NUR 331: Nursing Care - Medical Diagnosis - Case Study Assessment Answers

December 20, 2017
Author : Charles Hill

Solution Code: 1ADAA

Question: Nursing Care Case Study

This assignment is related to “Nursing Care Case Study” and experts at My Assignment Services AU successfully delivered HD quality work within the given deadline.

Nursing Care Case Study Assignment

Case Scenario

Mrs Jane Johnston is a 60 year old female who presented with acute abdominal pain. The pain came on yesterday after eating dinner.

Observations on presentation-

T 37.8, PR 96, RR 28, BP 90/60 Patient is complaining of sudden onset upper abdominal pain, that radiates through to the back and is associated with nausea and vomiting. GCS 15. Past history- appendicectomy at age 20. Does not drink alcohol.

Lipase is elevated at 2000. Mrs Johnson has been given a diagnosis of pancreatitis.

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Central Nervous System- CNS

The disease will lead to the loss of very critical cells and nerves in Mrs. Jane Johnston. For example, research shows that it result in the disturbance of the pancreatic microcirculation. What this means is that it Mrs. Johnstone will suffer from a possible nervous breakdown since the sensory nerves are hugely affected. Another effect that may be assessed is the likely inflammation of the Neurogenetics cells (Bass and Halligan, 2014). As such, Mrs. Johnstone may suffer from possible swelling around her body like the hands, feet, neck and other secondary body parts. The central nervous system is one of the core systems that an individual may suffer from, and its diagnosis is critical to averting possible death. A reasonable assessment of the discussed elements is Mrs. Johnstone suffering from inflammations, and she may lose feeling in some of her most crucial body parts. As such the whole mechanism is that pancreatic is considered to be dangerous and essential to treat and cure it.

Cardiovascular system- CVS

The ailment tends to promote inflammation the primary elements of the human body. Another possible assessment is that some the major organ sit one bid will not perform to their level best hence leading to an overall body weakness. Some of the abnormalities that may be experienced include loss of the cardiac rhythm that may expose Mrs. Johnstone to other related diseases. Some of the diseases include hypovolemia and metabolic disturbances. Others include the risk of hypertension and vascular resistance (Frick et al., 2014). What this means is that Mrs. Johnstone may suffer from other diseases hence needs to have the cover for other diseases as well. Clinical observations are very crucial since they help to curb any other illnesses that may pop from the general weakness of her body. It is also very possible that Mrs. Johnstone may result also from cardiac arrest if she is not guarded properly. As such a proper diagnosis of the assessment for Johnstone Include the risk of getting chronic diseases if she is not properly looked after in the clinic.

Respiratory System

The respiratory system is critical for the ordinary functioning of the body. The disease will affect the primary functions of the human body. As such, the general assessment of the respiratory systems will change Mrs. Johnstone in the following ways. The pancreas will mainly be affected, and Mrs. Johnstone may suffer from kidney failure. The disease also makes the body feeble hence making the body susceptible to bacteria and can easily be infected. Breathing problems can also be witnessed by the subsequent chemical reactions that occur as a result of the complications that may arise from the respiratory system. Breathing problems will also lead to a possible failure in lungs. As such, there may be a drop in the level of oxygen in the blood and the dangerously low concentrations. Another possible effect in the respiratory system is the risk of getting diabetes. Sugar concentrations in the blood may drop or rise depending on the complications that may arise.

Abdominal Assessment

The disease causes several issues that may affect the abdominal section. The abdominal assesses may include the different major operations in a body. For example, the disease may cause what is known as an ectopic pregnancy in pregnant women. Ectopic pregnancy is crucial as it has caused multiple deaths in women. Since Mrs. Johnstone is 60 years old, he is likely not susceptible to such adverse effects like ectopic pregnancy. On the other hand, however, it is optimal to note that depending on the age of an individual, it is important to understand what may affect an individual. As such, it is necessary to know what may cause a person to feel pain. Mrs. Johnstone may experience pain in the abdominal section due to differential diagnosis. Age plays such a huge factor in what exactly happens in the body of an individual. Associated diseases are very dangerous ad may also lead to the rise of associated diseases.

Renal assessment

Renal assessment is a consequent of understanding the difference between mortality and morbidity. Unfortunately, patients with the ailment suffer from the acute renal failure. As such, Mrs. Johnstone is advised to make sure that she gets tested on mortality and morbidity. Such allows an individual to understand that mortality is a concept that sometimes is barely misunderstood. To have the proper training on the relationship between mortality and acute renal failure. Following the methods and results is crucial in making sure that there is a retrospective study that is also relevant to the results realized (Ladouceur et al., 2015). Mrs. Johnstone may accurately be advised on what exactly is crucial before understanding what type of Medicare and Medicaid to invest in relevant to her needs. On the other hand, it is critical to comprehend that different clinical facilities offer various products and reading them helps to understand what exactly an individual can purchase. Mrs. Johnstone needs to understand the requirements of what Medicare and Medicaid can benefit her.

