The Role of a Primary Health Care Nurse in Managing Epilepsy: A Case Study
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This paper discusses the role of a primary health care nurse in managing epilepsy through a case study. It explores the care priorities and clinical needs of a patient with epilepsy, including seizures control, epilepsy control, financial distress control, loneliness, and social isolation reduction.
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Running head:NURSING ASSIGNMENT1 Nursing Assignment Student’s Name Professor’s Name Institution Affiliation Date
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NURSING ASSIGNMENT2 The role of a primary health care nurse willbe outlinedin this paper under Jenny Peterson’s scenario, a 23-year old single parent female with a young girl called Samara. Jenny who hasbeen diagnosedof epilepsy, a disease that is associated with the central nervous system (a neurological disorder) leading to development tonic-chronic seizure thatwashave become persistent even after clinical subjection to sodiumvalproratemedications. Thus,epilepsyhas led to other conditions such as nausea and diarrhea (Sazgar and Young, 2019). Under the analysis of Jenny’s case study, a vivid outcome willbe revealedon the two care priorities and clinical needs such as seizures control, epilepsy control, financial distress control, loneliness and social isolation reduction. However, caring and support for patients with acomplexcombination of chronic conditions will be justified and analyzed using clinical reasoning cycle (CRC) as illustrated by Levett-Jones (2018) in prioritizing priority cares which are the uncontrollable seizures and loneliness together with social isolation. Therefore, all the care plans will be family andpatient-centeredunder a guideline of holistic and collaboration approaches (Chang, and Johnson, 2014). To begin, the nurse should consider Jenny’s situation using the first stage of the CRC. Jenny is a young woman who has a young child Samara she adores under lack of financial and social support from the husband. However, Samara is taken care of by Jenny’s parents who help in looking after the young girl while Jenny is at work. Nonetheless, Jenny has been diagnosed of epilepsy after her vehiclewas knockedby a drunk driver making her develop tonic-Chronic seizure a condition associated with abnormal behaviors that require attention for the patient (Bonello, M., Michael and Solomon, 2015). Besides, that she has suffered from financial distress as she cannot go to work since the sick leaves, she is entitled areoverdueto consecutive seizures infection whichhasbecome uncontrollable even under medication using sodiumvalprorate(Schloesser et al., 2015). The presence of seizures has led to Jenny feeling nauseous occasionally, run down and tired. Moreover, she is more concernedwiththis condition while alone with atwo-year-oldSamara at home. The patient is not sureofhow she could manage the condition alone. Since the patient is finally distressed, the nurse should not be judgmental and should show empathy by accepting Jenny’s condition as the nurse decides on the appropriate care plan practices to be implemented (Urden, Stacy and Lough, 2019). It is also important for the nurse to practice therapeutic communications while handling the patient which may involve active listening, thus, encouraging Jenny to express her feelings freely as well as an indicator of the primary nurse’s respect and acceptance of the patient’s condition. By proper use of therapeutic communications, the nurse will be able to build a continuous, therapeutic and collaborative relationship with Jenny, therefore, facilitatingeffective goal-directedcommunication.
NURSING ASSIGNMENT3 Secondly, the primary nurse should gather information from Jenny’s past medical records which will help identify care and clinical needs alongside the patient’s health concerns and preferences using the second and third phase of the CRC guide. Moreover, further information canbe obtainedfrom the rehabilitation unit where the patient spent one week after being involved in a car accident. Besides, other information canbe obtainedfrom the hospital where Jenny was being treated with sodium valproratemedicine as well as from the neurology clinic where she often followed up appointments. Jenny’s uncontrollable seizures illustrate that the electrical brain actions within the brain are not performingnormallymaking her not to drive thepersonalcar as she is using taxi services. Additionally, Jenny cannot now attend the normal work she doestoearn an income. The inability for her not to attend work has made her suffer from financial distress.Thelevel ofpersistent level of epilepsy is a strong indication that neurological exams havebeen conductedonJenny. The neurological exam will help the nurse conduct various tests on Jenny’s behavior, mental function and motor abilities. On the other hand,several factors mayresult in Jenny have financial distress whichincludesthe inability of her husband to provide the support the familyeven thoughJenny has a small child that she adores. Besides, Jenny has fear and doubts on how her health conditionsaresince she stays with a very young girl who requires her support which cannot be possible since she alsohaschronic seizures, thus, requiring attention too. So, inability to attend work and meet other friends and colleagues as well as the absence of the husband and another personwho can take after the single parent family has led to loneliness and social isolation (Daaleman, 2018). The loneliness has also made Jenny to run-down, get tired and feel nauseous which has promoted financial distress within her. It, therefore, means that loneliness and social isolation haveanimpactonthephysicaland social well-being of the patient. The primary nurse is also required to identify the care needs of the patient as per the fourth phase of the CRC guide. The identifications willbe basedon the priorities,andthe care needs tobe requiredfor Jenny. Since Jenny’s healthis overlappedwith various complex health conditions, there is a needfor motivating the patienttodispel running-down and feeling of loneliness as well as socially isolated (DeVon et al., 2016). The nurse should recognize that the loneliness and social isolation can increase the effect of thereactionof epilepsy within the patient’s body as well as financial distress. Therefore, loneliness will make Jenny continuously suffer from other related stress infections such as headaches and a general reduction in her lifespan as Jenny will feel worthless and will lose interest in taking care of Samara as well as going to work. Additionally, the nurse should collaboratively with Jenny establish goals which are achievable according to the fifth phase of the CRC guide. The primary nurse should, therefore, make the
