DTH107 Determine Health: Care Action Plan - Case Study Analysis

This DTH107 assignment presents a case study requiring the analysis of a patient's health information and the development of a care action plan. The case focuses on Rob Carrington, a 53-year-old male with Type II Diabetes, obesity, and other health issues. The assignment involves identifying acute and chronic conditions, analyzing affected body systems, understanding normal anatomy and physiology, recommending diagnostic tests, and proposing conservative medical care interventions. The student addresses questions related to Rob's symptoms, potential diseases, and the impact of medical and surgical treatments, demonstrating an understanding of pharmacological processes and interdisciplinary team roles. This comprehensive analysis provides a structured approach to managing Rob's health issues, emphasizing both medical and lifestyle interventions.

DTH107 Determine Health Assessment 1: Case Study – Care Action Plan
Assessment 1 Care Action Plan
Subject Title DTH107 Determine Health
Unit of Competency HLTAAP003 Analyse and respond to client health information
Performance Criteria,
Knowledge and
Performance Evidence
Assessed
PC: HLTAAP003: 1.1-1.4, 2.1-2.3
PE: HLTAAP003: 1
KE: HLTAAP003: 1, 2a-c, 3a-m, 4a-b, 5, 6, 7, 8, 9, 10, 12, 13a-c, 14a-c
Title of Assessment Task Assessment 1: Case Study
Length 1000 words +/- 10%
For this assessment, students must view ONE (1) case study and respond to a care action plan . This
action plan requires analysis and care planning and is based on the following diagram.
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TH107 Determine Health Assessment 1: Case Study – Care Action Plan
Remove
surgical interventions
Care Action Plan: Scenario
For this action plan, students must view the following case study and follow this step to determine how
to manage Rob’s issues. His specifications are noted here.
Name: Rob Carrington
Gender: Male
Ethnicity: Caucasian
Australian
Aged: 53 years
Family Status: Father
Religion: Anglican
• Married
• Occupation – Delivery driver
• Earns good money
• Travels a lot
• Overweight 135kg
• Likes TV and beer to cope with stress
• Has Type II Diabetes needing close management for job
• Smoker
• Diet preferences are Convenience foods/ fast food
• Unknown social support and external interests
• Has c in L) knee
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The steps in the action plan for Rob Carrington are listed on the following pages. At each step, there are a
number of questions you must respond to. Questions 1-14 relate to Rob’s situation.
Read these questions and take note of the information or actions that need to be addressed at each step.
Then, respond in the spaces provided.
Step 1 Definition of Health Disorder
Question 1
Rob has presented with a number of issues and
symptoms; some of which are acute, some of
which are chronic. In the table below, list which
items are either chronic or acute.
Acute Issue Chronic Issue
hypoglycemia Osteoarthritis in L knee
Urinate Type II Diabetes
Unintended weight loss Nerve damage
Question 2 Of Rob’s issues, which should be dealt with first;
acute or chronic? Explain why in 50 words.
Response... That is very important to first dealt with the acute
symptoms of the Rob issues because acute can
become chronic due to the lack of care and
intervention. So in order to prevent the
development of other chronic health condition
associated with type 2 diabetes that is important to
address Robs acute problems like urination, weight
loss and hypoglycaemia first.
Question 3
List five (5) body systems that are affected by Rob’s
situation, and briefly note their purpose or
function. Related to Robs chronic/ acute presenting
issues.
Referencing required
Response... Five body system which get affected by the Rob’s
situation or health condition of type 2 diabetes are
eyes(visual system), heart (circulatory system),
nerves (nervous system), feet and kidneys (urinary
system).
Eye function- Is to identify the sense of light and
formulate several non-image photo response
function, through people can see. In context to the
Rob eye can not make the sharp vision due to the
muscular edema.
Heart function- Pumping the oxygenated blood into
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the other body part. Type to diabetes affects the
normal heart function by damaging the blood
vessels due to the high blood sugar and increasing
the blood pressure.
Nerves function- To transmit signals and enable
body senses. Type 2 diabetes damage the nerves,
due to the higher blood sugar and interferes with
the ability of signals signal transmission.
Feet function- Type 2 diabetes damage nerves and
lead to the diabetic neuropathy, pain and lose
feeling of feet.
