Reference no: EM133560204

Question

Introduction Sara Abaza is a 69 year old female that presented to the Oncology ward three days ago following deterioration over the last week. Patient is in the terminal phase of cancer and is experiencing severe pain. Sara and her family are not comfortable attending to end-of-life requirements at home. The patient's husband and two sisters have accompanied the patient to the hospital for end of life care. The husband informs the nurse that Sara has not been sleeping well for the past week due to experiencing severe pain. Situation Sara is becoming less conscious and is no longer verbalising but opens eyes to pain. Vital signs have remained stable for the past three days. The patient is receiving regular subcutaneous morphine and hyoscine via an abdominal subcutaneous butterfly. The patient is NBM. Mouth care has been attended and Colostomy has minimal output. Background Sara has a three year history of Colorectal Cancer and has a Colostomy insitu following bowel resection surgery three years ago. Sara developed terminal metastases in her lungs and brain three months ago. The patient's medical notes contain the required documentation for an Advanced Care Directive (ACD) which includes a do-not-resuscitate order and no other acute.