[2025] Benchmark Case Study Timothy Smith – Hospice/Palliative Care – Fast, Quality and Affordable Assignment Expert

Answer the following questions based on Mr. Smith’s presentation and history.

The decline in cardiac output is the other possible cause in the sense that it causes the accumulation of fluids in the lungs, causing decline in ventilation. The elevation of the pulmonary artery pressure linked to a condition like chronic thromboembolic pulmonary hypertension exacerbates unmanaged blood clot dysfunction. The weakness of the neuromuscular system due to prolonged inactivity coupled with deterioration of the cognitive health can interfere with breathing.

The second intervention which occurs within four hours of initiating therapy, involves examining the patient for the blockage of the lung’s artery by blood clot, which is known as Pulmonary Embolism (PE). This assessment involves performing CT pulmonary angiography to determine whether the condition is present (Shah et al., 2022).

Also employed as part of the interventions is performing echocardiography within 24 hours after the patient presents to the clinic. This is meant to examine the pulmonary blood pressure, and the strain on the side of the heart that comprises of the right atrium and ventricle.

Implementation of the blood thinning therapy occurs within 6 hours. This intervention prevents the exacerbation of thrombus, and it involves treatment with anticoagulant, which is administered directly and orally (Shah et al., 2022).

1. Managing hypoxemia: Perform oxygen therapy, immediately administering supplemental oxygen to relieve shortness of breath, improve ventilation, and reduce the risk of adverse health events due to hypoxia (Uzun et al., 2023).
2. Initiate anticoagulation: Initiate this intervention to minimize the risk of death considering the high PE risk tied to the left popliteal vein thrombus.
3. Management of the wound: This intervention focuses on preventing the deterioration of Mr. Smith’s health due to sepsis. This intervention involves initiating antibiotics treatment, and cleaning and treating the wound.
4. Implement psychotherapy to address the patient’s emotional and mental health needs: Before administering this intervention, it is important to first assess the patient, examining unresolved psychiatric issues including the signs of depression. The psychotherapy for this patient may entail the use of cognitive behavioral therapy.
5. Social support: Link the patient with resources that can help them to successfully go through the journey of recovery. The peer support program, for instance, is an ideal resource.

Establishing caring relationships is vital for the nurse-patient relationship, especially when taking care of patients with complex, chronic needs.

1. Active listening: Create a sound environment that encourages the patient to share their feelings including concerns.
2. Adopt non-biased approach when interacting with Mr. Smith: Rather than judge the patient because of his substance use behavior, recognize this behavior as a symptom of unresolved personal issues. This demonstrates to him that the provider understands his struggles.
3. Maintain transparent communication: Clearly explaining the Mr. Smith’s health needs including the interventions that can help improve his recovery is likely to nurture trust, allowing them to feel comfortable sharing their thoughts.
4. Engage the patient and encourage their collaboration in preparation of the intervention plan: Ask the patient’s his beliefs, values, and fears, incorporating these into the healthcare plan.
5. Maintain respectful conversation when engaging Mr. Smith.        

1. Showing compassion: Acknowledge the patient’s plight including his struggles with illness, and the suffering he endures as his health declines.
2. Empathetically communicate with Mr. Smith: Use words that show genuine concerns for his ill health. An example is, “I understand the challenges involved in dealing with these health issues.”
3. Adopt constructive criticism, avoiding confrontation with the patient: In case the patient misses appointment or continues using drugs, approaching him without judging him is the right thing to do. This prevents tension or confrontation.
4. Because unresolved psychiatric issues can interfere with Mr. Smith’s mood, it is crucial that their psychological needs be assessed and addressed using the right interventions like the CBT.

Caring for patients with complex needs requires the nurse to possess effective communication skills. You are assigned as Mr. Smith’s primary nurse during his most recent hospitalization. Consider Mr. Smith’s most recent assessment findings in addressing the following questions.

