Which is impacting on her oral medication management

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Reference no: EM133844746

Case study background information - Rosiane Mabweni

Rosiane is a 50-year-old Rwandan woman (born in the month of May) who arrived in Australia 18 years ago as refugee. She arrived with her husband (Lonji) and their 3 daughters (aged 12, 10 and 8 years) as refugees from Cogo where they had fled following The Rwandan crisis in 1994. They have settled well into Australian life; their family has been very important to them and has now grown to include 2 grandchildren with another grandchild due in 6 months' time.

After being reviewed by Mr Sheal, Surgical Oncologist and completing a number of investigations, Rosiane was diagnosed with Stage IV Cancer in her L) Breast. Rosiane commenced a trial of IV Chemotherapy, however this was not tolerated well and Rosiane decided to stop the treatment.

Rosiane has continued to deteriorate however is adamant she wants to remain at home. The multidisciplinary Palliative Care team are involved in Rosiane's care and her three daughters are also assisting in caring for their Mother.

Lonji is struggling to come to terms with Rosiane's deterioration over the past 6 months. After seeing Rosiane in the clinic last week post-discharge from CareShores hospital you are asked to review her at home as Lonji is very concerned about Rosiane.

When you arrive you find Rosiane is experiencing the following:

Nausea

Dry mouth

Pain and general body aches

Difficulty with swallowing

Anorexia

Constipation

Case study scenario 1

Rosiane is now finding it difficult to swallow, which is impacting on her oral medication management. It is agreed with her, Lonji and the team to commence a syringe driver via an 'Intima' device. Lonji asks what is a syringe driver and why does Rosiane need it?

In your response to Lonji include the following information

1. Outline the reasons why Rosiane needs to use a syringe driver

2. Can the Intima device also administer steroids and antiemetic medication?

Case study scenario 2

You can now identify early signs of imminent death. You have a discussion with Lonji about Rosiane's deterioration and ask about any cultural or religious needs she may have as a Muslim. Your colleague (John) is assisting you today and he is new to the community nurse role. Explain to John the following:

3. What are Rosiane's key needs of her religious faith required prior to and after death

4. You now ask yourself "Am I prepared for Rosiane's death"? Discuss ways in which you and your colleague's 'self-care' when caring for the dying?

Case study scenario 3

Lonji asks you 'What do I do when she dies here at home?' He is worried because originally Rosiane had wanted to donate her organs and he is uncertain about this. In addition to this, one of the members of their faith community had said Lonji can request an autopsy. He is confused with all these considerations and asks for clarification. In your response cover the following:

5. Explain to Lonji what will happen when Rosiane dies at home as a 'planned death'

6. Explain to Lonji Organ donation in relation to Rosiane's scenario

7. Explain to Lonji the process and the reasons around a request for an autopsy post-death.

Case study scenario 4

Rosiane asks you what will happen once she dies. She asks you how will my dignity be maintained? Outline how this will occur to Rosiane and in your response cover the following:

8. How will Rosiane's body be cared for once she dies?

9. How will Rosiane's dignity and privacy be maintained?

10. How will the nurses ensure Rosiane's cultural and religious requests are upheld after her death?

Reference no: EM133844746

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