Nursing Patients with Acute Illness Case Study 2022

Running head: NURSING PATIENTS WITH ACUTE ILLNESS
NURSING PATIENTS WITH ACUTE ILLNESS
Name of the Student:
Student ID:
Name of the University:
Date of Submission:
Author note:
Word Count: 1043 words excluding titles, cover page and references
Chosen Scenario: Case Study A

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Introduction
The following essay will demonstrate on the role of the nurse and interprofessional care
team for the case study of Wendy, the potential impacts on her family and care staff as a result of
hospitalization and discharge and therapeutic interventions and referrals which can be considered
for management of the same.
Question 1
Part A
Upon reading the case, one immediate potential impact of hospitalization to Wendy is a
change in personality, as a result of the progressive metastasis of her brain cancer. Bran cancer or
any tumor in the brain has been evidenced to result in a host of behavioural symptoms and
changes in personality, such as reduced memory or difficulty in recalling or speaking certain
words or incidences, increased irritability and confusion, blurring of vision or reduced sensory
capabilities in terms of tasting, smelling and hearing, vomiting and nausea, fatigue or weakness,
reduced consciousness or seizures and feelings of drowsiness (Bolt, Baylor, Burns & Eadie,
2018).
Such symptoms are a prevalent adverse consequences associated with brain cancer and
occurs as a result of increased intercranial pressure. Increased intercranial pressure occurs as a
result of blocked flow of cerebrospinal fluid or excessive space occupied by the brain tumour
(Chandran & Perugu, 2019). Additional reasons which contribute to such symptoms of brain
cancer include treatments like chemotherapy or radiotherapy, symptoms of depression or
deficiencies of certain nutrients in the body (Vega, Dumas & Newhouse, 2017). From the case

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study, it can be observed Wendy’s husband has reported repeated incidences of forgetfulness and
aggressive or non-compliant behaviour from his wife. Indeed, health professionals of her care
team have also warned Wendy’s family of the imminent possibility of personality changes in her
due to the fatal progression of her brain cancer. Additionally, Wendy’s condition of nutritional
deficiency is also demonstrated by her hypoglycaemic symptoms. Hence, such carcinogenic and
nutritional factors will result in an immediate potential impact of personality changes, aggressive
behavior and forgetfulness due to hospitalization in Wendy further contributing to possibility of
non-compliance to treatment and harmful consequences in terms of aggression or violence
directed towards herself or the staff of her care team.
Part B
One appropriate member of interprofessional team who can be engaged to support the
impact of personality changes identified in Wendy is a nutritionist. It is worthwhile to consider
that in addition to the health effects of brain cancer, Wendy is also affected by an abnormal drop
in her blood pressure. Considering that glucose is the only nutritional component to overcome
the blood brain barrier for utilization of the brain, personality, behavioural and cognitive changes
in Wendy due to combined effects of cancer and hypoglycaemia is not uncommon (Shrestha,
Shrestha, Prajapati, Karkee & Maharjan, 2017).). Further, cancer results in abnormalities in
metabolism and hence leads to increased hunger, weakness, deficiencies, catabolism and
cachexia in the affected individual (Martinez-Outschoorn, Peiris-Pages, Pestell, Sotgia & Lisanti,
2017).
Hence, from the above, it can be postulated that the role of a nutritionist is of utmost
importance in the interprofessional care team for Wendy. The nutritionist will have multiple
responsibilities of not only addressing the metabolic demands Wendy requires to fulfill due to

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her cancer, but also mitigating her symptoms of hypoglycaemia along with brain tumor
associated symptoms of personality changes. Thus, the nutritionist must work collaboratively
with Wendy’s general practitioner, oncologist and registered nurse in formulating and delivering
a diet adequate in simple carbohydrates and high in proteins, calories and fat to mitigate her
hypoglycaemia and cachexic symptoms (Aoyagi, Terracina, Raza, Matsubara & Takabe, 2015).
Additionally, the nutritionist must work collaboratively with Wendy’s neurologist in formulating
and administering a diet rich in fatty fish, colourful fruit and dark green leafy vegetables to
combat her personality changes. This is because nutrients like B vitamins, polyunsaturated fatty
acids and antioxidants (omega 3 fatty acids, resveratrol), have been evidenced to yield beneficial
cognitive effects which are abundant in the above diet (Woolf, Syed & Scheck, 2016). The
registered nurse (RN) for Wendy must ensure that therapeutic interventions are met through
consultation and collaboration with members of Wendy’s interprofessional team as per
competency standard 2.5. Additionally, considering that Wendy belongs to an ethnically diverse
family, the registered nurse must also ensure that interventions implemented and formulated for
Wendy are compliant to her cultural preference as per standards 4, 5 and 9 of the Nursing and
Midwifery Board of Australia (NMBA) (Nursing and Midwifery Board of Australia, 2019).
Question 2
From the discharge details of Wendy, the health professionals associated with her
interprofessional team have clearly enlightened her family on her critical stages of cancer and the
high possibility of personality changes. It is already known that Wendy’s husband is the sole
carer of Wendy at home and despite receiving advice on respite care, Wendy prefers to adhere to
her family tradition and shift to her daughter’s home as an alternative. Considering that

