Nursing Case Scenario for Health Care Professionals

Explore nursing case scenarios and their solutions for different age groups and demographics. Learn about primary health care, occupational health nurses, community nurses, and more. Get expert advice from Desklib.

Running head: NURSING CASE SCENARIO
Nursing case scenario
Name of the student:
Name of the university:
Author note:

1NURSING CASE SCENARIO
Table of Contents
Scenario 1:..................................................................................................................................3
Question 1a:...........................................................................................................................3
Question 2:.............................................................................................................................4
Question 3:.............................................................................................................................4
Scenario 2:..................................................................................................................................4
Scenario 3:..................................................................................................................................7
Scenario 4:..................................................................................................................................9
Infant (0-1yrs):.......................................................................................................................9
Children (1-11yrs):.................................................................................................................9
Adolescents (10-19yrs):...........................................................................................................10
Adults (20-65yrs):................................................................................................................10
Older People (65 + yrs):...........................................................................................................11
Scenario 5:................................................................................................................................11
Question 1:...........................................................................................................................11
Question 2:...........................................................................................................................12
Question 3:...........................................................................................................................13
Question 4:...........................................................................................................................13
Scenario 6:................................................................................................................................13
Question 2:...............................................................................................................................14
Question 3:...........................................................................................................................15

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Question 4:...........................................................................................................................15
Scenario 7:................................................................................................................................16
Question 1:...........................................................................................................................16
Question 2:...........................................................................................................................16
Question 3:...........................................................................................................................16
Question 4:...........................................................................................................................17
Question 5:...........................................................................................................................17
Question 6:...........................................................................................................................17
Question 7:...........................................................................................................................17
Question 8:...........................................................................................................................18
Question 9:...........................................................................................................................18

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Scenario 1:
Question 1a:
Biological:
 Biological approach takes into consideration all the biological factors associated with
health or the lack thereof (Sallis, Owen and Fisher 2015).
 The biological model of health attempts to discover the physical manifestation of the
disease or the illness. In this case, William, the patient in the case study had been
suffering from paediatric eczema.
 The eczema was apparent from the red and cracked patches on his skin.
Biomedical:
 The biomedical model or approach to health takes into consideration both physical
and biological aspect of health or illness (Sallis, Owen and Fisher 2015).
 The biomedical context when applied to the caseof William, the red and cracked skin
he had been exhibiting can be due to the eczema or skin infection that he might be
having.
 The crankiness and crying can be due to the illness and the fact that his mother had
been exhausted herself and sick.
Behavioural:
 The behavioural approach on the other hand focuses on exploring the behavioural
manifestation of the illness (Sallis, Owen and Fisher 2015).
 In this case the crankiness and crying is one such manifestation William had been
exhibiting which indicates at his ill health.

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 He also had challenging behaviour which had been challenging for his single mother
Ellen to manage on her own due to his building illness.
Question 2:
Primary health care can be defined as the first level of care for the consumers and is
also the kind of care services which is provided outside of the hospital setting. However, the
definition of primary health is an optimal state of healthy living with the complete absence of
any diseases. As per the definition provided by the World Health organization, health is ‘a
state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity’ (Who.int 2018). In this case, three socio-economic factors, physical
environment, economic standing and biomedical state, contribute to William’s illness. Due to
Ellen being a single mother to 4 children with no income, proper care was not being given to
William. With four children and only one sick mother to look after, the physical environment
had not been very nurturing as well, which further aggravated his medical illness, the eczema.
Question 3:
 First and foremost, maternal and child welfare agencies can provide resource
oriented support to the family and enhance access to privileges
 Government funded child protection schemes and child care packages can
help them ease the financial strain (Brady and Perales 2016).
 As they are living alone, the aid of a community support worker living with
them can be of extreme help.
 Proper education and vocational training to Ellen can better equip and
empower her to care for her family better.
Scenario 2:
Occupational health nurse:

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 The occupational health nurse works in the community groups to provide
health and safety services or programs. The discipline is focussed on health
restoration, health promotion, illness or injury prevention, hazard protection in
both occupational and environmental context (Anmf.org.au 2018).
 Their role in crucial in facilitating or promoting the onsite occupational health
program of an organization.
 These nurses provide specialist health and safety advice, injury management,
first aid, and emergency care.
Community nurse:
 The community nurse provides a combination of different nursing practices, including
public health, primary health, and health promotion.
 These nurses work in community settings across lifespan to remove barriers and
promotes health of the community (Anmf.org.au 2018).
 Along with illness management and promoting health, community nurses also
empower people to undertake healthier lifestyle as well.
School nurse:
 School nurses are also known as the primary school nurses that provide primary
health care and management to the school aged children belonging to the age group of
5-12.
 They work in the school settings in both government and privatized sectors.
 They mainly engage in clinical care, health counselling, health promotion, and
community development activities in school, disseminating health information, and
general health care referrals (Anmf.org.au 2018).
General Practice (GP) Doctor:

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 The practice in the general practice setting and provides primary health care
 They provide preliminary diagnosis and entry level care and management.
Occupational Therapist:
 They provide health promotional practice and occupational or environmental
hazard management
 They practice in both community and organizational sectors (Anmf.org.au
2018).
Aboriginal Health Worker:
 They mainly practice in the aboriginal community care setting
 They provide primary health care and advice in a culturally safe manner
Podiatrist:
 Podiatrists mainly practice in the health care facilities and also often in
community specialist care scenario
 They provide diagnosis, and medical or surgical treatment of disorders of the
lower extremities (Anmf.org.au 2018).
Physiotherapist:
 A physiotherapist practices both in community care and health care
organizations.
 They provide care to improve the range of motion to patients recovering from
injury or are disabled
Dietitian:

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 They are an integral part of the health care industry and they practice in
community and general practice setting
 They provide nutritional advice and help in dietary habit change (Anmf.org.au
2018).
Interpreter:
 They practice in the aboriginal or culturally diverse practice
 They provide assistance as cultural liaison for aboriginal and native patient
with language barrier
Social Worker:
 They mainly practice in the community setting ‘
 They engage in providing emotional, psycho-social and financial support
Dentist:
 They practice in both community and health care organization setting
 They provide primary, secondary and even tertiary care in oral health issues
(Anmf.org.au 2018).
Psychologist:
 They practice in both community and health organization setting
 They provide mental, emotional and cultural support
Scenario 3:
The community demographics that I have chosen for this particular scenario is the
aboriginal communities living in the rural and coastal parts of Australia. There is mounting
evidence that suggests that the disparities in the health status and the life expectancy of these

8NURSING CASE SCENARIO
aboriginal communities are far higher, which can be attributed due to the social, economic
and environmental issues (McMullen, Eastwood and Ward2016).
The environmental issue which has been illustrated many times in literature is the
contamination of the water resources that the aboriginals living in rural and remote regions
live in. It has to be mentioned that the water resources accessed by these communities are
extremely high, especially with bacterial and heavy metal contamination (Clifford et al.
2015). As the most of the aboriginal communities are dispersed across remote and very
remote regions of Australian with very limited or scanty resources, the impact of water
pollution is very high.
Exploring the impact of the water contamination on their health, it has to be
mentioned that the contamination has been attributed to both bacterial and heavy metal
originated. As discussed by the Clifford et al.(2015), the disease biomarkers that have been
identified includes the cytokines such as TNF-α and cardiovascular markers such as VCAM-
1. The diseases that have been attributed to be caused by the contamination includes
Diarrhoea, myocarditis, Lower respiratory tract infections, Bronchiectasis, Anaemia,
Cognitive decline, Cerebrovascular disease, diabetes, kidney diseases, cancer, infectious
diseases, obstructive lung diseases, and cardiovascular or coronary arterial diseases.
There is lack of any infrastructure for heavy metal remediation in the very remote
regions of the Australia, however, for the bacterial contamination, UV and chlorine treatment
have been introduced. Although, due to the lack of proper policy initiative and government
effort, there has not been enough initiatives to effective maintenance of the water resources or
even the contamination relieve activities even (Clifford et al., 2015). There is need for better
policy development and change to focus on introducing the various type of contamination
relief initiatives and infrastructure. Along with that, the policy makers will also have to focus

9NURSING CASE SCENARIO
on periodic maintenance of the programs to ensure frequent water purification for these
communities (Clifford et al., 2015).
However, policy reform awareness and education must not surpass the need for
awareness and education for the communities. The water borne diseases need a particular
range of health preventative and promotional activities which is needed to be promoted in
these settings by the community health care providers to enhance their awareness (Melody et
al., 2016). Precautionary measures such as boiling drinking water before consuming it,
filtering the water using sieve cloth, having electrolytes when experiencing diarrhoea, and
seeking immediate health care for deterioration of symptoms are a few topics that need to be
integrated in the patient education for the target group.
Scenario 4:
Infant (0-1yrs):
 This particular patient group experiences issues such as cold, asthma, gastroenteritis,
and hand foot or mouth diseases
 Apart from the above mentioned, other common disorders include conjunctivitis,
impetigo, and allergies (Hockenberry and Wilson 2018).
 Along with that, for communities with lower socio-economic standards and reduced
quality of living, the chances of lice, worms, and warts are also common.
 Depending on the harsh geographical conditions, asthma and skin disorders such as
rash or eczema can also occur.
Children (1-11yrs):
 The most common health issues for this pre-schooler and school aged children is cold,
cough and ear infections.
 Another very common disorders affecting these groups is diarrhoea and vomiting.

