A patient diagnosed with osteosarcoma of the right lower femur…

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Question Answered step-by-step A patient diagnosed with osteosarcoma of the right lower femur… A patient diagnosed with osteosarcoma of the right lower femur underwent an amputation of the lower leg. Essential initial postoperative nursing care for the stump includes: Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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Julia, aged 40, is a patient on a stroke unit. A massive stroke that she experienced a month ago was a major blow. She is known to be resilient and strong. For 10 years she had been living independently, in her own home, with multiple sclerosis (MS). Since the stroke she needs help with all her daily activities, including eating meals. Her suffering, she says, has gone "off the Richter scale" because she has lost all independence. She remains mentally alert and communicates clearly. An assessment by a speech pathologist concludes that Julia cannot swallow safely. An aphasic (soft food) diet is ordered. When the meal arrives and the nurse brings the food to her mouth, Julia purses her lips and tells her to stop. Julia is furious and says she will not eat the soft foods. The nurse informs her that if she eats solid foods and drinks clear liquids she will have a higher likelihood of aspirating food. One risk is that she would develop aspiration pneumonia (the result of food travelling to her lungs). Another risk is that she may choke and die when consuming regular food and drinks.Other nurses attempt to persuade Julia to take the soft food and reinforce what she has been informed about the risks. As they probe her reasons she tells them that food, coffee, and the occasional glass of wine are among the few pleasures she has left in life. To her taste, the soft diet and thickened fluids are unpalatable and she scoffs at the suggestion that the diet "is not that bad" and that eventually patients get used to it. Furthermore, she feels that the soft diet reduces her to feeling like a baby and that she loses her dignity being fed "baby food." Despite the efforts of the nurses to persuade her, she remains steadfast in insisting on her usual diet. Moreover, she makes it clear that if she aspirates she does not want anyone to try to save her life.Julia's partner, Mark, says that she has become unbalanced and is now a different person. Consequently, he believes that her wishes should not be respected. The nurses believe that she does have capacity, but to confirm this they ask for an assessment of Julia's capacity to decide. The capacity assessors find that she does have capacity to make decisions about nutrition and hydration. Mark rejects it, claiming that he knows his partner "better than complete strangers."
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