Outline what strategies and assessments you as a Registered Nurse would provide as part of your care for Mathew Thornton.

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Task 1: Written Assignment

Weight: 30%

Must Complete: Yes

Word Length: 1500 words

Notes: Written Assignment

Due Date: Is displayed at the bottom of this page

This assessment relates to:
Learning Outcomes 1 4 5 6

Nursing managment of chronic conditions

Using the case study in Module one; Mathew Thornton to address the task below

Task:

Outline what strategies and assessments you as a Registered Nurse would provide as part of your care for Mathew Thornton. Ensure you include holistic, person-centred and culturally appropriate care. Reflect on how these strategies and assessments would facilitate optimum health outcomes and relate these to the National Strategic Framework for Mathew.

Mathew Thornton – Case Study

Mathew is a 33 year old Aboriginal gentleman with a history of obesity, diabetes type 2 and hypertension. He is seeking treatment in an out-patient clinic at Farmdale Community health centre with the local dietitian. The local dietitian suggest that he sees his local GP to get a referral to a specialist endocrinologist for medical weight loss management. He is well aware of the link between obesity, diabetes and cardiovascular disease and felt this appointment could be his last chance in getting help with his health problems and losing weight. As a child Mathew had been normal weight; during adolescence he played rugby for his local club and ended up in a prop position on the field (the props “prop up” the hooker in the scrum. They form part of the front row of the scrum and push against the opposition’s props). He gradually put on weight and was overweight in his early twenties. The football culture which he loved was fun and he drank a lot of beer and ate a lot of fast food such as meat pies at the football field after the games.

Mathew developed diabetes type 2 and hypertension in his early thirties (two years ago) and is now medicated with anti-hypertensive and anti-diabetics. His GP (primary care physician) had not really been interested in his weight and instead suggested higher doses of medications or insulin injections on multiple occasions. Mathew was not interested in insulin injections as he was afraid of gaining more weight.

Mathew has now been sedentary for the last 5 years and has also had to give up work as a local farm hand on his sister’s property out of town. He had previously tried many weight loss efforts but his diet had been high in fat and calories although he was very well educated in nutritious food. However, he has admitted to overeating, and periods of bingeing. He drinks about 3 litres of coke a day and has at least three serves of hot chips per day.

Mathew is referred to a weight management clinic in a metropolitan tertiary hospital 600km form Farmdale .

His initial anthropometric measurements included a weight of 180kg with a height of 1.81m, a body mass index (BMI) of 54.94kg/m2 which classified him as morbidly obese. His fat % was 52.2% with 85 kg fat mass measured by bioelectrical impedance analysis (BIA) (Tanita Body Composition Analyzer BC-418) for analysing the composition of the body, such as weight, lean body mass (LBM), total body water (TBW), fat free mass (FFM) and basal metabolic rate (BMR). His HbA1c had in the last 2 months ranged from 11.7% to 8.8% and his BP was 160/95 mm Hg.

 

Identify the importance of client compliance with a treatment regimen to prevent a permanent disability.

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1. Identify the importance of client compliance with a treatment regimen to prevent a permanent disability.
2. Describe the purpose of the treatment regimen in preventing complications of the disease process.
Course Competency
• Strategies for safe, effective multidimensional nursing practice when providing care for clients experiencing sensory and perception disorders.
Instructions
Ms. Julia Jones, a 68-year old African American woman, has just been diagnosed with primary open-angle glaucoma. Her ophthalmologist has explained the pathophysiology of the disease to her and is trying to select the best treatment option for her. You are the nurse working with the ophthalmologist, and Ms. Jones has asked you about the eye drops the doctor has recommended. Mrs. Jones’s physician has recommended Combigan, one drop in the right eye every 12 hours. Your client has never administered eye drops and she does not know anything about the medication her ophthalmologist has prescribed. She is interested in how the medication works, the side effects, how it is administered, and why it is so important in the treatment of her glaucoma.
Develop a nursing care plan using template directly after these instructions to address Ms. Julia Jones concerns.
For this assignment, include the following: assessment and data collection (including disease process, common labwork/diagnostics, subjective, objective, and health history data), three NANDA-I approved nursing diagnosis, one SMART goal for each nursing diagnosis, and two nursing interventions with rationale for each SMART goal for a client with a musculoskeletal disorder.
Use at least two scholarly sources to support your care map. Be sure to cite your sources in-text and on a reference page using APA format… this professor is a tough grader