10NURSING CASE SCENARIO
 Different allergies, such as to pollen, mould, dust mites, certain food items, clothing,
medicines, insect bite and latex develop across this age span.
 For lower SES, infection due to different parasites such as head lice, measles, chicken
pox, meningitis, bronchitis, whooping cough, worms, whooping cough are also
common (Hockenberry and Wilson 2018).
Adolescents (10-19yrs):
 The health issues of the adolescents changes with the changes in their behaviour and
biology.
 Mental health problems, depression, violence, and even suicide becomes a priority
health issue for this age group.
 Other than that for rural and remote regions, infections such as UTI and other
infections heighten (World Health Organization 2014).
 For lower SES, alcohol and substance issues, HIV, and early pregnancy are also
common issues.
Adults (20-65yrs):
 The most common health issue is obesity, diabetes, and hyperlipidaemia.
 As the population ages further coronary arterial disease, renal diseases and diabetic
retinopathy enhances.
 Respiratory diseases, cancer and influenza or pneumonia can also occur (Chatterji et
al. 2015).
 Although, there are no demographic or SES oriented categorization for these age
groups, lower access to health care and literacy aggravates the risks.

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Older People (65 + yrs):
 This is the population that has aged considerably and is in the last phase of life with
several health issues.
 The age derived conditions such as arthritis, osteoporosis, and age derived retinal
degeneration are common
 Neurological disorders due to gradual brain atrophy leads to Alzheimer’s, dementia,
delusions and Parkinson’s disease as well (Chatterji et al. 2015).
 There are no demographic or SES oriented categorization for this age group as well,
lower access to health care and literacy aggravates the risks.
Scenario 5:
Question 1:
Biological:
 Biological approach takes into consideration all the biological factors associated with
health or the lack thereof (Sallis, Owen and Fisher 2015)\
 For George, the angina that he has developed for prolonged history of smoking is a
health issue
 He will need medical attention for his angina and possibility of coronary
complications
Biomedical:
 The biomedical model or approach to health takes into consideration both physical
and biological aspect of health or illness (Sallis, Owen and Fisher 2015).
 Under biomedical context, the impact of his smoking has aggravated his coronary
arterial health risks.

12NURSING CASE SCENARIO
 He also poses risk of respiratory disorders as well.
Behavioral:
 The behavioural approach on the other hand focuses on exploring the behavioural
manifestation of the illness (Sallis, Owen and Fisher 2015).
 The behavioural approach states his smoking and sedentary lifestyle which is staple
for indigenous populations is a considerable risk.
 The behavioural characteristics of lack of help seeking behaviour are also a
considerable risk here.
Question 2:
 The philosophical underpinnings of Primary Health Care define health as a optimal
state of emotional physical psychological social and cultural health devoid of any
anomalies. As mentioned by the definition of World Health Organization as well
health is nothing but a state of complete mental physical and social well being rather
than being just the absence of disease.
 In this case join is in a bowler Gentleman of 55 years who lived in a remote rural
location of Ceduna and had been a long term chain-smoker experiencing chest pain
which had been recognized as angina (Lee et al. 2015).
 Angina is a very acute pain that cardiac patients experience which exhibits a strong
cardiovascular health risk.
 Along with that considering his aboriginal background his medical condition and the
Health Care that he will have to access can also be overall emotional and socio
cultural burden on his health.

13NURSING CASE SCENARIO
Question 3:
 Access is a very important issue for aboriginals hence in this case the strategy will be
to educate and empower the patient regarding his rights of accessibility and free of
cost services that he is eligible for.
 In order to ensure equity in the care provided to him the next strategy should be
incorporating cultural safety.
 The cultural appropriate that should also consider the input of his family and language
interpreters along with cultural liaison officers.
 Lastly in order to empower the patient extensive patient education regarding
suggestion of smoking and improvement of his cardiac health should be given in a
culturally safe manner (Lee et al. 2015)
Question 4:
The clinical assessment that I will be carrying out for charge as a nurse in the service
will include ECG total blood count tests and arterial blood gas tests. Followed by the
assessment I will educate the patient on the presenting health risks and how it can be
recovered and prevented followed by which I will refer him to a cardiac specialist within the
service.
Scenario 6:
Biological:
 According to the biological model Joram had been suffering from Type 1 Diabetes
along with post traumatic stress disorder which are the two key health issues he is
suffering from.

