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Nursing Case Study

2640 words - 11 pages

This assignment intends to demonstrate the use of the Roper, Logan and Tierney model of nursing for assessment of a patient presenting with an ectopic pregnancy. The discussion begins with a definition of ectopic pregnancy. This will be followed with the introduction to the patient and an explanation of the model used to assess the patient. The assessment is based on pre-operative care. One particular identified need of the patient will be discussed in detail in relation to the care implemented. The care provided will be critiqued along with a critique of model of nursing.Ectopic pregnancy, also known as an extra uterine pregnancy is a potentially life-threatening form of pregnancy. It occurs when the implantation of the zygote is outside the uterine cavity (Walker & Jones 2002). The commonest location is within the fallopian tubes (Abbott 2002). In the UK there are around eleven thousand cases per year resulting in four maternal deaths (DoH 1998). Several predisposing factors increase the potential of an ectopic pregnancy occurring including: previous ectopic pregnancy, tubal damage as a result of abdominal surgery or an infection such as Pelvic Inflammatory Disease, smoking and with increased age. However, in most cases the cause is unknown (Tay et al 2000).Stacy (actual name withheld to maintain confidentiality) the patient, is a twenty five year old female. She lives with her partner of five years. Stacy presented via the ultrasound scan department. The day prior to admission she had discovered that she was pregnant. The scan was requested by her general practitioner due to her previous history of an ectopic pregnancy four months prior. The scan confirmed that there was no evidence of an intra uterine gestation sac. Appearances suggested towards an extra uterine gestation sac adjacent to the right ovary containing an embryo of three millimetres in size with heart pulsations. The conclusion of the scan showed there to be present an ectopic pregnancy in the right fallopian tube. Subsequently, Stacy was admitted as an emergency to a specialist gynaecology ward to which the writer was based. She was introduced to her primary nurse and the members of the team to which she was allocated. The ward uses a team approach to nursing care to provide a consistency in the care given. Stacy was scheduled to have an emergency salpingectomy (removal of fallopian tube) to be preformed by laparoscopy under general anaesthetic which is the passing of an endoscope through the abdominal wall.The nursing model used to plan Stacy's care was based on the Roper, Logan and Tierney Activities of Living Model (Appendix 1). It is the model of use on the ward to provide a holistic approach to care. This model was first published in 1980 as a result of a research project undertaken by Nancy Roper in 1976 (Roper et al 2002). The theories underpinning the model are Maslow's Hierarchy of Needs (1943) and the work of nursing theorist Virginia Henderson (1969).Maslow's...

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