Nursing Case Study Assignment Sample: Analysis of Four Medical Conditions

Nursing Case Study Assignment Sample: Analysis of Four Medical Conditions

Question

Examine the four medical cases listed below and respond appropriately to the questions for this nursing case study assignment.

Solve issue 1 Situation:

The first scenario from this sample nursing case study assignment is provided below.

Aged 78-year-old Antasia Kyrillos was admitted to the rehabilitation unit after a cerebral vascular accident that affected the left side of her brain. The patient experienced right-sided hemiparesis due to trauma to the left side of the brain. Since the event occurred two weeks, the patient has made some progress with his or her condition. She is given a wheelie walker for safe transportation, which will help her to transfer from bed to chair and cover a short distance. The patient's lack of English language proficiency and inability to communicate nonverbally due to her hemiparesis and aphasia make interactions with her extremely difficult. According to the information provided by her family, the patient is in a situation of knowing everything but is unable to communicate her ideas. The patient shared a home with her daughter up until her CVA. Her family is anticipating her quick return following therapy.

According to the patient's medical file, the patient had a history of untreated hypertension, which finally led to a haemorrhagic stroke. The current condition of the patient's blood pressure is stable. The student receives the prescribed dosage of antihypertensive medications to maintain an appropriate blood pressure level.

• What tasks does Anastasia need help with? Detail each assignment.
• How should nurses communicate with patients?
• Determine Anastasia's obvious and hidden care needs.
• What health risks does Anastasia's condition pose?

Solution

1. Anastasia's health is so poor that she needs daily nursing care. She requires help getting out of bed and walking for everyday requirements. Because of this, Anastasia is awarded amnesty.
2. Medical professionals can interact effectively with Anastasia using numerous approaches. Effective communication tactics include a better means of communication, clear communication in slow motion, avoiding jargon and medical terminology, and using plain English, clear directions, and more patience (Jirwe, Gerrish and Emami, 2010).

Anastasia is recovering. Her health must be monitored. Diabetic Anastasia Therefore, her blood glucose levels must be carefully analysed. The patient should take the required prescription to maintain glucose levels (Lammert, 2008). He has hypertension. Monitor and record her blood pressure frequently. Blood pressure test is crucial since she's having a haemorrhagic stroke.

Anastasia's medical difficulties make her exposed to health risks. Type 2 diabetes and hypertension have killed the patient (LeMone & Burke, 2008). Changing blood pressure or glucose levels put the patient at danger. If blood pressure increases, another stroke or CVA may develop.

Challenge 2: The second circumstance in this sample nursing case study assignment is provided below.

Situation:

22-year-old James Moorland was in an accident three weeks ago and had a fractured right femur. Soon after the accident, the patient was brought to the orthopaedic department, where his legs had two surgeries. The first procedure involved employing plates and screws for internal fixation, while the second involved cleaning the wound using the delayed closure technique.

The patients' bandages and closures were removed after two weeks, but now the incision has begun to separate and is seeping foul-smelling pus from the stitched region. The patient's history reveals a severe case of undernourishment, chain-smoking, and high alcohol consumption regularly. Since last month, a patient has experienced this MRSA disease three times in a row.

• Determine what caused the hospital MRSA epidemic. Describe the management and medical team's preventative measures.
• How did the patient get the nosocomial infection?
• How can management and medical staff prevent nosocomial infections?
• Describe how to report a nosocomial illness while following workplace laws.
• If the patient is undernourished and needs food supplements, what should the nursing staff do?

Solution

1. MRSA may infect a hospital for numerous reasons. The medical personnel can transfer sickness from patient to patient. Nurses and other medical professionals must care for many patients fast, increasing infection risk. Infected gloves or devices like a thermometer and intravenous tubing can transfer illnesses from one patient to another if staff members are lax about changing gloves.
2. In the orthopaedic department, the patient underwent two procedures: primary wound closure by stitching and internal fracture repair using screws and sheets. James acquired a nosocomial illness (Bennett et al., 2005). The patients' surgeries may have used dirty instruments.
3. Hospitals must act quickly to prevent the spread of MRSA. To reduce MSRA risk, patients, their surroundings, staff, and instrument condition should be inspected and audited.
4. Infection and control programmes involve documentation and reporting. In hospitals, new and old equipment should be well documented. Proper documentation reduces infection risk from aged, non-sterilized equipment. All nosocomial infections should be reported in hospital records (Gosbell et al., 2006).
5. Observations show James is underweight and malnourished. According to the patient's medical history and family remarks, he smoked and drank extensively. This is important. Nurses must ensure he gets enough vitamins and nutrients to stay healthy.
6. Problem: The third scenario from this sample nursing case study assignment is provided below.

