Julia Morales and Lucy Grey, Part 1 Guided Reflection Questions

Julia Morales and Lucy Grey, Part 1 Guided Reflection Questions Opening Questions How did the simulated experience of Julia Morales and Lucy Grey’s case make you feel? Personally, I felt a little uncomfortable during this simulation because of the discussion of hospice care. I understand that this is a difficult conversation to have, but an important one. What nursing actions did you feel were appropriate within this scenario? Nursing actions I felt were appropriate within this scenario was educating the family about palliative care and further information and resources they may need. Additionally, performing the Katz Index and Informal caregivers of Older Adults at Home was appropriate to assure that the goals of Lucy and Julia were clear, and both understood the changes of assistance needed as Julia’s illness progresses. Scenario Analysis Questions* PCC What priority problem(s) did you identify for Julia Morales and Lucy Grey? A priority problem I identified for Julia and Lucy was Julia’s ability to perform ADLs. Although she is able to do some ADLs independent, assistance is still needed. For instance, Julia would need a bathing chair, so she does not get tired while bathing and is able to wash her back and feet safely. PCC/ What teaching measures and what other members of the health care team should be included T&C/I in the home health nurse visit for Julia Morales and Lucy Grey? Julia and Lucy were concerned about needing assistance with ambulating and bathing. I think an occupational therapist should be included in the health care team to teach them the proper use of a walker and bathing chair. Due to her diagnosis of stage IV lung cancer, I would expect her to have shortness of breath overtime and would teach interventions to prevent SOB or the frequent occurrences of SOB. PCC What potential barriers might Julia Morales and Lucy Grey encounter that would hinder active participation in Julia’s care? Potential barriers could be the Lucy being unprepared for when Julia’s condition worsens (unable to ambulate, weakness, less nutritional intake). Being unprepared can cause a Lucy to be stressed and could hinder the participation in Julia’s care. Additionally, Lucy’s age could be a potential barrier because as Julia’s condition worsens, it could a physical strain on Lucy. Ellen Limpin PCC/I What appropriate assessments were made to help you decide what interventions Julia Morales and Lucy Grey needed? Because Lucy wants to be the primary caregiver, I felt that the Informal Caregiver of Older Adults at Home assessment was appropriate to do. Based on the assessment, a follow up appointment would be needed for managing at home, early changes, and assistance needed for ADLs. Additionally, it was appropriate to do the Katz Index to assess what ADLs Julia would need assistance for and which ones she is able to do independently. PCC/I What appropriate strategies could be implemented to empower Julia Morales and Lucy Grey in the management of Julia’s care? Lucy requested a bathing chair and a walker to assist Julia when she bathes and ambulates. Providing these assistive devices would help in the management of Juila’s care. Offering different resources that they can choose from can empower them in the management of Julia’s care as well. Additionally, asking them when the best times for the home health team to come visit would be appropriate. EBP What potential problems does Julia Morales face if the symptoms of her disease progression are not recognized and if actions are not initiated in a timely manner? Potential problems that Julia could face could be risk for falls if fatigue is not recognized. Respiratory distress could also be a potential problem if O2 therapy is administered in a timely manner. T&C/I What is the role of the home health/hospice interprofessional team, and what is the importance of teamwork and collaboration in the case of Julia Morales and Lucy Grey? The role of the home health/hospice interprofessional team is to provide comfort care based on the needs and goals of Julia and the family. The importance of teamwork and collaboration in the case of Julia and Lucy is to assure information is being passed down to assure that the roles of each member is understood and the information can be used to implement a patientcentered plan of care. S What potential environmental/safety hazards need to be assessed in the home care setting? Because Lucy assists Julia to ambulate around the house, the floor should be even, and no items are on the floor that could cause a fall. If there is an O2 machine is at the house, protentional fire hazards should be assessed. Additionally, the bathroom should be assessed to see if Julia is able to get in and out of the bath or shower safely. If not, handrails would be a g