Case Study on Mr. Dury's Diagnosis and Nursing Management

This case study discusses the primary admission diagnosis, nursing problems, nursing management, and discharge planning for Mr. Dury, a patient with ischemic heart disease. It provides insights into the role of registered nurses and the collaborative and effectiveness problems faced during the diagnosis process. The case study emphasizes the importance of discharge planning and a multidisciplinary approach to patient care.

Case study
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Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Primary admission Diagnosis......................................................................................................3
Nursing Problems........................................................................................................................4
Nursing Management...................................................................................................................5
Discharge Planning......................................................................................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9
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INTRODUCTION
The report is based on the case study about the patients who are suffering from particular disease
therefore, different medical professional will provide the health care service to client. According
to case study, Mr. Dury is a 58 years’ old who has been diagnosed with ischemic heart disease
known as coronary heart disease. He is having problem of chest pain and is planning to do
surgery of coronary anigiogram with iodinated radiocontrast. He is a male who lives in south
Australia and his wife has died 18 months ago with cervical cancer. During his medical treatment
he said that sometime he forgets to remember meditation. Also, he does not want to take fluid
medicines. However, there are many other problems which he faced such as pitting in both legs.
Also, he gets breathless on exertion and uses GTN spray 4 times a day. Besides that, Mr. Dury
has not spoken to his son regarding admitted to hospital (Chow, and Chok, 2019).
The report will describe about primary admission diagnosis for Mr. Dury. Furthermore, it will be
explained about nursing problems which may arise during it. Also, nursing interventions and role
of registered nurse will be discussed. At last, discharge planning of patient will be mentioned.
MAIN BODY
Primary admission Diagnosis
As per case scenario, Mr Ian Dury is a 58-year older person living in the rural South Australia.
His Wife Elizabeth passed away 18 months ago due to the cervical cancer.
As per investigation, it has found that Dury is a client, which mainly faced health issue or
problem in regarding of chest pain (Shahif, Idris and Rahman, 2019). That’s why, he was
planned to the admitted in memorial hospital for reason behind investigation of chest pain. Other
medical professional also suggested to diagnose with long history of Ischemic heart disease
otherwise, it become dangerous in future for increasing the health issue or problem (Thyrian. and
et.al., 2017).
The primary diagnosis of Mr Dury that can identify the current health status, condition.
Afterwards, medical professionals have decided to provide, what kind of treatment. Initially,
doctors have a responsible for occasioning the admission of patient within hospital for purpose of
special care services (Ayaz-Alkaya and Terzi, 2019).
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Furthermore, medical professionals are investigation on the pathophysiology of the disease,
which mainly describing the condition at the time of diseases. Sometimes, it can be identified as
abnormal condition which directly affecting the functionality of human body (Ma and et.al.,
2020). Moreover, it has been diagnosis as both process of classification or pre-existing set of
multiple categories upon by medical profession.
As per case scenario, when doctors have performed the diagnosis pathophysiology of coronary
artery disease but it will require to consider the pre-medical history of Mr. Dury. In order to find
out the various issues such as diabetes mellitus, Coronary Artery Bypass 5 years ago,
Hypercholesterolaemia and so on. These type of problem has already occurred in the pre-medical
history (Bottle and et.al., 2019). In this way, it is important for consider these assumptions and
then provide the treatment according to them. It would prefer to handle the complication while
easily diagnosis the pathophysiology of the disease.
Nursing Problems
By using the knowledge about the pathophysiology and clinical manifestation of Mr. Dury. The
medical diagnosis has made by physician and other health care practitioners (Oksman, Linna and
Talja, 2017). it is mainly deals with the disease, medical and pathological state of Mr. Dury.
Moreover, experience and well-known expert can be provided the better treatment.
Nursing Diagnosis help for identifying that how client responds to the potential health and life
processes (Kammersgaard and et.al., 2019). During primary care, it should be increased the
problem in the diagnosis process.
As per case study, it has been identified the nursing problem when professionals following the
coronary angiogram, which are undertaken to diagnose coronary artery disease. in this way, Mr.
Dury that faced the difficulty remembering when to take his own medication. this situation has
been occurred due to lack of collaboration problem between nurses and patient.
Problem: 1 Collaborative problem
It is one of most the common problem that nurses manage using both physical prescribe
intervention as well as independent. This type of problem or condition may have occurred during
primary diagnosis (Bahadori-Chinibelagh, Fathollahi-Fard, and Hajiaghaei-Keshteli, 2019). A
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lack of collaboration with client which may increase complex situation and also difficult for
understanding the initial cause of disease.
This type of problem will be increasing because nurse’s diagnosis directed towards patient and
his physiological or psychological response (Ayaz-Alkaya and Terzi, 2019). But at that time, it
should not consider the initial response of Mr. Dury towards treatment process. In this way, it
has been increased the situation or condition.
Problem: 2 Effectiveness problem
It is based on the process or method of nursing diagnosis but increase the problem to develop
unless nurse intervene. According to case study, the individual client such as Mr. Dury is more
susceptible to develop the issue or problem during diagnosis process (Konttila and et.al., 2019).
