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Case Study and Care Plan for Nursing Practice and Palliative Care

   

Added on  2019-09-26

11 Pages3694 Words341 Views
CASE STUDY AND CARE PLAN1AssignmentCase Study and Care PlanStudent Name:Student ID:Course Name:Course ID:Faculty Name:University Name:The Nursing practice requires many qualities. It requires specialised skills, knowledge and independent decision-making skills. There are many aspects of nursing practice. It includes the type of client, different disease management, care and also rehabilitation. This relation is based on mutual respect and trust. It is a helping relationship in which the nurse should be sensitive to self and others . Providing physical, emotional, spiritual support to the patient andtheir family.

CASE STUDY AND CARE PLAN2The palliative practise involves communication between nurses with officials , patients and also their relatives. By effective communication, a comfort level with the patient is developedby which patient conveys his pain, fear , shares anxiety. Listening is a very important mode of communication. It requires nursing skills and attention. By this nurses can access the situation and problems of the patient. By being a good listener nurses can provide care at all levels of recovery.Along with listening , speaking with the patient also becomes important .Conversations should be held in appropriate condition. Each patient has its own way to discuss the problem. After the nurse has listened to all the problems she can talk to the patient.Physically palliative approach is followed to manage pain and physical discomfort in most of the situations. Pain being the most important complaint in the palliative approach to treatment. As the discomfort increases the need for palliative approach increases. It becomes very important where treatment is painful .Old age people become prone to life-threatening disease or their suffering increases due to the natural ageing process. In many countries, palliative services are provided at home only. Mostly people by the end stage of their life prefer to spend their time at home. The palliative approach helps patient’s family to cope withthe terminal illness of the patient. Palliative care leads to hospice care which includes focusing on comfort and quality of life. A personalised action plan is required for every patient for comfort and care. In this, it has been found that the survival expectancy is increased by 6 months. In this, the main focus is on pain control which troubles the patient most. Pain control is done by analgesics and comfort measures which can be achieved at home. It is important to develop an integrated care pathway for the dying patient. This is for the patients whose diagnosis is known and loss of life is inevitable. In this symptoms are closely

CASE STUDY AND CARE PLAN3monitored and palliative approach is followed accordingly. In few cases, older people denied access to palliative care. In these cases, their admission in hospital and nursing home becomes very important. Specialised palliative care is required in many patients.Proper symptom control is impossible in older adults without proper communication. An accurate assessment of patient’s health requires effective communication. Communication is the centre of all treatment. Communication will deliver a great amount of palliative care to the older adults. In the society conversation about death is often very awkward and difficult. Among the health care professionals, there is a requirement of improvement of techniques to overcome these obstacles. In last two decades, there is awareness of the importance of communication skills (Kinley et al, 2013).A Patient age 60 years gets admitted to the hospital with uncontrolled type II diabetes. Nursing is very much required in this area. As a patient with Diabetes type II may require guidance, treatment and proper monitoring. Diabetes patients often stay on treatment for life-long. Here the nursing plans include the treatment to normalise blood sugar. The blood glucose should be around 120. More than these needs to be reported to the treating physician. Also to implement a strict and balanced diet for the patient. Also, it is important to make sure that adequate exercise regime is being followed. Also, it is important to monitor the day to day sugar levels of the patient. As here we can see the patient is having unstable blood sugar this can be due to many factors like inadequate blood glucose monitoring. There can be also non-adherence to diabetic management. A nurse needs to keep a check on these. (Dunning, 2013).Also, it is important to manage the timely medication of the patient. Also, it is important to give adequate knowledge to the patient regarding diabetes management. There should be a proper chart formed on the day to day development of the patient. So that the patient’s development can be monitored. Also, a nurse should be able to address any stress related concerns. As in diabetes, the main factor is stress. Stress causes aggravation in

CASE STUDY AND CARE PLAN4diabetic condition. Also, it is the duty of the nurse to encourage the patient for exercise. A sedentary lifestyle causes weight gain and this will cause increased chances of uncontrolled diabetes. It is the duty of the nurse of access the sign and symptoms of hyperglycaemia through regular blood glucose tests. Also, it is important to keep a check on blood sugar before mealsand along with blood sugar, it is important to access Hab1c values of the patient. It should be between 6.5 -7. Being a nurse it is important to monitor its level in every 2-3 months. At times the diabetic drugs cause immediate hypoglycaemia, There are few signs of hypoglycaemia like anxiety, tremors, slurring of speech. A nurse should be able to recognise these sign and symptoms. Also, it is important to keep a record of temperature and pulse of a diabetic patient. In many cases the patient is diabetic but he does not have any knowledge regarding diabetes. It is very important to inform and educate the patient about the changes heneeds to bring in his lifestyle due to diabetes. Exercise causes lowering of blood sugar. It is important to educate the client about proper exercise regime. It will help managing diabetes. Also, the old patient is on insulin, it is important to give him insulin on the prescribed timings. Also once the patient is discharged from hospital he needs to teach how to monitor his glucose levels at home. There are many cases that hypertension is also associated with diabetes. Along with blood sugar management, the patient has to monitor its Blood pressure. BP control will prevent many diseases like stroke, retinopathy etc. Also, regular urinary checkups are also important as it will help the patient to monitor the urine albumin levels. Itsincreased levels are found in renal nephropathy. The oral medications and insulin schedule need to direct properly to the patient. Also as the patient is on insulin there are few things which you need to tell him. Insulin injection should not be given at the same site again and again. Insulin needs to be refrigerated at 2 degrees to 8 degree Celsius. Check the expiry date

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