Kidneys function- Remove waste and extra fluid
from the body and due to the Rob type 2 diabetes,
kidney function get affected , such as prevention of
filtration by damaging the blood vessels.
Step 2 Normal Anatomy and Physiology
Question 4 For three (3) of the body systems affected by Rob’s acute issues, list two (2) signs or symptoms
that might indicate there might be a variation from normal function. Referencing required
Response... Circulatory and cardiovascular systems get affected by the hypoglycaemia of the Robs.
Kidney system get effected by the urination problem. respiratory system get affected by
low weight. The signs and symptoms which indicate variation of these body system from
the normal function are stroke, and coronary artery disease, Muscle cramps and swollen
feet due to fluid retention, pulmonary fibrosis and pneumonia.
Question 5 The body consists of different levels of structural organisation and complexity. In 100
words, describe how each of the following items combine to make up the human body.
In your response, specify what the different types of muscle tissue are and how human
body systems are formed at a cellular level.
Referencing required
• Atoms- 99% human body composed of 6 elements oxygen, carbon, hydrogen,
nitrogen, calcium, and phosphorus are involved in human body. 0.85% composed
of potassium, sulfur, sodium, chlorine, and magnesium.
• Molecules- Carbohydrates, lipids, proteins, and nucleic acids
• Cells- red blood cells, whit blood cells,
• Organs- Brain, skin, lungs,liver,bladder, kidneys, heart, stomach, intestines.
•
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• Muscle tissue- Skeletal, smooth and cardiac.
• Human Body systems- Integumentary system, skeletal system, muscular system,
lymphatic system, respiratory system, digestive system, nervous system,
endocrine system, cardiovascular system, urinary system, and reproductive
systems. All these above evaluated atoms combine to form molecules, it farther
combine to from cells, cells combine for tissue, tissue combine to form organ,
organ combine to from body system and organ system combine to form
organisms.
Response... Ward, L.C., 2018. Human body composition: yesterday, today, and tomorrow. European
journal of clinical nutrition, 72(9), pp.1201-1207.
Step 3 Physiology
Question 6
For each body system below, describe:
One (1) disorder or disease that may affect it
The pathophysiology of the disease associated with the body
system (20 words each system)
The impact of the disease on the body system and their
related structures in relation to potential impact of specific
health procedures provided (30 words each).
Referencing required
Brown, J.M., Scarlett, J.M. and Schwartz, M.W., 2019.
Rethinking the role of the brain in glucose homeostasis and
diabetes pathogenesis. The Journal of clinical investigation,
129(8), pp.3035-3037.
Body System Potential Disease Pathophysiology of Disease Impact of disease on body system
Endocrine system Diabetes
mellitus
This is caused due to the distraction of
the insulin producing pancreatic beta
cells. It lead to the high blood glucose
Frequent urination, blindness
Sudden vision changes, numbness
in the hands or feet etc.
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level and damage of the body organs
which further lead to the stroke, and
problems with the kidneys, eyes, gums,
feet etc.
Musculoskeletal
system arthritis
Arthritis Dysregulated inflammatory processes in
the synovium of the joints, which
eventually leads to the destruction of
both cartilaginous and body element of
the joints.
Pain and disability.
Special Senses
Colour
blindness
This mostly cased by the diabetes,
because blood sugar level damage the
retina.
Vision loss
Nervous system
Diabetic
neuropathy
Higher blood glucose level increase the
damages of nerve cells and lead to the
loss of sensation.
Pain and numbness in legs.
Respiratory
system
Asthma Due to the diabetes kidney function get
affected and lead to the backup of the
body fluid into the heart and lung and
lead to the shortness of breath or
asthma.
Swelling of the airways.
Cardiovascular
system
Stroke Diabetes lead to the thickness of the
blood due to the higher blood sugar and
blockage of the blood vessels due to
which blood pressure increase and lead
to the haemorrhage of the blood
vessels.. weakness or paralysis on one
side of your body
Weakness or paralysis on one side
of body.
Question 7
ROB has type 2 diabetes. In 50 words discuss the process of
carbohydrate metabolism, including your understanding of
anabolism and catabolism.
