NSB 231 Integrated Nursing Practice 2: Case Study and Interventions

This document provides a template and guidance for completing a nursing case study assignment, specifically focusing on NSB 231 Integrated Nursing Practice 2. It emphasizes identifying priority problems based on assessment data and underlying pathophysiology, such as overweight and hypertension in the provided example. The document outlines the importance of independent and collaborative nursing interventions, including medication and non-medication approaches, with a focus on the nurse's role in collaborative interventions. It includes a framework for evaluating the effectiveness of interventions based on specific goals and observable changes in the patient's condition, such as weight management and blood pressure reduction. The assignment requires a 2200-word essay covering the patient's condition, prioritized problems, nursing interventions, and evaluation of care.

I have provided this template to assist you with answering assessment 2 case studies. Remember monitoring is not an intervention; this is part of
your assessment process. You also need to have at least one independent intervention and only 2 of your interventions can be medication for
your essay.
You have to identify two (2) priority problems linking to the case study assessment data and underlying pathophysiology. Use the template
below to assist you here.
Priority Problem Goal Assessment data Underlying pathophysiology
1. Overweight Stop further
increase in weight
Reduce weight
Manage weight
Reggie appears fatigued
Reggie has put on about 10-15Kg in
the last couple of months
Reggie has bilateral pitting oedema of
the legs to knee height
Causes Metabolic dysfunction which involves lipid
and glucose
Causes organ dysfunction which leads interferes
with the normal functioning of cardiac, intestines,
liver, pulmonary, endocrine, and reproductive
system
It has inflammatory effects, which are mainly
associated with chronic and low-grade

inflammation
It induces hypoxic conditions in the adipose cells
It reduces the flow of oxygen in adipose tissue
May cause various diseases like cancer, depression,
cardiovascular disease and Type 2 diabetes
2. Hypertension Reduce blood
pressure levels
Reduce the
respiratory rate
High respiratory rate 28breaths per
minute
High blood pressure 184/75mmHg
Coarse crackles on his chest
Oxygen saturation of 92% on room air
Pain on inspiration
Reggie always appeared fatigued
Increases the risks of heart attack or stroke
Increases sympathetic nervous system activity
Interferes with the normal functionality of
autonomic nervous system
Increases sympathetic outflow, and repeated stress-
induced vasoconstriction
Leads to endothelial dysfunction

Your essay states you can choose two interventions to discuss in detail for your priority problems. These can be independent or collaborative, but
you must have at least one independent intervention. For the collaborative interventions identify the other members of the healthcare team.
PROBLEMS ARE NOT ASSESSMENT DATA and INTERVENTIONS ARE NOT EVALUATION OR
ASSESSMENT

Priority Problem Intervention Independent/Collaborative? Allied health care team involved
1.Overweight Physical activity intervention Independent
Dietary intervention Collaborative Dietitian
Nutritionist
2.Hypertension Education intervention collaborative Pharmacists
Physicians

Physiotherapists
Medical intervention Independent
You may choose to use medication as two (2 only) of your interventions for your selected priority problems. Your other two interventions must
NOT be medication.
Using online resources, complete the table below and consider the following information which is to be included in your essay if you are
discussing medication.

Priority problem 2
Medication name: thiazide diuretics, angiotensin-converting enzyme inhibitors (ACE), angiotensin ii
receptor blockers (ARBs) and calcium channel blockers
Medication type: Antibiotics
Indications for medication: Faulty kidney, Blocked blood vessels, high heart rates
Actions of medication: Thiazide diuretics which are sometimes called water pills will act on the kidneys to
help his body to eliminate sodium and water hence reducing the blood volume
The ACE inhibitors will help relax the victim’s blood vessels by blocking the
formation of natural chemicals which narrow blood vessels
The ARBs will help in relaxing the blood vessels by blocking the actions of the natural
chemicals which narrow blood vessels
Channel blockers will help relax blood vessel muscles and slow the heart rate
Usual dose and route: Injection
Any special precautions needed: No

Contraindications: None
Education required specific to drug including
common side effects:
None
Nursing responsibilities with administering
medication
Injecting the patient
Now consider your evaluation of your interventions
Priority Problem Intervention Evaluation linked to goal
1. Overweight Physical activity If the weight increase rate declines the intervention will be
marked effective.
If the rate continues to increase or remain stagnant, the
intervention will be deemed ineffective.

If the severity of the other symptoms associated with
overweight declines the intervention will be deemed effective .
Dietary If the weight increase rate declines the intervention will be
marked effective.
If the rate continues to increase or remain stagnant, the
intervention will be deemed ineffective.
If the severity of the other symptoms associated with
overweight declines the intervention will be deemed effective
2. Hypertension Medication intervention Reduced blood pressure will be an indication that the
interventions are working as expected whereas an increase in
the original blood pressure.
If there is no observable change in the blood pressure it will be
an indication that the interventions are ineffective
Severity of other symptoms like the respiratory rate, chest

complications, and inspiration pains will be expected to
continue declining.
In case they remain the same, the interventions will be deemed
ineffective.
Education intervention Starts physical exercises
Adoption of the advisable diet