Assessment 1: Case Study Word limit: 2000 words This assessment will consist of a clinical case report. Assessment 1: case report link by the assessment due date. Relevance: In order to plan and...

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Assessment 1: Case Study Word limit: 2000 words This assessment will consist of a clinical case report.


Assessment 1: case report link by the assessment due date. Relevance: In order to plan and provide optimal person-centred nursing care, Registered nurses need to be able to interpret clinical information and draw upon their knowledge of pathophysiology and evidence-based clinical practice. Therefore, the purpose of this assessment is to support the development of the skills needed to evaluate evidence and to develop reflection and clinical reasoning skills. What you need to do: Based upon the clinical scenario provided below, construct a case report which is a detailed report of the client’s clinical presentation, nursing diagnosis and inter-professional plan of care. The case report will draw upon your knowledge of pathophysiology, pharmacology and relevant academic literature to support an evidence-based plan of care. The case report must be presented using the headings provided below. A description of the content for each section of the report has been provided. It is important that all sections of the report are conceptually connected. For example, your knowledge of pathophysiology and pharmacology, and your understanding of this particular client, should underpin the nursing problems that you identify which should, in turn, drive the inter-professional plan of care that is relevant for this clinical scenario.




Case Report: The case report must include the following:


Introduction (2.5 marks) - 200 words Using the ISBAR clinical handover framework, introduce the client and provide a brief overview of their case. Provide an outline of the purpose and structure of the report.


Primary medical diagnosis (3.75 marks) - 300 words Identify the primary medical diagnosis for the client (i.e. Diabetic Retinopathy). Provide a brief description of the pathophysiology of Diabetic Retinopathy, with clear links to the case scenario. Support this discussion using current literature (last 10 years).


Medication management (3.75 marks) - 300 words Identify the current medications prescribed for the client. Provide a brief description of the medications (i.e. mechanism of action, indication, side-effects and precautions). Support this discussion using current literature (last 10 years). 2




Nursing diagnoses (3.75 marks) - 300 words (a) Nursing problem related to medical diagnosis Using your knowledge of pathophysiology, document one (1) nursing problem that may arise as a result of the client’s primary medical diagnosis. This problem may be an actual or potential nursing problem. Provide a brief description for why this problem may arise for this client. Support this discussion using current literature (last 10 years). (b) Nursing problem related medication management: Using your knowledge of pharmacology, document one (1) nursing problem that may arise as a result of the client’s current medications. This problem may be an actual or potential nursing problem. Provide a brief description for why this problem may arise for this client. Support this discussion using current literature (last 10 years).




Nursing Role and Inter-professional Plan of Care (6.25 marks) - 700 words As the community nurse working as part of the aged care assessment team, discuss how you would facilitate an interprofessional plan of care for this client, with consideration to the two identified nursing diagnoses. Discuss the aim for and importance of using an interprofessional approach. Discuss the role of the Registered nurse to facilitate the interdisciplinary plan of care for this client. Identify the key members of the interprofessional health care team, and the role that they would play, specific to the two identified nursing diagnoses. Support this discussion using current literature (last 10 years).


Summary (2.5 marks) - 200 words Summarise the major findings of this case report. Referencing (1.25 marks) The content of the case report must be supported through referencing of current literature and must include a reference list and intext citations.




You will be assessed on referencing so make sure to follow the Harvard referencing style closely to avoid losing marks. Please refer to the Harvard Referencing System to accurately reference your case report Overall writing and presentation (1.25 marks) This assignment must be saved and submitted as a word document. This case report must be structured using the headings provided and presented using academic writing. The use of dotpoints will result in a reduction of marks.