Referencing required
Response...
carbohydrate metabolism is involving the glycolysis, Krebs
cycle, and the electron transport chain. Carbohydrate
metabolism is stimulate by the influence of insulin, through
which cell observes the blood glucose and breakdown that
into the energy (ATP). Anabolism and catabolism are the
two key mechanism of the metabolism. These mechanism
work together to produce and energy and repair cells. In the
type 2 diabetes health condition of the Rob carbohydrate
metabolism is cannot take place properly due to the lake of
stimulation by insulin.
Brouns, F., 2018.
Overweight and diabetes
prevention: is a low-
carbohydrate–high-fat diet
recommendable?. European
journal of nutrition, 57(4),
pp.1301-1312.
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Step 4 Diagnostic Tests
Question 8 List three (3) methods you could use as an enrolled nurse/ within your scope of practice
to assess Rob’s abnormalities, and briefly describe each one.
Response... Funduscopic examination- This is the diagnosis by visualisation of the retina as it helps to
assess the patient health condition by the analysis of blood pressure, diabetes,
increased pressure in the brain and infection.
Neurologic examinations- This is the evaluation of the patient nervous system and
divided into eight components, with the help of which Rob’s abnormalities is can be
assess completely. As it involve the evolution of mental status, spine, cranial nerves,
motor, coordination and reflexes etc.
Foot assessment- This assessment use to classify foot type as well as identification of
the possible etiological factors relating to injury in order to properly prescribe
therapeutic interventions.
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Step 5 Prognosis
Question 9
In 150 words,
9A: Define the acute event that Rob is presenting with.
9B. The effects it has on the various body systems. Include potential signs and symptoms.
9C. The impact this could have on wellbeing and Rob’s health.
Referencing required
Response... 9A- The acute event Rob is presenting are hypoglycaemia, urination and weight loss.
These are the common acute symptom identifies with type 2 diabetes. Hypoglycaemia
occur due to the prevention of carbohydrate metabolism, which caused by the insulin
stimulation of the body cell to use carbohydrate for energy. Urination is due to the
failure of kidney function. And weight loss is due to the prevention of development of
body muscles due to the lack of energy and ATP production.
9B- These acute condition impact the respiratory, circulatory and urination system.
Symptoms are shortness of breath, higher blood pressure and UTI.
9C- All these acute condition impact the well-being of Rob by increasing stress, irritation
and difficulty in daily activities.
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Step 6 Conservative Medical Care
Question 10
Rob may need both conservative medical and surgical
treatment. For each intervention (medical and
surgical) specify:
• What the impact would be to Rob (20 words)
• One (1) relevant pharmacological process
and one (1) drug action
• One (1) potential indication and one (1)
potential contraindication
• The role of one (1) member of the
interdisciplinary team that might be required
• One (1) limitation of each member
• Referencing required
Medical Treatment
Impact to Rob
Surgical and medical treatment can impact
Rob in both positive terms with some health
improvement outcome and some risk. This
can increase postoperative morbidity and
mortality.
Discuss one
medication related
to Robs presenting
issue for medical
treatment, its
Pharmacological
process and action.
Refer to your e-MIMs
Metformin improve the blood sugar level
by improving the management of insulin.
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Medication
Indication and
contraindication
Metformin continued as long as it is well
tolerated and not contraindicated.
Interdisciplinary team
member role
It to make the effective care of Rob with
patient centred approach, collaborative
function and team relationship,clear goal
and communication with the diversity of
expertise.
Limitation of
interdisciplinary team
member
Conflict, lack of collaboration in team and
financial instability of patient.
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Step 7 Nursing Care Plan
Question 11
Based on your analysis of Rob’s
health information, you must
now prepare a nursing care plan
that demonstrates your
understanding of appropriate
care and consideration of his
needs.
Fill in the template below, noting
four (4) issues Rob has and how
you will manage each one. Do
not complete the final column
(Discharge Plan), as it will be
clarified in Step 9.
Referencing maybe required
Nursing Care
Plan
Nursing Diagnosis
(Note the issues you
have diagnosed in
Rob)
Rationales Multidisciplinary
member’s provide
support
Nursing interventions
(How should it be
treated?)
Expected Outcomes
(What do you expect after
treatment?)
Discharge Plan
hypoglycemia This
intervention is
important
because this
help to
frequently
address the
challenge of
hypoglycaemia
endocrinologist Glucose-elevating
agents.
Normal blood
glucose level.
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Frequent
urination
Strengthen
your pelvic
floor muscles,
which support
bladder.
