End-of-Life Care
Case Study, Chapter 16, End-of-Life Care
1. Joe Clark, 79 years of age, is a male patient who is receiving hospice care for his terminal
illnesses that include lung cancer and chronic obstructive pulmonary disease (COPD). He
developed bilateral pleural effusion (fluid that accumulates in the pleural space of each lung),
which has compromised his lung expansion. He states that he is short of breath and feels anxious
that the next breath will be his last. The patient is admitted to the hospital for a thoracentesis (an
invasive procedure used to drain the fluid from the pleural space so the lung can expand). The
thoracentesis is being used as a palliative measure to relieve the discomfort he is experiencing.
Low dose morphine is ordered to provide relief from dyspnea or discomfort. The patient is
prescribed Proventil (albuterol) inhaler 2 puffs per day, as needed, and Flovent (fluticasone
propionate) inhaler 2 puffs twice a day. The patient has 2 L/min of oxygen ordered per nasal
cannula as needed for comfort. (Learning Objective 9)
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