ACHPN case studies
ACHPN · Put your knowledge to work in context.
The Advanced Certified Hospice and Palliative Nurse (ACHPN) credential is awarded by the Hospice and Palliative Credentialing Center (HPCC) to nurses who practice at an advanced level with seriously ill patients and their families. It is typically pursued by advanced practice registered nurses-clinical nurse specialists and nurse practitioners-who assess and manage pain and non-pain symptoms, lead goals-of-care conversations, and coordinate care across an interdisciplinary team, in hospice settings, palliative care programs, and acute or outpatient services. The ACHPN case studies are 5 cases and about 4,381 words.
1Rising Creatinine, Myoclonus, and an "8/10" That Doesn't Fit
R is 68 with metastatic pancreatic adenocarcinoma palliated by a biliary stent; he weighs 58 kg. For three weeks he has taken extended-release morphine 60 mg every 12 hours plus 20 mg every 4 hours as needed, lately using about six rescue doses a day.
818 words, about 4 min2One Family Meeting, Two Siblings, and a Feeding Tube
L is 84 and lives in a nursing home with advanced Alzheimer disease; she no longer speaks in sentences, is dependent in all activities of daily living, and has had two aspiration pneumonias in six months. She has no advance directive.
918 words, about 5 min3Malignant Bowel Obstruction in a Patient Who Wants to Go Home
K is 61 with recurrent high-grade serous ovarian cancer, peritoneal carcinomatosis, and ascites. She has had two lines of chemotherapy and is not a surgical candidate.
836 words, about 4 min4Voluntarily Stopping Eating and Drinking, and a Wife Who Calls It Suicide
T is 66 with limb-onset ALS diagnosed three years ago, now with dysarthria, hand weakness, and a forced vital capacity of 38% predicted; he uses nocturnal BiPAP. He is alert and oriented, scores 4 on the PHQ-9, and manages his own affairs.
899 words, about 4 min5A 2 a.m. Death at Home: Ritual, Pronouncement, and the Year Ahead
M is 78 with end-stage COPD and heart failure who enrolled in hospice 11 weeks ago with a comfort-focused advance directive and a DNR order. his daughter, the primary caregiver, finds him unresponsive and calls the hospice line.
910 words, about 5 min