The client must have faced the issue in related the coronary artery disease, also identified that
difficulties in breathing, walking.
This type of risk nursing diagnosis problem will be increasing due to inappropriate knowledge,
skill of nurses whereas they were not properly follow the accurate schedule to monitor or track
patient activities.
Nursing Management
It is based on the process or method that mainly consists of performance and efficiency of
leadership function within hospitals.it may include the common processes for management such
as planning, organising, directing and controlling (O’Connor, O’Callaghan and Salim, 2019).
The nursing management is concept that must focus on the inpatient nursing assessment,
intervention and role of registered nurse in related to medication management.
The registered Nurses have performed the significant role in term of medication and also helping
for improve the hospital environment. As per case study, memorial hospital is accomplished the
significant task of improving patient health condition or situation. However, nurses are involved
in different stage of patient’s care such as prescribing, dispensing, monitoring and documenting
(Horner, Daddona and Wurcel, 2019). These will help for resolving the nursing problem which
mainly identified at the time of diagnosis. The registered nurses that have not participate as
prescription authority but it plays essential role in term of prescribing. It means that nurse
conduct accurate interpreting and also understanding the prescription. Through case study, it
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might be included significant role in medication while checking the patient health status. In
additional, registered nurses have more responsibility to evaluate, prevent and report the
particular drug and their side effects. Before giving the treatment, it should be considered the
medical history of patient. Therefore, it can easily understand the specific need or requirement of
patient.
Manage collaborative problem
As per given study, it has focused on the different nursing problem that usually occurred at the
time of primary diagnosis process. in this way, it can be identified the collaborative problem
which mainly consider as potential physiological complication that nurses monitor to detect the
onset changes in patient’s status. Therefore, it would require to manage the collaborative
problem (Zueger and et.al., 2019). The nurses would be concerned with aspect of diagnosing the
patient and prescribing the better treatment. It is important for nurse to give positive response
and quickly diagnosis the problem such as breathing pattern and chronic heart pain.
Both health care provider is helping Mr Dury achieve their own optimal state of health condition.
in order to improve the health problem when they are participating in the medical session
(Konttila and et.al., 2019). On the other hand, Nurses are completely establishing the effectively
interact with Mr Dury and also identifying their specific need or requirement. At that point, it can
resolve the collaborative nursing problem.
In additional, medical professionals such as nurses that help for following the procedure of
coronary angiogram, also performing the different test in regards of blood and check
functionality of kidney. In order to demonstrate the fall in eGFR.
Manage effectiveness problem
The effectiveness problem is that when representing the deficiencies in the nursing record. In
hospital, nurses are not accurate way to represent the information about patient health condition
(John and etal., 2020). There is no well-manner record to identify the best treatment that’s why,
it will increase the problem during primary diagnosis process.
According to case study, it has considered the better way to manage or eliminate effectiveness
nursing problem (Alam and et.al., 2017). The nurses have changing the documentation that come
from different sources such as hospital records, researcher’s and nurses themselves. This type of
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changing documentation process to reach the specific goal and objective. Through case study,
Sisters of Mercy Memorial Hospital that simplified a set of complex form and enable nurse to
spend more time caring for patient or client (Mr Dury).
Furthermore, it will be using the educational interventions which mainly designed to improve the
documentation record of patient. In order to provide the best quality of health care service of Mr.
Dury. The involvement of intervention that have nurses apply a theory of case to other plan.
Sometimes, it also promoting the more patient focused documentation.
As per discussion, it has identified the two different nursing problems which may be resolved for
considering the effective intervention procedures. In order to control or manage the problem, if it
has occurred the complex situation and condition (Carlson and et.al., 2020). According to case
study, memorial hospital also focused on the nurse care planning. The documentation records are
intended to facilitate information flow, especially when conceptualizes the care planning process
in the form of coordination communication that will generate accurate result or outcome.
Discharge Planning
It is based on the process which mainly involving the transition of patient’s care from one level
to another. The major participation of health care professionals towards the patient’s in term of
treatment service. It is important to do discharge planning so that patient is discharged in
effective way (Konttila and et.al., 2019). Here, aim is to it is to reduce length of stay in hospital
and unplanned re admission in it. also, to enhance services of discharge and coordination
between patient and care workers. Here, it must be ensured that each patient leaves hospital
within time (Kimura, 2018). The planning is done differently for patient depending on their
situation. However, multi-disciplinary approach enables in offering evidence based care to
patient. In this there are health professional and nurses that work together. So, with team work
and integrated practices care services are delivered. It has become way to work with various
health professionals (Martins, Silva and Lopes, 2019). With approach it services are delivered in
systematic way. Likewise, in discharge planning as well approach can be applied.
A registered nurse plays vital role in this approach. He communicates regularly with patient and
identify needs. Also, by interacting with doctors they provide care services to them. Similarly, in
case of Mr. Dury. Nurse will interact with patient and analyses his health condition. Moreover,
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as per schedule nurse will provide him all facility to fulfill needs. Besides that, nurse will ensure
that fluid balance remain maintained after surgery done. So, in this way all are roles which will
be performed by registered nurse. In addition, there will be some other members in team as well
(Nigro and Merlano, 2017).