Urologists Kegel
exercises
Control on the
urination.
Unintended
weight loss
Healthy diet is
involving the
essential
components of
the nutrition
and body
composition
which help to
manage the
healthy weight.
General
practitioners,
dieticians
Healthy diet. Normal body
weight.
osteoarthritis Self care is
essential
because this
help to
prevents the
further
complications
and
nonsteroidal
anti-
inflammatory
medications are
essential
because this
helps to
manage acute
pain of the OA.
GP, practice
nurses,
physiotherapists
nonsteroidal anti-
inflammatory
medications and
self care.
Decreased joint
pain and stiffness.
Step 8 Potential Complications
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Question 12
Describe the effects of biological maturation and ageing
processes on the body systems related to Robs
presentations (acute/ chronic) as discussed in the case
study.
Referencing required
Response... Biological maturation and aging process ensure
related to the type 2 diabetes acute and chronic
symptoms, because due to the biological maturation
individual resistance to the insulin get increase and
function of the pancreatic islet impaired. Lead to all
these complication. Diabetes also have grater
decline in functional status and muscle loss with
aging.
Shin, J., Pelletier, S., Richer, L., Pike,
G.B., Gaudet, D., Paus, T. and
Pausova, Z., 2020. Adiposity related‐
insulin resistance and thickness of the
cerebral cortex in middle aged adults.‐
Journal of neuroendocrinology,
32(12), p.e12921.
Question 13
Revised question:
Rob has suffered a cardiac arrest. In 150 words explain:
13A: The major types of cardiac adaptation
13B: How does a cardiac event affect the cardiac muscles/ tissues?
13C: Explain the changes a cardiac event has on the heart?
13D: How could physical exercise increase the strength of the cardiac muscles?
Referencing required
Response... 13A- The major type of the cardiac adaption
involving the increase of total body water, plasma
volume expansion, better sustainment, evaluation of
stroke volume and reduction in hart rate.
13B- Due to cardiac cardiac arrest heart muscle lost
the blood supply and begin to suffer injury. The
amount of the damage of the heart muscles depends
on the size of the area supplied by the blocked artery
and the time between injury and treatment.
13C Heart may become weak, and unable to pump
as much blood as usual. With proper treatment and
lifestyle changes after a heart attack.
13D-Due to the exercise, increases in cardiac stroke
volume and heart rate raise cardiac output, such as
increase in systemic vascular resistance, elevate
mean arterial blood pressure .
Szablewski, L., 2017. Glucose
transporters in healthy heart and in
cardiac disease. International journal
of cardiology, 230, pp.70-75.
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Step 9 Discharge Planning
Question 14
Discharge planning should form
part of a care plan. For the four
(4) issues you specified in Step 7,
provide a discharge plan that
includes:
• The
appointments that
should be made for
the client upon
discharge • The
information or
documentation that
should be provided
• The healthcare
professionals who
should be involved.
Do not fill in the greyed out
boxes.
Nursing Care
Plan
Nursing Diagnosis
(Note the issues you
have diagnosed in
Rob?)
Actual Potential Implementa
tion
Expected
Outcomes
Discharge Plan
(List what should be done to prepare the client for
discharge)
Hypoglycemia Discharge appointment to educate patient
about self care. 24-hour phone number
for emergencies, information related to
reason of hospitalization, important
findings, procedures and treatment
provided, patient discharge condition and
patient family instructions. Asian self care
instructions along with the eating pattern,
medication administration direction etc.
Social worker, nurse and case manger.
Urination Family education and patient education
for key interventions of the care to
prevent frequent urination. Good personal
Hygiene guide. Professionals should be
involved during discharge are social
worker and nurses.
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DTH107 Determine Health Assessment 1: Case Study – Care Action Plan
Weight loss Appointment with physician and other
participants of the care plan to guide or
educate patient about self care. Good
nutrition, physical activity and behaviour
modification guide and instructions to
family and patient.
Osteoarthritis Follow-up appointment to see the doctor,
review of the medication and direction of
its administration is very important in
discharge planning. The nation of the key
physical activities for reducing the joint
pain moderate-intensity aerobic activity,,
vigorous-intensity aerobic activity.
Orthopedists are surgeons a d nurse along
with social worker should involve in
discharge planning.
