P​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​lease use APA 7TH edition. References must be with in 5 y

P​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​lease use APA 7TH edition. References must be with in 5 years ( 2018-2022). Thank you!
There are 3 different SCENARIOS: Please follow instructions highlighted. Thank you.
BILLY 5.1
Billy is an 81-year-old male with congestive heart failure, chronic renal failure and diabetes. Billy has been on peritoneal dialysis for the past 6 years and has had two episodes of septicemia. He and his wife, Lorraine, agreed that they wanted palliative care services six months ago. An advanced directive was signed at that time.

Billy and Lorraine have four adult children. Their youngest daughter died two years ago of metastatic colon cancer. Two of the adult children live in the same city as Billy and Lorraine and one son, Ed, lives in another state about 300 miles away. Ed has not seen his father in three years, and when he was contacted by his sister a month ago that his father was quickly deteriorating, he decided to come home for a visit. When he walked into the house, he was shocked, confused, and angry that his father was so ill. He demanded to talk with the hospice nurse—he wanted to know why his father had lost so much weight, why he was not eating, why his breathing was so “heavy,” and why his doctors are not treating him more aggressively. “My sister had hospice and you all let her die. I will not let you kill my father, too.” The hospice nurse arrives to the home to speak with Ed. Ed demands that his father be admitted to the hospital where “he can get constant care and nutrition through his veins.”
ASSIGNMENT INSTRUCTIONS Please answer all of the questions listed below: Please use APA 7TH edition. References must be with in 5 years ( 2018-2022). Thank you!
1. How would you respond to Ed’s demands?
2. How could you assist Ed in respecting his father’s wishes?
3. How could you use the other family members to assist with Ed’s anger and confusion?
4. Would you consider placing Billy back into the hospital, per Ed’s demands?
o Why or why not?
MR. J 3.1
Mr. J. is an active 71-year-old Hispanic gentleman whose home health nurse calls you to tell you about his symptoms, which include increase in lethargy, constipation, and questionable altered mental status. The patient is known to have widely metastatic prostate cancer, including bone metastasis. A recent MRI of his brain was positive for metastatic disease. He is a very proud and private man, she tells you, and he doesn’t always listen to what the doctor tells him.
As the nurse in the medical oncology clinic, you have cared for this patient and family for several months. He has been on long-acting morphine at 200-mg q 12 hours po with morphine sulfate immediate release tablets 10 mg to be taken q 2-3 hours po prn for pain. His pain has been well managed on this regimen for the last month. He has been on an effective bowel regimen, until the last week. You, the oncology nurse, instruct the home care nurse to have the patient come to the clinic.
Please answer all of the questions listed below. Please use APA 7TH edition. References must be with in 5 years ( 2018-2022). Thank you!
1. Discuss the physical assessment that would be conducted on Mr. J.
2. What laboratory or radiographic studies might be ordered? Why?
3. Discuss the differential diagnosis for these complaints and how might these be managed?
4. What education would you provide to the patient/family?
5. Describe the strategies you would review with the home care nurse in promoting a comprehensive plan of care for this patient.
Mrs. S – Death of a Son 7.1
Mrs. S. is a 48-year-old woman who recently immigrated to St. Petersburg, Florida from West Africa. She is a mother of four and a grandmother of six. She has no friends in Florida as she has only been in the United States for a year. She is of the Muslim faith and attends religious services sporadically at a mosque in Tampa, Florida. Her religious beliefs are strongly internalized.
Her husband died of a genetic heart disorder at the time of the birth of her son, Micha, some 22 years ago. She supported herself and her children by carrying on the family b​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​usiness of food brokerage. Her youngest son, Justin, had begged her to come to America after she had sent him there to expand the family business. One year later, she followed at the request of her second son, Paulo, whose wife had left him with three young children. She came to help the family and care for the children in a comfortable home where Micha also lived. She has two other children, a married daughter with one child who lives in Minnesota and a son who lives in West Africa.
Her son, Micha, worked as a deliveryman for a grocery market. He began complaining of fatigue and wanted to quit this job but felt that he had to have another job first. He was engaged to be married to a young Christian woman who also urged him to continue with this job until he found another one. He never told his fiancée of his tiredness because he was worried about finances, as he had no benefits or health insurance and a salary of about 9 dollars an hour. He had hoped to go back to school to obtain a degree.
Mrs. S. was very close to Micha, who as an infant and child slept with her. He had always been her favorite child. She felt that he was “her husband, her father, and her brother” who had all died. She said he replaced the grief she felt for all the men she had lost. He was always very attentive to her needs. He would listen to her concerns, take her out, and buy her things. He never said no to any of her requests. Recently, she felt that she had not paid enough attention to him. She had been focusing her attention on her grandchildren and Paulo, who was going through so much turmoil with his wife’s “desertion.”
Although she had told Micha to quit his job and to go to the doctor, she had not insisted. At the time, she felt that he was an adult and she respected his independence and choice not to see a physician. Micha rushed out from his bedroom screaming in pain early one morning, collapsed and died of a heart attack from a genetic heart condition. This was a traumatic shock to all of the family, but one that Mrs. S. now feels extremely guilty about.
Eight months after Micha’s death, Mrs. S. states she cannot forgive herself and wishes God would take her so she can be with her son and husband. She states she would not commit suicide as it is against her religion, and if she did commit suicide, she would not be able to see her son again. She longs to see him even if only in her dreams.
Mrs. S. is only sleeping soundly for about two hours a night. She wanders the house at night hoping to feel and see Micha just one last time. Her appetite has decreased considerably. She has lost interest in her personal care and only dresses in the late afternoon right before her son, Paulo, comes home from work.
She chooses not to leave the home and no longer goes out to the backyard to watch the grandchildren play. She no longer goes to the mosque but prefers to stay in her room. She refuses to allow anyone to go in or touch Micha’s things in his room. She has asked the youngest boy grandchild to sleep with her at night so she does not become “frightened” or “lonely” during the night.
She has developed pain in her left side, headaches and stomach pains but refuses medical intervention. She states that doctors are too expensive here and she does not want to burden her son who now works two jobs to support the family. A concerned co-worker of Paulo’s suggests he contact the local hospice as maybe they can help his grieving mother.
Source:
Lo, K. (2000). Mrs. S. Largo, FL: The Hospice Institute of the Florida Suncoast. Reprinted with permission.
ASSIGNMENT INSTRUCTIONS Please discuss the following issues and answer all of the questions listed below: Please use APA 7TH edition. References must be with in 5 years ( 2018-2022). Thank you!
1. What additional information should be assessed by hospice about this family?
2. What are the risk factors for complicated grief in this case?
3. What bereavement services might be provided? What disciplines should be involved?
4. What kind of grief might the fiancée be experiencing? What interventions would be appropr​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​iate?