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You are a nurse caring for a 67-year-old who has recently retired from the fire department after 30 years of service and has been admitted to your unit with exacerbation of his COPD. He has a 40 pack-year history, uses portable O2 continually, and is quite anxious. His family has remained at his bedside; their interactions indicate that they are loving and supportive. The patient's wife is very involved in health decision making and typically includes her six adult children (and their spouses) in decisions whenever practical. All the children live nearby and are quite free in expressing their opinions regarding family matters, including the care of their father. Many times, the family discussion is focused on determining who will care for the family farm and homestead now and in the future. The patient's prognosis is terminal, and he is expected to live less than 6 months.
1. Using Maslow's hierarchy of needs, what is the rationale for the patient's anxiety?
2. What strengths does this family unit exhibit regarding the patient's illness?
3. Which areas of challenge might this family unit present regarding the patient's illness?
4. How are family functions addressed in this scenario?
5. What nursing interventions could you perform that would promote health within this family?
What are the ethical and legal implications? What does the professional literature say about how communication devices can support safe nursing practice?
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