PBL 3TT3 - LEARNING AIMS
1. Apply clinical reasoning related to the role of the nurse in supporting a client with cancer, including:
a. Establishing a therapeutic nurse-client relationship, including advocacy and resource coordination
b. Assessment and management of pain, fatigue and other symptoms related to both illness and
treatment, including pharmacological and nonpharmacological approaches as well as complementary
therapies
c. Explore the concepts of hope and suffering for a newly diagnosed patient with cancer - correct answer
- monitor body systems and managing side effects from treatment
- advocacy in terms of patient preference in treatment
- resource coordination: caregiver, financial, community
- promote discussion, identify issues early, approach sensitively, listen, recognize tolerance for
dysfunction
- fatigue: plan activities, rest, conserve energy
- nutrient supplementation, antidiarrhea, increase fluids
2. Discuss aspects of care that relate to:
a. Principles of palliative care
b. Advanced care planning (end of life)
c. Ethical decision making
d. Care of the client, family and caregivers
e. Resource coordination and community resources - correct answer Palliative care:
care of the whole person, not to cure or hasten death.
- human dignity, goals of care, recognize disease, family, autonomy, spiritual, right to end of life care
- three levels: approach, general and specialized
Planning: early and visiting it throughout a person's life, encourage people to reflect, communicate and
document their values
, Instructional directive: person's formal or informal instructions about their future care and choice of
treatment options
○ A written document that specifies which treatments an individual does and does not
want in case that individual becomes unable to make decisions about his or her care
3. Discuss initiating end of life / palliative care communication that reflects values and health care
wishes of persons and supporting families. - correct answer autonomy in decision
making and respecting their wishes
4. Explore the Square of Care model related to Clint.
a. Explore interprofessional practice teams related to cancer care (Oncologists, nutritionist, social
workers, physio / OT, spiritual leaders, complementary therapy experts, grief and bereavement
educators, and palliative care teams). - correct answer The Square of Care describes
the six essential steps in the process of providing care: assessment, information sharing, decision
making, care planning, care delivery and confirmation, and illustrates that they apply to the issues (or
domains) that patients and families commonly face: disease management, physical, psychological,
social, practical, end of life and grief.
- Interprofessional teams listed are in the learning aims. Difference between OT and PT is OT focuses on
ADLS PT is direct physical movement.
1. Differentiate between chronic stable angina and unstable angina (symptoms, treatment). - correct
answer Chronic stable angina refers to chest pain that occurs intermittently over a
long period with the same pattern of onset, duration, and intensity of symptoms.
- The pain usually lasts for only a few minutes (5 to 15 minutes) and commonly subsides when the
precipitating factor is resolved
- not present at rest
- antiplatelets, antianginals, ACE, beta blocker/BP therapy, smoking cessation, lipid management, diet,
diabetes, depression, education exercise and flu vaccine
Unstable angina: Chest pain that is new in onset, occurs at rest, or has a worsening pattern. The patient
with chronic stable angina may develop UA, or UA may be the first clinical sign of CAD.
- It is unpredictable and is a medical emergency
