Discuss the care concerns for the patient AND their family including interventions to meet those concerns.
Select one of the case studies below and write a professional paper according to the criteria noted in grading rubric for this assignment. Discuss the care concerns for the patient AND their family including interventions to meet those concerns. Your responses should be complete and refer to the case study. References should be from at least three (3) scholarly resources and may include resources linked in Module 7 as well as additional evidence found in the scientific literature.
Case Study #2
Despite studies showing that the majority of people would prefer to die outside of the hospital setting, some individuals find comfort in a more structured environment. Jake is a 90-year-old man diagnosed with end-stage dementia. He has been living in the home of his daughter and son-in-law, who are retired and in their 60s. His daughter is a power-of-attorney healthcare representative. He has a living will in which he indicates an intentional nondecision about artificially supplied nutrition and hydration. In the past two years, he has become progressively weaker, unable to ambulate, unable to carry on meaningful conversations, and increasingly incontinent of bowel and bladder.
He was admitted to the hospital with lethargy and dehydration. A hydration intravenous solution was started at 75cc/hr. The physician mentioned the possibility of a gastrostomy tube for feedings if the family wished to do so. The certified nursing assistant (CNA) reported Jake moaned when she turned him during his bath, and he did not arouse when she attempted to feed him breakfast.
You are Jake’s RN and his daughter is upset and stated “I don’t think dad would want a tube in his stomach, but he never told me that for sure. My brother thinks we should do it so dad does not starve to death. I tried to feed him oatmeal this morning, but he seemed to choke. He’s been coughing when he eats for a couple of months.”
Your physical assessment revealed crackles throughout his lung fields, respiratory rate of 44 breaths/minute, edema to lower extremities, decrease level of consciousness, an irregular apical pulse, and blood pressure of 76/48 mm Hg.