Biophysical and Psychosocial Processes in Three Case Studies

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NUR104 Assessment Task 3: Case study 40%
Case study 1.

Read Rob’s story, outlined on page 325-326 of your course textbook (Scoot,
Shannon & Davies, 2017, p. 325-326).
Discuss the biophysical and psychosocial processes pertinent to the case.
Rob Cameron’s health has deteriorated as result of biophysical and
psychosocial processes. Rob is 81 years old and is married to Margaret who is
65years and both live in a coastal town in New Zealand. Rob has become
forgetful and even got distracted when driving that caused damage to their car
and some laceration on the forehead. Rob has a medical history of
hypertension and was prescribed to take oral hypertensive by a GP. However,
Rob does not take his medication regularly and believes that he should do so
only when he feels unwell and uses garlic and cider vinegar to control his blood
pressure. Rob loves to do tasks by himself and spends most time building and
making everything on his own. Margaret is supportive and advises Rob to take
his medication regularly and also engage is social stimulation activities. Rob
and Margaret live under Universal superannuation pension of $576.20 per
week. Rob has believes that antihypertensive drugs can cause impotent that
undermine his acceptance of adherence to GP prescription.
The current health condition of Rob is as a result of biophysical and
psychosocial processes. His failure to regularly talk antihypertensive
medication has led to his forgetfulness. According to Lin et al. (2013),
hypertension causes progressive damage to organs and is the leading
cause of dementia and Alzheimer’s disease. Rob’s beliefs also affected
his consistency to taking prescribed medication by GP. Tsai and Pai
(2016) stated that a person’s beliefs, values and culture influence their
treatment acceptable and health professional should consider then
when providing health care.
Identify an assessment tool appropriate for use in this case and discuss key
elements of the tool.
Rob needs cognitive function assessment to establish if his memory has
been affected. The most approapriate tool to use to assess Rob’s
cognitive function is Montreal Cognitive Assessment (MoCA). The MoCA
design allows rapid screening for mild cognitive dysfunction. The MoCA
takes a wide scope of cognitive domains that include executive
functions, language, memory, attention and concentration, conceptual
thinking, orientation, calculations and visuo-constructional skill (Gorelick
et al., 2011). This methodology is more appropriate to diagnosing Rob
cognitive impairment. Therefore the GP can adopt the MoCA tool and
assess Rob’s cognitive function and establish his cognitive state.
Discuss 3 priorities of care for this person.
According to Rob’s scenario, there are 3 main priorities of care to manage his
health condition. Rob is experiencing forgetfulness, distractions, and
hypertension. Rob has cognitive impairment that makes him forget easily that
lead to frustrations. Secondly, Rob gets distraction when undertaking activities
that puts him and the surrounding to risk. The other care priority is
hypertension treatment. Rob suffers hypertension and does not regularly take
his medication that impairs his cognitive function. These care priorities will
enable Rob to remember things, concentrate or improve attention and

maintain his blood pressure hence managing the cognitive impairment.
Discuss any equity, rights and access issues relevant to the case.
People suffering from Cognitive Impairment fall under Alzheimer’s disease or
Dementia and there are policy to promote access and equity. One is entitled to
appropriate and highest attainable health services standards of care. People
with cognitive impairment have difficult in communication and making
decisions and therefore there are set out rights to facilitate their health care or
other activities. One of the relevant right issue in Rob’s scenario is appointing
someone to make health care and personal decision on his behalf. Rob can
appoint an enduring guardian who will then make decisions on his behalf about
medical treatments, consenting, home care, changing doctors, going to
residential aged care, and other health decisions. This right is important for
facilitating a person health care even when they lose their mental capacity.
Case study 2.
Read Dulcie’s story, outlined on page 370 of your course textbook (Samuelson,
Crawford & Alexander, 2017, p. 370.
Discuss the biophysical and psychosocial processes pertinent to the case.
Dulcie’s changes in biophysical and psychosocial processes led her
health condition to dementia. John died quickly that grieved her and felt
her alone in the house. She then stopped cooking as she was used to
and even started eating what she thought before was unhealthy. Dulcie
refused to share meal with her neighbours and spent much of her time
inside the house. Lack of companion in her house contributed to her
appetite loss. McGuinness et al. (2016) associated poor nutrition status
to development of dementia and adequate nutrition can reduce major
risks that lead to it development. According to Kim et al (2011),
prolonged grief triggers development of dementia. Dulcie was much
grieved by John’s death that made her spend more time inside the
house. Physical inactive lifestyle increases a person’s risk of developing
dementia. Therefore, Dulcie change in diet, physical activities, grief, and
isolation led to development of dementia.
Identify an assessment tool appropriate for use in this case and discuss key
elements of the tool.
Dulcie has early stage dementia and needs assessment to establish if
cognitive impaired. The most appropriate tool to use to assess Dulcie
cognitive impairment is Mini-Mental State Examination (MMSE)
(Kamaruzaman, and Riaz, 2013). The MMSE takes 10-15 minutes and
has 30 Scores. A score below 24 will indicate that Rob has cognitive
impairment. According to Artioli et al, (2017), MMSE provides a practical
methodology that can grade cognitive state of a person. Therefore the
MMSE tool will be effective for assessing Dulcie cognitive function and
establish his cognitive state.
Discuss 3 priorities of care for this person.
Dulcie’s health condition can be prioritized to meet her health need. These
care priorities are good nutrition, physical activities, and dementia treatment.
Dulcie need to get a balance diet that will reduce her risk of Dementia