Nursing Priorities in Chronic Disease

This essay discusses the nursing priorities for patients with chronic diseases, focusing on the case of Jenny Peterson, who has epilepsy. It explores the medication process, nursing care models, and necessary health care policies for managing chronic diseases. The importance of building a positive relationship with the patient and considering their mental health is emphasized. The essay also highlights the need for holistic care policies and the use of different health care models in chronic disease assessment.

Running head: NURSING PRIORITIES IN CHRONIC DISEASE
NURSING PRIORITIES IN CHRONIC DISEASE
Name of the Student
Name of the University
Author Note

1NURSING PRIORITIES IN CHRONIC DISEASE
Chronic diseases are the kind of illnesses that do not disappear quickly and cannot
be cured only by medication or vaccination. A chronic disease persistently affects the health
condition of a patient at least for three months (Chang & Johnson, 2018). Therefore, proper
care should be provided to these patients with the help of professional nurses. Epilepsy is
one of the chronic diseases that affect mostly the elderly and young people. In this following
essay the epileptic condition of Jenny Peterson who has been recently found experiencing
seizure attacks and as a single mother her disease puts pressure over the financial situation
as well. Hence, this essay will discuss about the proper nursing priorities for her health care.
The medication process and the nursing care models would also be discussed in the essay
to identify the necessary health care policies of this disease.
Jenny Peterson is a single mother who lives in a suburb with her daughter and works
in a hotel as a receptionist. Her husband is not supportive of her in both the way that is
emotionally and financially; however, Jenny's parents are supportive enough to her and lives
two suburbs far from her residence. One car accident sent Jenny to the intense care unit of a
hospital, and after that she was sent to a rehabilitation facility. After three months she faced
her first seizure, and her diagnosis leads to find her epileptic condition, and she was
medicated with Sodium Valporate. The nurse should have the proper knowledge of these
medicines and the doses of use of these medicines in epilepsy (Bryant & Knights, 2018). At
first, her seizures were under control; however, with time it got uncontrollable; thus she took
sick leave from her workplace and working on her treatment. Jenny and Samara found to
have a several cold, nausea and other residual diseases in this period. Though Samara is
now in good health condition, Jenny is not well and tired with occasionally nauseous
feelings. Her concern is about future of Samara as she is left with almost no sick leave and
her health condition would not let her join to work, and she is about to go out of money. In
Jenny's case it can be seen epilepsy a chronic disease could not be cured or controlled by
medication thus the health care professionals should be able to take other health care
measures to avoid further seizure attacks of Jenny. This disease severely affected Jenny’s
mental health as well as the financial condition gets worse with time, and thus she wanted to
stop her medication and start working again for Samara’s future.
A nurse should consider patient’s situation, gather and evaluate information, identify
the patient’s problem, set care plans and take action on the basis of that planning and lastly
evaluate the outcome and reflect on the learning and new experience, all these factors are
co-related and termed as the Clinical Reasoning Cycle OR CRC (Croft et al., 2018). CRC
would be helpful in the critical analysis process of Jenny’s situation for the nurse.

2NURSING PRIORITIES IN CHRONIC DISEASE
Here the nurse appointed for Jenny's health care should prioritize her health first to
avoid any future adverse conditions and also to prevent her seizure attacks the nurse should
consider her mental states. In order to lessen Jenny's seizure attacks the nurse should try to
decrease her depressions of life and maintain a relationship with her. This could gain her
trust and help her to open up about herself with her nurse, and it could help her know her
and help the nurse to take measures for Jenny's health care. Trust gaining would be a key
factor by which the nurse gathers information about Jenny to further care planning in
accordance with CRC. It also creates a positive effect on Jenny's mind that could help
lessen her depression and negativity that causing the seizure attacks more and more (Guzys
& Petrie, 2017). The nurse should also support her family with positive conversations so as
to establish a positive impact over them which could be the foundation of Jenny's positive
mindset build up as well.
The nurse should also be able to maintain and prioritize the privacy of the patient as
well as respect to the patient's dignity is one of the health care priorities. This would be
helpful in the relationship build up between the nurse and Jenny. The nurse would also
prioritize the self-respect of Jenny as she is a single mother and these factors would be the
foundation of the relationship. Moreover, in Jenny's case, she needed to be observed in a
daily or more effectively hourly observation is required as she faces seizure attacks often.
Jenny takes the Sodium Valporate 200 mg and Lamotrigine 200 mg daily to sustain against
these seizure attacks, and the nurse should prioritize her medication process as well to
prevent her seizure attacks and maintain a healthy condition of Jenny (Lubkin & Larsen,
2018). Samara and Jenny also faced several residual diseases in this period of Jenny's
seizure attacks; thus it could be an added concern for the health care professionals for the
treatment process. The nurse should also consider the health condition of Samara along
with Jenny as Jenny is unable to look after Samara in her recent state properly. In addition to
this concern the nurse should be able to evaluate the situation of Jenny and plan the care
process which is the part of her learning in the CRC system. In order to maintain all these
factors the nurse should be experienced and maintain the nursing standards of Nursing and
Midwifery Board of Australia and that are standards for practice, codes of conduct and codes
of ethics (Nursingmidwiferyboard.gov.au, 2019). In Australia, the Government use the
Primary Health Care model which depends on the five factors such as preventive,
rehabilitative, promotive, supportive and curative (Health.gov.au, 2019). In order to maintain
all these factors, the nurse needs to consider the relationship factor as well.
On the other hand for the proper medication of Jenny, the nurse needs to have
pharmacological knowledge, as well as the emergency conditions, need first actions with

