NRSG258: Case Study Analysis of Patient with Multiple Disorders

This report presents a detailed case study analysis of a patient diagnosed with prostatic hyperplasia (BPH), chronic obstructive pulmonary disease (COPD), and type 2 diabetes. The aetiology and pathophysiology of the patient's conditions, including the impact of tobacco use, blood sugar levels, and previous surgery (TURP) are discussed. The report examines the patient's vital signs, symptoms, and potential complications, emphasizing the importance of understanding the patient's condition for effective nursing management. It also covers the role of nurses in monitoring the patient post-surgery, including the assessment of vital signs, pain management, and nutritional support. The report further explores the application of the airway breathing circulation disability approach. Finally, it highlights the contributions of an inter-disciplinary healthcare team, including physicians, nurses, pharmacists, dieticians, and psychiatrists, in improving the patient's mental and physical health. Specific roles of a drug and alcohol counselor, a dietician, and a psychiatrist are also discussed, emphasizing their support in patient recovery and overall well-being.

TASK 1 NRSG258

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY ..................................................................................................................................1
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Case study has shown that patient is suffering from prostatic hyperplasia (BPH) which
includes signs like problem or pain in urine generation, infection in lower part. Service user is
also diagnosed with COPD and type 2 diabetes. Symptoms of these diseases may include
shortness in breathe and pain in chest. After suffering from these disorders patient can be seen
with conditions like restless, hopeless and exhausted. Aetiology related to this disease can be
inability to empty gall bladder and no continuous flow of urine. Pathophysiology after suffering
from hyperplasia can include conditions like exhausted, dizziness etc. It can be because of
advancing age. Essay will include the patient present situation and will also discuss the members
of inter-disciplinary health-care team which are involved in providing care to individuals
(Ballantyne, Kalso & Stannard, 2016). Appropriate nursing management used in improving
wellness of patient will also be included in written material.
MAIN BODY
Aetiology and pathophysiology of patient's present conditions
For improving patient's present conditions nurses need to have clear understanding of
signs and symptoms of defining situation of patient. Medical records of Peter reveals that service
has been suffered from chronic obstructive pulmonary disease and type 2 diabetes. It has been
analysed that COPD may be occurred in patient due to habit of consuming tobacco. Blood sugar
level may be increased in body because of consuming liquor or genetic disorder. Service user has
also undergone a surgery for trans-urethral resection of the prostrate (TURP) under spinal
anaesthesia (Bryant & Knights, 2015). This syringe is usually given to obese patients. Reason
for overweight in patient may be because of poor diet or high consumption of alcohol. Problem
or pain in urination can be the symptoms for this disease.
Peter's temperature has been noted at 35 degree Celsius which indicates that patient is not
suffering from fever. Blood pressure rate is measured at 100/60. This shows that user has been
diagnosed with low BP. Nausea or vomiting can be the sign which indicates patient is at risk of
developing this disorder. Pulse of service user has been shown at 128 breathe per minute which
is quiet abnormal (Brown, Purdon & Van Dort, 2011). This is because of the factor that Peter is
suffering from hypertension. Peter has a respiratory rate of 30 bpm that is considered as quiet
high. These problems may be occurred in patient as peter is suffering from COPD and Diabetes.
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Patient suffering from this can be seen with deep breathing and coughing. More symptoms which
can be seen in an individual due to these disorders are weakness, drowsiness, vomiting, hopeless,
restlessness. It has also been noted that main cause of developing these diseases are stress
whether emotional or pressure at work place.
Reason for these vital signs after post operation
Service user has also been seen with issue related to irrigation in urinary bladder and
urine outflows contains blood in it. Causes may be fluid and electrolyte imbalance or renal
failure. Symptoms may include pain in stomach, nausea, vomiting fast heart or respiratory rate.