1. Personal and spiritual beliefs: Ask if he aligns with any personal or spiritual beliefs that have the potential of influencing his health choices.
2. Consider Mr. Smith’s cognitive ability when offering instructions. This requires adapting communication to his level of understanding by clearly and concisely presenting instructions. When communicating to the patient, maintaining sensitivity to his post-traumatic stress disorder is crucial in terms of addressing his psychological needs (Sheehan et al., 2021).
3. Acknowledge Mr. Smith’s emotional pain: Mr. Smith is grappling with the loss of his mother, and he lacks the necessary support. Empathizing with him due to his experience and providing meaningful support like linking him with resources on dealing with grief provides healing opportunity.
4. Address Mr. Smith’s concerns about the healthcare system. Start by recognizing his fears about the healthcare system, acknowledging these fears as genuine.

Demonstrating self-awareness: This involves being aware of one’s misconceptions or prejudices about Mr. Smith’s lifestyle or habits. When interacting with the patient, ensure fair assessment of the patient, avoiding judgmental attitude (Michel, Lutz-Beck, & Engeroff, 2023).

Demonstrate empathy: Empathize with Mr. Smith, acknowledging his concerns, challenges and grief. This helps him develop a sense that the provider is concerned about addressing his needs.

Motivate Mr. Smith: Encourage Mr. Smith’s involvement in planning for his own care, considering him as a partner in the development of the intervention plan.

Maintain self-control: Approach patient care with composure and patience, even when the patient acts like he wants to be confrontational. Throughout the process of interacting with Mr. Smith, the provider should focus on calming tension (Michel et al., 2023).

Employing social skills can lead to easing of anxiety tied to working with a patient like Mr. Smith that has distrust for providers. For instance, the provider can maintain eye contact when having a conversation with the patient.   

Providing holistic nursing care for the patient with complex conditions requires that the nurse take into account the patient’s psychosocial and spiritual needs.

Providing emotional support: Actively listen as Mr. Smith shares his concerns, validating his emotions.

Administer interventions grounded in spiritual care: If Mr. Smith is likely to derive strength from prayers, tailoring care to his spiritual needs is crucial in the sense that it provides him with the opportunity to find meaning.

Collaborate with the patient to set therapeutic goals: When engaging Mr. Smith, work with him, and guide him to establish meaningful goals that can help guide him through the journey of recovery.

Recommend mental health support: Connect him with psychiatric services to address his psychosocial needs.    

You are assigned as the nurse case manager for Mr. Smith.

With palliative care, care is delivered at any point of the patient’s journey of living with a disease, often with focus on optimizing health outcomes. This kind of care specifically addresses various aspects of the patient’s needs including the emotional and physiological needs. The other aspect of this kind of care is that it involves a team of healthcare workers drawn from different disciplines.

The type of care that aligns with Mr. Smith’s needs is the palliative care. While the deterioration of Mr. Smith’s health is noticeable, his condition does not warrant hospice care.

1. Move Mr. Smith to adult home care where they would receive adequate care, and support related to performing of the activities of daily living. Some examples of care that he would benefit from while at this facility include wound care, and administration of medications.

Managing of the Patient’s Health Care Needs

Wound Management:

1. Control the infection using the prescribed medications, change the dressing, and regularly perform debridement procedure.
2. Administer supplemental oxygen with focus on optimizing ventilation.
3. Perform vascular care, initiating anticoagulant therapy with the goal of managing left popliteal vein’s thrombus.

Psychiatric Needs

1.     Focus on counseling as a means of addressing Mr. Smith’s substance dependence problem.

2.     Address depression and PTSD by engaging a psychiatrist.

  Addressing Financial Needs

1. Help the patient to navigate the healthcare system, allowing them to find cheaper health insurance programs like Medicaid.

Providing Support

1. Help the patient to find support systems within their communities. The peer support groups in particular are ideal source of support for this patient.
2. Mobilize a team of healthcare professionals to provide caregiver services.

Monitoring the Patient

1. Schedule follow-up, involving members of the interdisciplinary team to examine the patient for progress.

Primary Care Physician: Play a crucial role in overseeing and coordinating the patient’s health care. For instance, they make referral, prescribe drugs and manage lifelong illnesses. However, the contributions of the primary care physicians will be dependent on the contributions made by Psychiatrists who are responsible of providing psychiatric services, and their involvement in patient care is likely to translate to improved mental health outcomes (Nguyen et al., 2024). They will particularly contribute towards the alleviation of the symptoms of depression.

