Case Scenario
Mrs. J., is a woman in her 40s with cholangiocarcinoma*, which is advanced. She has been admitted to the hospital with a new onset of back pain, nausea and vomiting. She has already undergone surgery and a course of radiation therapy.
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1. See attachement. What focus/foci of care best fits Mrs. J. at this point? Support your response.
2. What do you see as foremost of the National Quality Forum’s framework and preferred practices for palliative and hospice care quality (NQF, n.d.) to incorporate into Mrs. J.’s care? Link below is: Preferred Practices is in Appendix 1: http://nationalconsensusproject.org/Guidelines_Download.asp
3. What recommendations do you have for an interdisciplinary team and for your discipline to most effectively address Mrs. J’s needs current and upcoming needs?
4. What potential area of disagreement on the course of treatment/care among team members do you foresee? Offer suggestions for how to work through them, to enhance the team’s effectiveness and the overall care of Mrs. J. and her family.
(*cholangiocarcinoma: a malignant cancer of the liver bile ducts )
Solution Preview
1. I think that the focus of care that best fits Mrs. J at this point would be the Palliative focus, largely due to the fact that it is quite evident that her condition and the state of her disease has worsened to the point that it has reached the advanced stages. In addition, the curative focus which has included radiation therapy as well as surgery, seems to have been exhausted at this point and returns for engaging in such a course of action again will not lead to any appreciable result in respect to her health status. It would also be torturous and detrimental to her already weakened physical disposition for there to be continued bouts of radiation therapy and/or surgery. Due to these factors, at this stage it would be much more pertinent to treat the symptoms of her disease as much as possible, so that she will suffer as little as possible as the disease progresses. It would also be pertinent to provide psychological comfort and support as a component of this Palliatve focus in order to …
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