1000words is ok and Essay format and instruction been provided in PDF file. Thanks.

Running Head: NURSING        1
NURSING        6
NURSING
Introduction
    Mary was a 48 years old women diagnosed with breast cancer 2.5 years ago and with bone secondary’s disease last year. Mary was provided with palliative care nurse at home. During week one, she was diagnosed to receive radiotherapy; however, she denied and recommenced chemotherapy. During week 2, her appetite was almost nil and she was not able to digest food due the development of ascites, which is a common symptom during metastatic cancers. As a result, Mary refused to take any further treatment, food and fluids. She died peacefully at home during week 3. The current assignment is a critical analysis of their situations and the evaluation over a period of three weeks.
1.
    Mary is reluctant to seek medical attention and there are several reasons behind it. First, she does not want to travel 60 km every day in order to seek radiotherapy. Further, Mary acknowledges her pain and still does not want to seek medical attention towards the issue, which reflects self-defiance. Moreover, Mary is aware that stronger doses of drugs and analgesics would lead to addiction.
2.
    There could be inclusion of several members in the palliative care. Lee et al, (2015) suggested that this should include
Family doctor - because they know the family history.
Nurses- in order to provide care and support along with medications.
Cancer specialist – to monitor the weekly progress of patient and regulate the diagnosis.
Counsellor – to provide emotional and mental support.
3.
    One of the major causes of vomiting and nausea was chemotherapy and drugs. As evident from week 1, recommencement of chemotherapy lead to nausea and vomiting. Further, she was diagnosed with panadeine forte after every 2 hours for pain relief and this could be a major reason behind nausea and vomiting. However, as the week 2 progresses, Mary reflected that she might have caught ‘gastro’ from her kids, which led to diarrhoea and vomiting.
4.
    Firstly, Mary should have been diagnosed with anti-emetics in order to control her vomiting and nausea during first week (Aslam, Naveed, Ahmed, Abbas, Gull & Athar, 2014). Further, the fluid loss due to gastro in second week should have been compensated with intravenous therapy (IV) in order to supply glucose and other elements directly into her blood. Likewise, application of fluids to her lips and tongue could have prevented dried lips and tongue.
5.
    Mary has been found crying holding her hip, which reflects the pain location. Further, the intensity of pain could also be considered as high; however, verbal or numeric rating scale could be used to monitor the level of pain. Van Poznak, et al., (2017) suggested that other locations and positions could also be accessed for the occurrence of pain.
6.
    It was evident from the case study that the provided doses of panadeine forte were not enough to provider her relief for more than 2 hours. Mary was worried that shifting to higher or stronger doses of analgesics would make her addicted to them. Likewise, she was also worried about having such drugs around children as it could had a negative impact on them.
7.
    Nurse should have informed Mary that even stronger...