Social Workers: Make the needed arrangements, enhancing the patient’s access to social support services like accommodation facilities. Part of this support also involves assisting the patient to transition to a nursing home facility. Additionally, their role involves assisting patients to apply for Medicaid or locate the necessary financial resources. These social workers equally work with providers, provided meaningful care.

Appropriate resources and a support network are important for Mr. Smith and will be imperative in promoting optimal outcomes.

Clinics at the community level: With some clinical facilities charging less for services, and others providing free care, these clinics provide affordable options for Mr. Smith.

Long-term care hospitals: They operate uninterrupted, consistently working to deliver care, and to address patients’ needs.

Virtual care: Provides the patient with the opportunity to access care from remote locations, which eliminates the need to physically be present at the hospital (Ezeamii et al., 2024). With lack of primary caregiver and financial support, this virtual care is ideal for Mr. Smith.

Free Meal Services: He can take advantage of these services to access free but healthy meals, which provides proper nutrients for his body.

Rehabilitation programs for people with addiction: These programs offer a wide range of services, from mental health care to detox treatment. This offers the patient the opportunity for recovery from addiction.

Faith-based organizations: Act as the link between the patient, and a web of caregivers working towards addressing patients’ welfare.

Community Centers: Provide individuals with common amenities like sporting arenas where they get the chance to interact and socialize with others.

Community-Based Non-Profits: These are voluntary organizations that volunteer to provide various forms of support including shelter.

Peer Support Groups: These groups bring together people with common experiences and needs. These individuals share these needs with each other, receiving emotional support in return. Learning from others’ experiences helps one understand that they are not alone in the journey of struggling with stressors (Pinho et al., 2021).

Healthcare Facilities that Focus on Serving their Communities: They provide services like those provided in assisted living facilities, with focus on improving the quality of patients’ lives, and preventing health complications linked chronic illnesses.

Ezeamii, V. C., Okobi, O. E., Wambai-Sani, H., Perera, G. S., Zaynieva, S., Okonkwo, C. C., Ohaiba, M. M., William-Enemali, P. C., Obodo, O. R., & Obiefuna, N. G. (2024). Revolutionizing Healthcare: How Telemedicine Is Improving Patient Outcomes and Expanding Access to Care. Cureus, 16(7), e63881. https://doi.org/10.7759/cureus.63881.

Michel, K., Lutz-Beck, D., & Engeroff, S. (2023). Improving the Therapeutic Relationship When Prescribing Antidepressants: A Pilot Study. Healthcare (Basel, Switzerland), 11(21), 2825. https://doi.org/10.3390/healthcare11212825.

Nguyen, M. T., Honcharov, V., Ballard, D., Satterwhite, S., McDermott, A. M., & Sarkar, U. (2024). Primary Care Physicians’ Experiences With and Adaptations to Time Constraints. JAMA network open, 7(4), e248827. https://doi.org/10.1001/jamanetworkopen.2024.8827.

Pinho, L. G., Lopes, M. J., Correia, T., Sampaio, F., Arco, H. R. D., Mendes, A., Marques, M. D. C., & Fonseca, C. (2021). Patient-Centered Care for Patients with Depression or Anxiety Disorder: An Integrative Review. Journal of personalized medicine, 11(8), 776. https://doi.org/10.3390/jpm11080776.

Shah, I. K., Merfeld, J. M., Chun, J., & Tak, T. (2022). Pathophysiology and Management of Pulmonary Embolism. The International journal of angiology : official publication of the International College of Angiology, Inc, 31(3), 143–149. https://doi.org/10.1055/s-0042-1756204.

Sheehan, J., Laver, K., Bhopti, A., Rahja, M., Usherwood, T., Clemson, L., & Lannin, N. A. (2021). Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: A Systematic Narrative Review. Journal of multidisciplinary healthcare, 14, 493–511. https://doi.org/10.2147/JMDH.S295549.

Uzun, A. B., Iliescu, M. G., Stanciu, L. E., Ionescu, E. V., Ungur, R. A., Ciortea, V. M., Irsay, L., Motoașcă, I., Popescu, M. N., Popa, F. L., Pazara, L., & Tofolean, D. E. (2023). Effectiveness of Intermittent Hypoxia-Hyperoxia Therapy in Different Pathologies with Possible Metabolic Implications. Metabolites, 13(2), 181. https://doi.org/10.3390/metabo13020181.