HLT54115 Diploma of Nursing
HLTENN012 - Implement and monitor care for a person with chronic health problems
Case Study Student Copy
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Student number: Unit:
Due Date: Date Submitted:
Type of Assessment – Case Study
• Please answer all questions. Total word count for all questions should be about 800 words.
• Please include a signed Assessment Cover Sheet. Failure to do this will result in a delay in marking your assignment.
• You may organise your responses as you choose either by using headings or in essay format. Please do not use dot points.
• All your answers must be correctly referenced. Please include a
Reference List at the end of your assignment. Work that is not correctly referenced will be returned for re-submission as a second attempt.
• Please submit your assignment by the due date. Assessment items submitted past the due date without an extension will be automatically marked as a second attempt.
• If you require an extension please contact your teacher 2 WEEKS BEFORE the assignment is due.
The following websites may assist with this case study https://strokefoundation.com.au/ https://www.diabetesaustralia.com.au/ http://www.agedcare.org.au/ https://www.heartfoundation.org.au/
Mrs. Cornellia Poulous is a 84 (DOB 33.11.1931, UR 12345668) year old Greek lady sent to the Emergency Department via ambulance by her GP with a suspected left sided CVA. Her husband called the doctor after Mrs. Poulous fell when she tried to get out of bed and said that she could not feel her right leg. Mrs Poulous states that she has lost some strength in her right arm and hand.
Mrs. Poulous lives with her 88 year old husband in a high set house in Melbourne. Until recently she was very well and is the principal carer for her husband who has congestive heart failure and sometimes requires hospitalisation. Mr. Poulous says that she has seemed tired and listless lately and he thinks she has lost weight. Their only daughter lives in Tasmania and their son and his family live in Greece.
Mrs. Poulous’s only medication is a daily multivitamin.
Mrs. Poulous is a type 11 diabetic, diet controlled and has osteoarthritis that gives her pain on movement.
Mrs. Poulous states her religion as Greek Orthodox
On admission to the emergency ward, Mrs. Poulous’s observations are:
BP: 160/95 P: 110 Temp: 36.5°C Resp: 20
SaO2: 97% on room air
Weight: 52kg (chair scales) Height: not done
BSL 3.2 Pain 7/10
Mrs. Poulous’s speech is slurred. She repeats the same Greek phrase several times, looks anxious and starts to cry when she tries to hold a glass of water but spills it.
The RMO conducts a neurological examination which seems to confirm the diagnosis of stroke. Blood is taken for a full blood count, Urea, creatinine and electrolytes and liver function tests. Following a brain scan (CT) in the afternoon, it is discovered that Mrs. Poulous has metastatic breast cancer. Her cerebral metastases have caused the stroke like symptoms.
Based on this case study and further research, please answer the following questions Question 1
Pathophysiology means the effect that a disease or condition has on a person. What are the likely effects/impacts the false stroke and the breast cancer will have on Mrs. Poulous and her family?
• Ability to communicate
• Psychological and emotional wellbeing
List the common sites for primary cancers.
The following website may assist with this question http://www.ajan.com.au/Vol33/Issue2/3Johnson.pdf
Health literacy has been defined as the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course. Discuss how you could provide information to Poulous and her family to increase their understanding of her condition and the community based services available.
Mr Poulous has asked that Cornellia not be told about her cancer as he believes this will be too distressing for her at the moment. Her Doctors agree and document this in her notes. Cornellia tells you the next day in the shower she believes she has cancer and asks you if she does? How do you respond?
Write a nursing care plan for Mrs. Poulous. Include in your nursing care plan
- Nursing interventions
- Nursing history
- Nursing admission
- Actual and potential problems
- Neurological Chart
- Vital signs
- Diabetic chart
- Pain Chart
What community agencies might be called on to assist Mr. Poulous with his heart failure and Mrs Poulous with her cancer and stroke? What would their roles be?
Late that evening, Mrs. Poulous’s level of consciousness begins to deteriorate. What would your role be in this emergency?
After ten days in hospital, Mr Polous and family wish to take Mrs Polous home. Formulate a discharge plan, include activities of daily living. Identify the levels of support that Mr Polous can provide for Mrs Polous and the community support services that will be required. How do you actively involve Mr and Mrs Polous in planning and formulating their care plans? List four potential impacts on Mr Polous as the primary carer of Mrs Polous?
Mr Polous has received 2 hours of assistance for cleaning per week. Discuss additional support that may be required for Mr and Mrs Polous
The following website may assist with this question
Patients with a chronic or terminal medical condition and complex care needs requiring care or services from their usual GP and at least two other health or care providers are eligible for a case conference service.
A ‘chronic medical condition’ is one that has been, or is likely to be, present for at least six months, for example, asthma, cancer, cardiovascular disease, diabetes mellitus, musculoskeletal conditions and stroke. There is no list of eligible conditions. However, the CDM items are designed for patients who require a structured approach and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary team.
Case conferences can be undertaken for patients in the community, for patients being discharged into the community from hospital and for people living in residential aged care facilities.
The case conferencing team must include a GP and at least two other health or community care providers, one of whom can be another medical practitioner. Each team member should
provide a different kind of care or service to the patient. Give examples of the interdisciplinary team that may be included in a case conference for Mrs Polous.
Discuss the case conferencing process and how it provides a holistic approach to patient care.