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Topic 5 DQ 3

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Topic 5 DQ 3

Movie Character Presentation (STEPMOM) By: Shannon Burtis Background of Movie Character Functional

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Assessments Analysis of Health Assessment Overview of Presentation Additional Observations Nursing Considerations Conclusion References Background of Movie and Character A family struggles with managing multiple life challenges • Divorce • Terminal illness • Transitioning into a blended family unit Main Character: Jackie (Susan Sarandon) • Former publisher • Full time mother • Diagnosed with cancer Functional Assessments Health Perception/Health Management Nutrition/Metabolic Pattern of Elimination • Routine follow up appointments • Diagnosed with cancer • Weight loss during chemotherapy • Provides healthy family meals • Nausea/Vomiting related to chemotherapy • No complaints of constipation • No complaints of diarrhea Assessment Continued Pattern of Activity/Exercise Conceptual/Perceptual Pattern Pattern of Sleep and Rest • Active mother • Walks/dances • Horseback riding • Positive attitude/Hopeful to win her fight against cancer • Expresses self clearly and logically • Bachelor’s degree or higher (Publisher) • Appears tired • Inability to sleep/rest related to increased anxiety and fear for children • Established bedtime routine Pattern of Self Perception and Self Concept Role/Relationship Patterns Sexuality/Reproductive Patterns • Shock and disbelief • Pain • Anger • Bargaining • Depression • Acceptance and hope • Independent • Single Mother • Daughter/Son = important relationships • Recently divorced • Lack of trust in Isabela (stepmom) • Two healthy children • Comfortable with sexuality Assessment Continued Assessment Complete Pattern of Coping and Stress Tolerance • Talks about problems • Ability to compromise • Coping mechanisms work well Pattern of Values and Beliefs • Strong family values • Co-parenting is important • Family/Past co-worker support • Fears for her children’s wellbeing • Believes that death is imminent • Accepts her cancer diagnosis Analysis of Health Assessment Normal assessment findings • Appears to be a healthy, well adjusted, single mom in beginning of movie • Within normal weight range before chemotherapy • Healthy eating habits • Energy level meets demands of an active lifestyle before cancer diagnosis • Attends routine follow up doctors appointments • No complaints of constipation/diarrhea • Seven stages of grief Abnormal or risk-based findings • Recurrent cancer • Weight loss related to chemotherapy • Increased fatigue • Nausea/Vomiting Additional Observations Cultural Mixed rural/city Geographical New York Religious Ethnic No mention of religious affiliation Caucasian Spiritual Belief of afterlife Nursing Considerations Nursing Diagnosis Interventions Resources Imbalanced nutrition related to nausea and vomiting as evidence by weight loss Health promotion-Educate on the importance of maintaining proper nutrition Health prevention-Encourage patient to have small, frequent feedings Health maintenance: Obtain weekly weight Casa De La Luz Hospice American Cancer Society Conclusion  This comic-drama portrays the struggles of a women named Jackie who is experiencing divorce and a terminal diagnosis of cancer as she assimilates to the idea of another women named Isabela replacing her as a mother. The family overcomes many trials as they transition into a blended unit and accept their new roles. Once compromise is found between the two women, Jackie is able to let Isabela into her children’s lives and the family becomes one. “They can have us both. I have their past, you can have their future.” References  American Cancer Society. (2018). Find Support Services Programs and Services in your Area. Retrieved from https://www.cancer.org/treatment/support-programsand-services.html  Casa De La Luz Hospice. (2016). Why Casa De La Luz? Retrieved from https://casahospice.com/  Columbus, C. (Director), Barnathan, M. (Producer), Finerman, W. (Producer), & Radcliffe, M. (Producer). (1998). Stepmom [Motion picture]. USA: 1492 Pictures.
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Topic 5 DQ 3

