Nursing Case Study Analysis of Harold Blake

Running head: NURSING ASSIGNMENT
NURSING CASE STUDY ANALYSIS OF HAROLD BLAKE
Name of the student
Name of the university
Author note

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Introduction
While working with critically and terminally ill patients, it is important to implement
the priority based care so that with accurate categorisation of the care depending upon the
need of the patient, effective interventions could be applied (Papastavrou et al., 2014).
Priority based nursing care depending upon the needs and requirement of the patient also
helps the nursing professionals to comply with the patient/person centered care (Li & Porock,
2014). As mentioned by Kogan, Wilber and Mosqueda (2016), application of person centered
care helps the patients to be an effective part of the nursing process and allows them to
express their feelings, needs so that they could reflect on their own care process and develop
a self-awareness. This would help patients after their discharge from the healthcare facility
and with the help of the self-awareness and healthcare literacy achieved in care process, they
would be able to maintain the improvement in their health condition (American Geriatrics
Society, 2016).
In this paper, one such health condition of Harold Blake would be discussed who is 83
years old and has been admitted to the healthcare facility after an episode of angina and
cerebral vascular accident (CVA). However, on day 2, the patent has shown signs of
improvement and hence, a proper nursing diagnosis, nursing interventions and priority based
care should be provided so that effective care improve his healthcare condition.
Therefore, this paper would identify the primary nursing diagnosis so that with
identification of two nursing diagnosis process, the multidisciplinary that would be employed
for the effective care for the patient could be included. Besides these, the ethical and legal
standards for the application of such diagnosis and intervention strategy would also be
provided in the paper.

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Five sequential nursing process and nursing diagnosis of Harold Blake
According to Ball et al. (2014), nursing care plan is a strategy application of which in
care process helps to include the evidence based and standardised care in the holistic and
person centered as well as family centered care for the patients wellbeing and recovery. There
are five aspects of a nursing care plan that helps the nurses to categorise the care for the
maximum benefit of the patients. These are assessment, diagnosis, planning,
implementation and evaluation (Boersma et al., 2015). All these steps are interlinked with
each other as application of patient assessment helps to collect the patent data and symptoms
so that depending upon the vital signs and symptoms, accurate diagnosis interventions could
be applied in the care process (Ausserhofer et al., 2014). Further, with diagnosis, all the
information is collected and then a care plan is developed so that all the healthcare gaols
developed for the patients could be implemented and archived. In this case of Harold Blake,
application of five nursing process aspects would be done so that with the application of
effective care process, the patient could be provided with effective interventions for health
improvement (Ball et al., 2014).
It was seen on the day two that the Mr. Blake is drowsy, drooling and suffering from
difficulty of speech. Further, it was also observed by the healthcare professional that
compared to his state last night, he has lost his orientation of time, person as well as place.
This indicated towards the loss of reflexes and lack of self-care deficit as these aspects would
affect his activities of daily life. Further, if Mr. Blake’s past healthcare condition is observed
it could be said that angina and CVA are among the critical healthcare condition, recurrence
of which are among the primary risk for the patient. Besides this, his past occurrence of
Hypercholesterolemia and hypertension could also be adverse for his current health condition
due to which he should be provided with effective intervention or it would gradually decrease
his wellbeing. The third concern of patient that is observed in the care process is his

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incontinence and inability to perform activities of daily life such as hygiene and sanitary
actions and always requires a helping hand for cleaning and other purposes. Therefore, these
are the three primary aspects which could be collected and assessed after the application of
assessment.
As the above-mentioned aspects are found after patient assessment, the next step
should focus in the nursing diagnosis and hence, application of two type of diagnosis process
should be applied to comply with the person centered and priority based nursing care
(Sharma & Klocke, 2014). As per Komatsu and Yagasaki (2014) nursing care is the process
which helps the nursing professional to understand the degree and extent of the intervention
which could improve patient condition. In this Actual Diagnosis is the process that is
conducted so that all the current ailment of patient could be assessed and then depending
upon the defining symptoms, effective intervention could be applied in the care process of the
patient (Kotronoulas et al., 2014). On the other hand, the Wellness Diagnosis is the process
which is applied on the care process with the help of patient, their family and community
members to provide the patient with holistic care to increase their coping skills and spiritual
wellbeing (Komatsu & Yagasaki, 2014). Therefore, depending on these diagnosis process,
code stroke, GCS assessment and patient’s risk of fall would be assessed so that all the
critical aspects of his care could be addressed. As per the case study of Harold Blake, he has
suffered from Cerebro- vascular accident twice and due to his Hypercholesterolemia and
hypertension condition, his risk of myocardial infarction has increased. Therefore, it could
increase the patients stay in the healthcare facility. Therefore, assessment of code stroke
would help the nursing professionals associated with the care process to evaluate the care
process provided to the patient in healthcare facility. Hence, Kotronoulas et al. (2014)
mentioned that application of such assessment helps the nursing professionals to focus on the
critical aspect of the healthcare and provide holistic care to the patient. Further, in this aspect,