Jim Copper’s Health Issue Case Study.

Case scenario 1 Jim Cooper – Evening shift Word limit – 1500 words Read Assessment Guide Lines First Write strictly according to marking rubric, don’t stretch in Information or conclusion Read Frequently Asked Questions file before starting Assignment Maintain writing and wording as per 3rd year nursing student Accurate referencing using the ‘Harvard (UTS)’ style is expected with link to Journal article. Case study information are provided in ZIP File Case Study information Some resources provided in Important Links 1 Word file and in Resources ZIP file TASK: State the case study that you have chosen including whether the assignment addresses (morning shift) or (evening shift) of the case study. Identify a total of five patient health issues from the case study that nurses can address within their scope of practice. You may include ‘risk for’ or ‘potential for’ health issues. Select the three highest priority patient health issues from the five health issues that have b

Jim Copper’s Health Issue Case Study 1
JIM COOPER'S HEALTH ISSUE CASE STUDY
By (Name)
Course
Professor
Institution
City and State
Date

Jim Copper’s Health Issue Case Study 2
Jim Cooper's Health Issue Case Study
Part one
Dyspnea (SOB) is a common respiratory problem affecting about 25% of patients within the
health setup. This problem if not solved, can lead to more respiratory complications and can be
life-threatening (Berliner et al., 2016, p.834). Nurses are believed to have a leading role in the
control and treatment of SOB in various capacities. The structure of this assessment addresses
the evening shift of a case study of a 69year old Jim Cooper and the role of nurses in handling
the patient problems within their scope. The nurse's role is determined relative to the regulatory
policies and framework of health. Cooper showed signs of SOB and persistent cough throughout
the week and was diagnosed of pneumonia, and the doctor had prescribed the use of
azithromycin for his treatment. However, the patient develops allergic reactions to the antibiotic
and reports feeling chest tightness and develops rashes as the drug commences.
Cases of allergic reactions to azithromycin have been witnessed before and study shows adverse
effects of use of this drug in curing pneumonia. Patients with chronic lung diseases like Jim are
at higher risk of such reactions. This is due to high risk of bacterial resistance to azithromycin
among these patients. The drug contains macrolides which are necessary to cure respiratory
infections. However, long term use of these macrolides causes changes in microbiological
patterns and patients risk cardiovascular side effects and increased risk of infections with
nontuberculous mycobacteria (Li et al., 2014, p.515). They also risk potential impaired hearing.
Therefore, long term use of azithromycin in chronic lung disease patients should be carefully
considered and adverse effects in future should be explored. Seeing that Jim has ECG is a sign
that he may be experiencing heart and breathing problem. Breathing problems may be brought
by chronic deceases since Cooper had been diagnosed with COPD. In reference to Jim’s case,

Jim Copper’s Health Issue Case Study 3
heart infections may be a major challenge to people suffering from COPD since they have a
pulmonary disorder that obstructs air to the lungs. Failure to proper treatment may lead to a heart
attack.
Jim experiences various health issues which should be tackled by the assigned nurse. The five
most important health issues to be tackled are impaired gaseous exchange, dehydration, potential
alcohol withdrawal, impaired physical mobility, and risk for anxiety development or depression.
According to Pesola and Ahsan (2016, p.143), dyspnea is a proxy for underlying infections such
as heart and lung and should be evaluated to allow for treatment in a bid to reduce mortality and
chronic infections. Considering the fact that Jim had been diagnosed with COPD years ago, he
risks suffering from chronic disease infections which affect his lung and therefore, the primary
concern should be the SOB treatment. However, other issues such as depression are also of
major concern as depression boosts heart and lung infections and could stimulate dangerous
measures to solve it.
The assessment has been done as per Gordon’s Functional Health Patterns. The patterns provide
a framework for assessment using data collected by the nurse (Edelman, 2017 p.1). Data is
collected in a systematic manner and evaluated to determine patient requirement. Every pattern
consists of NANDA diagnostic techniques to enable the nurse perform relevant diagnostics
(Doenges et al., 2016, p.8). The importance of these issues in the diagnostics is addressed within
the scope of the assessment thus providing for a rationale for selection of the issues.
The health issues identified as important are as follows: impaired gas exchange since Jim was
diagnosed of COPD and GORD five years ago. The severity of the disease makes it a high
priority issue as per the prioritization criterion (Diederich, Swait and Wirsik, 2012). Acute lung
and heart diseases are life-threatening and patients require proper assessment and prescription.

