Medical Surgical Nursing Assessment 1

Medical Surgical Nursing Assessment 1
Description/Focus: Care of the person with a medical condition
Value: 40%
Length: 1800 - 2000 words
This assignment requires you to focus on the holistic care of a patient admitted to
hospital with an acute presentation of a chronic condition and to demonstrate your
ability to apply the clinical reasoning cycle to develop and plan nursing care.
Select following case scenarios:
Mr. Peter Newman is a 44-year-old man admitted to the ward with infective
exacerbation of Chronic Obstructive Pulmonary Disease
(CHRONIC OBSTRUCTIVE
PULMONARY DISEASE ). Mr Newman is a heavy smoker and social drinker. Mr Newman
is a Fly-In-Fly-Out (FIFO) truck driver with a remote mining company and is finding it
difficult to meet work responsibilities due to increasing breathlessness.
Mr Newman lives with his wife Marcy and 2 teenage children in a southern capital city and
works a 2 weeks on/2 weeks off roster.
Based on the information provided in the above case scenarios complete the following
tasks.
Task 1. Consider the patient
What will you consider when preparing the care plan for your chosen patient?
While discussing the healthcare condition of Peter Newman (44) upon admission in the ward, his
chronic healthcare conditions that required rapid and adequate healthcare interventions would be
discussed. As per Ek and Svedlund (2015), while providing care to patients with chronic and severe
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Medical Surgical Nursing Assessment 1
health complications, nursing professionals should develop priority of care so that with prioritized
care, a structured approach could be developed and holistic care could be provided to the patient.
Levett-Jones Clinical Reasoning Cycle (CRC) would be used for the healthcare assessment of Peter.
As per the first step of CRC, considering patient situation is crucial as the complete intervention is
dependent on the identified issues from the patient’s current situation and health history (Dalton,
Gee & Levett-Jones, 2015). Upon admission, the patient was observed with an infective exacerbation
of Chronic Obstructive Pulmonary Disease or COPD. While assessing the patient’s health history it
was identified that he works as a truck driver for a remote mining company however increased
breathlessness has affected his working abilities. As per Slater, Abshire and Davidson (2018),
increased breathlessness is an indication of severe or chronic COPD and in severe healthcare
conditions, could also lead to severe heart or lung disorders. Further, it is clearly identified that his
workplace is a major contributing factor for his health condition as Hendryx and Luo (2015)
mentioned that majority of the people living or working in mines of remote locations are seen to be
affected with severe COPD. The primary reason behind this is the mine dust around such areas that
deposits in the airway of people working around it affecting their healthcare condition. Hence, these
are the conditions which would be considered while developing a care plan for Peter (LeMone et al.,
2014).
Task 2. Nursing assessments
Identify three (3) nursing assessments you will conduct and explain why they are a priority for you.
After patient consideration nursing assessment would be carried out as the next step of the clinical
reasoning cycle required to identify the cues of the patient’s health condition so that the symptoms
of the patients could be processed. Hence in such a situation, the patient assessment would be
conducted. In the case of Peter, the diagnosis process that would be conducted for assessment of his
health condition would be conducting Chest X-ray, ECG, and spirometry (Onur et al., 2018). These
three assessment techniques would be conducted for the patient because as per the priority of the
patient, it would help to understand the severity of COPD condition (Nilsson et al., 2017). As per the
Australian general practice, for the assessment of COPD and its severity, ECG should be conducted
because it could help to observe any abnormality. Further as per Ponikowski et al. (2016), ECG could
help to locate any damage in the myocardium as in severe cases of COPD patients develop risk factor
of myocardial infarction (Chen et al., 2015). Further, application of chest x-ray would help in this case
of Peter to locate any abnormality in the lungs, because the patient works around the mining area
and severe accumulation of dust and other foreign particles could harm the lung. Hence X-ray would
be conducted in this condition. Spirometry is the lung functioning test which helps to identify the
ability to the lungs to exhale and inhale adequate air. Therefore, application of this would help to
identify the progression of COPD in patients health condition and he would be provided with
effective healthcare interventions for the patient condition (Yamada et al., 2017). As per Soriano,
Molina and Miravitlles (2018), spirometry is a COPD assessment method which helps to identify the
inability of lungs in providing the blood with enough oxygen due to which it would be easier for the
healthcare professionals to assess the ability of the lung, measure the lung volume and pulse
oximetry.
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Medical Surgical Nursing Assessment 1
Task 3. Care planning
Identify three (3) priority nursing diagnoses for your chosen case scenario and explain why they are
relevant.
After conduction of the healthcare assessment healthcare professionals would be able to
understand the healthcare priorities as per which the healthcare professionals should be provided
with interventions. As per Berkowitz (2016), care priority would help the healthcare professionals to
understand the healthcare requirements of the patient and then provide them with holistic care so
that with physical healthcare condition, he could be provided with mental healthcare interventions.
Further, through the help of nursing intervention that is decided after application of healthcare
priorities, nursing professionals would be able to develop self- goals, and self- determination in the
patient that would encourage them to take care in the healthcare interventions (Ek & Svedlund,
2015). The priorities for Peter, in this case, the study would be treating his breathlessness. As per the
patient, he is suffering from rapidly increasing breathlessness and hence, he should be provided with
fast and rapid healthcare intervention so that he could focus on his COPD healthcare complication
and fulfil his financial responsibility for his family (Chen et al., 2015). Further, it should be mentioned
that patient with chronic COPD and increasing breathlessness could develop crucial healthcare
conditions such as Asthma, emphysema, heart failure, pneumothorax, myocardial infarction, and
others (LeMone et al., 2014). Therefore as per the primary priority of the patient, it should be
included in the case study so that patients could be provided with effective care interventions
(Tinetti et al., 2016). Further, as per Negewo, McDonald and Gibson (2015), patients who are
suffering from impaired lung health and severe conditions of COPD could lead to chronic bronchitis
and hence with patient health, it could affect their quality of life. Besides this, due to such healthcare
conditions, their financial burden could also increase and would eventually increase their depression
and stress. Hence, as the first priority for Peter, this healthcare condition would be selected (Søyseth
et al., 2016).
The second healthcare priority that would be selected for the patient condition would be decreasing
his exacerbation of Chronic Obstructive Pulmonary Disease as the presence of such healthcare
condition could increase the patient lung injury and would increase the occurrence of a secondary
health condition in the patient (Vogelmeier et al., 2017). It is seen that Peter is suffering from
chronic COPD and due to which he has developed chronic breathlessness and hence, it would be
treated for the patient condition so that the crucial conditions for his breathlessness could be
avoided. Further, it was mentioned in the research by Goldman et al. (2017) that if the patient
constantly stays in contact of chemical fumes or dust particles, the COPD becomes worst and
increases the chances of lung congestion, and lung infection could increase. Hence, this priority
would help healthcare professionals to achieve the long term goal of the patient condition (Shomi,
2018). The third nursing priority for Peter would be addressing his smoking and drinking habits, as
according to Chaudhary et al. (2016) such addiction could lead to severe conditions of COPD and
related risk factors. Further, as per Knolle, Chatterji and Pulimood (2015), smoking and drinking in
severe COPD condition could affect the patient’s ability to pump adequate blood to the entire body
and not addressing his this aspect of condition could increase the complication related to COPD and
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