case scenario

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case scenario


Read the clinical scenario and the answer the assessment questions in an essay format. Clinical Scenario You are working in a community clinic as a registered nurse. Your next patient is Ms Florence ‘Flo’ Ljukuta and her husband Lionel. Flo is 70 years old, and Lionel is 84 years old. Flo is the primary carer for her husband who has physical disabilities due to a stroke and was recently diagnosed with dementia. Flo would normally attend the clinic regularly, but you notice in her records she has not presented in nearly 12 months. The last entry on the eHealth record is a hospital visit due to a fall last year. When Flo and Lionel arrive, you notice that Flo is limping and they both appear underweight. You also notice Flo and Lionel looking untidy wearing clothes which appear to be dirty, which is very unusual for them. You read both Flo and Lionel’s medical file and identify no services are currently linked to them and Flo is looking after a lot of family in her house. When you ask Flo, what has brought her in, Flo tells you she has a wound on her right foot which she has been dressing at home for three months, but it is not getting better. Flo tells you she hasn't seen a doctor about her foot earlier because it was only a small wound and she didn’t want to trouble anyone. Flo also stated because she doesn’t drive, she is finding it difficult to catch public transport with Lionel. She can’t leave him at home because he sometimes becomes agitated and upset plus the children are so busy looking after their little ones, she doesn’t want to bother them. Parameter Assessment data Patient profile Florence ‘Flo’ Ljukuta 70-year-old female from Alice Springs Presenting complaint Diabetic foot wound History of complaint Small wound appeared over 3months ago, unsure what caused it. Applying pawpaw ointment and dry dressing every few days. Hypertension, Type 2 diabetes, Angina, Hypercholesteremia, Phx Asthma, Osteoarthritis. Complete hysterectomy 30years ago for treatment of endometrial cancer. Allergies Nil Known Allergies Medications Aspirin 100mg mane Perindopril 2mg mane Metformin XR 2g mane GTN 600mcg tablets S/L prn Osteo paracetamol 1330mg TDS Codeine 60mg QLD as required for acute pain Atorvastatin 40mg mane Salbutamol inhaler 2-4 puffs PRN Ethnicity/language Aboriginal. Speaks Waramungu, Walpiri, Eastern and Western Arrentre, English Alcohol use Few wines or beers with family and friend 3-4 times perweek Tobacco use Smoker ½ packet per day/ whole family smokes.Regular exposure to campfire and passive smoke Drug use Nil Home environment Currently lives in town camp in 3brd house with extended family. Approximately 13 family members staying at the house. Flo’s husband who requires assistance due to physical deficits from a stroke. Lionel has dementia, always needs supervision as he likes to walk off and becomes disorientated easily. Lionel needs prompting to eat/drink and assistance to wash and dress. Adult daughter and her 4 teenage boys Adult daughter and her 2 toddlers Adult son and his partner and their new baby Adult son Work environment Retired 10 years. Previously manager of community health clinic Stress Currently eldest daughter receiving treatment for breast cancer. States she is doing very well. Teenage boys have been a little naughty - two are heading to boarding school soon. Eldest son is working in the mines ‘FIFO’ which helps financially. Education VET level certificate Economic status Family land and house in remote community but staying in town to be with children and support needs for husband Religion/spirituality Baptised Catholic by missionaries when young ADLs Independent IADLs Does not drive anymore due to decreased vision (diabetic retinopathy). Starting to develop cataracts. Had glasses a few years ago but they don’t help much now. Cognitive function No concerns identified Diet Diabetic diet when able Sleep 5-6 hours a night, broken sleep. Gets up several time to assist Lionel with toileting. Falls asleep in the chair whilst watching TV most evenings Health check ups Last checkup 11months ago Vital signs Temp 36.8oC, HR 84bpm regular, Resp 24, SpO2 93%RA, BP 145/80, BGL 11.0 mmols/L, Pain 6 out of 10 Neurovascular Bilateral feet appear normal colour, cool to touch, cap refill >3sec, Pedal pulse diminished bilaterally, Numb sensation bilaterally, Weak strength but full range of movement. Skin to heels very dry and cracked. Assessment Questions Question 1: Aged care services and interdisciplinary care to maintain independence (recommend 1250words) Students must: Identify TWO (2) aged care services/packages Identify TWO (2) interdisciplinary referrals Detail the goal or purpose of each of these services/packages/referrals Provide a rationale for each service/referral you have selected Explain how each service/referral relates to Flo’s presentation Explain the impact of Flo’s geographical location may have on accessing these services and interdisciplinary referrals Hint: you can identify services in your local area to help increase your knowledge of services you will be referring to in your local health network. Question 2: Medication management (recommend 750words) The older person is vulnerable to adverse drug events. Examining Flo’s medication history answer the following questions. Identify and describe Three (3) factors in the case study which increases the risk of an adverse drug event Choose TWO (2) medications and describe: 1. what is the indication for each medication? 2. any potential complications that Flo may experience while taking this medication Two (2) nursing actions or health promotion you would implement to minimize adverse drug events. Please note: if a student details more than the requested volume of factor, the marker will address and mark only the prescribed amount as outlined. Presentation guidelines Complete the footer with last name_student number_NUR341_ Assessment 3 Format your assessment with size 12 Arial/Calibri or similar font, 1.5 spacing Complete spelling and grammar check using English (Australia) default A minimum of 5 peer reviewed journals or texts no more than 5 years old Use CDU APA 7th referencing style 2000word limit: recommend Part 1 (1250 words) and Part 2 (750 words). The end-of-text reference list is NOT included in the word count. Save the final version of your paper using the filename of last name_student number_NUR341_ Assessment 3 and submit as a word document
Answered 3 days AfterMay 25, 2022