Clinical Scenario:




As the community nurse for the Aged Care Assessment Team, you have been asked to conduct a home visit to assess Mr Hank Jackson. Mr Hank Jackson is a 64-year-old newly retired truck driver, who has recently been diagnosed with diabetic retinopathy and is legally blind in his left eye. Mr Jackson has a medical history which includes type 2 diabetes mellitus (diagnosed five years ago) and hypertension (diagnosed 7 years ago). Mr Jackson’s doctor has prescribed Metformin 500mg twice daily and Metoprolol 50mg twice daily. Mr Jackson lives alone, in his own home. He is a self-described bachelor, but he has a daughter who lives interstate, from a relationship he had in his 20s. The referral from the General Practitioner (GP) indicates that he has suboptimal blood pressure and diabetes control, despite medication management and recommended dietary control. The last blood pressure recorded was 159mmHg/96mmHg and his glycated haemoglobin (HbA1C) has never been less than 8%. Mr Jackson lives in a single-storey home, with a sunken living room and an outdoor veranda leading to a large, overgrown garden. Each room of the home appears cluttered, with ‘keepsakes’ from overseas travels and old newspapers stacked in piles in each room of the home. On general appearance, Mr Jackson appears overweight and has a flushed facial appearance. He wears glasses for reading and says that he loves to read but has been having trouble recently and describes his vision as ‘patchy and blurred’. On questioning, he does admit to feeling ‘fuzzy in the head’ if he forgets to take his tablets, but otherwise feels that he is in good general health. He states that he has “never been sick a day in my life” and only retired because he lost his drivers’ license due to his impaired vision. Mr Jackson does not routinely test his blood glucose levels at home and expresses doubt that this would help him, saying: “what would knowing the numbers do for me? The doctor already knows the sugars are high”. Mr Jackson has been trying to lose weight for the past 6 months, without success; but feels that he has more time for exercise now that he is retired. Mr Jackson wants to remain in his own home, that he has lived in all his adult life, and takes pride in his cooking and making his own home-brew. He will require an interprofessional community plan of care. 4 How will I get assistance to complete this assessment? Each of the topics delivered in this course will provide content that will give you the knowledge that you will need to successfully complete this assessment. For example, the weekly learning activities to develop the ISBAR plan of care will prepare you to complete the case report. You should make sure that you read all information provided, use opportunities to discuss this assessment in the weekly tutorials or virtual classrooms. In addition, the library will run a workshop (via virtual classroom) to support you to identify relevant sources of literature and the course coordinator will run a workshop (via virtual classroom) to support you to plan and write your case report. These workshops will be accessible via the NURS 2024 course site assessment folder. Case Report Feedback and Results: Feedback comments and grades will be provided using the Assessment Rubric and grades will be released via the assessment link within 10-15 working days. Resubmission Resubmissions will NOT be available for this assessment item.



Answered Same DayApr 02, 2021NURS 2024University Of South Australia

Answer To: Assessment 1: Case Study Word limit: 2000 words This assessment will consist of a clinical case...

