Case Study Post Mortem Care
Beth Cavuto is a 47-year-old woman admitted to the medical–surgical unit from the intensive care unit (ICU) with a diagnosis of terminal metastatic lung cancer. She has an advance directive and a DNR order on her chart. She is also a single parent of two children, ages 8 and 10. The transfer report from the ICU indicates that Ms. Cavuto’s mother and children visit frequently.
On admission, the nurse performs a comprehensive assessment. Ms. Cavuto has mild dyspnea, and her respiratory rate is approximately 25 to 28 per minute. In addition, Ms. Cavuto reports having some trouble “catching my breath.” She is becoming increasingly restless and has an anxious look on her face. As part of the spiritual assessment, the nurse asks Ms. Cavuto if she has a spiritual leader she would like to have contacted. The nurse also notes that Ms. Cavuto has a small Bible, a colorful scarf, and numerous cards on her bedside table. During the assessment, Ms. Cavuto asks, “What are your visiting hours? My kids need me!”
Several days after Ms. Cavuto is admitted, she becomes increasingly unresponsive. The nurse continues to provide comfort care to Ms. Cavuto, and she addresses her by name. She also allows flexible visiting hours. In addition, extra seating is provided in the room. While Ms. Cavuto’s mother is in the room, she asks the nurse, “Do you think my daughter can hear me?”
After 4 days on the medical–surgical unit, Ms. Cavuto dies while her family is at her bedside. Ms. Cavuto’s young son runs out of the room, and her daughter clutches her mother’s scarf and wraps it tightly around her shoulders. The nurse comforts Ms. Cavuto’s family and offers to stay and contact their spiritual leader. After first determining from the authorized healthcare provider that Ms. Cavuto will not need an autopsy, the nurse begins to prepare Ms. Cavuto’s body for viewing by other family and friends. Before beginning her postmortem care, the nurse asks Ms. Cavuto’s mother whether she has any special requests or preferences regarding her care.
Answer the case study questions below.
Case Study Questions
- Considering Ms. Cavuto’s diagnosis of terminal cancer, her signs and symptoms on admission, and her DNR status, what is the nurse’s immediate priority regarding her care?
- Identify spiritual, bereavement, or possible referral needs Ms. Cavuto and her family may have.
- During the initial assessment, Ms. Cavuto asks the nurse about visiting hours and states, “My children need me!” How can the nurse respond in a therapeutic way?
- As Ms. Cavuto faces imminent death, she becomes increasingly unresponsive. How can the nurse respond to Ms. Cavuto’s mother when she asks, “Do you think my daughter can hear me when I talk to her?” What additional advice and care could the nurse offer to the family?
- Immediately after Ms. Cavuto’s death, the children have an emotional response. Considering their age, how is their reaction helping them cope with the death of their mother? How can the nurse respond in a therapeutic way at this time?
- Before and after Ms. Cavuto’s death, the nurse does several things that show respect and cultural/spiritual sensitivity for Ms. Cavuto and her family. Describe these interventions, and describe additional ways the nurse could help Ms. Cavuto and her family.
- Describe how the nurse can prepare Ms. Cavuto’s body after death for viewing in order to optimize her physical appearance.
- Evidence has shown that providing bereavement support after a client’s death may be helpful. In this scenario, discuss how the nurse can facilitate the grieving process for Ms. Cavuto’s family after her death and during postmortem care. What are some possible follow-up interventions the nurse might do to facilitate the family grieving process?