NURSING ASSIGNMENT4 involvementof Jenny, the rehabilitation unit officer and the neurologist officer while assessing the decision-making process (Devinsky et al., 2016). Jenny’s expressions and preferences will always be reflected in the process of making goals to make the patient feel a sense of independence and as a contributortoher treatment as it creates a sense of ownership. The primary concern of Jenny is on how she can manage to stay lonely with her young girl despiteher sufferingfrom seizures. The nurse should further investigate why the husband cannot manage to stay with his wifetoprovide the required support in taking care of Jenny and his daughter as well as supporting the family financially.Research conducted by Holt-Lunstad and Smith (2016) indicates being a single parent family can be as a result of thedeathof one parent or divorce which further leads to loneliness and social isolation as apartnership is lost. Therefore, Jenny will not have the encouragement to thrive under conditions of loneliness and social isolation. The primary nurse should find ways to interact with family members and relatively and clearly illustrate the patient problem as well as request any volunteer who may wish to assist in taking care of the young Samara and Jenny before her recoveryin casethe husband is not willing to help his family. Nevertheless, Jenny is required to set achievable and short-term goals as they will make iteasy for the nurse to find different best ways of treatment required for treating Jenny to minimize seizures, nausea and generally minimize running-down of the patient. The goals will also help also be of benefit to the patient as she will not develop financial distress. Avoiding thedevelopmentof financial stress will mean that Jenny will be treated collaboratively with the ways she may accept which she can easily manage (Moshe, Perucca, Ryvlin and Tomson, 2015). As a result, the primary nurse would promote personal control and enhance recovery by keeping Jenny active while her motivationis maintained alongside her social life. Besides, achievable long-term goals will help Jenny and increase her connection with husband and fellow workers, thus, eliminating loneliness and social isolation. But reflection and evaluation are necessary as they will rejuvenate and empower Jenny to achieve her goals. Besides, achieving goals will encourage and promote self-awareness and self- awareness since identification of own strengths and weaknesses is at ease (Ostendorf and Gedela,2017). To maintain the care plan for the complex priorities, the primary nurse should always revisit the initial stage of CRC in collecting new cues, new issues identification and theestablishmentof new goalsin case of any changes of Jenny’s physical, emotional and social health conditions. In conclusion, the analysis of this essay hasbeen basedon two chosen complex care priorities. The planning care has entailed the patient’s complex combinations such as seizures that lead to various other infections such as the change in general behavior and head nausea.However, the proposed care
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NURSING ASSIGNMENT5 plan and analysis for the two complex care priorities has been actively enhanced through the use of CRC, holistic, person centered-care and principles of collaboration which has justified and addressed the complex care priorities. These include the chronic seizures and Jenny’s loneliness alongside social isolation as he lives alone with a young two-year-old girl and worries about her life with seizures along with her daughter.Thus, in collaboration with Jenny and the rehabilitation unit team, all care has been planned to attain and increase the benefits of the patient’s health care.
NURSING ASSIGNMENT6 References Bonello, M., Michael, B. D., & Solomon, T. (2015). Infective causes of epilepsy. InSeminars in neurology (Vol. 35, No. 03, pp. 235-244). Thieme Medical Publishers. Chang, E., & Johnson, A. (2014). Chronic illness and disability: Principles for nursing practice. Sydney: Sydney: Elsevier Health Sciences APAC. Daaleman, T. P. (2018). The Long Loneliness of Primary Care. Retrieved from http://www.annfammed.org/content/16/5/388.full Devinsky, O., Marsh, E., Friedman, D., Thiele, E., Laux, L., Sullivan, J., ... & Wong, M. (2016). Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial.The Lancet Neurology,15(3), 270-278. DeVon, H. A., Rice, M., Pickler, R. H., Krause-Parello, C. A., & Richmond, T. S. (2016). Setting nursing science priorities to meet contemporary health care needs.NursingOutlook,64(4), 399-401. Holt-Lunstad, J., & Smith, T. B. (2016). Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry. Levett-Jones, T. (2018).Clinical reasoning: Learning to think like a nurse. Melbourne, Victoria: Pearson Australia. Moshe, S. L., Perucca, E., Ryvlin, P., & Tomson, T. (2015). Epilepsy: new advances.The Lancet,385(9971), 884-898. Ostendorf, A. P., & Gedela, S. (2017). Effect of Epilepsy on Families, Communities, and Society. In Seminars in pediatric neurology(Vol. 24, No. 4, pp. 340-347). WB Saunders. Sazgar, M., & Young, M. G. (2019). Seizures and Epilepsy. InAbsolute Epilepsy and EEG Rotation Review (pp. 9-46). Springer, Cham. Schloesser, R. J., Orvoen, S., Jimenez, D. V., Hardy, N. F., Maynard, K. R., Sukumar, M., ... & Martinowich, K. (2015). Antidepressant-like effects of electroconvulsive seizures require adult neurogenesis in a neuroendocrine model of depression.Brain stimulation,8(5), 862-867. Urden, L. D., Stacy, K. M., & Lough, M. E. (2019).Priorities in critical care nursing. Elsevier Health Sciences.