Question 15
In 50 words, describe homeostasis and the relationship between homeostatic imbalance
and disease.
Response... Homoeostatic is the process of self regulation, this is the condition of optimal
functioning of the body. Such as healthy blood pressure, temperature, water level etc.
homoeostatic imbalance like decrease of the insulin secretion , higher blood sugar etc.,
which lead to the type 2 diabetes and aging. Example of the homeostatic imbalance
relationship with disease is that disease causes the homeostatic imbalance and lead to
the physical changes as aging.
Step 2 Physiology
Question 16
For each body system below, describe:
One (1) disorder or disease that may affect it
The pathophysiology of the disease associated with the body
system (20 words each system)
The impact of the disease on the body system and their
related structures in relation to potential impact of specific
health procedures provided (30 words each).
Referencing required
Body System Potential
Disease
Pathophysiology of Disease Impact of disease on body
system
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Urinary System
Urinary tract
infection
There are the multiple potential mechanism
through which diabetes cause the urinary
tract infection, such as it increase the blood
glucose level which promotes the growth of
bacteria. Diabetes also a the immune system
introduced capability of urinary tract to
prevent bacterial growth.
Enlarged prostate gland and
kidney stone.
Lymphatic
System
thoracic duct
lymph flow.
Type 2 diabetes causes the thoracic lymph
flow by damaging the lymph nodes, due to
the higher blood sugar and high blood
pressure.
infections, or compression or
invasion of lymph nodes by
tumours.
Special Senses
Diabetic
peripheral
neuropathy
Blood vessels due to the high blood sugar
level become damage and lead to the
damage of Nerve , due to which patient
develop the disease called diabetic
peripheral neuropathy. Due to that cannot
feel legs and hands.
tingling or numbness in a
certain body part to more
serious effects, such
as burning pain or paralysis.
Along with the legs and feet
damage.
Digestive system
Gastroparesis
Type 2 diabetes lead to the damage to the
vagus nerve. Which control the movement
of food through the digestive system due to
its damage food cannot move to the
digestive system and remain at the stomach
cause gastroparesis.
Cause nausea, vomiting and
abdominal pain.
Integumentary
system
digital
sclerosis
Type 2 diabetes cost in damage of blood
vessels and nerves vessels due to the higher
blood glucose level, for the lead to the
stiffening and thickness of the skin in hands
and finger.
Connective tissue, and
internal organs, also impact
the other body systems,
such as lungs, kidney,
gastrointestinal tract etc.
Reproductive
system
Sexual
dysfunction
Diabetes can damage the blood supply to
the penis and the nerves that control an
erection.
Cause premature
ejaculation, or it may cause
pain.
Immune system Autoimmune
disease.
Insulin resistance may be the result of
immune system cells attacking the body’s
tissues. with type 2 diabetes, these cells
may mistakenly attack healthy tissue.
Damage of the other body
organs and connective
tissues.
Tumminia, A., Vinciguerra, F., Parisi, M. and Frittitta, L., 2018. Type 2 diabetes mellitus
and Alzheimer’s disease: Role of insulin signalling and therapeutic implications.
International journal of molecular sciences, 19(11), p.3306.
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Question 17
In 50 words explain the process of osmosis including osmotic and hydrostatic
forces.
Referencing Required
Response...
The osmotic pressure is the pressure generated through the diffusion of the water across a
membrane. When the compartment pressure, into which water is flowing is raised to the equivalent of
the osmotic pressure and the movement of water will stop then this pressure is call as hydrostatic
pressure.
Yamauchi, Y., Blonskaya, I.V. and Apel, P.Y., 2018. Osmosis in Negatively Charged Nanocapillaries and Its
Enhancement by an Anionic Surfactant. Colloid Journal, 80(6), pp.792-802.
Step 4 RENAL ACIDOSIS and ALKALOSIS
Question 18
A UTI presents with ketones, blood, nitrates and leucocytes
In 50 words, explain the process of renal acidosis and alkalosis and what effect this has
on the pH of the blood.
Referencing required.
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DTH107 Determine Health Assessment 1: Case Study – Care Action Plan
Response... Renal acidosis process is prevention of the removal of acids from the blood into the
urine through kidneys. The situation at which level of the acid in blood become too high,
is called as acidosis. This excess of the acid in the blood causes changes in the pH to fall
below 7.35.