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Topic 5 DQ 3

MOVIE CHARACTER PRESENTATION: “MY SISTER’S KEEPER” BY: JAMIE FALLIGAN AUGUST 19, 2018 NRS-434VN

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OVERVIEW OF PRESENTATION ➢Summary of the disease Acute Promyelocytic Leukemia ➢Functional Health Pattern Assessment (FHP) of the client; movie character “Kate” ➢Observed health patterns of the client ➢Nursing diagnosis including interventions ➢Available resources MEET THE CLIENT ➢Name: Kate Fitzgerald ➢Age: 15 ➢Diagnosed with acute promyelocytic leukemia at age 2. ➢Sister, Anna, was conceived with the intent of becoming a genetic match for Kate. FUNCTIONAL ASSESSMENTS ➢ Health Perception/Health Management • Client is aware she has APL that will eventual result in her death • Current health issues include frequent epistaxis, bruising, vomiting, anemia, neutropenia, and fatigue • To maintain health, client takes prescribed medications and avoids those with acute illnesses due her immunocompromised state ➢ Nutrition/Metabolic • Client is underweight • Intake is less than recommended requirements due to decreased appetite and nausea caused by chemotherapy treatments ➢ Pattern of Elimination • Reports diarrhea due to current chemotherapy treatment • Current renal failure resulting in minimal urination ASSESSMENT CONTINUED ➢ Pattern of Activity/Exercise • No active exercise program and minimal activity due to fatigue, shortness of breath, and bone pain ➢ Conceptual/Perceptual Pattern • Client is currently in the 9th grade • Normal mental and sensory functions • Experiences joint and bone pain with activity ➢ Pattern of Sleep and Rest • Sleeps >8 hours each night • Takes frequent naps and rest periods frequently throughout the day ASSESSMENT COMPLETE ➢Pattern of Coping and Stress Tolerance • Client copes by keeping a daily diary and discussing feelings with her parents • Discusses illness with other cancer patients during her chemotherapy sessions, which helps her cope ➢Pattern of Values and Beliefs • Feels that everyone should live life to their fullest • No religious affiliation • Supportive family and friends ANALYSIS OF HEALTH ASSESSMENT ➢Normal assessment findings • Role/Relationship Pattern • Pattern of Coping and Stress Tolerance ➢Abnormal or risk-based findings • Nutrition/Metabolic Pattern • Pattern of Elimination ADDITIONAL OBSERVATIONS ➢ Cultural • American ➢ Geographical • Lives with her family in Rhode Island ➢ Religious • No specific religious affiliation ➢ Ethnic • Caucasian ➢ Spiritual • Shows alleviation of fear and loneliness during her last days of life. NURSING CONSIDERATIONS ➢ Nursing Diagnosis • Risk for Infection related to Neutropenia Secondary to Chemotherapy ➢ Interventions • Encourage a well-balanced diet • Teach measures for prevention of infection, such as proper hand washing and avoiding those with infectious illnesses • Educate patient and family members on signs of infection, including elevated temperature, cough, sore throat, mouth sores, and any area that appears to be infected ➢ Resources • CancerCare • Leukemia Research Foundation CONCLUSION ➢Acute promyelocytic leukemia (APL) presents similarly in children and adults. ➢Previously considered a highly lethal form of leukemia, APL is now the most curable subtype of adult acute myeloid leukemia (AML). ➢Rapid treatment is key to a positive outcome. ➢Today, cure rates can be as high as 98% if diagnosed and treated rapidly. REFERENCES ➢CancerCare. 2012. About us. Retrieved from http://www.cancercare.org/about ➢Clark, P. A., Drain, M., & Malone, M. P. (2003). Addressing patients’ emotional and spiritual needs. Joint Commission Journal on Quality and Safety, 29(12), 659-670. Retrieved from https://doi.org/10.1016/S1549-3741(03)29078-X ➢Colón, Y. (2017). Ethnic diversity and cultural competency in cancer care. Oncology Issues, 22(5), 28-31. Retrieved from https://doi.org/10.1080/10463356.2007.11883357 REFERENCES ➢ Leukemia Research Foundation. 2018. About us. Retrieved from http://leukemia-research.org/ ➢ St. Jude Children’s Research Hospital. (2018). Leukemias: Acute promyelocytic leukemia (APL). Retrieved from https://www.stjude.org/disease/acute-promyelocyticleukemia.html?vgnextoid=9c0c061585f70110VgnVCM1000001e0215acRC ➢ Walker, D., & Held-Warmkessel, J. (2010). Acute promyelocytic leukemia: An overview with implications for oncology nurses. Clinical Journal Of Oncology Nursing, 14(6), 747-759. doi:10.1188/10.CJON.747-759.
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Topic 5 DQ 3

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Topic 5 DQ 3

Dad Dad-Jack Lemmon Son-ted danson Grandson-ethan hawke Overview • Background of the Movie DAD •

