Question: The patient is a 58-year woman diagnosed with Stage IIIB breast cancer which required a mastectomy, chemotherapy and radiation treatments. She has a variety of chronic illnesses, including hypertension, diabetes and asthma. She is knowledgeable about her health and sees the doctor regularly to stay healthy.

She is very devout Catholic and grew up in a strongly devout family. Her church family is very important to her. Her mother and siblings live out of state. All of her family prays regularly for her along with their church and friends.

The patient was very sick as a child requiring frequent hospitalizations. Although her parents were repeatedly told that the patient would soon die from pneumonia, she always pulled through. This caused her family to note her strong-willed nature as a child. Her family nick name was "the happy child" because she was known for her cheerful, optimistic nature despite her frequent illnesses.

She has been married for 36 years. Her husband is very supportive. She has 2 grown sons who live about 4 hours away. Neither son is married. Her best friend is a local nursing instructor. The friend has taken her back and forth for most of her treatments because her husband cannot get time off. Her co-workers are very supportive and assisted with money and food during chemotherapy. She has been a teacher in the community for 20 years. Her former students created a face book page to keep up with her progress and regularly send her encouragement.

1. Describe the patient's world view.

2. Explain the concept of affiliated-individuation.

3. Explain the concepts of self-care, self-care knowledge, self-care resources, and self-care action.

a. self-care-

b. self-care knowledge -

c. self-care resources -

d. self-care action -

4. What is APAM in MRM theory?

a. What does it mean?

b. Describe her adaptation potential. .

c. What was the stressor?

d. What was the arousal response?

e. What happened with the arousal?

5. Identify one way the nurse can role-model for this patient.

6. Using the patient in the scenario, discuss at least one nursing intervention for each of the MRM Five Aims of Interventions.

a. Build trust

b. Promote Positive Orientation

c. Promote Perceived Control

d. Affirm and Promote Positive Strengths

e. Set Mutual Health Promotion Goals