Process of the Renal alkalosis is enhancement of the hypokalemia, proximal bicarbonate
re-absorption. Decrease in the carbon dioxide level or increase in bicarbonate level is
called renal alkalosis. This process rice the pH above 7.45.
Slater, T.A., Waduud, M.A. and Ahmed, N., 2021. Pocketbook of Differential Diagnosis E-
Book. Elsevier Health Sciences.
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DTH107 Determine Health Assessment 1: Case Study – Care Action Plan
Additional Health Information Knowledge
Questions 19- 21-29 are not specifically linked to the care action plan you completed above. However,
they relate to a range of healthcare information that you, as a healthcare professional should know in
order to provide appropriate care to you clients.
Question 19
For each of the issues below:
Give an example of what the issue could be
Note two (2) body systems that could be affected
Explain the impact on each body system
Referencing required
Preshaw, P.M. and Bissett,
S.M., 2019. Periodontitis
and diabetes. British dental
journal, 227(7), pp.577-584.
Issue Example Two (2) Affected Body Systems Impact on Body System
Diving emergency
barotrauma Lungs (respiratory),
gastrointestinal tract
(digestive) system.
Dizziness, positive pressure ventilation.
Tissue damage
Charcot Nervous and immune
system.
Weakness in feet and legs.
Altitude emergency
Nausea Digestive and
reproductive system.
Hormonal changes and motion sickness
Temperature
exhaustion
emergency
heatstroke Repertory and kidneys
system.
breathing may become rapid and shallow.
decline in kidney function is part of that
abnormality in metabolic systems related to
heat stroke. Break down of the muscles tissue
which results in the kidney failure.
Overdose or
poisoning Emergency
Empagliflozin
Overdose
(burning,
itching, odor,
discharge,
pain,
tenderness
etc).
Digestive and nervous
system.
Response... Confusion, vomiting and stomach
pain
Skin penetration
wound
Open sores
and wounds
and blister.
Skin and immune system. reduce the ability of the skin to heal itself,
lower limb amputations, disability.
Blunt object wound
Blunt
traumatic
injur.
Liver and kidney. Injury of the liver and kidney.
Question 20 In 20 words, for each response, address the below points:
• Explain the difference between molecules and compounds
• Describe metabolism and the two processes it involves
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DTH107 Determine Health Assessment 1: Case Study – Care Action Plan
• What is pH?
• How does respiratory acidosis occur?
• What is alkalosis and how is it prevented?
• Referencing required
Point to Address Response
Molecules and compounds Molecules form due to the combination of two or more atoms and compounds are
formed by the combination of two or more elements.
Metabolism Metabolism is the life sustaining biochemical process breakdown food nutrition into
the essential components of body function. The two process involve in metabolise is
anabolism and Catholicism.
pH Scale sue to specify acid or base.
Respiratory acidosis When the lungs do not remove the all of carbon dioxide from the blood then it lead
to the higher level of the acid in blood and consider as Respiratory acidosis .
Alkalosis Lack of the chloride or potassium lead to the higher level of base in the body called
as Alkalosis . Medication supplement.
Serova, O.V., Gantsova, E.A., Deyev, I.E. and Petrenko, A.G., 2020. The Value of pH Sensors in
Maintaining Homeostasis of the Nervous System. Russian Journal of Bioorganic Chemistry, 46(4), pp.506-
519.
Question 21
For each of the body processes described below, specify the type of transport it relates
to, using this list.
Passive-Simple diffusion
Active transport
Passive- Facilitated diffusion
Osmosis
Hydrostatic pressure
Type of Transport Process
Osmosis The passage of water molecules down the concentration gradient across a
semipermeable membrane.
Active transport Sodium potassium pump: The movement of sodium ions from a lower concentration
inside the cell to a higher concentration outside the cell, with the assistance of ATP.
facilitated diffusion
Cellular metabolism requires glucose, a large molecule. The cell provides glucose-specific
carrier proteins that bind to glucose molecules and allow them to enter the cell from a
higher to lower concentration.
• Passive-
Simple
diffusion
Gas exchange at the alveoli: Oxygen is exchanged from the air to the blood and carbon
dioxide from blood to air.
• Hydrostatic
pressure
The force exerted by blood against the walls of the blood vessels by the pumping action
of the heart.
Reference List (APA):
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