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possibility of personality changes and loss of her independence due to her chronic condition, one
impact of discharge after hospitalization and Wendy going home is increased strain on Wendy’s
husband and Brigit as the main carers. With progression of cancerous symptoms it is likely that
Wendy’s husband and her daughter will feel increasingly pressurized emotionally, socially and
possibly even financially while providing long term care at home (Bolton & Isaacs, 2018).
Hence, the RN must comply with standard 6.4 and provide appropriate referrals which
may be helpful for Wendy’s family (Nursing and Midwifery Board of Australia, 2019). The RN
in this case can provide Wendy’s family a referral for Residential Respite Care. As postulated by
the Department of Health, the residential respite care worker – a health professional approved by
the Aged Care Assessment Team (ACAT) can provide care for Wendy at her home itself, and
hence, in the process, provide assistance and mitigate the pressures which Wendy’s husband and
her daughter may encounter. The respite care worker can deliver residential care as per the time
duration and cultural considerations preferred by Wendy’s husband and her daughter’s family.
Conclusion
Hence, this paper clearly demonstrates the multidisciplinary role of the care team
allocated for patients with illnesses like that of Wendy’s. Collaborative work by the nurse and
the nutritionist coupled with a referral of a residential respite care service in alignment of cultural
preferences can be useful in mitigating the impacts of discharge and hospitalization on Wendy.

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References
Aoyagi, T., Terracina, K. P., Raza, A., Matsubara, H., & Takabe, K. (2015). Cancer cachexia,
mechanism and treatment. World journal of gastrointestinal oncology, 7(4), 17. doi:
https://dx.doi.org/10.4251%2Fwjgo.v7.i4.17.
Bolt, S., Baylor, C., Burns, M., & Eadie, T. (2018). “I would have told you about being forgetful,
but I forgot”: the experience of cognitive changes and communicative participation after
head and neck cancer. Disability and rehabilitation, 1-9. doi:
https://doi.org/10.1080/09638288.2018.1514535.
Bolton, G., & Isaacs, A. (2018). Women’s experiences of cancer-related cognitive impairment,
its impact on daily life and care received for it following treatment for breast
cancer. Psychology, health & medicine, 23(10), 1261-1274. doi:
https://doi.org/10.1080/13548506.2018.1500023.
Chandran, S., & Perugu, S. (2019). Chemo brain–The need to defog the cognitive offshoot of
chemotherapeutics. Medical Journal of Dr. DY Patil Vidyapeeth, 12(3), 286. doi:
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Gibbons, P. A. (2017). The Lived Experience of Chemo Brain in Early Stage Breast Cancer in
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Martinez-Outschoorn, U. E., Peiris-Pages, M., Pestell, R. G., Sotgia, F., & Lisanti, M. P. (2017).
Cancer metabolism: a therapeutic perspective. Nature reviews Clinical oncology, 14(1),
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Nursing and Midwifery Board of Australia. (2019). Nursing and Midwifery Board of Australia -
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https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx.
Shrestha, J. T. M., Shrestha, H., Prajapati, M., Karkee, A., & Maharjan, A. (2017). Adverse
effects of oral hypoglycemic agents and adherence to them among patients with type 2
diabetes mellitus in Nepal. Journal of Lumbini Medical College, 5(1), 34-40. doi:
https://doi.org/10.22502/jlmc.v5i1.126.
Vega, J. N., Dumas, J., & Newhouse, P. A. (2017). Cognitive effects of chemotherapy and
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Psychiatry, 25(12), 1415-1426. doi: https://doi.org/10.1016/j.jagp.2017.04.001.
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hydroxybutyrate: novel approaches to adjuvant brain tumor therapy. Frontiers in
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