- Information
- AI Chat
Was this document helpful?
Professional Nursing Case Study Template
Course: Bachelor Science in Nursing (BSN 2019-2020)
132 Documents
Students shared 132 documents in this course
University: St. Paul University Dumaguete
Was this document helpful?
CareSearch is funded by the Australian Government Department of Health.
May 2015
www.caresearch.com.au
CASE STUDY
Marjorie was a 60-year-old woman who came to the hospice after a long and arduous hospital admission.
She was a single woman who had enjoyed a rural farm life, including managing race horses and a large
rural property.
Initially she was admitted to a NSW hospital with a Basal Cell Carcinoma that, despite initial surgical
intervention, had infiltrated her brain tissue. Following a second surgical intervention she had been in an
ICU, where she was intubated and suffering seizures. After a successful extubation and the use of anti
convulsants, she was finally released from ICU. Unfortunately following the surgery she also developed a
deep intracranial infection that was not resolving.
As her condition worsened, her brother requested palliative care consultancy input at the hospital. Marjorie
had become unresponsive at the hospital and it was agreed at that point she would be transferred to the
hospice for end-of-life care.
Marjorie had a range of symptoms which were causing issues. These included ongoing seizure activity,
headaches, and a hyperactive delirium. Her pain medication, seizure medications and medications
associated with her history of anxiety and depression were reviewed and revised numerous times. Whilst
remaining very frail, dependent, and largely symptomatic, her condition stabilised.
Her family were her Enduring Power of Attorney and were clear that Marjorie was not for further
burdensome interventions, including cannulation, transfer to another acute facility, surgical options or
resuscitation. The hospice was the preferred place of death.
Her nursing care included; ongoing management of her worsening mobility and associated falls risk
issues. Our Physiotherapist and Occupational Therapist reviewed her mobility on a regular basis,
observing her with transfer use of the MRAT and the PCOC RUG ADL tools she was able to mobilise with
a wheelie walker for some time, until she was eventually bed-bound or utilising a sling lifter, lifted into a fall
out chair.
Marjorie had skin integrity issues due to her increase frailty and continence issues her care needs were
modified as her condition deteriorated. Management of these continued to be integral to Marjorie’s comfort
and care. Her scalp wound was quite purulent and malodourous. Wound care had to accommodate these
issues, as well as addressing aesthetic issues and Marjorie being confused was constantly attempting to
remove dressing material. Nursing staff utilised a range of head wear to suit Marjorie’s needs.
Marjorie’s family were initially quite relieved that she was in a facility and that her illness was coming to an
end, but after a week she awoke from her comatose state. This was challenging for the family. An early