NUR250 Medical Surgical Nursing 2 Assessment 1

NUR250 Medical Surgical Nursing 2 Assessment 1 Semester 1 2019
Description/Focus: Care of the person with a medical condition
Value: 40%
Due date: Friday 12th April 2019 by 1300 ACST
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 one of the following case scenarios:
Mr. Peter Newman is a 44-year-old man admitted to the ward with infective
exacerbation of Chronic Obstructive Pulmonary Disease (COPD). 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.
Or
Miss Violet Paterson is a 77-year-old woman admitted to the ward following an Acute
Myocardial Infarction (AMI). Miss Paterson is currently in a stable condition. She has a
history of primary hypertension and longstanding osteoarthritis. Over the last few
months the arthritic pain has increased significantly, and both her blood pressure and
1
Double click here to fill in this footer
Last name__ _student number_NUR250 S1 2019 Assessment 1

NUR250 Medical Surgical Nursing 2 Assessment 1 Semester 1 2019
osteoarthritis are impacting on her ability to meet her daily living needs.
Miss Paterson lives alone in an apartment on the 3rd floor (with no lift access) with her
cat Molly and has no extended family.
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?
Mr. Peter Newman is experiencing an acute exacerbation of chronic obstructive pulmonary disease.
This is a condition which occurs following Chronic Obstructive pulmonary disease. It is when the
symptoms have worsened (Vogelmeier, et.al, 2017). A care plan is an important tool that is
necessary for the management of every patient. It usually client-centered and therefore the care of
each client will be individualized according to the individual’s needs (Castro, et.al, 2016). This is vital
for the improvement of the quality of life and overall health. While developing a care plan for Mr.
Newman, there are some of the things that have to be considered. This includes: breathing difficulty,
lifestyle modification, emotional support, and patient education. This is discussed below.
Mr. Peter is experiencing breathlessness that is increasing. This is affecting him so much that he
cannot even meet his work responsibilities. Accomplishing the activities of daily living also becomes
more difficult with breathlessness. This, therefore, has to be considered in order to ensure that
Newman gets to be comfortable while performing day to day activities. It is also of importance to
consider the difficulty in breathing since this may lead to hypoperfusion if left unattended which may
create further complications for him. The delivery of oxygen may be improved by letting the patient
sit in an upright position and teaching breathing exercises to reduce airway collapse.
Mr. Newman is a chronic smoker and also social drinker. This habit may have contributed to the
worsening of his conditions. Therefore, it is important to consider lifestyle modification during the
development of his care plan. The nurse should ensure that Peter gets to understand clearly the
effect of such habits on his health. Lifestyle modification may also involve food and nutrition. Mr.
Peter nutrition has to be modified in such a way that the diet is balanced so that his immunity is
boosted and moreover, he remains healthy. This will also aid in medication regime since some
medication is recommended to be taken after food for better metabolism.
Emotional support is another factor to consider while developing a care plan for Mr. Peter. The
worsening of such a chronic condition as Chronic Obstructive Pulmonary disease can be hard for the
mental state of an individual. A person may get anxious for fear of the unknown. Feelings of
2
Double click here to fill in this footer
Last name__ _student number_NUR250 S1 2019 Assessment 1

NUR250 Medical Surgical Nursing 2 Assessment 1 Semester 1 2019
hopelessness together which depression may develop (Laurin, Moullec, Bacon, &
Lavoie, 2012). The nurse, therefore, has to consider psychological support even though the
multidisciplinary team will be required for management of this.
Lastly, patient education should also be considered important when preparing a care plan for the
patient (Barry, & Edgman-Levitan, 2012). This deals with the patient understanding his condition
clearly and also clarification of any query that is of concern to the patient. This also plays a great deal
in emotional support, since when the patient has adequate knowledge, he clearly understands his
condition and therefore anxiety is relieved. Better understand also contribute to swift management
because the patient will be able to cooperate throughout his management.
Task 2. Nursing assessments
Identify three (3) nursing assessments you will conduct and explain why they are a priority for you.
The nurse will assess Mr. peter’s Airway. This a priority because blockage of a patient airway puts
him in risk. This will include the presence of the mucus in the airway since patients with chronic
Obstructive pulmonary disease usually produce mucus and gets inflamed which may block the
airway (Barnes, 2016). The nurse has to educate the patient on effective coughing to ensure that the
airway is effectively clear and is a pattern.
The nurse has to also assess the patient’s breathing (Haugdahl, et.al, 2015). This will involve an
assessment of the patient’s respiratory rate and pattern. The normal respiratory rate range is 12 – 20
breaths/min for adults. COPD patients usually require oxygen therapy due to difficulty in breathing.
The nurse can further perform chest assessment to check for breathing sounds and note if there are
any abnormalities. The nurse should be checked to determine whether he is using accessory muscles
when breathing, which is usually abnormal.
The nurse will also asses the ability of the patient to perform activities of daily living. It is advisable
to always encourage the client to perform activities to the best level he can. This means that the
nurse should not let the patient be fully dependent. The nurse, however, has to be careful that he is
able to determine the patient ability to perform the tasks and make sure that the patient does not
3
Double click here to fill in this footer
Last name__ _student number_NUR250 S1 2019 Assessment 1