3NURSING PRIORITIES IN CHRONIC DISEASE
appropriate medication and other primary pharmacological strategies as well. In order to
maintain Jenny's good health and to prevent her seizure attacks the nurse needs to develop
knowledge about her daughter as well and also needed to prioritize her health condition to
avoid adverse impact over Jenny's mental health. According to Josephson et al., (2017)
depression and negative thought process have a significant effect over the epileptic seizure
attacks; thus these factors should be avoided for these patients. However, the
pathophysiological aspects of these two different age group patients are different, hence the
nurse should be able to intervene the different aspects of their illness and proper care and
medication as well (McCance et al., 2018).
All these factors would be justified by introducing another factor of nursing that is the
holistic care policies. The spiritual aspect of health care needed to consider in this case as
the holistic care consider the physical and mental health of a patient along with the spiritual
aspect of care. Spiritual conversation puts a great impact and thus plays a crucial role in
mental health development as well. However, the proper holistic care policies is not a regular
practice within the nurses and according to NHS Australia the holistic care policies needed
to be incorporated in the nursing education (About.healthdirect.gov.au, 2019).
There are several legislative acts and regulations in Australia found in terms of
proper health care for the Australian personnel. All these acts needed to be properly
maintained by the health care professionals as well. Health and Other Services Act 1995,
Aged Care Legislation Amendment Act 2016, Australian Hearing Services Act 1991,
subsections 8(4) to 8(8) and other legislation established by the Government of Australia in
the field of proper health care management (Health.gov.au, 2019). All these legislative acts
needed to maintain in terms of appropriate health case of Jenny as well by the nurse to keep
healthy policies and the trust with Jenny (Forrester & Griffiths, 2015).
The nurse should also use different health care models in accordance to improve the
health conditions of Jenny. Primary Health Care model is one of the most useful health care
models; however, the use of Primary Health Care would not suffice in terms of Jenny's
condition as she faces a mental condition more than a physical one. According to NIH, the
Primary Health Care does not deliver proper care in terms of mental or psychological illness,
and thus the Four Quadrant Clinical Integration Model is more useful in mental illness as it
considers both the psychological and physical condition in context to deliver proper care
(Nimh.nih.gov, 2019). This health care model deals with the behavioral state and physical
state of the patient, and it is more effective than the Primary Care model.
The nurse should be able to learn and evaluate Jenny’s case with the steps of CRC
as he/ she would gain trust of Jenny by prioritizing her health condition, proper medication

4NURSING PRIORITIES IN CHRONIC DISEASE
and positive conversation along with prioritizing her mental state. After that the nurse should
be able to gather information of Jenny to plan a better health care process
(Nursingmidwiferyboard.gov.au, 2019). In this case the proper planning would be prioritizing
her and her daughter’s health. Positive conversations would be helpful in her mental health
development. The nurse need to evaluate the outcome that is all these factors lessening
Jenny’s seizure attacks or not and plan based on that evaluation.
As a nurse I need to contemplate on that evaluation and gather experience from this
situation and use this experience to my future patients. The knowledge would help me to
analyze and take primary decisions in critical conditions. It will also help me in creating
relationship with my patients and thus improve my health care abilities in this kind of chronic
diseases. In this manner the CRC system would be helpful for me to develop knowledge
about these critical conditions of different patients.
Based on the above discussion it can be concluded that the nurse should consider
the effects of depression over the patient's mental condition and thus the epilepsy prevention
must avoid negative conversations. The positive relationship between the nurse and the
patient is one of the most useful aspects of health care in chronic disease such as epilepsy.
However, the inclusion of different health care models other than the Primary Health Care
model in chronic disease assessment is needed in Australian health care institutions as well.
The holistic care policy is also one of the factors that should be integrated into the health
care process. In the case of Jenny's epilepsy all these factors should be prioritized by the
nurse in terms of prevention of her seizure attacks. The nurse should maintain all these
factors and devise a proper planning for Jenny’s health care in accordance with the Clinical
Reasoning Cycle.

5NURSING PRIORITIES IN CHRONIC DISEASE
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