Doctor- their role will be checking report and doing planning for discharge.
Health professionals- they will provide treatment to Mr. Dury by discussion it with doctor and
checking medical data as well.
Nurse- his role will be to ready paper of discharge and provide primary care services to patient
CONCLUSION
From above discussion, it has been concluded that Mr. Dury has decided to go for surgery of
coronary anigiogram with iodinated radiocontrast. He is being admitted to hospital and having
some serious past medical history. Thus, he requires proper and effective care in it. Furthermore,
the documentation has described about primary admission diagnosis for Mr. Dury. In order to
determine the various type of nursing problems, which may arise during the diagnosis of patient.
Therefore, it has summarized that medical professional and nurses that should consider the
intervention interventions, performed the significant role play by registered nurse in the hospital.
Afterwards, it has provided the better quality of treatment but they can examine the previous
medical history of patient. As per identified the nurse’s problem but it can be implementing the
effective management procedure to improve the complex situation or condition. it helps for
recognizing the issue or problem before performing diagnosis process. However, the report has
described the discharge planning, which is based on the process that should include all essential
multidisciplinary approach.
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REFERENCES
Book and Journals
Alam, R. and et.al., 2017. Managing diagnostic uncertainty in primary care: a systematic critical
review. BMC family practice. 18(1). p.79.
Ayaz-Alkaya, S. and Terzi, H., 2019. Investigation of health literacy and affecting factors of
nursing students. Nurse education in practice. 34. pp.31-35.
Bahadori-Chinibelagh, S., Fathollahi-Fard, A.M. and Hajiaghaei-Keshteli, M., 2019. Two
constructive algorithms to address a multi-depot home healthcare routing problem. IETE
Journal of Research. pp.1-7.
Bottle, A. and et.al., 2019. Frailty and co-morbidity predict first hospitalisation after heart failure
diagnosis in primary care: population-based observational study in England. Age and
ageing. 48(3). pp.347-354.
Carlson, G.A. and et.al., 2020. Behavior modification is associated with reduced psychotropic
medication use in children with aggression in inpatient treatment: A retrospective cohort
study. Journal of the American Academy of Child & Adolescent Psychiatry. 59(5).
pp.632-641.
Chow, F.C.L. and Chok, K.S.H., 2019. Colorectal liver metastases: an update on
multidisciplinary approach. World journal of hepatology. 11(2). p.150.
Horner, G., Daddona, J. and Wurcel, A.G., 2019. “You’re kind of at war with yourself as a
nurse”: Perspectives of inpatient nurses on treating people who present with a comorbid
opioid use disorder. PloS one. 14(10). p.e0224335.
John, J.R. and et.al., 2020. Cohort Profile: Effectiveness of a 12-Month Patient-Centred Medical
Home Model versus standard care for chronic disease management among primary care
patients in Sydney, Australia. International Journal of Environmental Research and
Public Health. 17(6). p.2164.
Kammersgaard, M. B. & et.al., 2019. Assessment of the proposed EBMT pediatric criteria for
diagnosis and severity grading of sinusoidal obstruction syndrome. Bone marrow
transplantation. 54(9). 1406-1418.
Kimura, T., 2018. Multidisciplinary approach for bone metastasis: a review. Cancers. 10(6).
p.156.
Konttila, J. and et.al., 2019. Healthcare professionals’ competence in digitalisation: A systematic
review. Journal of clinical nursing. 28(5-6). pp.745-761.
Ma, R. and et.al., 2020. The effectiveness of interventions for reducing subjective and objective
social isolation among people with mental health problems: a systematic review. Social
psychiatry and psychiatric epidemiology. 55(7). pp.839-876.
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Martins, R.R., Silva, L.T. and Lopes, F.M., 2019. Impact of medication therapy management on
pharmacotherapy safety in an intensive care unit. International Journal of Clinical
Pharmacy. 41(1). pp.179-188.
Nigro, C.L. and Merlano, M., 2017. Head and neck cancer: improving outcomes with a
multidisciplinary approach. Cancer management and research. 9. p.363.
O’Connor, R., O’Callaghan, C. and Salim, U., 2019. An audit of discharge summaries from
secondary to primary care. Irish Journal of Medical Science (1971-). 188(2). pp.537-540.
Oksman, E., Linna, M. and Talja, M., 2017. Cost-effectiveness analysis for a tele-based health
coaching program for chronic disease in primary care. BMC health services research.
17(1). pp.1-7.
Shahif, S., Idris, D.R. and Rahman, H.A., 2019. Knowledge and attitude towards mental illness
among primary healthcare nurses in Brunei: A cross-sectional study. Asian journal of
psychiatry. 45. pp.33-37.
Thyrian, J.R. and et.al., 2017. Effectiveness and safety of dementia care management in primary
care: a randomized clinical trial. JAMA psychiatry. 74(10). pp.996-1004.
Zueger, P.M. and et.al., 2019. Older medicare beneficiaries frequently continue medications
with limited benefit following hospice admission. Journal of general internal medicine.
34(10). pp.2029-2037.
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