Situation: Gordon Freemason, a 53-year-old man in his middle age, fell into a gutter while working at home from a ladder. The person's occipital bone in his head was cracked, and his L4 and L5 vertebrae were broken. The patient also has an epidural hematoma in addition to the skull fracture. He underwent surgery, and the occipital fracture's state was elevated surgically to drain the bleeding that had developed in the skull. After his operation, he was under surveillance in the Intensive Care Unit for 12 hours.

Additionally, the patient has a disease where fluid is constantly running via the intravenous system. Since he frequently suffers from asthma episodes, he is given preventative inhalers. Long before the accident, the patient was taking antibiotics daily for a respiratory illness he was being treated with.

• How will the patient's current medical condition and hospital care affect pre-fall health?
• What are Gordon's post-op risks?
• Health care corporations don't give lift plans for safety, health, and physical therapy. Consider how the medical team can provide the patient back treatment and a new bed.
• Administration rules and legislation govern the medical staff. The student's morphine and saline supply dwindles. The patient needs morphine and saline.
• This patient will need a frame until he regains movement or motor function. What should be done if Gordon wants to go home?

Solution

1. Gordon's medical history revealed he had asthma. When the accident happened, the patient had respiratory disease. Asthma preventive inhalers. This accident will probably affect asthma. Gordon's respiratory problems worsened due to lower back pain. Weight affects breathing. His critical injury requires strict bed rest.
2. The surgery may herniate Gordon's brain. Brain herniation increases skull pressure. Due to increased intracranial pressure, an intracranial haemorrhage would impede brain blood flow and harm delicate structures.
3. Before raising a patient from bed, medical professionals should log roll him. Due to obesity, the patient's spine needs additional care. A bed stick should help him sit. Using an overhead bar, correct his posture.
4. Schedule 2 drugs include morphine. Medicine administration includes the suitable medication, route, patient, dose, reason, timing, and documentation.
5. If Gordon leaves the hospital, a nurse should help him at home. Gordon will use the frame to navigate the home, and he may trip and injure his spine. The nurse should help him restore mobility and motor abilities.

Problem: 4: The fourth circumstance in this sample nursing case study assignment is provided below.

Situation:

Due to an appendix rupture, Louise Young, a 30-year-old lady in her middle age, underwent laparoscopic surgery. She has since been admitted back to the ward. Her data were later recorded as follows: blood pressure 140/75, respiration 28, pulse 112, and temperature 38.96°C. Louise has four abdominal incisions hidden beneath the skin and covered with clear occlusive bandages. The surgical sutures are all still releasing fluid, and the incisions are all completely intact.

The patient's abdomen is swollen, and she rates her pain as 8/10 on the pain scale. The patient has an intravenous line in the left cubital fossa, which lies within the elbow. Saline fluids and maintenance dextrose are being given to the patient at a rate of 125ml/hr. Louise is fitted with a nasogastric tube, allowing easy drainage because she does not take any medicine orally. During the convalescent period, the patient received the intravenous fentanyl dosage, and an extra prescription of intravenous morphine was completed.

The patient's health worsened after spending a half-hour in the ward. Following the deterioration of the situation, her medical measurements are pulse 160, temperature 40.1 °C, blood pressure 100/55, and respiration 36. The patient's abdomen has become more distended and swollen. The patient is unconscious and does not become cognizant again until she gets startled.

• Considering the patient's dressing, observations, analgesia, and other circumstances, describe the priorities for treatment when the patient is brought back to the ward.
• What ought to have been done and what ought to have been done when the patient's condition deteriorated?
• What is going on with Louise?
• Describe the precautions and measures that should be used if Louis's health worsens.

Solution

1. After surgery, the patient's dressing, medical care, and analgesia should have been prioritized. After 30 minutes inside, the patient's pulse, temperature, and respiration rate were abnormal. Worse, her blood pressure dropped. The patient's surgical sutures discharged, and the incision was infected. Incision needs greater care.
2. The deteriorating patient should have been given an oxygen mask. Her tachycardia may have been caused by a medical condition that should have been addressed with medicine.
3. The patient has severe Necrotizing Fasciitis after laparoscopic appendix ectomy (Raghavendra, Mills and Carr, 2010).
4. If the patient's health worsens, the nurses should call a doctor. Both phases establish if a patient's medical state requires a medicine change. When the hospital was told the patient needed morphine, he had already taken fentanyl.

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