PATIENT Dilemma
Chemotherapy/End of Life
STUDENT Worksheet
Ken Johnson, 52 years old
Overview
Holistic nursing care entails caring for not just the physical needs of every patient, but also the soul (emotional)
and
...
PATIENT Dilemma
Chemotherapy/End of Life
STUDENT Worksheet
Ken Johnson, 52 years old
Overview
Holistic nursing care entails caring for not just the physical needs of every patient, but also the soul (emotional)
and the spirit. In this dilemma, a patient with a stage IV lung cancer has a strong faith and belief system, but his
illness is beginning to cause him to question his faith. How the nurse can practically support and care for his
emotional and spiritual needs in this context is the essence of this patient dilemma.
© 2015 Keith Rischer/www.KeithRN.com
Clinical Dilemma Activity: STUDENT
Chemotherapy/End of Life
I. Scenario
History of Present Problem:
Ken Johnson is a 52-year-old who was diagnosed with stage IV small cell lung cancer two years ago. He has been
managed with a daily oral chemotherapeutic drug that had kept his tumors in both lung fields and lymph nodes in
remission. He had a repeat CT scan last month that revealed that every tumor had grown dramatically in size and that he
would need to undergo aggressive intravenous chemotherapy to have any hope of long-term survival.
Personal/Social History:
Ken has a strong Christian faith and acknowledges that he feels that God has used the numerous people who are praying
for him as well as the medical care he has received have kept him alive. He has a supportive wife and two teenage sons.
What data from the histories is important & RELEVANT; therefore it has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
52 yr old, diagnosed with lung cancer two years
ago. Has been managing with an oral
chemotherapy that has kept him in remission.
CT scan last month revealing that the tumors
have grown in size and he would need to do IV
chemotherapy for hopes of long term survival.
The patient has an aggressive form of cancer, which does have a high
mortality rate. His cancer is currently being treated with chemo and is in
remission.
Before, his illness was being successfully treated, but now things have
changed. This type of cancer is the most aggressive, causing the growth of
these tumors. If the Pt does not undergo the treatment, his chances of
survival are low.
RELEVANT Data from Social History: Clinical Significance:
The pt has a strong Christian faith, and also
belives the care he has been given has kept him
alive, as well as the power of prayer.
He has a supportive wife, and two sons.
The pt’s faith is a huge factor and important to him, so healthcare team
should keep that in mind and do whatever may be necessary to respect the
patient/familys wishes.
The nurse should note that the patient has support from family
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