Illness Trajectories in Terminal Lung Cancer and COPD

Case Study: Illness Trajectories Please see the Case Scenario Below Please see the Case Scenario Below Belw ATI Basic Concept Learning Template Students will complete an ATI Basic Concept Learning Template using a provided patient case to analyze illness trajectories at the end of life. Emphasis is placed on clinical judgment, anticipatory guidance, and interprofessional collaboration. Required Sections. Concept overview Illness trajectory identification Nursing interventions Client education Complications Interprofessional collaboration Case Study Rubric Criteria Exemplary (6) Proficient (5) Developing (34) Needs Improvement (12) Concept Understanding Thorough, accurate Accurate Partial Inaccurate Trajectory Identification Correct with strong rationale Correct Partially correct Incorrect Nursing Interventions Comfort-focused, evidence-based Appropriate Limited Inappropriate Client Education Clear anticipatory guidance Adequate Minimal Missing Interprofessional Collaboration Clear roles & communication Identifies roles Minimal Absent Week 2 Assignment You are advised to develop an active Learning Template System Disorder following the case Scenario below. Scenario Overview Patient: Julia Johnson Diagnosis: Terminal Lung Cancer Gender: Female Age 65 years Weight 170 lb Height 64 in. (163 cm) DOB: 2/7/XX Allergies: No known allergies Immunizations: Up to date Summary: Scenario: Ms. Julia Johnson a 65 year old female, single and lives with her daughter Lucy and her son Mathew, and presents with complaints of shortness of breath, and generalized pain, rating pain level 10 on the numeric scale 0 10. Client is currently admitted with a medical diagnosis of COPD and stage IV terminal Lung Cancer. On this admission, client presents with chief complaints of odifficulty of breathing, and frequent productive cough for about the two days. Appears anxious, Denies chills, chest tightness, but c/o nocturnal symptoms of shortness of breath. Client also reports generalize4d pain Client reports h/o COPD, HTN, obesity, Hyperlipidemia, generalized pain > 2 months, smoke one pack cigarette a day, and X 2 chemotherapy for past month. Client denies illicit drugs and alcohol. Lucy and Mathew are supportive of Julias decision and provide her comfort. Julia inquiries about hospice service for comfort at end-of-life. Current Medications Oxygen 2 liter via N/C, continuous Albuterol 0.083 % via nebulizer 4 X Day as needed (PRN) Proventil MDI (Inhaler) two puffs two times a day as needed (PRN) Lorazepam (Ativan) 2 mg 1 tab oral 2 X Day as need Metoprolol Tartrate 25 mg 1 tab oral two time Heparin injectable 5,000 unit subcutaneous every 12 hours Pantoprazole 40 milligrams 1 tablet oral every day Simvastatin 10 my 1-tab oral daily at bedtime Meds PRN Acetaminophen 325 mg 2 tabs oral every 6 hours as PRN (needed )(1 3) Hydromorphone injectable 1 mg IVP every 6 hours PRN (as needed) (7 10) Oxycodone 5 mg/Acetaminophen 325 mg 2 tabs oral every 4 hours PRN (as needed) 4 6. Physical assessment findings: Client Julias Johnson appears anxious, moderately dyspneic at rest. Color: Pallor: Abnormal for ethnicity. Vital signs (V/S) B/P 130/80, HR. 110, R. 24, pulse oximetry: 90% in 2 L via N/C ABG: PC02 50, PAO2 90%, PH 7.30 Weight: 170 lb, height: 5.4 Labs: On admission Peak Flow Rate (PFR) 60% which indicates mild dyspnea and wheezing CBC: Hemoglobin 14 and Hematocrit 45 (H/H) 16/49, WBC: 5,000. Medical Procedures: Chest Xray, Lung Scan, s. Pulmonary Function Test (PFTs), ABG, Lung Scan, Sputum samples for gram stain & C & S. Review of system information (ROS): Neurological: Alert and oriented to time, place, and person. Good historian Respiratory: Mild Dyspnea Breath sounds: expiratory > and on auscultation Adventitious sounds: crackles findings bilaterally on auscultation, and weheezings Cardiovascular: Heart rate 110 strong and regular Jugular venous distention: Negative on assessment Peripheral edema 2 + Elimination Pattern Gastrointestinal (GI): Abdominal soft. nondistended Bowel sounds present in all four quadrants Bowel habits: Consistent. Last BM: 01/2/2026: Stools characteristics: Firm Genitourinary (GU): As per patient states, no abnormality upon urination. Void frequently, color: Clear yellow urine Mobility: OOB – Mobile with unsteady gait requires assistance with mobility Integumentary (skin): Dry, warm, and intact Skin color: Pallor Diet: 2 grams sodium as ordered Oral fluids: 1 Liter/day Fluid restriction Assignment requirements Develop a patient Plan of Care (POC) using an Active Learning Template System Disorder and the Active Learning Template to identify the Related Content, underline Principles, and Nursing Interventions on the case scenario listed above Based on the Active Learning Template, identify Alterations in Health (Diagnosis), Pathophysiology related to client Problem, Assessment, Expected Findings, Laboratory Tests, Diagnostic Procedures, Health Promotion and Disease Prevention, Safety Considerations. Based on Active Learning Template, identify the Related Content, Underline Principles, and Nursing Interventions.. You will need to assess Julias and Lucys level of understanding of what will happen as Julia faces death. They will need to prioritize their actions based on listening closely to the patients and familys priorities and meeting needs as they arise. ALL ASSIGNMENT IS DUE Thursday, 2/08/2026 at 11:59 PM Please feel free to contact me for any questions you may have regarding this assignment