case study

MSN 5550 Health Promotion: Prevention of DiseaseCase Study Module 12Instructions: Read the following case study and answer the reflective questions. Please providerationales for your answers. Make sure to provide citations/references for your answers in APAformat.Deadline: Due by Sunday at 23:59 p.m.CASE STUDY: Caregiver Role Strain: Ms. Sandra A.Sandra, a 47-year-old divorced woman, received a diagnosis of stage 3 ovarian cancer 4 yearsago, for which she had a total hysterectomy, bilateral salpingo- oophorectomy, omentectomy,lymphadenectomy, and tumor debulking followed by chemotherapy, consisting of cisplatin(Platinol), paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years and thenmoved back to her hometown near her family and underwent three more rounds of secondlinechemotherapy. She accepted a less stressful job, bought a house, renewed old friendships,and became more involved with her two sisters and their families.Sandra developed several complications, including metastasis to the lungs. Then she could nolonger work, drive, or care for herself. She had been told by her oncologist that there wasnothing else that could be done and that she should consider entering a hospice. She met herattorney and prepared an advance directive and completed her will. She decided to havehospice care at home and, with the help of her family, set up her first floor as a living andsleeping area. She was cared for by family members around the clock for approximately 3 days.Sandra observed that she was tiring everyone out so much that they could not really enjoy eachothers company. At this time, she contacted the Visiting Nurse Association (VNA) to seekassistance. Her plan was to try to enjoy her family and friends visits. After assessment, the VNAnurse prioritized her problems to include fatigue and caregiver role strain. Other potentialproblem areas that may need to be incorporated into the care plan include anticipatory grievingand impaired comfort.Reflective Questions1. What are some of the stresses on Sandras middle-aged sisters and their families?2. What resources are available to manage these stresses and support the sisters whilecaring for their dying sister Sandra?3. Describe Sandras feelings about dependency and loss of autonomy because she isunable to do her own activities of daily living any longer