Case study: PATIENT SCENARIO
Task
In aIDressing this case study you are required to present your paper under five headings:
o Introduction. ( I already done this part )
Present a short patient history (approximately 250 words). This history should demonstrate the complexities of the patient. The patient problems are expected to provide you with an opportunity to demonstrate under the following assignment headings how you aIDress issues in your selected area of nursing practice using sound clinical judgement, critical analysis and planning to ensure the best patient outcome.o Signs and/or symptoms ( I already done this part)
Identify the pertinent signs and symptoms which you believe contributed to the patients key issues or problems. You are required to use current literature to justify why these signs and symptoms were of particular significance in this instance and how they contributed to (or allowed the identification of) the key patient issues or problems.o Key issues or problems. ( I need you to start from this part please)
The key patient issues or problems may be nursing, and/or collaborative (i.e. involve other members of the interdisciplinary team). When examining the nurses role and appropriate nursing interventions make a case for the development or continuation for an advanced practice role (e.g. nurse practitioner or clinical nurse consultant).
o Care recommendations ( I need you to do this part please )
Given the problems you have identified what is the best approach to patient care which should be taken in this instance. You must draw upon current research and/or evidence based practice guidelines to support your argument.o Conclusion ( I need you to do this part please )
Make some concluding remarks.Key issues or problems and care recommendations will constitute the majority of your word count.PATIENT SCENARIO
Patient profile
Mrs SS, a 68-year-old woman, was admitted to the medical unit of a hospital in your country (King Fahad Hospital- Saudi Arabia) with complaints of increasing dyspnoea on exertion. She has type II diabetes, hypertension and chronic kidney disease. Mrs SS is a retired school teacher who lives alone in an apartment on the second floor and is normally able to attend to activities of daily living, cooking, cleaning and shopping. She has two adult children who live in other cities; she has no other family nearby. She has several good friends who live nearby.Subjective data
Had a myocardial infarction at 62 years of age
Has experienced increasing dyspnoea, frequent cough, and oedema in legs over the last 3 weeks
Has to sleep with head elevated on three pillowsObjective data
In respiratory distress, use of accessory muscles, respiratory rate 36 breaths/min
Heart murmur
Skin cool and diaphoretic
Venous leg ulcer on left ankle
Bloated abdomenPhysical examination
Pulse full and bounding: 92 bpm, blood pressure: 162/106 mmHg, O2 saturation: 88% (room air)
Temperature: 37.1oC
Urinalysis: protein++++; pH 6.8; SG 1.020; blood, glucose & ketones nilDiagnostic studies
Serum: K 5.9 mmol/L; HCO3 14 mmol/L; Urea 13.7 mmol/L; Creatinine 238 mmol/L; eGFR 17 mL/min/1.73m2; Hb 98 g/L; HbA1C 7.2%.
Chest X-ray result: left ventricular hypertrophy; fluid in lower lung fields
ECG: normal sinus rhythmCollaborative care
Frusemide 80 mg BD
Peridopril 8 mg daily
Lercanidipine 10mg daily
Atorvastatin 10mg daily
Calcium carbonate 600mg TDS
Calcitriol 0.5g daily
Lispro 25% 12 units BD
Oxygen 6 L/min via Hudson mask
Daily weight
Renal diabetic diet
Referral to renal team (nephrologist & CKD nurse practitioner)
This is useful link about Advanced Practice Nursing (E-BOOK)
http://reader.eblib.com.au.ezp01.library.qut.edu.au/(S(oiuackews0ysxcgf4tnup0iv))/Reader.aspx?p=1119700&o=96&u=Y%2bI6XM1ClIDqPeGUzkTKgQ%3d%3d&t=1411560452&h=4DC1470981B2C7A677BF9F6BFB0B86C51F8DFE47&s=15609015&ut=245&pg=1&r=img&c=-1&pat=n&cms=-1&sd=1#
Important notes on the assignment
Please ensure a word count is included on the title page. You may have plus or minus 10% of the
designated word count, not including in-text references and the reference list.
*Use size 12 font, Times New Roman or Arial font and double line spacing for all assignments, left and right justify, and esure margins of 2.5cm on the left, right, top and bottom of the page.
*Include footer with page numbers x of y and a header with your name and student number on all pages.
*Reference according to APA convention only. All references must be e-journals. Use from database such as :
Dynamed
-Cochrane Library
-Joanna Briggs Institute Evidence Based Practice database
-BMJ Best Practice
-Therapeutic Guidelines
-Mosbys Nursing Consult
-EBM Guidelines