Explain components of multidimensional nursing care for clients with musculoskeletal disorders

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1. Plan evidence-based interventions to assist the client in meeting optimum outcomes.
2. The actions planned are designed to meet the health care needs of the client
Course Competencies
• Apply knowledge of integumentary disorders for safe, effective nursing care
• Explain components of multidimensional nursing care for clients with musculoskeletal disorders
• Select appropriate nursing interventions for clients experiencing alterations in mobility
Instructions
Develop a client-centered SMART goal and 6 individualized nursing interventions with rationale (using the template on page 2 of this document) for a client with the following nursing diagnosis on the care plan:
• Risk for impaired skin integrity related to mechanical factors and impaired physical mobility.
Use at least two scholarly sources to support your care plan. Be sure to cite your sources in-text and on a reference page using APA format.

Describe strategies for safe effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious and inflammatory disorders.

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For this assignment, you will demonstrate knowledge of the diagnostic process using the template below. You will identify common assessment data, three priority nursing diagnoses, client-centered outcomes, and nursing interventions with rationale for a client with impaired immunity.
Course Competency
• Describe strategies for safe effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious and inflammatory disorders.
Instructions
Tom Howard, a 45-year old man with HIV from the community, has come to the clinic because he reports he had not been feeling well recently. During the intake process, Tom complains of a dry cough and chilling. The intake nurse takes his vital signs, and they are: Temp 102 degrees Fahrenheit, Pulse 102, Respirations 28 breaths per minute, Blood pressure 135/86. The clinic physician refers Tom to the local hospital for a suspected opportunistic infection.
Use the template directly below these instructions to complete a care map to design care for a client with impaired immunity. For this assignment, include the following: assessment and data collection (including disease process, common labwork/diagnostics, subjective, objective, and health history data), three NANDA-I approved nursing diagnosis, one SMART goal for each nursing diagnosis, and two nursing interventions with rationale for each SMART goal for a client with a musculoskeletal disorder.
Use at least two scholarly sources to support your care map. Be sure to cite your sources in-text and on a reference page using APA format…

Create a concept map on how followership is related to leadership and organizational performance.

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1. Create a concept map on how followership is related to leadership and organizational performance.

2. The concept map must include Robert E. Kelley’s four followership types.

Provide a list of the tasks performed as part of data collection in the study, add comments as needed.

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Post your initial response to the article, addressing the following criteria:

Read the process for data collection employed in the study.
Identify the method used in the study.
Provide a list of the tasks performed as part of data collection in the study, add comments as needed.
Draw conclusions about the data collection process.
Enter your responses in the organizer.

Describe the nursing assessment of this patient following her vital signs using an ABCDE framework and any associated assessment tools as per the eviQ guidelines.

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Case study analysis: Esther

Based on your understanding of blood cancers, the associated symptoms and side effects of chemotherapy, review the case scenario, readings and resources provided and formulate a detailed response which considers the following points:

Nursing diagnosis of the case scenario patient and the most probable cause of infection.

Examine and interpret the blood results from day +6.

Describe the nursing assessment of this patient following her vital signs (using an ABCDE framework and any associated assessment tools as per the eviQ guidelines.

Care of the Hickman’s line (CVAD).

Education you may provide to this patient prior to the commencement of her treatment (consider psychological management in your discussion).
Your short answer response should be no more than 500 words in length and must be referenced as per Harvard. Rubric attached and other reading materials. Check NSWHP data.

Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps

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Assignment Details:

Perform the following tasks:

  • Complete the reading assignment and the interactive lesson before attempting this assignment.
  • To complete this assignment:
    • Review the case study.
    • Download the provided PowerPoint template to create a presentation that includes:
      • Your name on the title slide of the presentation
      • Identification of two or more issues with existing system
      • Identification of appropriate “work-a-round” solutions for using existing system
      • Overview of standard language used only in nursing
      • Overview of multidisciplinary standard language
      • Set of five (5) survey questions for staff input on transitioning to new system
      • Presentation is free of spelling and grammar errors.
      • Submit the Week 10 Assignment: 

        Read the following case study:

        A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.

