Patient’s History, Presenting Problems and the Related Pathophysiological Processes – Medical Science Assignment Help

Assignment Task:

Task:

The written assessment task is related to a case scenario below. The context of the scenario will be based on disorders that have been covered in the first three weeks of the block, and from Contemporary Nursing A & B, Contemporary Nursing A & B Mental Health.
The assessment piece should be developed with reference to the clinical reasoning cycle. Through application of critical thinking and clinical reasoning you are to explore the following points:

• patient’s history, presenting problems and the related pathophysiological processes to identify priority problems
• comprehensive assessment, i.e. specific observation, assessment tools and or tests
• holistic plan of care is developed by setting specific goals
• formulate nursing interventions and or treatments, with rationales and consider ways to evaluate the effectiveness of actions
• consider relevance of specific nursing standards, code of conduct, code of ethics and legalities and relevant legislation
• adherence to cultural awareness and diversity considerations
• Consider patient-centred care, recovery-oriented and trauma-informed practice, patient/consumer perspectives, and or lived experience research
• Consider current/future nursing practice and research implications
• Scenario:
• James Peter is a 54 year old male who has previously been diagnosed with anxiety and substance misuse of heroin intravenously.  He had a recent episode of pneumonia and was treated with amoxicillin. James is a smoker (tobacco), and regularly drinks excessive amounts of alcohol. James has had issues with housing and is currently homeless. James has no close relationships with family except with his sister Sandra. He is divorced with two children who live interstate with their mother and stepfather. James is a former carpenter who saw a close friend and colleague die after suffering a workplace injury. James was also injured in the workplace incident and required surgery (open reduction, external fixation of left radius).  Since then James has developed anxiety and began to regularly use cannabis and is now also using heroin. James was dismissed from his job and then his marriage also broke down leading to a divorce. After the divorce James ended up homeless, staying with his sister or in the local men’s shelter He spends time with his sister who also engages in heavy drinking and cannabis use.
• James initially presented to the GP with the infected right leg ulcer and was prescribed clarithromycin 500mg BD PO for seven days but was non-cooperative with this treatment. James has now presented to the Emergency Department (ED), with worsening infection in the leg ulcer, cellulitis, and increased pain. James went to theatre and had the ulcer debrided and has come into the vascular ward post-operatively.
• James describes his mood as low and reports often feeling stressed and angry. He has previously been prescribed an antidepressant mirtazapine, although has stopped taking this medication, stating it doesn’t work. He also takes oxazepam when able to get a script. He has inconsistently been on a suboxone program, but this has not been charted on this admission yet. When James arrives on the ward he is initially stable with his vital signs and comfortable.
• As the shift progresses he reports increased pain as the local anaesthesia given in theatre is starting to wear off. James is becoming agitated and demanding pain relief and beer. He is prescribed 1g paracetamol, 5mg oxycodone 6hrly PRN.  James’ sister is visiting and when you are assessing James you notice that his breath smells of alcohol. You speak with Nurse in Charge (NIC), about this and are told that James is an attention seeker, and that he can’t be in that much pain as he had morphine in theatre. In the meantime James is becoming increasingly verbally aggressive and his sister is increasingly belligerent towards you. James is now attempting to pull off the wound dressing and yelling out that he is in pain.
• Case Study Question:
• How would you as the Registered Nurse manage this situation?
• In your answer you will need to consider the Registered Nurse Standards for Practice (Nursing and Midwifery Board of Australia [NMBA], 2016), and relevant legislation.
• CASE STUDY- ESSAY STRUCTURE
• (The clinical reasoning cycle & essay key points will also be interwoven into below structure).
• Your case-study essay should be structured as follows: 
• Introduction
• Start by setting the context and providing relevant background information.
• Include a statement that is a response to the case-study-essay question, and that summarises the main aim or points of the case-study essay.
• Outline the main ideas to be discussed in the case-study essay, in the order they appear in the body of the essay.
• Body
• Each paragraph should cover a single idea expressed in a topic sentence, followed by supporting evidence and examples from contemporary academic literature, including peer-reviewed journal articles.
•  Conclusion: A summary of your appraisal.
• Restate your essay question, and sum up your main points
• This is an academic assignment; therefore, academic standards inclusive of grammar, sentence structure, paraphrasing and APA 7th edition referencing for both in-text citations and referencing apply.
• All written assessments must align to the following academic standards:
• use high-level quality contemporary evidence-based literature to inform the discussion and critical analysis, date of evidence within five years;use of the third person, unless specifically indicated otherwise;APA 7th edition for in-text citations and reference list;the following structure: an introduction, body and conclusion or as per directions in the assessment instructions;adherence to the word count; ten percent allowed either side of word count;a 12 size font in either Arial, Times New Roman or Calibri;