Health of Adults: Case Study Analysis and Nursing Care Plan

Running head: HEALTH OF ADULTS
HEALTH OF ADULTS
Name of the Student
Name of the University
Author Note

1HEALTH OF ADULTS
Introduction:
The discussed case study explains the condition of a patient named as Mrs.
Marla Anthony who is 35 years of age has been admitted to the hospital at HHHS
ward 1. She caught up with an accident and admitted to the emergency department.
She had suffered from multiple fractures and mild trauma and for that incident she
had gone through several operations. She had a past medical history of Type-2
diabetes mellitus. She was assumed to be a patient of hypoglycaemia. The following
part of the essay will describe about the medical conditions of the patient. In order to
analyse the present condition of Mrs. Marla the proper use of pathophysiological and
the pharmacological approach is necessary. Also, this paper will describe about the
nursing care and the inter-professional healthcare model that can be applied to offer
the patient with maximum care. Later, the essay illustrates about the quality, safety
and risk management to care for adults who are going through acute health
problems.
Discussion
Part 1
Analysis of the case study of Mrs. Marla
The case study describes about a woman whose name is Mrs. Marla Anthony
and she is 35 years of age. She has met with a car accident while her car hits a tree
and she was sitting in the passenger seat. The accident causes several incidents to
her body so she is admitted to HHHS ward 1. Mrs Anthony has required multiple trips
to the operation theatre. When she caught up with the accident and trapped inside
the car, she suffered multiple fractures in her both legs. She also inhaled mild smoke
while she was in the car for 15 minutes but there was no external burn injuries in her
body.
Social history of the patient is collected which illustrates that Mrs. Marla is a
working woman who works as a full time basis in a local supermarket. She is
estranged from her former partner. Mrs. Marla has support from her co-workers and
friends. She is an active smoker and usually smokes 10 cigarettes per day. She
consumes drug which includes cocaine and IV methamphetamines. However, shows
no signs of drugs in the past seven days prior to admission in the hospital and she is

2HEALTH OF ADULTS
a vegetarian. She is diagnosed with Type-2 diabetes mellitus in her past medical
history. She has made several trips to the operation theatre for several operations.
On day one in the hospital, she was taken for a left distal closed transverse tibia and
the left distal comminuted fibula fractures of her ankles. On day two in the hospital
she had the program for the gamma nail insertion for the neck of the left side of
femur fracture. On present day in the hospital she had been scheduled for cleaning
her wound of her deep cut right thigh. In addition to her wound clean, she was
scheduled for internal fixation (ORIF) on her right ankle internally.
Nursing notes
According to the nursing notes in the case study, Mrs. Marla has an impatient
night. She has not taken any food since the last night as a preparation for her
operation theatre in the present morning. She has no complaints of any kind of pain
during the night. She has required the preoperative medications and along with that
her obs is charted. Her fluid balance chart, neurovascular vitals needs to be
continued. After completion of her daily weigh she weighed 80 kg. The nursing notes
states that Mrs. Marla has not slept well since the last night and she is worried for her
surgery in the morning. Notes states that when the nurses called her in order to take
her to the theatre she is not able to respond verbally. She is scared and she
issweating. Her obs and medical data are noted and the records are presented in the
appendix. Dr. Leon and along with his members suspected the risk of hypoglycemia
in the patient body.
Application of pathophysiological knowledge
The irregular results of medical condition in the patient body shows that she
may have hypoglycemia. Hypoglycemia is a medical condition in which the blood
sugar level decreases in the body than that of the normal levels. The
pathophysiological condition which occurred in the patient body due to the reduction
of blood glucose level and eventually it shows the alteration of her mental and
physical status and certain types of behavioural changes. It hits the stimulations of
the syampathetic nervous system and it can cause any cardiovascular symptoms as
well. It can lead to a heart problems as well. Moheet and Seaquist (2013). Low blood
sugar levels can cause dizziness, anxiety, restlessness as shown by the patient.
Sometimes hypoglycemia can be caused by the fasting or starvation and the use of

3HEALTH OF ADULTS
drugs can cause the disorder too. Methamphetamines can cause a change in the
blood glucose level. Mrs. Marla is starving since last night for her operation in the
theatre and it causes a fluctuation in the blood glucose levels. From her medical
reports it was seen that her blood glucose level falls the range of 50 mg/Dl. In order
to recover the glucose level in the body, doctor has prescribed a dose of glucagon.
Glucagon can cause a change in the liver function where the stored glycogen present
in the body can be converted to usable glucose. This causes an elevation of blood
glucose level in the body of Mrs. Marla (Fish et al. 2013, p. 1384)
Nursing care plan
According to Nursing and Midwifery Board of Australia, (2016), nurses and
midwives should be registered with the Nursing and Midwifery Board of Australia or
NMBA, and they should meet the NMBA’s professional standards to practice in
Australia. That nursing is the science of profession and caring together. Nursing care
is required for Mrs. Marla to curb down the case of hypoglycaemia (Clayton et al.
2013, p. 69).. Nurses and midwives should care for Mrs. Marla who had an elevated
blood glucose level. They should adopt several interventions to reduce the sugar
levels in the patient body. The nurses should administer the liquids that contain
glucose Harper and Maloney (2016). The blood glucose level should be checked in
the interval of 1 hour from the time of incorporation. If the patient body is conscious
then the nurses should administer the patient with juice which is followed by complex
carbohydrates and proteins in order to prevent the hypoglycaemia during the next
hour (Rosenstock et al. 2014). If Mrs. Marla has a reduced level of consciousness
the nurses should set up a large bore I.V. line and administer 50ml of 50% dextrose
as a bolus. If none of the above interventions are possible then the patient body
should be treated with glucagon. The oxygen is important throughout, so an airway
should be maintained Morton and Fontaine (2013). All the other vitals like the blood
pressure, heart rates should be monitored (Refer to appendix). The nurses should
provide a nasogastric tube if the patient feels uncomfortable while taking the food
(Refer to the appendix). The nurses should help Mrs. Marla to consume the food
which will give her energy. According to the case study, the patient has been
administered with 1M glucagon as a dose of 1 mg. This drug is important to treat
hypoglycaemia. I mg of standard dose of glucagon is administered in the severe case