Following poor diet, consumption of harmful substances like drugs and physical inactivity can
also be the major reason for this disease. This issue in older male can develop problems like
prostrate. These diseases may occur due to advancing age. It has also been noted that Peter has
also undergone IV therapy via peripheral line which includes transfer of nutrients to vein through
syringes or catheters (Bullock & Hales, 2013). This medical aid can be provided to service user
when they are suffering from hypertension.
Critical discussion of patient pathophysiology and nursing management
Peter has been undergone a trans-urethral resection of the prostrate (TURP) due to
outflow of blood clots in urine. It may occur because of loss in erection or advancing age.
Generally this type of disease is seen patient of older age. This disorder can make a person
extremely weak or even seen with symptoms like nausea, vomiting, chronic pain, restlessness
and hopelessness. Medical record of service user has revealed that for surgery physician has
given spinal anaesthesia to peter. After, surgery it might happen that user is been seen with side
effect of this medicine. Respiratory and circulatory failure may be seen due to this. Study says
that if ever error occur in providing this pain reducing injection to patient it directly occurs in
death.
Changes and effect after surgery
To improve Peter's condition nurses can play an active role while performing all their
duties and responsibilities. After undergoing surgery patient has been transferred to post
anaesthesia recovery room (Bullock & Manias, 2017). Carers have the duty to monitor service
user over there. They must ensure that individual has no problem related to breathing. Keen
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assessment should be done by health-care professionals about problems like nausea, stomach
ache, chronic pain and vomiting. All the information regarding temperature, pulse, respiratory
and heart rate, fluid outflow, blood pressure, pain scale should be recorded and manage by
nurses. Any changes if seen in patient's mental and physical condition should be immediately
address. Nursing management should be effective and efficient as there might occur changes that
after surgery user is seen with changes like pain muscles, vomiting, dehydration etc.
Peter can only become healthy if proper nutrition is provided to patient by health-care
providers. As after therapy individual might feel weak. Nurses can help in promoting nutrients in
diet of service user by serving appropriate proportion or desire of food, giving them healthy diet
containing more amount of vegetables and fruits (Chiew & et.al., 2015). Reasons for following
poor habit of eating of patient may be because of living alone, isolation or due to stress. Effective
pharmacology should be given by nurses as after taking anaesthesia patient might face issues like
sore throat, clumsiness and confusion. They should have a keen understanding about the adverse
events which might occur in patient after surgery (How to reduce the risk of deterioration after
surgery, 2017).
Airway breathing circulation disability approach
To improve health conditions of service users, nurses may also make use of airway
breathing circulation disability approach. In this process health-care providers have the
responsibility to completely assess patients in order to have keen understanding of their disease.
They can see the sign of airway obstruction where changes in chest of individual occurs (Sng,
Tan & Sia,2014). Signs and symptoms of suffering from this may include confusion and
consciousness. Breathing model may include signs which show shortness in breathing of user
which might be because of Peter has a history of suffering from COPD. Circulation of urine
should be properly noted by nurses in order to reduce problem related to prostrate. Disability can
occur in form of wounds which might not heal because of diabetes.
Role of inter-disciplinary health-care team in improving condition of patient
Multidisciplinary team which includes physicians, nurses, pharmacist, dietician, carers,
psychiatric etc. can also support patient in improving their mental and physical conditions.
Workforce are expected to have keen understanding and awareness about the problem through
which peter is going (Harsten & et.al., 2015). This will help them in providing better support to
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patient and builds a healthy relationship between them. Other than nurses the specialist who can
provide assistance to service user may include drug and alcohol counsellor, dietician and
psychiatrist. These experts can help in enhancing the health conditions of patient.
Three specific member of inter-disciplinary team
Drug and alcohol counsellor can provide help in a way to Peter by allowing service user
to limit the use of liquor, cigarette smoking and drugs. It can help in making patient aware about
the disadvantages of consuming harmful substances. This specialist can provide them with
therapies like meditation which can help Peter in reducing use of liquor or cigars. They provide
them motivation and encouragement in order to achieve early recovery for people suffering from
this addiction. Support can be also be provided in way as they can refer them groups which can
help service user in limiting use of alcohol.
