Case study 1: Mr Harinder Kumar
Mr Harinder Kumar is a 60-year-old man referred by his GP to the cardiology clinic. Mr Kumar has known severe left ventricular systolic impairment secondary to ischaemic heart disease with extensive peripheral oedema diagnosed as decompensated heart failure.
NUR535 Bio Science For Nursing Practice Assessment 2 – Australia.
His past medical history includes diabetes type 2 treated with insulin and diabetic peripheral neuropathy. On examination, Mr Kumar was generally well, with no shortness of breath at rest, orthopnoea, chest pain, palpitations, or syncope. Mr Kumar works as a taxi driver and has limited physical activity, recently he is having been trying to walk at least 30 minutes each day but reports feeling fatigue and breathlessness with his ordinary physical activity. His vital signs were within the normal range: BP sitting 122/58mmHg and standing 112/55mm Hg, HR 70bpm , Spo2 97% on RA, temperature 36.2ºC. Mr Kumar’s GP noted a significant increase in his weight compared, his weight is now 87kg up from 75kg two months ago.
Pmhx:
Severe left ventricular systolic impairment
ischaemic heart disease
T2DM
Peripheral Neuropathy
His current medications includes:
bumetanide 1 mg twice daily
spironolactone25mg once daily
aspirin 75mgonce daily
metformin 1gtwice daily
NovoMix® 30
ramipril 5mg twice daily
simvastatin40 mg once daily
bisoprolol3.75 mg once daily and
Bendroflumethiazide 5 mg twice weekly.
Task 1: Consider the patient based on the case scenario and in grammatically correct sentences:
• Define the patient’s current medical condition/disease.
• Explain the pathophysiology of the disease.
• Discuss how the current presentation relates to the patients past medical history?
Task 2: Care plan
Based solely on the case study you have received and using the template provided (see example below), complete a nursing care plan for your chosen patient. Your plan must address the physical, functional, and psychosocial aspects of care.
NUR535 Bio science For Nursing Practice Assessment 2 – Australia.
In the above template two (2) nursing problems have been provided for you. For each nursing problem on your care plan you need to complete the following sections:
o What it is related to?
o Goal of care
o Interventions
o Rationales for interventions
o Evaluation Notes for Task 2 only
o Dot points and single line spacing may be used in the care plan template.
o Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
o All rationale must be appropriately referenced (Only the rationales need to be referenced in the care plan).
NUR535 Bio Science For Nursing Practice Assessment 2 – Australia.
Task 3: Patient education Discharge planning
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to on on going disease management or prevention of deterioration on discharge. Patient education and discharge planning starts on admission and you need to provide your patient with education during your shift in preparation for discharge home.
• Explain two (2) important points/topics you will need to include in the patient’s preparation for discharge to aid healing and prevent further illness.
• One (1) strategy to assist the patient to implement the education into their daily routine.
Task 4: Medications
Choose at least two (2) medications that your patient has been prescribed and discuss the following:
How does the medication work?
Why has your patient been prescribed this medication?
Discuss any side effects that could affect the patient.
In addition, answer the questions below relating to the case study you have chosen.
According to above word count it is already 2000 but you can explain the following questions in one or two points only so just cover up with some parts of above and fit the answer within the word limit.
Case Study:
Suggest a medication that can be used to reduce Mr Kumar’s peripheral oedema? Explain the type of drug, its mechanism of action and your rationale for choosing it.
NUR535 Bio Science For Nursing Practice Assessment 2 – Australia.
Which of Mr Kumar’s medications would you temporarily withdraw to improve his renal function and why?
Hence, answers must be straight to the points you can right it as bullet points not all the paragraphs required.
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