in the future as Anne becomes weaker. Anne’s biggest concern is her handicapped son, saying, “He can’t be by himself for long and I don’t know where he can go now that I can’t take care of him.” Except for the handicapped son, all of her children and many of her grandchildren are active in her care.
Assessment
On her initial visit, the hospice nurse collects the following data about Anne, her family, and her community. In this case, the community consists of Anne’s social support outside of her family, such as her neighborhood and church.
- Pain assessment, including history, character, severity, location, effects on quality of life, precipitating factors, and relieving factors
- Other physical symptoms, such as fatigue, nausea, vomiting, constipation, diarrhea, decreased appetite, and decreased mobility
- Client and family fears, anxiety about dying and the dying process
- Support network and family dynamics
- Client’s anxiety about situation concerning handicapped son
- Additional support network outside of family
- Effect of diagnosis and prognosis on Anne’s social support, including her neighbors and her church community
Diagnosis
Individual
- Pain related to disease process
- Potential for constipation and discomfort related to decreased mobility
- Apprehension related to concerns about safety and well-being of handicapped son
Family
- Strong support system indicated by active family participation in Anne’s care
Community
- Anticipatory grieving related to social isolation after leaving neighborhood and moving in with daughter
Planning
Individual
Long-Term Goals
- Pain will remain controlled until client expires.
- Client will have regular bowel movements for the next 2 months.
- Client will verbalize satisfaction about resolution of situation concerning handicapped son.
Short-Term Goals
- Pain will be well controlled within 24 to 48 hours.
- Client will have a bowel movement within 24 to 48 hours.
- Client will have decreased anxiety about handicapped son within 24 to 48 hours because the social worker will have found a place for the son to live.
Family
Long-Term Goals
- Family will remain active in Anne’s care until she is buried.
- Family will provide a support network for each other and use hospice services for continued support through Anne’s death and burial and for months afterward.
Short-Term Goal
- Family will actively participate in Anne’s care.
Community
Long-Term Goal
- Client will continue to receive support from friends.
Short-Term Goal
- Client will verbalize feelings about moving in with daughter and leaving friends behind.
Intervention
Individual
After talking with the doctor, the hospice nurse starts Anne on methadone 20 mg daily and Roxanol 5 mg as needed for breakthrough pain. The nurse explains to Anne and her daughter that she is constipated because of her decrease in mobility. The nurse obtains an order for a stool softener and instructs Anne to take it twice daily. The nurse also explains to Anne and her daughter that, as Anne declines, her appetite will decrease and she will eat less and less and may not have bowel movements very frequently. Anne should let the nurse know if she ever feels uncomfortable because she has not had a bowel movement in a few days. The nurse talks to the social worker, who finds a group home for Anne’s handicapped son.
Family
The nurse and social worker talk with the family and help them develop a system so that Anne always has someone with her and to help ensure that all of the responsibility for Anne’s care does not fall on one person. They also inform the family about resources to support them.
Community
Anne has a nurse, social worker, spiritual counselor, and nurse assistant assigned to her care. Each of these hospice workers helps Anne discuss her feelings about her situation and works with her to continue to receive support from her friends and neighbors.
Evaluation
Individual
All of Anne’s goals are met, because she has good pain control until she dies, she no longer experiences discomfort and problems with constipation, and she expresses less anxiety and worry about her handicapped son. Although she still has some concerns, she feels much better about the situation.
Family
The family’s goals are met, because they remain active in Anne’s care until she dies. In addition, they use hospice resources appropriately and as necessary, and they support one another through the entire process.
Community
The goals are met, because Anne expresses her feelings about her situation, and her closest friends remain supportive to Anne through visits and phone calls.
Levels of Prevention
In this case, the three levels of prevention focus on helping the client and family through all phases of hospice care from admission until death. Some examples are as follows.
Primary
- Anticipating needs and intervening early on to prevent problems such as skin breakdown and lack of pain control
- Educating the client and family about hospice and the dying process
Secondary
- Responding quickly to needs as they arise
- Continued education about the hospice and dying experience
Tertiary
- Assisting the client and family through the active phase of dying
- Providing follow-up bereavement support to the family
- Decide to accompany a PHN, a home health nurse, and/or a hospice nurse on home visits.
- Interview a PHN about the types of client referrals received, and ask what interventions are usually performed. Repeat this activity with a home health nurse and a hospice nurse. Ask the nurses what they like best about their jobs.
- Attend a team meeting in a home health agency or a hospice program to see how the roles of the various team members blend together to provide family-centered care.
- Interview a PHN and a home health nurse, and ask how the community affects the care they provide.
- Define home health care.
- Discuss the purpose of home health services.
- Differentiate between the purpose of a public health nursing visit, a home health nursing visit, and a hospice nursing visit.
- Use the nursing process in outlining the steps involved in conducting a home visit.
- Identify the types of home health agencies.
- Apply the nursing process to a home health client situation.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. 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Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. 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