14NURSING CASE SCENARIO
 The Type 1 Diabetes with Glucose level on 12.6 maol is a grave health risk for him
requiring immediate interventions.
 Along with that his psychological health issue which is post traumatic stress disorder
can also complicate is recovery and is a contributing factor to his illness.
Biomedical:
 Biomedical approach only considered by logical and physical manifestations of the
disease.
 Here the first health issue is Type 1 Diabetes which is caused due to the high Glucose
level 12.6 mmol leading to the Juvenile diabetes.
 Another issue is the post traumatic stress disorder which can be caused by his past
trauma and suffering (Arevalo‐Rodriguez et al. 2015).
Behavioral:
 Behavioral health model on the other hand takes into consideration the psycho social
and emotional response associated with the disease.
 In this case is passed hardships and trauma which is further activated by the loss of
family members along with his younger sister has left his PTSD which will further act
as a challenge.
 Along with that the language barrier will also act as a constable challenging health
issue for his Type 1 Diabetes and PTSD Management.
Question 2:
 The philosophical underpinnings of Primary Health Care define health as a optimal
state of emotional physical psychological social and cultural health devoid of any
anomalies. As mentioned by the definition of World Health Organization as well

15NURSING CASE SCENARIO
health is nothing but a state of complete mental physical and social well being rather
than being just the absence of disease.
 In this case the patient is suffering from both mental physical and emotional illness
which will require a Holistic approach to health.
 Both PTSD and Type 1 Diabetes are priority health risks for the patient.
 His traumatic past the onset of depression and sell farming tendencies can also be
severe risk for the patient (Arevalo‐Rodriguez et al. 2015).
Question 3:
 The first strategy for the patient will be too focus on the accessibility of health
services that he can take advantage of while being in Australia.
 In order to ensure accessibility the strategy should be too educate and inform the
patient his guardians regarding health services that He can access without a cost.
 In order to ensure equity the patient should be referred to Child Protection agency is
and child welfare organizations.
 To empower him he should be educated regarding how to invest manage his diabetes
and his PTSD.
Question 4:
The assessments that I will be carrying out for him will be blood glucose test along with a
mental State examination. Followed by the assessments I will recommend or refer him to
pediatric diabetic experts and psychotherapists for assistance. Along with that I will educate
him regarding diabetes management PTSD management and how to prevent depression in a
Language assisted manner (Creavin et al. 2016).
Scenario 7:
Question 1:
Biological:

16NURSING CASE SCENARIO
 Hypertension
 Weight loss
 Insomnia and disorientation
Biomedical:
 High blood pressure at 165/105
 PR 105
 Weight loss and disorientation and insomnia.
Behavioral:
 Bereavement stress
 Low and flat mood
 Social withdrawal
Question 2:
 A lot of factors contributed to the illness of the patient.
 The death of her husband and her son is a major contributing factor to her illness.
 Age and her mental state together and acting on her present state of disease or illness.
Question 3:
 Ensure Elise understands aged care services that she can access along with
community support (Creavin et al. 2016).
 Educate Elise on different community engagement activities that she can engage to
cope with loss and depression.
 Provide assistance in heart disease management in medication management.

17NURSING CASE SCENARIO
 Mental health care services for her possible neurological disorders.
Question 4:
The assessment will be carried out for her includes neurological assessment such as
Mini mental State examination, mental health assessment for her grief and depression, and
her blood pressure and coronary assessment including an electrocardiograph (Creavin et al.
2016). I will advocate heard on the edit care services that cannot receipt of your health needs
and will refer to a community home setting which can offer her the services that requires.
Question 5:
 Neurologist: for dementia or delirium
 Occupational therapist: for her social withdrawal
 Psychotherapist: depression
 Nutritionists: malnutrition and weight loss
Question 6:
Confusion is a state that the patient does not understand the basic difference between
certain things and dementia is a clinical neurological disorder associated with brain atrophy
and delirium (Pugliese et al. 2014).
Question 7:
Her family and relatives to ensure a family centred optimal care for her (Brooker and
Latham 2015).
Question 8:
 Patient education
 Medication management

18NURSING CASE SCENARIO
 Community support 24/7
 Psychosocial support (Pugliese et al. 2014)
Question 9:
 Dementia support assistance
 Medication management with reminder routine
 Ensure proper ADLs and proper personal hygiene
 Religion assisted mental support services such as dementia Australia


19NURSING CASE SCENARIO
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