Verified Document

A Brief Case Study Regarding Treatment Noncompliance Case Study

Patient is a 69-year-Old male who is refusing treatment for cancer. The following is a description of the patient. Primary diagnosis: Malignant Neoplasm of Head, Face and Neck (C76.0) because this is the diagnosis that brought the patient into treatment (Hogston, 1997).

Patient's past medical history: Hypertension, hyperlipidemia, stomatitis, anemia, neutropenia. Patient had right radical neck dissection in 2012.

Current Medications: Carvedilol 12.5 mg. q.d.; Furosemide 40 mg q.d.

Social History: Patient is a former smoker who quit two years ago following cancer diagnosis. He is married with children.

Current Issue: Patient is refusing to engage in further treatment regarding his cancer (chemotherapy and radiation) stating that he is tired of the untoward effects of treatment. Patient wants information regarding other options.

Complicating factors:

A. Patient's family does not agree with his decision to stop treatment.

B. Patient does not have an advanced directive or living will.

7. Possible Secondary Diagnoses:

A. Depressive Disorder (Reactive Depression; F32).

B. Adjustment Disorder with Anxiety and Depressed Mood (Grief Reaction; F43.23)

C. Cognitive Changes due to a General Medical Condition (R41.89).

D. Of course it is possible that there is no secondary diagnosis.

There are several approaches...

The nurse can ask a series of questions in order to determine which path to investigate further.
Ten Questions

I. Decision-making:

First it is a good idea to determine if the patient has the capacity to make informed decisions. This is mostly related to diagnosis C but can be a result of the other potential diagnoses under consideration as well. It could also be that the patient is not sufficiently informed regarding his treatment and potential outcomes associated with continuing or discontinuing it. These questions can determine the need for further investigation (Sessums, Zembrzuska, & Jackson, 2011):

1. Just to make sure we are on the same page, can you describe for me the medical problems you are dealing with now as you understand them?

2. Can you describe the possible treatments that have been discussed with you and briefly tell me their pros and cons?

3. What is your understanding of what will happen to you if nothing is done?

4. General questions such temporal orientation questions (what is the month, day, year, time).

5. Questions to judge reasoning such as how are a banana and orange alike (fruit); bicycle and train (transportation); watch and ruler (measure things; Sizoo, Pasman, Buttolo, Heimans, Klein, et al., 2012).

If the patient is unclear on these or way off there may be need…

Sources used in this document:
References

Auning, E., Selnes, P., Grambaite, R., Saltyt? Benth, J., Haram, A., Lovli Stav, A., ... & Aarsland, D. (2015). Neurobiological correlates of depressive symptoms in people with subjective and mild cognitive impairment. Acta Psychiatrica Scandinavica, 131(2), 139-147.

Ellershaw, J., & Wilkinson, S. (2011). Care of the dying: A pathway to excellence. New York:

Hatfield, R. C. (2014). The everything guide to coping with panic disorder. Avon, MA: Adams.

Hogston, R. (1997). Nursing diagnosis and classification systems: a position paper. Journal of Advanced Nursing, 26(3), 496-500.
Cite this Document:
Copy Bibliography Citation

Related Documents

Blood Pressure Treatment Compliance With
Words: 2219 Length: 5 Document Type: Research Paper

This shows that monitoring of lifestyle changes can effectively be implemented in conjunction with other drug therapies to provide the most effective results for patients in need. Additionally, another 2010 (Navidian et al.) study showed that although lifestyle monitoring may not have been much different in terms of systolic blood pressure, there were statistical differences in terms of diastolic blood pressure. In this study, 61 patients with systolic hypertension

Enforcement of Psychology Treatment for the Mentally Ill
Words: 8451 Length: 27 Document Type: Thesis

Psychology Treatment For most of U.S. history up to the time of the Community Mental Health Act of 1963, the mentally ill were generally warehoused in state and local mental institutions on a long-term basis. Most had been involuntarily committed by orders from courts or physicians, and the discharge rate was very low. Before the 1950s and 1960s, there were few effective treatments for mental illnesses like depression, anxiety disorders and

Tuberculosis TB Prevention and a
Words: 6084 Length: 22 Document Type: Term Paper

5 per 100,000 in 1986. In 1994, the number of TB cases among residents of correctional facilities for 59 reporting areas had reached 24,361 (4.6% of the total reporting correctional population) (Braithwaite et al.). The incidence rate was 139.3 per 100,000 by 1993 and the unadjusted case rates for prison populations in many areas are significantly higher than the rates for the general population (Braithwaite et al.). According to these

Activities to Reduce Inappropriate Behaviors Displayed by
Words: 10021 Length: 25 Document Type: Term Paper

Activities to Reduce Inappropriate Behaviors Displayed by Children With Autism and Other Developmental Disabilities The purpose of this dissertation study is to test the effectiveness of an everyday activities-based protocol (Holm, Santangelo, Fromuth, Brown & Walter, 2000) for managing challenging and disruptive behaviors of 13- to 23-year-old residential students (male and female) with Autism who live at Melmark Homes, Inc., of southeastern Pennsylvania, and attend school or adult day programs.

Effect of Forgiveness on Health
Words: 28998 Length: 105 Document Type: Thesis

Forgiveness on human health. In its simplest form, the purpose of the study is to evaluate human psychological stress that might constitute a risk factor for heart disease. Further, the study will also evaluate the impact of forgiveness on heart disease. However, such a simple dissertation clearly demands further definition. What, exactly, do we signify when we speak of heart disease? What is properly considered as forgiveness? What impact does

Nursing Plan and Implement and
Words: 2712 Length: 10 Document Type: Term Paper

He or she will literally take issue with the physician and issue and even sterner and more emotional warning concerning why compliance is essential. Before the patient is released, the nurse will once again speak with the patient and ask, on a scale of ten, how important do they think it is to wear the appliance post-surgically. The nurse will also ask how likely the patient himself or herself thinks it

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now