Nursing Assignment: Case Study Analysis (Marcel)

This nursing assignment focuses on the case study analysis of Marcel, a patient suffering from critical healthcare conditions. The paper discusses nursing priorities, interventions, and evaluation of the interventions applied.

Running head: NURSING ASSIGNMENT
CASE STUDY ANALYSIS (MARCEL)
Name of the student
Name of the university
Author note

1NURSING ASSIGNMENT
Introduction
While working in the care process of terminally or critically ill patients healthcare
professionals should focus on the priority based collaborative nursing interventions so that
depending on the need of the patients, healthcare interventions could be provided (Koivisto et al.,
2016). Similar situation of Marcel (70) has been mentioned in this paper, who is suffering from
critical healthcare conditions and plan of care for the patient need to be developed.
Priorities of nursing care
While providing care to Marcel (70) who is suffering from chronic diabetic condition,
nursing professionals should be able to determine nursing priorities as per which healthcare
interventions for the patient would be formulated and effective care would be provided to the
patient (Hunter& Arthur, 2016). As per the Levett- Jones clinical reasoning cycle, priorities
should be developed after identification of patients current and past medication history
and then collecting cues from it so that reasoning for his current health condition could be
obtained (Dalton, Gee& Levett-Jones, 2015).
To increase the patients’ affinity for his medications and develop a routine in his
personality, the nursing professional should conduct a detailed processing of patient information
and observe his lifestyle (Thomas et al., 2016). This is an important aspect as Feaganet al. (2014)
mentions that inability to comply with medication administration schedule increased the risk of
patients physical and mental adverse conditions and in adverse conditions could increase life
threatening risk. Further, in the case study, it was observed that due to inability to manage his
medication and healthcare condition, he developed the risk of hypoglycemia, which is a severe
condition if not treated properly. Therefore, this priority would be chosen. The second nursing

2NURSING ASSIGNMENT
priority for Marcel would be providing him with healthcare literacy and education regarding him
increased blood glucose level, increased risk of primary and secondary health risks, and his
lifestyle factors due to which, such condition arises (Ackley et al., 2019). Therefore, this priority
would be aiming to provide the patient with education and literacy about his mental and physical
health, and the future risks of severe condition (Asif, 2014).
Interventions
While developing the intervention for the priority selected for Marcel, the nursing
professionals would be implementing the clinical reasoning cycle in the entire process so that
with collaborative and prioritized care interventions, maximum benefit could be provided to the
patients. As per clinical reasoning cycle by Levett- Jones Dalton, Gee and Levett-Jones (2015),
in this aspect the nursing professionals should develop an action plan and nursing SMART goals
for the patient and then thorugh interventions apply those interventions in the care process so that
maximum benefit could be provided to the patient within a specific time period (Kearney et al.,
2014). As per Ackley et al. (2019), understanding of healthcare issues and problems are of
utmost importance among the patients so that they could take effective steps for their own
healthcare improvement and could support the healthcare facility by accepting the interventions.
Therefore, healthcare literacy with medication management has been chosen as the priority of
care for Mr. Marcel. In this aspect, application of clinical reasoning cycle would also promote
patient centred care and holistic care. The first intervention would be providing the patient with a
detailed schedule of his medication, the dosage, the time and the effect of it in his health
condition (Vashist, Schneider & Luong, 2014). Further, through the utilization of therapeutic
relationship, the nurse would educate the patient regarding medication administration and hence,
interventions would be applied for 4 weeks. Similarly, the patient education related second

3NURSING ASSIGNMENT
nursing intervention would be applied for 4 weeks continuously in his ward so that he could
develop competency of conducting healthcare assessment with or without the help of medical
assistance (Peiris et al., 2014). Further, with increased knowledge of his healthcare
complications, he would be able to implement all the preventive and improvement measures
related to diet, activity disease management in his lifestyle and his affinity towards medication
would also increase.
Evaluation of the interventions applied
After detailed scrutiny of the case scenario provided, the two nursing priorities which was
identified in the case scenario were patient’s inability to manage his diabetic condition, due to
the lack of healthcare literacy and his adverse medication administration routine, that made him
irregular to it and develop severe symptoms. After the completion of four weeks, patient’s ability
to comply with the medication strategy and schedule would be assessed by observing his own
ability to consume adequate dose of medication (Thomas et al., 2016). This would help them to
develop and evaluate a medication administration plan for the patient and he would be provided
with a detailed schedule in easy and lucid language, so that maximum achievement of it could be
observed. Further, his ability to maintain required level of physical activity, his controlled blood
glucose level, his adherence to the diet and his ability to prevent all the lifestyle measures that
could lead to progressive diabetes condition would be assessed (Vashist, Schneider & Luong,
2014). Further, after the detailed evaluation, if any aspect required further implementation, then
it would be applied in the intervention strategy for Marcel for more 3 weeks so that each of the
intervention could be successfully implemented in the care process of the patient (Peiris et al.,
2014). It was seen that the primary reason of his disease progression was associated to his
inability to comply with diet management interventions, medication such as insulin and other

4NURSING ASSIGNMENT
oral medication administration, lack of physical activity and sedentary lifestyle. Therefore,
through the application of healthcare intervention related to patient education and healthcare
literacy would help the patient to understand his healthcare interventions and implement
strategies provided by the healthcare professionals related to his diet, physical activity, disease
and medication management in his own lifestyle and hence determining increased affinity
towards health and wellbeing improvement (American Diabetes Association, 2015).
Conclusion
While concluding it could be said that clinical reasoning cycle and nursing priority with
effective collaboration helps the nursing professionals to identify the chronic symptoms of the
patients and then decide the utmost priority in the care process so that complete adherence to the
effective health outcome could be received. Similar situation was observed while completing this
paper with case study of Marcel and hence, multidisciplinary approach, collaboration with
patient and holistic care were implemented in the process to achieve healthcare improvement for
the patient.

