2019 NSG2ANB WRITTEN TASKS
Word Count: 1000 words
Due Date: Please refer to the attached table depending on your cohort
1. Analyse the Australian Nursing and Midwifery Board [ANMB] Standards of Practice for a Registered Nurse when caring for individuals and their families presenting with acute to chronic conditions.
2. Critically examine the impact of hospitalization for individuals and their families experiencing acute on chronic illnesses.
3. Evaluate person-centred care, using the Clinical Reasoning Cycle to individuals experiencing haematological, renal, gastrointestinal and musculoskeletal disorders.
The purpose of this assignment is to assess your understanding regarding the impact of the hospitalisation to patients and their families admitted for acute to chronic illnesses and your knowledge to engage appropriate members of Interprofessional team during hospitalisation and discharge.
You are provided with 2 case scenarios. You are to choose only 1 case scenario where you are to discuss the guided questions provided.
Choose one (1) from the two (2) Case Scenarios provided below:
Case Study A Name: Wendy Xu
Address: 11 Borrow Street, Carrum Downs, 3201
Admission date: 27/05/2019
Admission Diagnosis: Increased confusion, pain and Unstable BSL secondary to Brain Ca.
Past Medical History: T2DM (Oral Hypoglycaemics and Lantus), HTN, Hypercholesterolaemia, exsmoker, Coronary Artery Disease – Stent to LAD, Brain Ca (Stage 3), depression.
Wendy was diagnosed with brain cancer five years ago. At the time of discovery, she underwent treatment of chemotherapy and radiotherapy however showed little improvement. Since her diagnosis five years ago, Wendy became depressed and lost her optimistic outlook on life. As Wendy slowly lost her independence, her husband became her full-time carer. The pair continue to live in their home in Carrum Downs.
Over the last week, Wendy’s husband has been complaining that his wife has become increasingly confused and forgetful. At times, she was also verbally aggressive. She has been been refusing her medication regime and her BSL was 22.5. Wendy’s husband called the ambulance and she was admitted into hospital into the neurology ward.
Social History: Wendy and her husband have a daughter, Brigit, who lives 20 minutes away. Brigit lives with her husband and 15-year-old daughter. Wendy has a close relationship with her daughter’s family.
During Admission: It is now Day 5 into Wendy’s admission.
CNS: Currently alert and oriented. GCS 15. Patient can become intermittently confused, however easier re-oriented. Patient has been prescribed regular Targin 5/2.5mg which has continued to help alleviate her pain.
CVS: Peripherally warm to touch.
RESP: Nil SOB or increased WOB. Saturating 95% on RA. Lungs clear bilaterally on auscultation. GIT: Eating and drinking as tolerated. BNO 2/7. No aperients administered. RENAL: nil issues
SKIN: Dry and intact.
SOCIAL: Family meeting was held with Wendy, her husband, daughter and medical team today. Findings of Wendy’s recent CT-Brain and Abdo was informed to family. Her cancer had become widely metastatic. The doctors warned Wendy and her family that they might start to see some personality changes due to the cancer’s progression and she may become more forgetful. She was recommended by her doctors to enter a respite facility where she can be looked after properly. Wendy had recently heard about euthanasia and have queried if this was an option for her.
Coming from a Chinese background, Wendy and her family did not believe in respite care. They have a strong family value, and all agreed it was best that Wendy move into Brigit’s home for the remainder of her time.
Case Study B Name: Timothy Anders
Address: 32 Falcon Drive, Fawkner, 3060
Admission date: 04/04/2019
Admission Diagnosis: Sporting accident with head strike and loss of consciousness.
Past Medical History: nil
Presenting History: While Timothy was playing a football match, he lost his footing and fell backwards. He sustained a head injury and lost consciousness. He was admitted to ED via ambulance transfer.
Social History: Timothy plays football with the Victorian Football League and had great aspirations to make it to the AFL one day. He is currently studying a Bachelor of Sports and Exercise Science at La Trobe University. He is an outgoing and social 19-year-old. Timothy moved out of home six months ago with some friends. He remains close with his family. Timothy is the oldest of three boys. His brothers aged 16 and 14 both look up to him. His parents own a small family restaurant in Fawkner and Timothy often helps out with the family business. Both his parents work fulltime with no close relatives to assist.
During Admission: Timothy regained consciousness as he arrived into the Emergency department. A neurological exam was performed.
CNS: Alert and oriented, GCS 15, PEARL. Patient is complaining of 8/10 pain to his head, which has been relieved with PRN endone.
CNS: Vital signs stable, BP 112/70 HR 88 RR 15 Temp 36.7 SpO2 99%. Peripherally warm to touch.
CR 2 seconds.
RESP: Nil SOB or increased WOB, Patient saturating 95% on RA. Lungs are clear on auscultation. ABDO: Soft and non-tender.
RENAL: nil issues.
SKIN: Some bruising to upper body, otherwise skin is intact.
Diagnostics: A CT scan showed that his spinal cord was damaged at his Thoracic spine, resulting in him having partial paralysis. The medical team were not confident that they could save the damage caused on his spinal cord.
When Timothy’s family had arrived, they were informed of the results of the CT scan. Timothy was recommended to go to a temporary rehabilitation facility where he could retrain his body and become as independent as possible before transitioning back home. Since finding out his diagnosis, Timothy has been experiencing low mood and loss of appetite since finding out about this news. He no longer wishes to see his friends and is constantly angry towards his family.
1. During hospitalisation
A. Identify and discuss one (1) immediate actual or potential impact of hospitalisation to your patient/or family in your chosen case scenario. Include information from the scenario in your discussion.
B. Identify and discuss one (1) appropriate member of Interprofessional team that you will engage to support the impact identified. Provide credible references.
2019 NSG2ANB WRITTEN TASKS