atient John lives at home with his child Sam. John has a history of Alzheimer’s Disease, NIDDM, AF, GORD, CCF, mild depression, and previous hernia and AAA repair and one week ago was diagnosed with advanced CA of the liver and metastases in the pancreas, lungs, and brain. Two weeks ago, John was bought into ED by his daughter with a history of new confusion, fevers, and rash, refusing diet and fluids for the previous two days and was jaundiced in colour. Jo deteriorated with sepsis. He experienced a cardiac arrest in ED. Following resuscitation, John was transferred to intensive care. He underwent further investigations and was diagnosed with advanced CA of the liver with metastases in the pancreas, lungs, and brain. John’s family then requested no further active treatment and asked that he be discharged home with support from the community nurses. Find 2 nursing problems with high priority for John and For the nursing problem of highest importance: Establish a minimum 3 goals for each nursing problem that include all 5 elements of the SMART acronym.

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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Patient John lives at home with his child Sam. John has a history of Alzheimer’s Disease, NIDDM, AF, GORD, CCF, mild depression, and previous hernia and AAA repair and one week ago was diagnosed with advanced CA of the liver and metastases in the pancreas, lungs, and brain.

Two weeks ago, John was bought into ED by his daughter with a history of new confusion, fevers, and rash, refusing diet and fluids for the previous two days and was jaundiced in colour. Jo deteriorated with sepsis. He experienced a cardiac arrest in ED.

Following resuscitation, John was transferred to intensive care. He underwent further investigations and was diagnosed with advanced CA of the liver with metastases in the pancreas, lungs, and brain.

John’s family then requested no further active treatment and asked that he be discharged home with support from the community nurses.

Find 2 nursing problems with high priority for John and For the nursing problem of highest importance:

  • Establish a minimum 3 goals for each nursing problem that include all 5 elements of the SMART acronym.
  • List a minimum 6 actions, in order of priority that you would undertake to achieve each goal. Specify if the action is a dependent or independent nursing action. You must consider the holistic requirements of the patient. Provide a rationale that associates the pathophysiological and psychological principles with each selected nursing action. 
  • Describe how you would evaluate the effectiveness of the care provided (i.e. how will you know that your actions were beneficial to the patient?)  A minimum 1 evaluation of the outcomes for each action.
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For the nursing goals of the problem of highest importance, "Impaired Nutrition and Fluid Intake", List a minimum 6 actions for each goal, in order of priority that you would undertake to achieve each goal. Specify if the action is a dependent or independent nursing action. You must consider the holistic requirements of the patient. Provide a rationale that associates the pathophysiological and psychological principles with each selected nursing action. 

  • Describe how you would evaluate the effectiveness of the care provided (i.e. how will you know that your actions were beneficial to the patient?)  A minimum 1 evaluation of the outcomes for each action.
 
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