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Written assignment - Nursing

Written Assignment - Nursing:Family analysis and education

Length: 800 words, with additional appendices

Learning Outcomes

This assignment addresing the following unit learning outcomes

  1. demonstrate an understanding of the cardiac systemincluding related anatomy and physiology,pathophysiology, diagnostics,pharmokinetics,pharmodynamics,the quality use of medicines and complementary therapies;
  2. demonstrate and apply comprehensive cardiac assessment andevidence based clinical reasoning skills in theory,clinical and simulated environments;
  3. demonstrate the capacity tointegrate and relate principles of ethical and legal practice within an intra and interprofessional team approach to person centred care;
  4. learn andapply reflective practice and professional communication strategies that facilitate the delivery of safe and effective culturally sensitive quality care across diverse settings;
  5. plan and implement person centred primary health careand health promotion strategies related to cardiac health and wellbeing.

Q. Task

Your response needs to be supported byrecent evidence-based resources.This could include information from your texts and from other peer reviewed sources. This assignment makes use of the Katrina and Trevor case studies which can be found on the Moodle home page.

  • Outline the incidence/ prevalence and main causes of Hypertension in Australia
  • Discuss the grading system for hypertension, Outlining the modifiable and non-modifiable features of the disease and their primary management included in each stage.
  • As an appendix, present an evidence-based education plan for both Katrina and Trevor. The Patient Education Plan should include their cardiac medications. It should discuss all aspects of cardiac health (there are several problems including physical, social and psychological), and set goals to improve their health. The plan should include the interdisciplinary team. This needs to be in table format, with referencing throughout.

Referencing

Your planmust be appropriately referenced.A minimum of 8recent evidence-based resources is required for this section of the assignment.APA is the required referencing style for assignments in the School of Health.

Case study ofTrevor

Taking Trevor's history

You and the RN begin your assessment by taking Trevor’s history. This is the information he gives you:

  • He is a 61 year old man. He was born in Sydney and lived there until he was 50, when he and his wife, Susan, decided to move to this rural town (around 40,000 residents including a large Indigenous population).He is a smoker.
  • He and Susan have four children, aged 23, 25, 27 and 30, who all live in Sydney.
  • Trevor works as an architect, spending a lot of his work day at his desk. He and Susan like to spend their weekends either relaxing at home or visiting their family.
  • Trevor doesn’t really like physical activity and hasn’t played any type of sport since he was a teenager at school. He tells you he is too busy and 'doesn’t see the point'.
  • He tells you he generally doesn’t pay much attention to what he is eating. He says he eats whatever Susan cooks for him and when they go out for dinner (about twice each week), he usually orders steak and chips.
  • He was told by a GP a few years ago to 'get checked out' for type 2 diabetes mellitus, but he has never followed up.

Assessing Trevor

You and the nurse begin a full physical assessment of Trevor. Here is some of the information you collect:

Trevor is 172cm tall and weighs 122kg.

Trevor’s vital signs are:

  • Blood Pressure (BP) 143/87mmHg
  • Heart Rate (HR) 87 beats per minute (at rest, sitting on the examination bed)
  • Respiratory Rate (RR) 24 breaths per minute (at rest, sitting on the examination bed)
  • Temperature (Temp) 36.6oC
  • Oxygen Saturation (SpO2) 94% on room air
  • Heart sounds are normal: S1 and S2 heard clearly
  • Lung fields sound diminished, but clear to bases
  • Blood Glucose Level (BGL) 12.4mmol/L (about 4 hours after his last meal).

The doctor's opinion

With this information, the GP suspects Trevor has Ischaemic Heart Disease (IHD) and decides to send Trevor for a fasting BGL, HbA1C and serum cholesterol tests.

Focus for investigation

What is Ischaemic Heart Disease?

  • Describe the aetiology, pathogenesis and clinical manifestations
  • Which signs and symptoms can you see in Trevor’s story that fit this disease?

What are the risk factors for IHD?

  • Which ones can you find here in Trevor’s history?

What tests can be done to diagnose IHD?
What other information would you like to collect in your assessment of Trevor (remember, you are in a GP office- think of the resources you have available to you there).

What complications (or potential complications) can arise from IHD? Relate these to how they might influence Trevor’s story.

A month later

Trevor's test results were as follows:

  • fasting BGL 9.6mmol/L
  • HbA1C 7.2%A
  • serum cholesterol level 9.1mmol/L

Trevor has now been diagnosed with IHD and type 2 diabetes. He isprescribed atorvastatin 20mg oral daily and advised to manage the diabetes via his diet for the time being.

2)Katrina case study

Katrina is assessed by the community nurse

Katrina Tyler is a 12 year old student who has recently commenced high school in the rural town (population approximately 20,000 people) where she grew up and where she lives with her parents and older sister, Karen, 15. Katrinaand her family identify as Indigenous Australians. Katrinais normally fit and well. Her only ailments are an occasional cold. The only major illness she has experienced to date is a bout of gastroenteritis at age 10, which lasted 3 days. Katrinaplays netball on Saturdays and goes swimming during the summer with her sister.

Katrina's mother, Amanda, is 41 years old. She works as a teller at one of the banks in town. Amanda was diagnosed with low grade hypertension last year and is managing this with Avapro. Amanda’s BMI is 28.
Katrina’s father, Jim, is 43 years old. James works in the local abattoir. Jim was diagnosed with type 2 diabetes mellitus three years ago, which he is currently managing through diet and exercise. He was also diagnosed with atherosclerosis at the same time. He is taking Lipitor as a treatment for this at the moment.

You are currently on clinical placement with a community health service and are visiting Katrina’s school with a Registered Nurse to perform health assessments on the middle school students and educate them about heart health.

Focus for investigation

  • What differences in cardiovascular anatomy and physiology might you find between an adult and paediatric patient?
  • What are some differences in cardiac assessment findings you might find between an adult and a paediatric patient?
  • What would normal findings be in a healthy child?
  • What familial risk factors are there for cardiac disorders?
  • Relate this to Katrina’s story- can you find any here?