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Essay / Research Paper Abstract
A 3 page research paper that addresses a problem with a hospice patient using the PICO method.
This involves addressing the problem of a fungating malignant lesion. Bibliography lists 1 source.
Page Count:
3 pages (~225 words per page)
File: KL9_khhospico.rtf
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Unformatted sample text from the term paper:
when Mary develop renal impairment and stents were inserted in order to relieve bilateral hydronephosis. Due to disease progression, Mary has developed a fungating malignant lesion, the main symptoms of
which are "pain, discharge, malodor and occasionally bleeding" (Hawthorn, 2010, p. 71). The goals of Marys symptoms management are to address helping her to achieve "comfort, spiritual peace...[and] improve her
quality of life and correct any reversible causes of her complex symptoms" (Hawthorn, 2010, p. 71). Intervention Marys pain and discomfort are greatest when passing urine or when defecating,
as well as whenever the dressing on her wound is changed. Due to the obstructive nature of the bladder tumor, urinary catheterization is not possible. However, by administering a fentanyl
lozenge, which is a short acting opioid, and by applying a lignocaine-based anesthetic gel direct to the vulval region prior to attending to Marys hygienic needs, it was possibly to
address Marys most acute pain. Additionally, using the World Health Organizations analgesic ladder guidelines, it was decided to convert Marys "oral dose of oxycodone to the highly soluble opioid diamorphine"
(Hawthorn, 2010, p. 72). This was delivered "via continuous subcutaneous infusion and titrated to maintain constant symptom relief" (Hawthorn, 2010, p. 72). Dexamethasone was also administered in order to decrease
inflammation and improve appetite (Hawthorn, 2010). Mary was particularly disturbed by the malodor caused the malignant lesion, as she found the odor offensive and was embarrassed by it.
A swab taken from the wound showed that hemolytic B streptococcus infection was present (Hawthorn, 2010). Following the advice of experts, a trial course of erythromycin, which is a broad-spectrum
antimicrobial) was initiated. Furthermore, metronidazole was also prescribed as this agent is know to have a beneficial effect on odor (Hawthorn, 2010). Citing Paul and Pieper, Hawthorn (2010) indicates that
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