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55714 -Case of Mrs. Mendez

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Course Number: Course Title

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Patient condition.

Having studied Mrs. Mendez’s health condition from the case scenario provided above, she

suffers from advanced breast cancer with metastasis resulting in deteriorating signs and

symptoms like severe pain, difficulty in breathing, and declining general health condition of the

patient. This condition justifies the necessity to handle the patient with extreme care and

sensitivity to try to prolong life and lead to a peaceful death.

To deliver quality and holistic care to the patient, it is important to establish thorough

therapeutic interaction with the patient and all the members of the family. This interaction should

be aimed to identify and understand Mrs. Mendez’s cultural and religious beliefs which greatly

impact her decision-making in matters regarding her treatment process. She is reluctant to

undergo myomectomy due to fear of having her soul stationed at the breast. The family does not

believe in a formal health system but relies on prayer and alternative therapies to address their

health needs.

The key concepts relevant to the case study.

Related to the study, key concepts are relevant to be considered to deliver holistic care to

the patient physically, emotionally, and socially. For instance, it is important to pay attention to

the patient’s physical experiences portrayed in this case study such as the life-threatening breast

cancer that is spreading to other parts of the body. Secondly, we pay attention to the concept of

wound care and cancer symptom management. Thirdly the concept of pain management using

opioids such as morphine should be viewed in a wider prospection. The complications that may

arise from the patient’s hospitalization such as the pressure ulcer and incontinence due to

immobility is another concept of interest in this case study. Lastly, the concepts of possible drug
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side effects should be put into consideration during this case study (PDQ Supportive and

Palliative Care Editorial Board, 2020).

Emotionally, the patient might suffer from psychological distress trying to figure out the

new coping mechanisms. This is in relation to their denial and acceptance of their prognosis. The

patient might present with a self-care deficit thus overburdening the caregiver with lots of stress

and responsibilities. The family’s process of grief and bereavement is a concept that should be

addressed since their loved one is terminally ill. Lastly, it’s important to identify family

dynamics as the other important concept relevant to this study (PDQ Supportive and Palliative

Care Editorial Board, 2020).

Socially, the concept of cultural beliefs and practices of Mrs. Mendez’s family and

community should be a concept of relevance in this study. This is because their beliefs and

culture affect their health-seeking behavior and influence their decision-making about their

treatment. The concept of family involvement in the delivery of care is a concept that should be

considered in this study. Involvement of the role played by religion and spirituality in healing

and coping should not be left unattended. The interpersonal relationship and communication of

the patient should be a key concept of this study. Finally, it is important to consider it relevant to

link the family to social support networks which will help them to access the resources that will

aid in the support of the patient (PDQ Supportive and Palliative Care Editorial Board, 2020).

Middle range theory selection and rationale.

The theory selected is the resilience model theory which focuses on the ability to adapt

positively to difficulties and stress. The theory emphasizes the strengths, resources, and coping

mechanisms. Following Mrs. Mendez’s terminal illness, she and her family are faced with

difficulties including physical symptoms, emotional distress, and interpersonal conflicts. These
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reasons rationalize the choice of the resilience model to help guide the family on proper coping

skills, foster support networks for them and promote overall psychological well-being amidst

difficulties (Fleming & Ledogar, 2018).

Application of the resilience model inpatient clinical assessment and intervention.

Through the guide of this model, the questions in the assessment would focus on

identifying the individual’s and family's strengths, coping mechanisms, and available support

systems. To learn how the family has been thriving in the past challenging situations is

significant to be able to solicit the resources to rely on for support.

The theory will help to enhance resilience by expounding on the available resources and

strengths of the family. Interaction with the family will focus on establishing problem-solving

skills, fostering proper communication among the members of the family, and most importantly

enhancing mutual support one another in among the family members. Not forgetting the

emphasis on the education and support group as per the provision of this theory to help the

family gain knowledge on the coping strategies. Finally, the resilience model would guide the

nurse to convince the family to engage in religious practices that provide comfort and support.

How inter-professional health-related sciences inform advanced nursing practice.

Evidence-based practice has been rated the best nursing practice modalities of care that

are used to deliver individualized and holistic care to patients. Due to this reason, nurses need to

involve other disciplines in the healthcare sector to get to the route of establishing effective,

standard, evidence-based, and holistic care. These disciplines may include spiritual care

providers, social workers, psychologists, nutritionists, physiotherapists, and physicians (Fossum

et al., 2022).
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Following the principle of advanced nursing, inter-professional collaboration, in the care

of Mrs. Mendez is crucial based on her needs. For instance, collaboration with the physician will

help understand the disease process and the treatment options for her. The physiotherapist will

come in to prevent complications such development of pressure ulcers and possible atrophy due

to immobility. The nutritionist's expertise is needed to help meet the patient’s nutritional

requirements without leaving the constipation issue unattended (Fossum et al., 2022).

For the family, they are faced with psychological stress and emotional distress. Due to

this reason, there is a vital significance in involving the psychologist to help the family go

through the bereavement process. Spiritual and religious guidance is of the essence to the family

as it affects their decision-making concerning their health and treatment approaches, thus

requiring the nurse to collaborate with the religious cadres to provide spiritual care. Due to the

resources required to support the therapeutic procedures of Mrs. Mendez, the family needs a

connection to the social work team so that they can be informed about the social support systems

and access the community resources for the support of their terminally ill (Fossum et al., 2022).
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References

Fleming, J., & Ledogar, R. J. (2018). Resilience, an Evolving Concept: A Review of Literature Relevant

to Aboriginal Research. Pimatisiwin, 6(2), 7–23.

Fossum, M., Opsal, A., & Ehrenberg, A. (2022). Nurses’ sources of information to inform clinical

practice: An integrative review to guide evidence‐based practice. Worldviews on Evidence-Based

Nursing, 19(5), 372–379. https://doi.org/10.1111/wvn.12569

PDQ Supportive and Palliative Care Editorial Board. (2020, January 13). Grief, Bereavement, and

Coping With Loss (PDQ®). Nih.gov; National Cancer Institute (US).

https://www.ncbi.nlm.nih.gov/books/NBK66052/