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Functional Assessments • Analysis of Health Assessments • Additional Observations • Nursing Considerations and Interventions • Conclusion Background of Dad • • Jack Lemmon, Dad, plays the aging father of Ted Danson, his son. Always proud of being able to fend for himself, Lemmon despises being reliant upon others, but his enfeebled state does not allow him his old independence. For his part, Danson resents having to care for his dad, who is in early stages of Alzheimer’s disease. Things take an upward turn when Jack Lemmon becomes filled with self-confidence. But then Lemmon is stricken with cancer, an affliction that he can’t jolly himself out of, and as the reality of his imminent death strikes everyone around him, Lemmon retreats into fantasy, recalling the past happy events of his life as though they’re happening here and now. The rest of the family humors their dying dad, and in so doing draws them closer together than they’ve been in years. “Right click” in the image above, hit preview and play for trailer of movie. Functional Assessment • • • Health Perception/Health Management • • 78-year old man in general good health • • Nonsmoker and occasionally drinks wine at dinner settings Able to walk w/o assistance, dress and bath self, and no history of falls Early stages of Alzheimer’s disease, and during the movie is diagnosed with cancer Nutrition/Metabolic • • • Regular diet with appetite, drinks plenty of fluids No recent weight loss and skin appears pink and intact No dentures and wears reading glasses Pattern of Elimination • • One bowel movement every 1-2 days Urine is clear until blood occurs in the urine before he is diagnosed with cancer Functional Assessment • Pattern of Activity/Exercise • • • • • • Daily walks, except when hospitalized (then stiff with limited activity) Enjoys gardening, chess, bingo and other leisure games Able to groom self and use toilet Normal range of motion and able to grip items Conceptual/Perceptual Pattern • • • • • Steady gait and able to walk 0.5-1.o miles Alert and oriented x3, with periods of forgetfulness (Jarvis) No dentures and uses glasses to read Clear speech After diagnosis of cancer he is traumatized and is alert, but has loss of memory of people and surroundings with limited speech Pattern of Sleep and Rest • • Normal sleep patterns After diagnosis of cancer has periods of sleeplessness and occasionally sleeps under bed because of fear of dying Functional Assessment • Pattern of Self Perception and Self Concept • • • • Makes good eye contact and clear speech when talking with family and others Once diagnosed with cancer has decreased perception of self and unable to recognize self, others, and surroundings Role/Relationship Patterns • • • • Is upbeat and feels good about self always wanting to do activities with family • Lives with spouse and has family support Decreased relationship with son in the beginning of the movie until relationship becomes resolved as son takes care of Dad Towards end of movie family relationships are healthy and supportive Social outings to events like bingo, dining Sexuality/Reproductive Patterns • Sexual relationship is appropriate to age Functional Assessment • • Pattern of Coping and Stress Tolerance • • • • Unable to cope with diagnosis of cancer Temporarily loses perception of self, people, and surrounds Periods of shaking/rocking back and forth, unable to sleep in own bed (Goldberg) Family unable calm Dad down during bouts of stress Pattern of Values and Beliefs • • • Doctor diagnosis him with “Successful schizophrenia” after he regains memory from cancer diagnosis Has a temporary period of retreating back in time 20-40 years ago from suppressed memory and wants to go dancing, fishing, and other activities. Catholic, but not actively attending church Analysis of Health Assessment • Normal assessment findings • • • • • • • Alert and oriented x3 and skin is intact Free from pain and distress Steady gait and walks 0.5-1.0 miles often Good appetite with regular bowel movements Enjoys family and social activities (chess, bingo, walks) Good relationships with family Abnormal or risk-based findings • • • • Early onset Alzheimer’s disease as evidenced by periods of forgetfulness Recent diagnosis of bladder cancer Unable to cope as evidenced by loss of perception of family and surroundings Recent diagnosis of successful schizophrenia Additional Observations • • • • • Cultural • • • Heterosexual Caucasian with American values Likes family gatherings and social events Believes in individual independence Geographical • Setting is located in Los Angeles, California Religious • Catholic family, however not actively attending church Ethnic • Retired Caucasian living in a primarily white middle class community and socializes with an elder group Spiritual • • Believes in God Prays for family and medical condition Nursing Considerations • • Anxiety related to uncertainty about outcomes, feelings of helplessness and hopelessness, and insufficient knowledge about cancer (Carpentito). Interventions • • • • Expect initial shock and disbelief following diagnosis of cancer and traumatizing procedures (disfiguring surgery, death). Reinforce teaching regarding disease process and treatments and provide information as appropriate about dying. Be honest; do not give false hope while providing emotional support. Encourage verbalization of thoughts or concerns and accept expressions of sadness, anger, rejection. Acknowledge normality of these feelings. Resources • • American Cancer Society. www.cancer.org American Cancer Society is on a mission to free the world from cancer. They fund and conduct research, share expert information, support patients, and spread the word about prevention. Nevada Cancer Research. www.cccnevada.com This is a large research program in the state of Nevada to help cancer patients. Conclusion • Dad is a heart felt movie that draws family closer after a family crisis occurs. The crisis draws the dad and son closer from a relationship that appeared broken. In addition, the son, Ted Danson, reestablishes a relationship with his own son that he left when the son was 5-years old. After early onset Alzheimer’s disease, Dad is diagnosed with cancer at the age of 78. Dad is unable to cope after hearing the news and is unaware of family and surroundings. Weeks later he finally becomes aware of everything and then lives in a fantasy world from suppressed positive experiences he’s held inside for 20-40 years. He starts reliving past experiences and becomes happy and energetic. This period bonds the family closer. In the end, dad finally loses his battle to cancer that spread to the lymph nodes. References • Carpenito, Lynda., (2013). Handbook of Nursing Diagnosis. 14th Edition. Wolters Kluwer/Lippincott Williams & Wilkins. • Goldberg, Gary., (1989). Dad. United States. Amblin Entertainment. • Jarvis, Carolyn, (2016). Physical Examination and Health Assessment. 7th Edition. St. Louis, MO: Elsevier.
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