Paulami answered on Apr 02 2021
156 Votes
Running head: NURSING
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NURSING
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NURSING
Name of the Student:
Name of the University:
Table of Contents
Introduction    3
Primary medical diagnosis    3
Medication management    4
Nursing Diagnosis    5
Nursing role and interpersonal plan of care    6
Summary    9
References    10
Introduction
Using framework of ISBAR meaning introduction, situation background, assessment and recommendation, the case study will be overviewed based upon these terms sequentially while describing. The client is Mr. Hank Jackson who is 64 years old, a recently retired truck driver who approached to diagnose his ey
es where left one is legally blind, finding his vision as blurred and patchy even after wearing glasses. He has medical history describing type-2 diabetes (diagnosed 5 years back) and hypertension, showing his doctor prescribed him with Metformin and Metoprolol also general practitioner pointed him having suboptimal blood pressure and diabetes control. Based on his medical history and diagnosis done, turns out he is suffering from diabetic retinopathy, one complication arising from diabetes affecting eyes due to damage on blood cells of tissue (light sensitive) present behind retina of eye where poor control of blood sugar (which the client has) is a factor of risk with symptoms which client is facing currently, might cause blindness. Some nursing plans can be recommended- examining ocular fundus, naturally lowering blood sugar levels, controlling blood lipids and blood pressure etc. In this assignment, discussions will be made on medical and primary diagnosis, managing medication, nursing diagnosis, nursing role and NCP.
Primary medical diagnosis
Eye examinations are recommended upon children of 10 years above and adults having type-1 diabetes within initial 5 years after its onset while for ones having type-2 which Mr. Hank has, examination is to be given after diabetes diagnosis is done. Thereafter, eye exams on regular basis are necessary for most diabetic patients at least 2-3 times in a year. Accordingly, if examinations show retinopathy in progress then examinations are needed frequently. Eye exams being comprehensive involve tonometry (measuring pressure in eye), dilated eye exam and visual acuity test among which dilated eye exam being most reliable for Mr. Hank where eyes are widened for applying drops, dilating pupils, allowing the doctor for clear view of eye’s insides, drops might make closer visions blur till it goes off after few hours. During examination the doctor would check for optic nerve abnormalities, detached retina, jelly like clear substance bleeding filling eye centre, scar tissue and new blood vessels growth, retina deposited with fat or blood, swelling, blood vessel abnormalities (Kern, Antonetti & Smith, 2019). Then there’s fluorescein angiography where doctor clicks picture of eye insides, optical coherence tomography where imaging tests give retinal images cross-sectioned showing it’s thickness for determining fluid leakage in retinal tissue. Its pathophysiology can be described by hyperglycaemia, thickening of basement membrane, loss of pericyte, microaneurysms, preretinal neovascularisation and IRMA causing blindness eventually through detachment of tractional retina and haemorrhage (Kusuhara et al., 2018). Diabetic retinopathy consists of 4 stages- microaneurysms which are capillaries dilated not affecting vision going unnoticed (mild non proliferative retinopathy), blood vessels blockage where they get swollen much not getting nourishment for retina causing visible change (moderate non proliferative retinopathy), more blood vessel blockage where blood flow decreases sending out signals for growing new blood vessels (severe non proliferative retinopathy) and blood vessels growing on retina being abnormal and weak causing blood leakage in eye resulting in vision issues then blindness eventually (proliferative retinopathy) (Behl, T., Velpandian, T., & Kotwani, 2017.
Medication management
The case study mentions that his doctor has prescribed him with medicines named metformin and metoprolol. Metformin causes decrease in producing hepatic glucose, decrease glucose absorption in intestines, aids in improving sensitivity of insulin by increased utilization and uptake of peripheral glucose (Gilbert et al., 2020). Its taken with proper food diet and program of exercise and maybe with other medicines (Mr. Hank taking metoprolol along with metformin) for controlling elevated blood sugar levels, utilized upon patients having type 2 diabetes (Mr. Hank’s medical history shows he has). Its side effects involve, asthenia (weak physically), flatulence, myalgia (pain in muscle), hypoglycaemia, vomiting, nausea, dizziness, constipation, heartburn, bloating, diarrhoea, discomfort in chest, low vitamin B-12 in blood, lactic acidosis. Hyperglycemia might take place if metformin not taken enough or skipped, meal plan disrupted or overeat, having infection or fever, exercise not done as needed (Hurley, 2017). Metaprolol is cardio-selective (beta-1 selective) which acts upon blocking adrenergic receptor, where such effect being preferred would not be absolute, though, with concentrations of plasma at its peak, metaprolol acts upon inhibiting adrenergic receptors being beta-2 in nature being located chiefly in musculatures in vascular and bronchial means. Metaprolol has it’s usage with (Mr. Hank having metformin along with metaprolol) or without different medicine for treatment of hypertension (Mr. Hank’s medical history shows he has) involving high blood pressure (Shah & Gardner, 2017). Reducing peaked blood pressure aids in preventing strokes, kidney issues and heart attacks. Such medicine also aids upon treating angina (pain in chest). It’s side effects has many similarities with metformin with added side effects show here like, depression, dry mouth, itching, rashes, hand and feet being cold, running rose, stomach pain. When getting up or sitting, fainting or dizziness might happen so doing that slowly helps. Lying down...
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