5NURSING ASSIGNMENT
References
Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M.
(2019). Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to Planning
Care. Mosby. Retrieved From: https://books.google.co.in/books?
hl=en&lr=&id=GyOJDwAAQBAJ&oi=fnd&pg=PP1&dq=Ackley,+B.+J.,+Ladwig,+G.
+B.,+Msn,+R.+N.,+Makic,+M.+B.+F.,+Martinez-Kratz,+M.,+%26+Zanotti,+M.+(2019).
+Nursing+Diagnosis+Handbook+E-Book:+An+Evidence-
Based+Guide+to+Planning+Care.
+Mosby.&ots=I8j7B4NsfH&sig=J_Ae6WH3WAnJlKS5b5jS0_cOeg4#v=onepage&q&f
=false
American Diabetes Association. (2015). Standards of medical care in diabetes—2015 abridged
for primary care providers. Clinical diabetes: a publication of the American Diabetes
Association, 33(2), 97. DOI: https://dx.doi.org/10.2337%2Fdiaclin.33.2.97
Asif, M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary
pattern. Journal of education and health promotion, 3. DOI:
https://dx.doi.org/10.4103%2F2277-9531.127541
Dalton, L., Gee, T., & Levett-Jones, T. (2015). Using clinical reasoning and simulation-based
education to'flip'the Enrolled Nurse curriculum. Australian Journal of Advanced Nursing,
The, 33(2), 29.Retrieved from:
https://search.informit.com.au/documentSummary;dn=018184224173600;res=IELHEA
Feagan, B. G., McDonald, J. W., Panaccione, R., Enns, R. A., Bernstein, C. N., Ponich, T. P., ...
& Fedorak, R. N. (2014). Methotrexate in combination with infliximab is no more

6NURSING ASSIGNMENT
effective than infliximab alone in patients with Crohn's
disease. Gastroenterology, 146(3), 681-688. DOI:
https://doi.org/10.1053/j.gastro.2013.11.024
Hunter, S., & Arthur, C. (2016). Clinical reasoning of nursing students on clinical placement:
Clinical educators' perceptions. Nurse education in practice, 18, 73-79. DOI:
https://doi.org/10.1016/j.nepr.2016.03.002
Kearney, L. K., Post, E. P., Pomerantz, A. S., & Zeiss, A. M. (2014). Applying the
interprofessional patient aligned care team in the Department of Veterans Affairs:
Transforming primary care. American Psychologist, 69(4), 399. DOI:
https://psycnet.apa.org/doi/10.1037/a0035909
Koivisto, J. M., Multisilta, J., Niemi, H., Katajisto, J., & Eriksson, E. (2016). Learning by
playing: A cross-sectional descriptive study of nursing students' experiences of learning
clinical reasoning. Nurse education today, 45, 22-28. DOI:
https://doi.org/10.1016/j.nedt.2016.06.009
Peiris, D., Praveen, D., Johnson, C., & Mogulluru, K. (2014). Use of mHealth systems and tools
for non-communicable diseases in low-and middle-income countries: a systematic
review. Journal of cardiovascular translational research, 7(8), 677-691. DOI:
https://doi.org/10.1007/s12265-014-9581-5
Thomas, P. A., Kern, D. E., Hughes, M. T., & Chen, B. Y. (Eds.). (2016). Curriculum
development for medical education: a six-step approach. JHU Press. DOI:
https://books.google.co.in/books?
hl=en&lr=&id=UxF4CwAAQBAJ&oi=fnd&pg=PP1&dq=Thomas,+P.+A.,+Kern,+D.

7NURSING ASSIGNMENT
+E.,+Hughes,+M.+T.,+%26+Chen,+B.+Y.+(Eds.).+(2016).
+Curriculum+development+for+medical+education:+a+six-step+approach.
+JHU+Press.&ots=1eOyVWN_MD&sig=4wvlS7fZEQV4Rz2ftSKla4fficg#v=onepage&
q=Thomas%2C%20P.%20A.%2C%20Kern%2C%20D.%20E.%2C%20Hughes%2C
%20M.%20T.%2C%20%26%20Chen%2C%20B.%20Y.%20(Eds.).%20(2016).
%20Curriculum%20development%20for%20medical%20education%3A%20a%20six-
step%20approach.%20JHU%20Press.&f=false
Vashist, S., Schneider, E., & Luong, J. (2014). Commercial smartphone-based devices and smart
applications for personalized healthcare monitoring and management. Diagnostics, 4(3),
104-128. DOI: https://doi.org/10.3390/diagnostics4030104