Case Analysis of Mr. Orkins' Health Assessment and Nursing Interventions

“Assessment 2: Guided case analysis – Deteriorating patient”
“Name of the Student: SIMARPREET KAUR GHAI”
“Student ID: 266537”
“COURSE NAME – GRADUATE CERTIFICATE IN NURSING (BRIDGING AND RE- ENTRY)”
“COHORT- 175”
“COURSE COORDINATOR- ROSS PANCHO”
“ASSESSMENT ITEM- CASE ANALYSIS”
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SIMARPREET KAUR GHAI STUDENT ID 266537

“Assessment 2: Guided case analysis – Deteriorating patient”
“CASE ANALYSIS”
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1. Introduction
Stroke is the leading cause of disability and Australia's largest killer disease
(Strokefoundation.org.au, 2019). Stroke is a severe and fatal disease involving brain
circulation and can have a severe impact on an individual maintaining a safe atmosphere,
communication, mobility and other living activities (Miss.B.M.Gund, 2013). The case
analysis includes the health assessment and nursing and medical interventions of Mr.
Orkins, a gentleman of 84 years old who was admitted after his fall at his residence. He
was a part of Australia's Aboriginal society. It has been obvious from his attitude when a
female nurse was attending to his personal hygiene that he prefers male nurses according
to the prevailing culture of indigenous populations (Freeman et al., 2014). To avoid
further complications, he needed continuous monitoring of the signs and symptoms.
2. The Body
2.1 Analysis of the Problem
In order to complete Mr. Orkins’ health assessment, four steps will be involved. The first
step will involve obtaining patient’s medical history followed by primary assessment,
secondary assessment and focused assessment (Dains, Baumann and Scheibel, 2018).
2.1.1 Patient’s Medical History.
Mr. Orkins had been very old and his past medical history showed he had diabetes
mellitus of type 2, high blood pressure and hyperlipidemia.
2.1.2 Primary Assessment
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SIMARPREET KAUR GHAI STUDENT ID 266537

“Assessment 2: Guided case analysis – Deteriorating patient”
This assessment is based on the responsiveness of the patient (Johnston et al., 2019).
According to his wife, he was unresponsive for a short time following the occurrence of
the fall but was orientated afterwards toward time, person and place. The patient's
reaction was blank in the original evaluation when he was welcomed by the shift nurse
attending the morning shift. When asked how he was feeling, it became apparent that Mr.
Orkins tried to answer the question, but he spoke in a sneaky way. His face dropped to
his right side and from his mouth saliva dropped. There was also a smell of urine in the
room. Nervous complications resulted in loose muscles and an absence of control
mechanism equipment was the reason for this foul smell (Menon et al., 2015).
2.1.2 Secondary Assessment
The medicines provided to Mr. Orkins are not adequate for controlling the stroke. Mr.
Orkins is receiving medicines like Diamicron, Amlodipine and Simvastatin, which
mainly act for other pharmacokinetic functions. The combination of these drugs can
boost simvastatin blood levels substantially. This can increase the risk of side effects such
as harm to the liver and a rare but severe disease called rhabdomyolysis involving the
breakdown of muscle tissue in the skeleton. Rhabdomyolysis may cause harm to the
kidneys and even death in some instances (Drugs.com, 2019). Among the side effects of
the two drugs that Mr. Orkins is taking (Amlodipine & Diamicron) were dizziness and
symptoms of confusion that ultimately trigger fainting. At the hospital, the night shift
nurse mentioned that the patient had slept well during the night and he could walk to the
bathroom. His vital signs at 6:00 o'clock were also satisfactory but his situation worsened
after being handed over to the morning shift nurse and he could not reply to the query of
the nurse.
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SIMARPREET KAUR GHAI STUDENT ID 266537