Case Study Assessment: Health Variation Running - University Name

This case study analysis examines health variations, focusing on the administration of Pethidine for pain management, the pathophysiology and implications of Crohn's disease, and the use of Hartmann's solution for fluid and electrolyte balance. The analysis covers nursing responsibilities before, during, and after Pethidine administration, emphasizing patient safety, adherence to NMBA guidelines, and legal and ethical considerations. It explores the causes and effects of Crohn's disease, including intestinal stricture formation, and the rationale for using Hartmann's solution. The case study highlights the importance of thorough patient assessment, monitoring for adverse reactions, and providing appropriate care. The document references several sources to support the analysis and provides a comprehensive overview of the health variations presented.

RUNNING ; CASE STUDY ANALYSIS
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TASK
CASE STUDY ASSESSMENT

HEALTH VARIATION
Question 1
Pethidine drug is used for analgesic purposes to manage sever pain during preoperative
medication especially for the patient in the case study. Its administration is facilitated through
subcutaneous, intramuscular or slow intravenous pathways.
A. Nursing responsibilities before Pethidine
According to NMBA, (2018), nurses should always practise professionalism, ensure
safe practice of medication, acting professionally and promoting health and well being. In
administering Pethidine drug for the patient, a nurse must ensure that there is a complete
assessment of contraindications of the drug to the patients. Further she/he should read
carefully the labels and exercise care.
Rationale
Most often adverse effects associated with Pethidine are huge with effects on the
respiratory and linked to hypotension. Other adverse effects associated include nervous
system, headaches, agitations, anxiety and various forms of aggressions. There is need for
safe practices when handling the drug is paramount.
B. Nursing and legal aspects during Pethidine medication
As a nurse, there is need to check on the rights of medication, confirm on the sign order
of the medical officer before administering the drug. Further for maintaining patient records,
administer the drug in presence of another registered nurse. Further, as a nurse in practicing
safety of the patient, document all the drug administration on the chart and inform the MO in
case of abnormal reactions. The nurse should administer the drug ethically best of ability.
Effective responsibility is to ensure good judgement and proper action in drug administration
Rationale
This is in line with the NMBA guidelines on mandatory reporting, the nurse should
ensure that all the documentation is recoded and kept. As a nurse they need to ensure that
Nurses commit to teaching, supervising and assessing students and other nurses in order to
develop the nursing workforce across all contexts of practice. For any drug administration it
must have well thought plan and research to enhance patient safety.
C. Nursing responsibility after Pethidine administration
After drug administration to nurse should ensure that there are adverse reactions which
arise from the patient. Effective patient assessment and regular observation is necessary. This
is geared to NMBA principle 7 of promoting the overall well being of patient.
Rationale
The rationale of these actions is that nursing action on drug administration leads to
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HEALTH VARIATION
recovery process of the patient , it is long process which ends in patient recovery. Thus
assessing contradictions of the drug and progress is key to the patient.
Question 2
Chrohn’s disease is often dilapidating and incurable causing severe inflammatory
disease of the bowel. It affects the mucosal ulceration and inflammation which occurs along
the gastro intestinal wall, (Prideaux et al, 2012). It is with this alteration of the GI lining that
causes ineffective of food absorption leading to poor food absorption in the body. This in
turns leads to weight loss to the patient.
The disease further leads to discontinuous, and transmural bowel inflammation on the
thickness of the bowel walls which leads to lymphoid aggregates and development of
granuloma. The occurrence of stricture in these patients occurs due to the long standing
associated inflammation of the bowel, (Moledecky et al, 2011). This intestinal complication
leads to the devolvement of the stature on the patient.
Chrohn’s disease cases have exhibited intestinal stricture which have thickening of wall
layers which causes extracellular matrix and increase in the size of mesenchyma cells. Its
path physiology however is complicated in the manner they arise due to prolong
inflammation and fibrosis development which leads to stitures, (Kassem et al, 2011).
Question 3
Administration of Hartmann’s solution
Hartmann’s solution is appropriate for replenishing body fluid and mineral salts which
might be lost in the body. It is suitable for patients who have tested blood presence in the
blood. In this case the patient has suffered from Chrohn’s which has caused severe ileum
obstruction leading to limited absorption of fluids in the body.
Contra indications of Hartmann’s solution administration include presence of heart
disease, pregnancy, breast feeding or any allergic reaction on its use. The prescription for the
patient indicates intravenous injection of the solution within six hours.
Rationale
The basic rationale for administration of this drug to the patient is the assessment of the
lab results which gives the doctor a confirmation of its usage. The loss of the body fluid
which has been shown indicates the patient has lost large amounts of body fluids which need
to be replenished.
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HEALTH VARIATION
References
Kassem, R.R., Abdel-Hamid, M.A. and Khodeir, M.M., 2011. Effect of lyophilized amniotic
membrane on the development of adhesions and fibrosis after extraocular muscle surgery in
rabbits. Current eye research, 36(11), pp.1020-1027.
Molodecky, N.A., Soon, S., Rabi, D.M., Ghali, W.A., Ferris, M., Chernoff, G., Benchimol,
E.I., Panaccione, R., Ghosh, S., Barkema, H.W. and Kaplan, G.G., 2012. Increasing
incidence and prevalence of the inflammatory bowel diseases with time, based on systematic
review. Gastroenterology, 142(1), pp.46-54.
Nursing and Midwifery Boarad of Australia, (NMBA), online http:
http://www.nursingmidwiferyboard.gov.au/, accessed on 29/03/2018.
Parente, J.M.L., Coy, C.S.R., Campelo, V., Parente, M.P.P.D., Costa, L.A., da Silva, R.M.,
Stephan, C. and Zeitune, J.M.R., 2015. Inflammatory bowel disease in an underdeveloped
region of Northeastern Brazil. World Journal of Gastroenterology: WJG, 21(4), p.1197.
Prideaux, L., Kamm, M.A., De Cruz, P.P., Chan, F.K. and Ng, S.C., 2012. Inflammatory
bowel disease in Asia: a systematic review. Journal of gastroenterology and hepatology,
27(8), pp.1266-1280.
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