help with Case Management paper needed

pippylockstocking · Nov 28, 2010

I have a Case Management paper due for a BSN course. The client I chose is a 64 yo woman with Stage IV Breast Cancer with mets to the lungs. I have completed 3/4 of the paper. But this one criteria is where I could use a little help. If anyone can share their fresh perspective, I'd really appreciate it. I have been working on this paper all week, and I am now to the point where my head is going to burst! Could really use a fresh pair of eyes!

here is the criteria:

Present an analysis of the factors or issues that need to be addressed to effectively manage the care of the patient (you may select one aspect of the illness for this portion of the paper; i.e. CABG during treatment of CAD).

Another part of the assignment asked us to make a summary of health problems/diseases that the patient has experienced, using a table or outline form.

So if I am to select just ONE aspect of the illness, do I use one from the health problem list? The example given was CABG during CAD. Well my patient has Stage 4 Cancer and Chemo side effects. Would I focus the analysis on that? But really, what can you say about Chemo? It sucks. It wreaks havoc on the body. But it is a necessary evil. And what does it have to do with effectively managing the care of the patient? There aren't really any other options. It's either the chemo or nothing at all. So I just don't get what I am supposed to be analyzing here.

I don't know why this isn't making sense to me. Like I said, I have been working on this paper for a week and a half and my brain just won't cooperate anymore.

Here is my health problem list as it is so far. Maybe someone reading this will see something that I am not seeing. If anyone has any ideas, please share! It looks better on my word processor, so please don't mind the set up. :

The following list summarizes the client's health problems and history.

I. Breast Cancer

A. MRM of left breast in 2004.

1. Body Image Disturbance

2. Grief

B. Adjuvant Chemotherapy 2004-2005

1. Side-effects

a. Nausea and Vomiting

b. Mouth Sores

c. Neutrapenia

d. Alopecia

1. Body Image Disturbance

2. Grief

e. Fatigue/Weakness

C. Breast Cancer Recurrence in 2007

1. Metastasis to Lungs

2. Second-line Chemotherapy 2007 - present

a. Neutrapenia / Immunocompromised

1. Risk for Infection

b. Thrombocytopenia

1. Risk for Injury/Bleeding

c. Neuropathy

1. Pain

d. Nausea and Vomiting

1. Anorexia and Cachexia

e. Periodontitis

1. Tooth Loss

2. Stomatitis and Oral Mucositis

f. Fatigue and Weakness

II. Cardiovascular Disease

A. Hypertension

B. Hyperlipidemia

C. Family history of Stroke, Hypertension, etc.

III. Pulmonary Disease

A. Smoker of one pack/day X 35 years

B. Emphysema

C. Pulmonary nodules from metastatic cancer

1. Ineffective Breathing Pattern

IV. Mental/Mood Disorders

A. Major Depressive episodes X 5

1. Ineffective Coping

B. Dysthymia

C. Generalized Anxiety Disorder

D. Social Phobia

E. Alcohol Abuse / Quit in 2005

1. Family History of Alcoholism and Depression

V. Gastrointestinal Disorders

A. Cholecystectomy in 2010

B. Gastroesophageal Reflux Disease (GERD)