Multidisciplinary team also involves dietician which can allow patient to have a proper
and healthy diet full of nutrients. They can help them in providing food which comprises lots of
vegetables and fruits (Basques & et.al., 2015). These experts can also encourage patients to
participate in physical activities in yoga, dance and aerobics. Dietician helps in assessing and
monitoring the problems related to consumption of nutritional diet. They can also provide
counselling associated with effective diet to patients which can support in preventing disease and
promote health condition of service user.
Medical record of Peter shows that patient is been suffering from various disease. There
might occur chances that service user is seen with problems like anxiety, depression, restlessness
,fatigue etc. Psychiatrist can provide help to them in these situations. They can give emotional
and friendly support so that Peter can share thoughts, beliefs and information related to treatment
(Lim, Choo & Tan, 2014). These specialist can encourage and motivate patients that there
disease is curable. This will lay a positive impact on health and mind of service user. It can also
help in facilitating growth of service user.
CONCLUSION
This is to summarise that essay consists of aetiology and pathophysiology related
patient's disease. Peter has been diagnosed with several disorders like diabetes, COPD, prostrate
and causes of these disorders may include following poor diet, obesity, consumption of alcohol.
Further, assignment also includes role of effective nursing management. This shows that carers
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should continuous monitor and assess patient after anaesthesia surgery. Service user might have
seen with problems like vomiting, nausea, chronic pain, allergies after therapy. Essay also
includes role of dietitian, alcohol and drug counsellor, psychiatrist in order to improve health
condition of patient. These experts are involved in providing motivation to users.
REFERENCES
Books and journals
Ballantyne, J.C., Kalso, E., & Stannard, C. (2016). WHO analgesic ladder: a good concept gone
astray. British Medical Journal, (Online), 352, 1-2.
Basques, B. A. & et.al., (2015). General versus spinal anaesthesia for patients aged 70 years and
older with a fracture of the hip. The bone & joint journal.97(5). 689-695.
Brown, E.N., Purdon, P.L., & Van Dort, C.J. (2011). General anesthesia and altered states of
arousal: A systems neuroscience analysis. Neuroscience, 34, 601-628.
Bryant, B. & Knights, K. (2015). Pharmacology for health professionals (4th ed.). Australia:
Elsevier. (Via Clinical Key) Analgesics Ch15, 308-339.
Bullock, S. & Hales, M. (2013). Principles of pathophysiology. Australia:Pearson.
Bullock, S. & Manias, E. (2017). Fundamentals of pharmacology (8th ed.) Sydney: Pearson
Australia.
Chiew, A.L. & et.al., (2015). Summary statement: New guidelines for the management of
paracetamol poisoning in Australia and New Zealand.Medical Journal of Australia,
203(5) 215-218.
Harsten, A. & et.al., (2015). Total intravenous general anaesthesia vs. spinal anaesthesia for total
hip arthroplasty: a randomised, controlled trial. Acta Anaesthesiologica
Scandinavica.59(3). 298-309.
Lim, Y. C., Choo, C. Y. & Tan, K. T. J. (2014). A randomised controlled trial of ultrasound-
assisted spinal anaesthesia. Anaesthesia and intensive care.42(2). 191.
Sng, B. L., Tan, H. S. & Sia, A. T. H. (2014). Closed‐loop double‐vasopressor automated system
vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean
section: a randomised controlled trial. Anaesthesia. 69(1). 37-45.
Online
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How to reduce the risk of deterioration after surgery. (2017). [ONLINE] Available through:
<https://www.nursingtimes.net/Journals/2013/06/13/a/s/v/120613-How-to-reduce-the-
risk-of-deterioration-after-surgery.pdf>
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