Jim Copper’s Health Issue Case Study 4
Physical mobility is critical in Jim’s assessment. His strength should be restored through exercise
and proper medication. Jim’s age requires him to be energetic enough to reduce infections and
therefore good dietary instructions and physiotherapy practices are recommended. The
immobility has negatively affected the quality of Jim’s life making it a high priority issue. The
issue of depression should be prioritized. If a person doesn’t feel emotionally okay, the person
becomes unhealthy and social life is also ruined (Deady, 2016, p.8). Depression has made Jim
resolve into drinking and smoking, which is deteriorating his health with time and making him
vulnerable to chronic respiratory infections.
Potential alcohol withdrawal and dehydration issues have not been considered for selection. This
is due to less severity of the issues and the net outcome of the selected issues. By solving the
depression issue, Jim will be able to stop drinking due to the fact that he drinks to reduce
depression. According to Deady, (2016, p.7) depression is caused by isolation or stigmatization
thereby causing social dissatisfaction, patients resolving to drinking to reduce depression. Also,
by curbing depression and alcohol addiction, there is no dehydration due to alcohol consumption.
With this assessment, it is important to curb the three important issues which include impaired
gaseous exchange, impaired mobility and depression.
Part two
Ranking of priorities is done based on the intensity of their effect on the health of Jim. The
ranking includes impaired gaseous exchange, impaired physical mobility, and depression,
respectively. Jim has had chronic heart and lung disease for the past five years. He has been
diagnosed with shortness of breath (SOB) and persistent cough during the week and is under
medication of the same. Study shows that excessive drinking causes high alcohol vapor

Jim Copper’s Health Issue Case Study 5
concentrations in the airways, which might cause gaseous exchange problems to the patient
(Mehta and Guidot, 2017, p.243). Heavy drinkers, therefore, experience increased lung
infections which need quick and proper medical attention as it might cause other chronic
problems. Just like Jim, such patients are highly vulnerable to pneumonia. The universally
accepted and recommended cure for pneumonia is the Azithromycin.
Impaired physical mobility, on the other hand, can lead to more complications if not medicated.
Immobility can cause musculoskeletal, cardiovascular, gastrointestinal, and respiratory disorders
to the patient. Potential complications include skin breakdown, fatigue, decreased balance, and
stability and also make patients vulnerable to hypoxemia (Crawford and Harris, 2016, p.3).
Assessment of nutrition and physical examination is recommended for Jim's immobility
situation. Good dietary instructions should be administered to the patient to reduce risk of
impaired mobility that Jim experiences.
Lastly, depression is a significant issue affecting the patient's social and economic life. The nurse
is required to intervene at a primary level for the success of depression treatment. Understanding
the patient's condition is essential when handling depression (Bygstad‐Landro & Giske, 2018,
p.514). Based on the nurse’s skills, understanding the patient is done as per the NANDA
guidelines. Jim feels stigmatized. His family is away for unknown reason and there is no one to
monitor his health at home. He doesn’t have anyone to take care of his addiction and therefore he
drinks heavily thereby deteriorating his health. Depression can increase risk of fall and
according to Bao et al., (2014), depressed patients have low motivation recovery motivation and
do not comply with medical regiments. Jim is mentally sick, and has also lost energy and
physique due to this alcohol consumption.

Jim Copper’s Health Issue Case Study 6
Part three
The nurse plays a role in each of the issues cited. For the impaired gaseous exchange, the nurse
should make the family aware of the problem and other associated risks (Kandula et al., 2019,
p.123). The nurse should perform assessment and recognize complications, ensure timely
administration of the prescribed medicine, and teaching on the need for exercise by the patient.
Additionally, nurses have a role in medication safety. This regarding NSQHS standards. The
safety will help reduce medication incidents that may occur and ensure that nurses administer the
right medicine to the patients. When Jim was administered with azithromycin, he developed an
allergic reaction and resulted to tightening of the chest which was a side effect of the antibiotic.
The nurse should have used a medication that would respond positively to the patient. Making
the wrong choice of medicine to the patient may deteriorate the patient’s health condition as in
the case of Jim. Would the nurse follow this standard, he would prescribe the right medicine to
Jim. The NSQHS standards require nurses to use the right tools and documentation to assess
patient issues. The nurse should also ensure that emergency breathing assists are always
available to assist Jim in case of severe breathing complications. Monitoring the changes in
breathing conditions and reporting progress to the doctor is a role the nurse must play to know
the patient’s progress. Timely administration of medicine should be done by the nurse to ensure
that the severity of the condition is reduced.
For impaired physical mobility, therapy is recommended for such patients. The Australian
standards recommend therapeutic practices to these patients. Provision of safe, quality and
comprehensive physical assessment is necessary to mobility impaired patients (Cashin et al.,

