Mrs. Georgia D’Angela is 76 years old. She has been married to her husband Marcus for 58 years. Marcus is 80 years old. The D’Angelo’s live in a well-kept, middle class home. The D’Angelo’s have
three grown children: two sons and one daughter. All of the children are married and only their daughter lives close to them. The two sons each live more than 3 and a half hours away. The
D’Angelo’s are very close to their children and talk with the children every day. Four months ago, Mrs. D’Angelo noticed her skin was “yellowish” in color and upon calling her primary care
provider, she was told to go immediately to the emergency room for evaluation. After having a CT scan of the abdomen and laboratory studies, Mrs. D’Angelo was told she had pancreatic cancer and
that she should immediately have a Whipple Procedure. This news was devastating to the D’Angelo’s and their family and friends. Mrs. D’Angelo called a friend who is a nurse and asked who she might
go to for a second opinion. A second opinion was obtained and the second opinion reaffirmed the diagnosis of pancreatic cancer however the recommendation was to have chemotherapy prior to the
Whipple Procedure. Mrs. D’Angelo began the chemotherapy and has suffered severe issues secondary to the chemotherapy and her quality of life is greatly impacted with a huge decrease in her
functional status and activities of daily living. As of today, Mrs. D’Angelo has not discussed her fear of dying with you as the primary care provider or with her family. She has an excellent
attitude about “fighting this horrible disease.”
1. Discuss the advanced practice nurse role facilitating end-of-life care and advance directives for Mrs. D’Angelo.
2. Compare and contrast an advance directive and palliative care and the relevance of advance directives and palliative care to this case study at this time.
3. Describe how you would approach the topic/issue of advance directives with Mrs. D’Angelo.
4. Identify 2 ethical principles and 2 legal challenges related to end of life and palliative care for Mrs. D’Angelo if these issues are not addressed with her at this time.
5. Describe your area of greatest learning from completing this Assignment.