NUR250 Medical Surgical Nursing 2 Assessment 1

NUR250 Medical Surgical Nursing 2Assessment 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 osteoarthritis are impacting on
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NUR250 Medical Surgical Nursing 2Assessment 1 Semester 1 2019
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?
I have chosen the first case study of Peter Newman who has infective exacerbation
of Chronic Obstructive Pulmonary Disease (COPD). I will consider several factors
that will enhance delivery of a holistic nursing care. The objective of considering
more than body diagnosis is to adopt a holistic care approach that will improve the
patient’s health outcome. First, I will consider Newman body’s illness diagnosis that
is COPD. The diagnosis is the unhealthy aspect that requires treatment and has led
the patient to be admitted in the ward. This consideration will involve helping the
patient receive health care to improve his condition. Secondly, there will be
consideration of the patient’s age and gender. Peter is 44-years old meaning he is a
middle aged adult. Age and gender are important factors because people’s needs
change with age groups and gender (Berend, 2016). Peter is in an age group that
has responsibilities both at family level and workplace. According to Dury (2016),
middle aged adults will need to communicate and work and a care provider should
assess their ability to communicate and work with family, friends and co-workers.
The third consideration for preparing Peter’s care plan is his social behaviour. Peter
is a smoker and a social drinker and these have impact on his health. The patient
has risky behaviours that can deteriorate his health condition. Smoking increases
risk of death by 80% for COPD patients (Leidy et al., 2014). According to Li et al.,
(2016) smoking is a leading but preventable cause of premature death and harms
nearly all organs of the body. Arora et al. (2014) noted that quitting smoking lowers
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NUR250 Medical Surgical Nursing 2Assessment 1 Semester 1 2019
exacerbation of smoking-related disease adding years to a patient’s
life. The fourth factor to consider in Peter’s condition is work. Peter works as a driver
in a mining company in a FIFO basis. Place of work affects a person emotional,
physical and mental health. Harrison, Brooks, Desveaux, and Goldstein (2015) noted
that workplace stress, injuries, job dissatisfaction, bullying, accidental deaths, and
discrimination can negatively affect an individual health. They found that job loss,
unexpected loss of income or retrenchment cause distress to a person. Working
environment can damage an employee’s health putting their safety at risk (Faisal et
al. 2016). Another consideration that I will making when preparing peter’s care plan
is the family. Peter has a wife and two children and whom are teenagers. Family is
an important part of a person’s health and aspect in provision of holistic nursing care.
According to Dury (2016) a supportive and close-knit family provides economic
wellbeing, emotional support and increase overall health while a bad family has
conflicts and stress that negatively affect an individual. Therefore I will consider all
factors that impact Peter’s condition and as a person when preparing his care plan
for holistic nursing care.
Task 2. Nursing assessments
Identify three (3) nursing assessments you will conduct and explain why they are a
priority for you.
Nursing assessment is an important part in gathering patient’s information and
prioritizing nursing care. The assessment will identify patient’s current and future
care needs. The three nursing assessments that I will conduct are sociological,
psychological and physiological needs. Physiological assessment will involve
physical examination of the patient’s body to assess the physical needs. Physical
assessment differentiates between normal and abnormal conditions in the patient
body (Williams & Hopper, 2015). Peter’s body need to be examined to find out
physiological needs that have to be addressed in order to have continued high
quality life. The physiological areas to be examined are the respiratory, temperature,
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NUR250 Medical Surgical Nursing 2Assessment 1 Semester 1 2019
and blood pressure. Peter had reported breathlessness and there is
need to address assess and outline an intervention for the abnormal condition. The
second assessment is sociological needs of the patient. The sociological
assessment will assess the patient social factors that affect the patient and need for
consideration when providing nursing care. Social factors to be assessed are family,
recreational interests, use of substance, social status, employment and social
patterns. Peter has a family, a wife and two children and they live together. Peter
works in a mining company as a driver on a FIFO basis and there is need to assess
his working condition and social status to find out how they impact his COPD. He
also likes having social drinking and smoking that puts his COPD condition into more
risk (Elbehairy et al., 2015). This means that peter’s recreational interests and use of
substance need an intervention to stop his drinking and smoking in order to manage
COPD and enhance his quality of life. The other assessment is physiological needs.
Psychological assessment evaluates a patient’s mental health and general well
being. Mental health is an important assessment as it can be negatively affected by
physical illness (Hangaard, Helle, Nielsen, & Hejlesen, 2017). Nurse need to assess
the patient’s attitude and thoughts and find inte3rventions for factors that cause
stress or anxiety to a patient. According to Faisal et al. (2016) failure to fulfil one’s
roles and duties as a result of a chronic condition lead to mental stress. Mental
health is important for an individual quality of life and their family member. Peter has
a family, friends and co-worker that can impact his psychological health. The inability
to meet his responsibility as an employee can also impact his mental health (Dury,
2016). The following three assessments are prioritized to meet current and future
nursing care for Peter while adopting a holistic approach that considers nursing
needs behold physical illness or condition.
Task 3. Care planning
Identify three (3) priority nursing diagnoses for your chosen case scenario and
explain why they are relevant.
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