        A major change is being planned. A new chief information officer (CIO) was hired last year and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor and the hospital selected a commercial system.

        As a member of the clinical staff with informatics education, the CIO has requested that you develop a training and information presentation for the clinical staff that will:

        • Provide staff with appropriate “work-around” for using the existing system
        • Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps
          • One standard language should pertain only to nursing
          • One standard language should be multidisciplinary.
        • Obtain clinical staff input, using a five-question survey, of specific methods to support transition to the new system; questions should be open-ended.

Discuss the disease process’ pathophysiology. Explain the alterations from normal cell/organ/body functioning that are seen in this disease process.

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  2021

 

The case study assignment will be based on a patient (case study provided) and will include the application of the nursing process.  Review the patient data provided to develop a comprehensive case study database.

In this assignment, students are expected to explore a patient’s presentation, history and diagnostic investigations in relation to the underlying pathophysiological process.  Evidence from scientific peer-reviewed literature as well as your course textbooks must be included to demonstrate the appropriateness of the diagnosis in relation to the patient’s clinical manifestations.  The paper must present a thorough description in order to demonstrate an understanding of how the disease is affecting the patient and how that disease is being managed.

This understanding will assist you in developing a comprehensive plan of care. Guided by the nursing process, you will demonstrate pattern recognition and the ability to interpret and analyze all data to identify the priority nursing diagnoses. Using clinical judgment skills, patient priorities and critical decision-making, your will plan of care will address the highest priority nursing diagnosis.

It is understood that the plan of care cannot be implemented by the learner considering it is  a case scenario; however, the patient goals (short-and long-term) and nursing interventions (supported by referenced rationale) must be congruent with the case study. Relevant evaluation criteria for the goals and interventions must also be included.

Overall Assignment Components/Criteria

Part A: BSN2107

Introduction

Provide a brief introduction for your paper. This introduction should include what you intend to present in both Part A and Part B of the paper. Only 1 introduction is needed as this is considered 1 paper.

Patient Presentation

Provide a brief summary of the relevant patient information:

  • Include important demographics such as age. Clearly identify the main health challenge. Then describe the patient’s clinical presentation on admission – what brought the patient to seek medical attention? What were the clinical manifestations exhibited by the patient on admission?
  • Signs and Symptoms: Identify the significant signs and symptoms presented by the patient on the clinical day.
  • Past Medical History: Describe findings in the past medical history which are relevant to the patient’s clinical presentation (e.g. co-morbid conditions, previous injury, relevant family history)
  • Treatments: List current medications and relevant treatments (include in Data Collection Template: Appendix 1).

Theoretical Discussion of Disease Process

Provide an in-depth analysis of the disease process:

  • Provide a definition for the disease process and its Canadian epidemiology.
  • Discuss the disease process’ pathophysiology. Explain the alterations from normal cell/organ/body functioning that are seen in this disease process.
  • Discuss the risk factors and causative factors for the disease process as it relates to the patient.
  • Based on your examination of relevant literature pertaining to the pathophysiologic process, identify all assessment data (subjective, objective, diagnostic tests) that should be collected and monitored by a nurse who is caring for a general patient with this disease process.

Analysis

Provide an in-depth analysis of the patient presentation (deviations from the expected normal findings):

  • Detail how the pathophysiology lends itself to the patient presentation.
  • Discuss/explain assessment data (both objective and subjective) (Every symptom and abnormal diagnostic test should be linked to the pathophysiology or otherwise addressed).
  • Were the usual diagnostic tests ordered for this patient? If not, why not? If so, what do the results reveal? What other diagnostic tests were performed on this patient? Discuss why the lab/diagnostic test would be ordered for this patient.
  • What evidence of the disease process is found in the diagnostic test information for the patient?
  • Include lab work/lab tests performed and results using the Lab form from clinical. You are not expected to fill this in. You can only input the lab values provided in the case study (available on Moodle: Appendix 2).
  • Use evidence from the literature to demonstrate that the patient’s presentation is a result of the pathophysiologic processes.

Nursing Implications 

Based on your knowledge and examination of relevant literature pertaining to the pathophysiologic process, explain how this information informs your practice. Identify all assessment data (subjective, objective, diagnostic tests) that should have been collected and monitored by the nurse who is caring for this specific patient. Provide rationale for why this information is relevant. Include how writing this paper can inform your future practice.