Answer To: case scenario

Dr. Saloni answered on May 28 2022
82 Votes
14
A Case Study
Contents
Question 1    1
Aged Care Packages/Services    1
Anglicare    1
Home Caring    2
Interdisciplinary Referrals    3
Diabetes Educator    3
Dietician    4
Question 2    4
Factors    4
Multiple Drugs    5
Gender/Sex    5
Age    5
Medications    6
Perindopril    6
Metformin    6
Health Promotion/Nursing Action    7
Include the Patient, Family Member, and Carers in the Care Plan    7
Assessing and Screening Patients to Reduce Adverse Drug Reactions    7
References    7
Question 1
Aged Care Packages/Services
Anglicare
Anglicare has
been providing community assistance and care for almost nine decades. Anglicare was established in care services approximately in the 1800s. Their purpose is to empower those who are in need, improve the lives of individuals, and preach the love of the Almighty. It is a residential care facility that encourages liberation by delivering individualised in-home care. Individuals are assisted by their qualified professional home care workers, who would get extensive ongoing professional development as well as support in an attempt to offer high-quality services. They have indeed been delivering aged care in care homes for approximately 75 years (Ancion et al. 2019).
Anglicare can deliver a tailored falls prevention plan for Flo since she has a health history of hypercholesterolemia, high blood pressure, angina, type 2 diabetes, asthma, a history of a fall, and osteoarthritis. They would also give her an occupational therapist to aid her with the wound care of the foot. Since Flo has difficulty walking and is limping, she would gain from the services of a physiotherapist (Jordan et al. 2019).
Since Ms Florence and Lionel, her husband appeared to be underweight, a dietitian may assist her in sustaining a healthy diet and regulating their body weight. Anglicare also delivers podiatric services, so Flo's feet may be taken care of. Its residential aged care facilities, including nursing homes, have indeed been meticulously intended to give person-centered treatment in a home-like context whilst also encouraging individual liberty. They want to enable humans to keep on living purposeful and satisfying lives by learning about their experiences, preferences, and habits. The Community and Mobile Community Pantries at Anglicare Op Stores can also supply low-cost food assistance (Barry, Greenhalgh & Fahy 2018).
This service is simply accessible to Flo. The allied health services of Anglicare are delivered to others and may be available from several locations. Medical discussion rooms are also offered in some localities. Flo can find out about certain services that are accessible in her town centre by reaching them, and personal consultations can be arranged through her medical professional. Individuals in in-home care can indeed interact with their team of health care experts and professionals, offering a comprehensive range of services as their circumstances change and demand (Jordan et al. 2019).
Home Caring
Home Caring was established in 2015 with the purpose of providing in-home, high-quality care that is aimed at the patients and their preferences. They are focused on delivering professional and skilled treatment and services to all individuals. They offer help and care to the aged individuals in an attempt to make the experience more independent and confident, as well as to strengthen their quality of life both outside and within the residence. In a respite setting, they have specialists prepared to support individuals managing their diabetes (Ancion et al. 2019).
Patients can receive the highest effective assistance from the home care agency. Their providers will be present for patients both physically and psychologically, from communication and assistance to meal preparation that satisfies their dietary demands (Jordan et al. 2019). Dietitians and healthcare professionals will construct an eating plan for patients, whether it's minimal cholesterol, vegan, fat-free, vegetarian, or lower sodium, and their caretakers will assure they implement it. Moreover, they will be present to help the families to manage their diabetic therapy, encompassing administration of medication and regular exercise encouragement, to assure they have been in the finest quality healthcare (Dobrică et al. 2019).
In the case of Flo, she appears to be underweight, has indeed been limping, and is experiencing diabetes. This may have been due to her poor diet and dearth of self-care. Thus, Home Caring can assist Flo in treating her diabetic disorder. They will also aid Flo with foot care as well as her nutrition (Skibitskiy et al. 2020). This may aid her manage her weight. This service may also remedy her limping as it will enable her with regular exercise encouragement. They assure that every skilled caregiver is trained to determine any factors that induce long-term injury, including ingrown fingernails and wounds. Skilled caretakers can assess the foot on a regular schedule to assure that no damage has developed (Reynolds et al. 2022). Flo may have no trouble accessing the home care service since she currently resides in a region where she might access this service by visiting them and sending an email to a provided email address (Mulchandani & Kakkar...
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