What Should the Nurse Do?
Gloria, a seventy-five-year-old widow, arrives at the oncology clinic accompanied by her daughter, Emily. She has been diagnosed with advanced-stage lung cancer. Gloria presents with symptoms of increasing pain, fatigue, and shortness of breath. Her medical history includes a previous diagnosis of chronic obstructive pulmonary disease (COPD), which has exacerbated in recent months. Vital signs show an elevated blood pressure of 150/90 mm Hg, a heart rate of 95 beats per minute, and a respiratory rate of 22 breaths per minute. During the assessment, Gloria expresses concerns about the impact of her illness on her family and worries about being a burden. Emily mentions their family’s cultural background and the importance of certain end-of-life rituals. Recognizing the social, emotional, and cultural dimensions of Gloria’s concerns, the health-care team aims to provide holistic and culturally sensitive care.
1
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What nonverbal cues from Gloria and verbal cues from Emily might indicate that cultural considerations are crucial in addressing their concerns about end-of-life care?
2
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Considering Gloria's COPD diagnosis and advanced-stage lung cancer, prioritize hypotheses regarding the emotional concerns that are likely to have the most significant impact on her well-being. How might these emotional concerns influence her overall care plan?
Frank, a sixty-year-old male, visits the outpatient clinic following the recent loss of his wife to cancer. He presents with symptoms of overwhelming sadness, difficulty sleeping, and social withdrawal. Frank’s medical history includes hypertension, for which he takes medication regularly. Vital signs reveal an elevated blood pressure of 140/85 mm Hg, a heart rate of 92 beats per minute, and a respiratory rate of 18 breaths per minute. During the assessment, Frank expresses feelings of guilt about not being able to do more for his wife and struggles to engage in conversation about his grief. Recognizing the concepts of grief and loss, the nurse aims to understand the social factors influencing Frank’s response and be mindful of the potential impact of grief on both the client and the health-care provider.
3
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How can the nurse create a safe and empathetic environment that encourages open communication about grief?
4
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If the nurse implements interventions to address Frank’s grief, what specific indicators of progress or positive outcomes would you monitor to assess the effectiveness of the interventions for both Frank and the nurse?