Task goal:
The goal of this case study is for you to identify the role of the registered nurse in evidence-based assessment and care of individuals experiencing health alterations when access to healthcare is suboptimal or compromised. You also articulate the role of the nurse in encouraging access to, and participation in healthcare.
Task description
Present a response to a clinical scenario demonstrating appropriate assessment, management and discharge of an individual experiencing health alterations.
In this task you will conduct a case study. There are three clinical scenarios, you will study only one.
Please follow the steps below:
Step 1: Secondary assessment of the patient
Detail the secondary assessment and investigations appropriate for this person
Step 2: Select the essential intervention
Select one (1) essential intervention from the following list:
- administration of Frusemide,
- administration of nitrolingual spray,
- Falls risk management,
- Thromboembolism prevention
Step 3: Implementation and evaluation
Describe and justify the nursing actions required to implement and evaluate the chosen essential intervention
Step 5. Plan the patient discharge
Select and describe nursing actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare
Alternate Clinical Scenario
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Identification
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Peter Kelly, 71 years of age.
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Situation
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Admitted to the medical ward for increased peripheral oedema and reduced mobility. The patient has been admitted with stable angina pectoris. The patient has been walking to the cafeteria, but called for help due to chest pain.
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Background
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Allergies: nil
Medications: digoxin 250 micrograms OD, atorvastatin, metformin
Pass medical history: congestive cardiac failure, cardiomegaly, type 2 diabetes mellitus, hyperlipidaemia,
Last ate: lunch in ED
Events:
Decreased mobility, shortness of breath on minimal exertion (walking to the bathroom), chest pain on mobilising more than 1 minute, pitting oedema, alopecia on the lower legs, purple discolouration to the lower legs
Lifestyle:
The patient is a taxi driver, he works 6 nights a week. The patient has a very poor diet, he snacks a lot from vending machines. He can perform all ADLs but it increasingly takes him a long time.
Social:
Peter had to move out of his house when he divorced his now ex-wife. Pam. Peter rents out a room from Blanche.
Peter is estranged from his family. Peter goes to the RSL every Friday to meet with other Vietnam Veterans.
Patterns of healthcare use:
Peter doesn’t have a GP as his last one left town 4 years ago. Peter doesn’t remember to take his medications regularly. Peter doesn’t like going to the ED, but often does, because he hasn’t found a GP in town that he likes.
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