NSB231-Care Plan Case Study & Nursing Problems – Nursing Assignment Help

Assignment Task

Task 

CASE STUDY 1: Acute case study
Brian Nolan is an 80-year-old man who has been admitted to the stroke unit overnight after having a left sided cerebral vascular accident (CVA). He was found by relatives on the floor of his home, where he had been lying for an estimated 6 hours prior to being found. A computed tomography (CT) scan showed an ischaemic stroke that infarcted a significant area of the brain. Brian has a past medical history of Chronic Obstructive Pulmonary Disease (COPD) which he developed from a lifelong smoking habit. He continues to smoke one pack of cigarettes each day which may have contributed to his CVA. From nursing handover, you are informed that Brian has been grumpy and annoyed all night. He arrived onto the ward quite late in the evening and consequently has not been seen by any allied health team members yet. He was briefly reviewed by the junior doctor who prescribed 1g of Paracetamol every 6 hours for pain; no other medication orders or plans of medical care have been noted.

When you meet Brian, he is laying almost completely flat and has a pronounced right sided (his dominant side) hemiplegia with no movement on that side of his body. He lets you know he is uncomfortable and wants to use the toilet. You notice his speech is slurred, a gurgling sound in his throat with each breath, and he has some saliva coming from the right side of his mouth. The kitchen staff have left his breakfast of porridge and orange juice on the table at the end of the bed. It is untouched.
On closer examination you notice that Brian’s right calf is slightly larger than the left, hot to touch and Brian states it is painful when touched. His calf measurements are right leg 36cm widest part of calf, 39cm from heel to bend of knee, and left leg, 33cm widest part of calf, 39cm from heel to bend of knee. His last set of observations showed BP of 124/68mmHg, regular pulse of 78 beats per minute, SpO2 95% and a respiratory rate of 18 breaths per minute. His temperature is 36.9 degrees Celsius.

Task description:
1. For this essay you are required to select ONE (1) case study option:
• Option 1: Case with an acute presentation of illness, or
• Option 2: Case with a chronic illness.

The case studies are available on Blackboard under the Assessment 2 tab.

Carefully review your chosen case study and apply your knowledge of evidence-based nursing practice and the clinical reasoning cycle to plan person-centred care by answering the following questions using academic 

writing style.
1. From the chosen case study, identify and discuss TWO (2) current problems which are directly impacting the patient’s health.
2. For each problem, identify TWO interventions. At least one (1) intervention for each problem must be entirely nurse initiated and led.
When discussing collaborative interventions, you must focus on the role of the nurse in that intervention.
3. Justify your chosen interventions in comparison with current and relevant evidence.
4. Discuss how you would evaluate the effectiveness of each intervention.
NB. Responses to all questions above require you to integrate peer reviewed, current and relevant evidence from valid reference sources to support your academic writing.

What you need to do: The 1,800 word essay should include the following points:

Introduction s):

• Identify the case selected, provide an overview of the condition experienced by the patient and identify your TWO (2) current problems.

• Establish how the assessment data led you to identify TWO (2) current problems. In doing so demonstrate your understanding of the relevant pathophysiology that explains the link between each chosen problem and the relevant assessment data in the case study.

• For each problem identify TWO (2) interventions aimed at resolving the identified problem. ONE (1) intervention for each problem must be  a nurse-initiated intervention.

• Justify your chosen interventions by explaining what is involved in implementing the intervention, why it is suitable, and any special considerations relevant to the case.

• Outline the method of evaluating the effectiveness of the interventions and expected evaluation criteria/data. Discuss how you would determine that each intervention is improving or resolving the identified problem. 

Conclusion 
• Summarise your chosen interventions and how they addressed your patient’s identified problems.

The following points must be addressed in your work:
• You must discuss at least ONE (1) nurse-initiated intervention per problem in your essay.
• Collaborative interventions must include a discussion of the relevant nursing responsibilities associated with each intervention. 

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