Excerpt from Case Study:
Patient is actually a 69-year-Old man who is declining treatment intended for cancer. The following is a description in the patient.
Major diagnosis: Malignant tumor, metastatic tumor of Mind, Face and Neck (C76. 0) because this is the medical diagnosis that brought the patient in to treatment (Hogston, 1997).
Person’s past health background: Hypertension, triglycerides, stomatitis, anemia, neutropenia. Individual had right radical neck of the guitar dissection in 2012.
Current Medicines: Carvedilol doze. 5 mg. q. d.; Furosemide 45 mg queen. d.
Interpersonal History: Sufferer is a ex – smoker who have quit couple of years ago subsequent cancer prognosis. He is wedded with kids.
Current Issue: Patient is refusing to interact in further treatment regarding his cancer (chemotherapy and radiation) declaring that he could be tired of the untoward associated with treatment. Patient wants info regarding other available choices.
Complicating factors:
A. Patient’s family would not agree with his decision to stop treatment.
B. Patient would not have an advanced directive or perhaps living will certainly.
7. Feasible Secondary Diagnoses:
A. Depressive Disorder (Reactive Depression; F32).
B. Realignment Disorder with Anxiety and Depressed Feelings (Grief Effect; F43. 23)
C. Cognitive Changes because of a General Medical Condition (R41. 89).
D. Naturally it is possible that there is no secondary diagnosis.
There are several approaches to decide which of such diagnoses is suitable. The nurse can inquire a series of questions in order to identify which path to investigate further more.
Ten Queries
I. Decision-making:
First this can be a good idea to ascertain if the sufferer has the capacity to produce informed decisions. This is mostly related to prognosis C but can be a reaction to the various other potential diagnoses under consideration too. It could become that the sufferer is not really sufficiently informed regarding his treatment and potential results associated with continuous or discontinuing it. These kinds of questions can determine the need for further analysis (Sessums, Zembrzuska, Jackson, 2011):
1 . Only to make sure were on the same page, can you describe for me the medical concerns you are dealing with at this point as you understand them?
2 . Can you explain the likely treatments which have been discussed with you and quickly tell me all their pros and cons?
three or more. What is your comprehension of what will happen to you personally if absolutely nothing is done?
four. General inquiries such temporal orientation inquiries (what is a month, time, year, time).
5. Questions to judge reasoning such as how are a banana and orange as well (fruit); bike and train (transportation); observe and leader (measure
