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Situation: Julia Morales is a 65-year-old woman who was diagnosed with Stage 4 lung cancer 4 years ago. She has had radiation and chemotherapy and has decided to forego further treatment. You are doing a home visit with orders from the oncology nurse practitioner to assess client's needs for comfort, safety, and other support.
Background: Julia and her partner, Lucy, have lived in their home for almost 20 years. Julia is retired and has a 42-year-old son, Neil, who lives in the area. Lucy is Julia's primary caregiver. She is in her 70's and has some knee problems. Julia saw Dr. Davis and Laura Johnson NP yesterday, and Julia is certain that she wants no further treatment for her cancer. She is currently on morphine sulfate-controlled release as needed for pain, and 2 liters of oxygen per nasal cannula as needed. Julia is determined to stay at home and is aware that she may need more care as time goes on.
Assessment: Alert and oriented patient with Stage 4 lung cancer. Currently mobile but may be needing more assistance with activities of daily living and symptom management
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