Part Two

Nursing care plans are essential in ensuring that patients with the disease are well taken care of and they may or not include the following. There are about 6 to 8 plans that are used to ensure that people with the disease are well taken of medically. They include the following;

  • Risk of infection
  • Deficient knowledge
  • Acute pain
  • Risk of imbalanced fluid volume
  • Imbalanced Nutrition
  • Increased risk of an inadequate fluid volume.

The patient may experience an insufficient in the fluid volume due to the following risk factors. The many patient experiences excessive losses like vomiting and gastric sanctioning. There is also the possible danger of the increased size of the vascular bed where there is a vasodilation about the effects of kinins. Another risk factor is the third space fluid where there is the formation of ascites. Another huge risk factor is the alteration of the clotting process popularly known as haemorrhage (Brown and Edwards, 2015). Depending on the prevalent risk factors, the following nursing programs may be used in the care of an individual. The purpose of the nursing programs is ensuring that desired applications are realized. One of the most proficient nursing programs is the monitoring of BP and measuring of the CVP should it be available. The rationale behind the nursing intervention is the fluid sequestration where there is the release of the vasodilators in the cardiac depressant factor triggered by the pancreatic ischemia. The ischemia may result in the reduced cardiac output and poor organ perfusion (Alegría et al., 2015).

Another basic nursing care plan is the measurement of the concept of diseases related to vomiting, gastric aspirate, diarrhoea where there is the 24-hour fluid balance. The rationale behind such an intervention is making sure that there are indicators of the replacement needs and effectiveness of the therapy introduced. Nurses are also advice to take measurements of the proposed urine output that should be less than 400 Ml in a period of 24 hours. There are vital signs that are indicators that individuals may have the disease in the content of their urine. What this means is that by the measurement of the urine, it is crucial to understand the dynamics of the disease. Signs that may be observed include Oliguria, renal impairment, and the acute tubular necrosis. The purpose of knowing the signs is contemplating what components increase or decree the risk of being infected with the disease (Shear et al., 2015).

Another important concept relevant to nursing care is making sure that weight is indicated and correlated with the fluid balance. The idea of understanding that weight should be observed is understood the weight loss. Weight affects many functions in the body of an individual, and the rationale of the weight loss is the increase and decrease. For example, weight loss may suggest the concept of hypovolemia. It may also be a sign of the following diseases as well, edema, fluid retention and ascites. It is vital for an individual to have stable weights to reduce muscle wasting. What this means is that the presence of tissue indicates that a person may have the risk of gastric bleeding and acidity may also be high. Another nursing aid to look out for is noting the skin colour whereby the dry skin and mucous membranes were reports of the different body reactions.

Observing the skin colour helps to understand whether there are any physiological indicators of dehydration. Also, it is also relevant to comprehend that the observation of the record peripheral is dependent on the dependent edema. It is crucial to understand that measuring of the abdominal girth is the present ascites. The purpose of having the paraphernalia to have a shift as a result of increased vascular permeability. It is also relevant to note that understanding exactly is needed to understand what exactly the disease entails. The purpose of having the investigation of the urine. Having the concept ideology to investigate the changes in sensorium. Amidst the changes that are needed, it is crucial to comprehend that concept of weights loss often contribute to what is considered to be a poor prognostic sign. Cardiac changes are necessary as they help to determine what exactly is needed by a medical specialist. The onset of the dysrhythmias s may affect and reflect on what changes to look out for as a medical professional. Other chronic diseases are crucial to understanding them as a way of making sure that patients of the disease should they do not suffer from the same diseases are not affected by the conditions.

Another nursing care program that should be observed is what is known as the inspection for the petechial where there is the prevention of bleeding. Bleeding heavily affects the way the disease affects an individual. On the other side, there are auscultate heart sounds that help to note that rate and rhythm need to be monitored relevant to the appropriate changes. The essence of having the DIC concept may be initiated by the release of the active pancreatic proteases that are usually in circulation. The disease affects some of the most frequented areas where there are organs relevant for the kidneys, skin, and lungs. It is pertinent to watch out for the signs of calcium deficiency. It is vital to comprehend that calcium deficiency leads to the coarse muscle experiencing tremors where there are also muscle twitching prospects that is not presumed to be positive. Understanding exactly the signs to look out for are a consequent of looking out for the evidence of calcium deficiency. Such will lead to the understanding of other possible ailments that may arise from the disease.

The traditional methodology depends chiefly on textbooks whereas the current method depends on the active materials approach. In ancient methodology, presentation of materials starts with the elements. The old method emphasizes on core competencies whereas trendy methodology emphasizes on huge ideas. With old method of teaching, assessment is seen as a separate activity and happens through testing whereas, with the stylish methodology of instruction, assessment is viewed as an alternate activity integrated with education and learning, and occurs through portfolios and observation. One of the most compelling issues discussed is how the research is conducted. The field of study is a broad concept where critical elements need to be followed (Bonevski et al., 2011). Research conducted needs to be informative, of sound mind and data collected needs to be relevant. The main issue being discussed here is how to do research when gathering information.

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