What nursing measures should the nurse use to manage the patient’s dyspnea? The patient complains that he has no appetite and struggles to eat and breathe. What nursing measures should the nurse implement to manage this physiologic response to the terminal illnesses?

  1. Nursing measures to manage dyspnea: The nurse can use various measures to manage Joe Clark’s dyspnea. One effective measure is to maintain a semi-fowler’s position for the patient to facilitate lung expansion and ease breathing. The nurse can also encourage the patient to perform pursed-lip breathing and deep breathing exercises, which are helpful in relieving dyspnea (Ferrell, Coyle, & Paice, 2019). The nurse should assess the patient’s oxygen saturation levels regularly and adjust the oxygen therapy as needed. A nurse can also provide support for the patient’s emotional well-being by being present and using calm, reassuring language and reducing the use of anxiety-provoking stimuli (Ferrell and al., 2019, 2019). The nurse can also provide distraction techniques, such as music or reading, to help ease the patient’s discomfort.

Nursing measures to manage anorexia: The nurse should assess the patient’s nutritional status, including weight, food intake, and hydration. A nurse should offer small and frequent snacks and meals throughout the day, as well as food and beverages that are enjoyable to the patient. A nurse must also be able to offer healthy food alternatives, including smoothies or high-calorie snacks (Ferrell and colleagues, 2019). Additionally, the nurse can provide mouth care, such as brushing and flossing the patient’s teeth, using mouthwash, and applying lip balm to alleviate dryness and soreness. To create an individual nutritional plan, the nurse must work with a registered dietitian.

  1. Principles of hospice: The underlying principles of hospice care include providing comfort care, maintaining the patient’s dignity, and enhancing the quality of life for the patient and family during the end-of-life phase (Ferrell et al., 2019). Hospice focuses on relieving symptoms and improving the patient’s overall well-being, including physical, emotional, and spiritual needs. Hospice care is provided in the patient’s home, or in a hospice facility, and a team of healthcare providers, including nurses, physicians, social workers, chaplains, and volunteers, work together to meet the patient’s needs.

Eligibility for Medicare and Medicaid Hospice benefits: To be eligible for Medicare and Medicaid Hospice benefits, Ms. Williams’ physician must provide a written certification of her terminal illness with a life expectancy of six months or less if the illness follows its usual course (Centers for Medicare & Medicaid Services, 2022). The physician must also certify that Ms. Williams has chosen to have hospice care, and that it is appropriate for her terminal illness.

Pain management in hospice: Hospice provides comprehensive pain management to relieve the patient’s pain and suffering. Together with the physician and the nurse, the hospice team will create a pain management program that can include both non-pharmacological or pharmacological intervention. The non-pharmacological options include heat, cold, massage and relaxation, as well as acupuncture. The non-opioid medications, such as Acetaminophen and fentanyl may be used as pharmaceutical interventions (Ferrell, et al. 2019, 2019). The hospice team will closely monitor the patient’s response to pain management and adjust the treatment plan as needed to ensure optimal pain relief.

References: Centers for Medicare & Medicaid Services. (2022). Medicare hospice benefits. Retrieved from https://www.medicare.gov/coverage/hospice-and-respite-care

Ferrell, B. R., Coyle, N., & Paice, J. A. (2019). Oxford textbook on palliative Nursing (5th Edition). Oxford University Press.

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