Part A: counts towards the BSN2107 grade.  The value is 10%

Maximum length of this section of the paper is to be 4 pages (12-point font) (not including title page, reference page or appendices).

All papers and submissions are to be formatted and references according to the most recent APA manual.

Part B: BSN2144

Case Study Analysis

  • Using the Data Collection Template (Appendix 1) as your source to gather and store information, analyze the data and identify relevant patterns and clusters within the data. Use a concept map to aid in clustering (Appendix 3).
  • On the concept map: include relevant data from the interview, physical assessment, diagnostic tests, current medications, relevant pathophysiology, medical treatments, and changes in status identified in the data collection tool that explain the general health challenge. All abnormal and other relevant data must be reflected on the concept map.
  • In your paper, include additional symptom analysis data for abnormal data collected.
  • Continue to analyze the data presented on the concept map by explaining your diagnostic reasoning (assessment and establishing nursing diagnoses). Explore how you recognized cues/clusters in order to determine nursing diagnoses.
  • From your data analysis, identify and list all pertinent nursing diagnoses – stated according to NANDA.
  • Actual nursing diagnostic labels (as per NANDA) must be indicated on the concept map (Appendix 3) and linked with the appropriate data / clusters.
  • List all complete actual and potential nursing diagnostic statements that apply to the patient: (Appendix 4).
  • Refer to the literature to support the analysis.

Nursing Diagnosis Priority Rationale

  • From the list of all nursing diagnoses, choose the top three priority nursing diagnoses and provide rationale for hierarchy (use at least one actual and one potential/risk diagnosis). This discussion must be supported by both the literature AND based on patient need.
  • Discuss the diagnostic reasoning used to determine the top 3 priority (actual and potential/risk nursing diagnoses listed). For example, relate to knowledge of pathophysiology (patient who is neutropenic is at risk for infection); or to a treatment the patient is receiving (patient receiving a heparin infusion is at risk for bleeding); etc.
  • Refer to your care plan table where appropriate.

Care Plan

  • Complete one care plan for the highest priority nursing diagnosis (use the clinical placement portfolio Plan of Care template: Appendix 5).
  • The care plan must include a short-term and a long-term SMART outcome relevant to the nursing diagnosis and patient.
  • Indicate all relevant interventions. Interventions must relate to the outcome and relevant to the patient. Interventions should be specific rather than broad – e.g. if your patient is hypoxic – rather than having a general intervention “Monitor vital signs q4h and PRN”; be specific “Monitor SpO2, respiratory rate and heart rate q4h and PRN”. If your intervention includes administering medications – the medication must be ordered for the patient and the specific name provided in the intervention.
  • Identify how interventions and outcomes will be evaluated, including pertinent follow-up.

 

Relevance of Care Plan

  • Discuss how the patient care plan is relevant and individualized for the patient.
  • Refer to care plan (Appendix 5) where appropriate.

 

Conclusion

Provide a brief conclusion to your paper. Include a restatement of what the intent of the paper was and summarize your main points. Only 1 conclusion is needed as this is considered 1 paper.

 

Part B: Counts towards the BSN2144 grade.  The value is 20%

Maximum length of this section is to be 6 pages (12-point font) (not including title page, reference page or appendices).

All papers and submissions are to be formatted and references according to the most recent APA manual.

Appendices:

  1. Data Collection Form
  2. Lab/Diagnostic Results
  3. Concept Map
  4. List of all relevant Nursing Diagnoses
  5. Care plan

Note: These Appendices will be graded.

Technical Aspects:

  • This is a formal paper and must follow APA formatting, be written using paragraphs, and have an introduction and a conclusion.
  • The paper is not to exceed 10 pages of text in total (excludes title page, appendices and reference list).
  • A minimum of 5 peer-reviewed references (all to be more recent than 2015) are required and must support the analysis of the case. Please DO NOT ATTACH ARTICLES.
  • An electronic copy must be submitted onto the Moodle drop box by the posted due date.
  • All appendices must be submitted in PDF format and as separate documents for the online submission.
  • Program policies will be followed for late papers.

 

 

Explain the role of nursing and responsibilities

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Explain the role of nursing and responsibilities