Jim Copper’s Health Issue Case Study 7
2017, p.263). The nurse should be able to exercise the patient to enable him/her to regain
physical mobility. The nurse should be able to monitor the progress of the patient and detect any
change in the welfare of the patient (Morais et al., 2017, p.2). The nurse should be aware of
changes in mass, alterations in balance, joint stiffness, and muscular functionality changes.
Within the hospital, it is also important for the nurse to ensure Jim has the correct dietary
recommendation especially energy giving foods to assist in restoring the mobility of the patient.
The role of a nurse in handling Jim's depression is providing primary care following the
regulatory framework. According to the NSQHS standards with regards to mental health
assessment, the nurse should apply a person-centered approach to conduct the mental health
assessment of the patient. With this approach, the patient will be able to give sensitive
information which is important in mental health assessment. This approach acknowledges the
nurse’s expertise in dealing with patients and assists in gaining personal information from the
patient. The nurse should know the timeframe for doing comprehensive health assessment using
the correct assessment. The nurse should use standardized documentation in supporting clinical
judgement. The standards recommend a systematic approach of data collection and analysis to
ensure correct information is taken from the patient during the assessment. The guidance and
techniques used to interview patients are very crucial in improving the patient's motivation (Pols
et al., 2017, p.26). The family should be advised on the best way to care for Jim’s condition. The
nurse, therefore, has a critical role in ensuring that Jim's issues are effectively solved and Jim is
cured. Ensuring proper prescription and medication is vital for Jim's health restoration.
According to Jim's case, he has been diagnosed with COPD for the last five years which is a very
dangerous infection to his breathing system considering it causes pulmonary disorder which later
blocks air from the lungs, yet Cooper resolves his depression through alcohol and smoking

Jim Copper’s Health Issue Case Study 8
which may worsen his health. Concerning the NWS standard of patient information and consent
to medical treatment, nurses have the role of advising the patient on proper health measures to
follow during the medication. The nurse should have advice Jim on the dangers of alcohol and
smoking to his health. Moreover, the patient’s family should get information on how to solve
Cooper’s loneliness. To add to that, the America Nurses Association stress on health information
technology in that it allows the nurses to have standardized data of the patient to monitor patient
progress. This data is later used to advice the patient on better eating habits and what to avoid
during medication.

Jim Copper’s Health Issue Case Study 9
Bibliography
Australian Commission on Safety and Quality in Health Care, 2012. National safety and
quality health service standards. Australian Commission on Safety and Quality in Health
Care.
Bao, Y., Eggman, A.A., Richardson, J.E. and Bruce, M.L., 2014. Misalignment between
Medicare policies and depression care in home health care: Home health provider
perspectives. Psychiatric services, 65(7), pp.905-910.
Berliner, D., Schneider, N., Welte, T. and Bauersachs, J., 2016. The differential diagnosis
of dyspnea. Deutsches Ärzteblatt International, 113(49), p.834.
Bygstad‐Landro, M. and Giske, T., 2018. Risking existence: The experience and handling
of depression. Journal of clinical nursing, 27(3-4), pp.e514-e522.
Crawford, A. and Harris, H., 2016. Caring for adults with impaired physical
mobility. Nursing2019, 46(12), pp.36-41.
Deady, M., Mills, K.L., Teesson, M. and Kay-Lambkin, F., 2016. An online intervention
for co-occurring depression and problematic alcohol use in young people: primary
outcomes from a randomized controlled trial. Journal of medical Internet research, 18(3),
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Diederich, A., Swait, J. and Wirsik, N., 2012. Citizen participation in patient
prioritization policy decisions: an empirical and experimental study on patients'
characteristics. PLoS One, 7(5), p.e36824.

Jim Copper’s Health Issue Case Study 10
Doenges, M.E., Moorhouse, M.F. and Murr, A.C., 2016. Nursing diagnosis manual:
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Edelman, C.L., Mandle, C.L. and Kudzma, E.C., 2017. Health promotion throughout the
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Mehta, A.J. and Guidot, D.M., 2017. Alcohol and the Lung. Alcohol research: current
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Morais, P.C.A., Mauricio, T.F., Moreira, R.P., Guedes, N.G., Rouberte, E.S.C., Ferreira,
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Pols, A.D., Schipper, K., Overkamp, D., Van Dijk, S.E., Bosmans, J.E., Van Marwijk,
H.W., Adriaanse, M.C. and Van Tulder, M.W., 2017. Process evaluation of a stepped-

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care program to prevent depression in primary care: patients’ and practice nurses’
experiences. BMC family practice, 18(1), p.26.