Palliative Care Patient • Online Nursing Essays

Value: 100 points

Due: Create your initial post by Day 3, Initial Response Post by Day 5, and Reflective Response by Day 7.

Gradebook Category: Discussions/Quizzes – Simulated OV Discussion

Initial Post

Mr. Brown, who was your eighth-grade science teacher, has been a patient in your practice for many years. Several years ago, he was diagnosed with cancer and has been undergoing treatment. He recently was told that his cancer was no longer responding to treatments and that his condition is terminal. Mr. Brown, along with his wife and daughter, have scheduled an appointment to discuss palliative care and what can be expected. Although Mr. Brown’s death is not imminent, his care needs clearly will continue to increase, and they will continue until his eventual death from the disease. The disease process is typically accompanied by an increasing level of pain, which is of great concern to Mr. Brown and his family. The meeting today is intended to determine whether the patient and the family feel that palliative care is appropriate.

Initial Post by Wednesday (Day 3) at 11:59 p.m.

• List 10 to 20 additional pieces of subjective information you need to elicit from the patient to help formulate your differential diagnoses and plan. You may not ask questions that were already addressed in the HPI/ROS. You will need two scholarly references for the questions you ask. See the rubric for more detail.
• Keep in mind: What are some open-ended questions that can be asked to explore the need for palliative care?

Reply Posts

Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:

• Choose a classmate’s questions to answer.
• Every peer post should have only one response post. Please do not reply to a peer if a response is already posted.
• You are answering as the patient. Make it case-appropriate but imaginative. Be creative and answer thoroughly. No references are needed.

During the Visit

As you learn that Mr. Brown’s level of pain has increased since his treatments ended, you suggest the use of opioids for pain management. Mr. Brown’s daughter expresses concern about the use of opioids to manage pain, stating, “Aren’t opioids bad? I hear about people dying from opioid abuse on the news all the time.” She also asks, “What is the difference between palliative care and hospice?” What information should you provide to assuage the daughter’s concern? Include this patient education in your plan. What did you discuss with the family? Document it in the reflective response.

Reflective Response Post by Sunday (Day 7). Please respond with the following:

• Four differential diagnoses and rationales with references. Support your answers with references.
• Create a plan of care for that patient.
• Plan must include pharmacology, non-pharmacology, labs/diagnostics, referrals/interprofessional communications, patient education (10 to 15 individual items minimum), and follow-up.
• How should Mr. Brown’s spiritual well-being be evaluated, and why is it part of total pain management?
• Don’t forget to document the patient education with the above information on opioid therapy in palliative care.

Please refer to the Grading Rubric for details on how this activity will be graded.

Posting to the Discussion Forum

1. Select the appropriate Thread.
2. Select Reply.
3. Create your post.
4. Select Post to Forum.

Note: Scholarly resources are defined as evidence–based practice, peer–reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Criteria	Exemplary Exceeds Expectations	Advanced Meets Expectations	Intermediate Needs Improvement	Novice Inadequate	Total Points
Initial Post	Post includes 10–20 questions of subjective information that are appropriate for the patient vignette. Questions are targeted toward the content of the vignette. Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 30 points	Post includes questions of subjective information that are appropriate for the patient vignette. Questions are general and NOT targeted toward the content of the vignette. Questions are supported by appropriate references. Initial Post by Wednesday (Day 3) at 11:59 p.m. 26 points	Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague. Questions are supported by appropriate references. Initial Post is late. 23 points	Post includes less than 10–20 questions of subjective information and/or are not appropriate for the patient vignette. Questions are vague or not appropriate for patients. Questions are NOT supported by appropriate references. Initial Post is late. 20 points	30
Initial Response Post	Student answers ALL peer’s questions appropriately, as the patient. Answers drive discussion and analysis forward. Initial Response Post by Friday (Day 5) 11:59 p.m. 30 points	Student answers ALL peer’s questions appropriately, as the patient. Answers struggle to drive discussion and analysis forward. Initial Response Post by Friday (Day 5) 11:59 p.m. 26 points	Student does not answer ALL questions appropriately or from patient perspective. Initial Response Post by Friday (Day 5) 11:59 p.m. 23 points	Student does not answer ALL questions appropriately or from patient perspective. Questions are irrelevant or do not makes sense. Initial Response Post is late. 20 points	30
Reflective Response Post	Student replies to additional post with 4 appropriate differentials and rationale that are well supported by evidence. Appropriate and evidence–based plan of care is developed for one differential; supported by references. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 30 points	1–2 minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 26 points	3+ minor omissions from differentials or plan of care. These do not constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. 23 points	1–2 major omissions from differentials or plan of care. These constitute missing must not miss differentials or safety issues. Reflective Response Post due by Sunday (Day 7) 11:59 p.m. Responses after Day 7 will not receive any credit. 20 points	30
Organization	Well–organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas. 5 points	Organized content with minimal issues in content flow. 4 points	Poor organization, and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. 3 points	Illogical flow of ideas. Missing significant content. Prose rambles. Purpose statement is unclear or missing. Demonstrates incomplete understanding of content and/or inadequate preparation. 2 points	5
APA, Grammar, and Spelling	Correct APA formatting with no errors. There are no spelling, punctuation, or word–usage errors 5 points	Correct and consistent APA formatting of references and cites all references used. No more than two unique APA errors. The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability. There are minimal to no grammar, punctuation, or word–usage errors. 4 points	Three to four unique APA formatting errors. The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused. Multiple grammar, punctuation, or word usage errors. 3 points	Five or more unique formatting errors or no attempt to format in APA. The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language). The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented. Grammar and punctuation are consistently incorrect. Spelling errors are numerous. 2 points	5
Total Points					100