CHPN case studies

CHPN · Put your knowledge to work in context.

CHPN® (Registered Nurse) is the hospice and palliative nursing credential for registered nurses in the HPCC credential family. The Hospice and Palliative Credentialing Center lists CHPN® alongside ACHPN® (Advanced Practice RN), CHPPN® (Pediatric RN), CHPLN® (Licensed Practical Nurse), CHPNA® (Nursing Assistant), CHPCA® (Administrator), APHSW-C® (Social Worker), and CPLC® (Perinatal Loss Care). The CHPN case studies are 5 cases and about 4,872 words.

Myoclonus and sedation on morphine in combined renal and hepatic failure

R is 68 with unresectable pancreatic cancer and new liver metastases. Labs: creatinine 2.4 mg/dL, eGFR 26 mL/min/1.73 m2, total bilirubin 3.1 mg/dL, albumin 2.6 g/dL.

817 words, about 4 min 2

Anarthric patient on BiPAP says 'I'm done' while her agent objects

Delgado is 62 with ALS diagnosed two years ago. She is anarthric, communicates reliably through an eye-gaze device, has a forced vital capacity of 28% predicted, uses noninvasive BiPAP more than 20 hours a day, and receives all nutrition by feeding tube.

1,006 words, about 5 min 3

Malignant bowel obstruction with two transition points and a patient who wants home

Okafor is 54 with recurrent high-grade serous ovarian cancer, peritoneal carcinomatosis, and moderate ascites after three lines of chemotherapy; ECOG 2. She is admitted with three days of vomiting about 1.2 L/day, colicky periumbilical pain, and no flatus or stool for four days.

892 words, about 4 min 4

Family demands a PEG tube in advanced dementia against the patient's prior wishes

Kowalski is 84 with advanced Alzheimer disease, bedbound, no recognizable speech, and no recognition of family. He has had two aspiration pneumonias in two months and is finishing a seven-day antibiotic course with clinical improvement.

1,067 words, about 5 min 5

High-risk bereavement five weeks after a sole-caregiver death

She was the sole caregiver for her father, who died of hepatocellular carcinoma five weeks ago on your hospice service; she managed his medications and was alone with him at the moment of death. She has called the hospice three times this week.

1,090 words, about 5 min