Case Study of Nellie Essay Writing – Medical Science Assignment Help

Assignment Task

Task

Read the case study below and use it to answer one of the two options below:

Case Study:

Cancer treatment and management.

Nellie was a 63 year old patient who died in hospice care. She battled colon cancer for 4 years but it was only detected at stage IVA when a number of lesions had also appeared in her liver. The only reason she went to the doctor in the first place was because she had noticed a lot of blood in the toilet bowl after a bowel motion. The doctor immediately referred her for a colonoscopy, which detected a number of polyps in the colon and these were surgically removed. The ensuing MRI revealed a number of spots on the liver.

Over the nort 4 years, she had several rounds of chemotherapy, starting with 5-fluorouracil, then irinotecan and finally oxaliplatin. During annual follow-up colonoscopies, there was never any sign of recurrence of the cancer in her colon. The cancer in the liver had shrunk initially and then re-grown with each new chemotherapy drug. Routine blood tests were conducted with each cycle of chemotherapy She had to deal with various side-effects including hair loss, and periods of intermittent diarrhcea and constipation, hypokalaemia, neutropenia and fatigue. With the support of her husband Ron and two adult daughters who live in the same city, she was able to cope with the changes to her physical appearance and gradual deterioration in her sense of well-being.

She was relatively stable until 2 months ago when she experienced severe back pain after falling awkwardly while playing tennis with her husband Ron and she became unable to walk An X-ray confirmed that the cancer had spread to her spine (stage IVB) and was compressing the spinal cord. Targeted radiotherapy at a major cancer hospital failed to shrink the tumour. Nellie was transferred to hospice care and pain management medication was initiated.

Nellie’s pain was carefully monitored and she received 4g of paracetamol per day as well as subcutaneous morphine. She developed oral dysphagia and could not swallow oral medications or fluid and she felt nauseous. Oral medications ceased and feeding and hydration was exclusively via an intravenous tube. She appeared agitated and made frequent requests for extra medication for breakthrough pain, even though she reported feeling no pain. Staff reassured her and psychological counselling was also initiated. She experienced bouts of anger that her family could not be with her 24 hours per day and guilt because she felt that she was a burden on them. Her family became more and more upset and concerned about her changing moods. They asked if something could be done to ‘help her calm down. The family was reassured that this was a phase Nellie’s terminal illness that would progress to gradual acceptance with lots of love and support. Nell ie did become more peaceful in her relationship with her family, and found great solace in writing theme!l letters to read after she had passed on about her love for them and how she would live on through them. However, as renewed pain from her spinal tumour continued to increase, she became agitated, nauseous and emotional and the dose of morphine was difficult to titrate against the pain.

Following a family meeting in consultation with her medical team, she was commenced an end-of-life pathway with levomepromazine and sublingual clonazepam. She became more and more drowsy and unresponsive and died after 9 days. Her husband and children had been called in urgently the night before she died and they were grateful that they were with her when she passed away.

Option 1:

a) Discuss the ethical issues that could be considered and how they influence medication and other treatment for a dying patient. These should include the management of both physical and psychological pain as well as palliative sedation.

b) Discuss the diagnostic procedures that were undertaken during the course of the case. in terms of their sensitivity and specificity. OR

Option 2:

a) Map the treatments that were administered over the course of her illness (from the time of diagnosis to her death) including mechanism of actions of the drugs used for cancer therapy, pain and psychological issues.

b) Describe other technologies that might be used to detect colorectal cancer before it becomes malignant.

This Medical Science Assignment has been solved by our Medical Science Expert at TV Assignment Help. Our Assignment Writing Experts are efficient to provide a fresh solution to this question. We are serving more than 10000+ Students in Australia, UK & US by helping them to score HD in their academics. Our Experts are well trained to follow all marking rubrics & referencing Style. Be it a used or new solution, the quality of the work submitted by our assignment experts remains unhampered. You may continue to expect the same or even better quality with the used and new assignment solution files respectively. There’s one thing to be noticed that you could choose one between the two and acquire an HD either way. You could choose a new assignment solution file to get yourself an exclusive, plagiarism (with free Turn tin file), expert quality assignment or order an old solution file that was considered worthy of the highest distinction.