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Nursing Case Study

2126 words - 9 pages

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.Jack, the patient presented through Accident and Emergency to Ward D3, an acute medical ward specialising in respiratory medicine. He was admitted due to an exacerbation of dyspnoea, which was more significant over the last twenty-four hours. The writer met Jack on admission to the ward.Jack a 58 years old engineer, is divorced with one daughter. Jack is a smoker for the past thirty years; he smokes twenty cigarettes a day. He has a family history of lung cancer, his father died two years ago from lung cancer. Jack has a four-year history of dyspnoea. He has also experienced a persistent cough, productive of a small amount of yellow stained sputum. The cause of these symptoms had not been determined, as Jack has not visited his general practitioner in fifteen years. In the twenty-four hours prior to his admission, Jack noticed a considerable increase in his symptoms, he was now dyspnoeic at rest and could not mobilise as it caused him considerable respiratory distress. Jack called his daughter who in turn accompanied him to hospital.The model used to plan Jack's care was the 'Activities of Living Model' developed by Nancy Roper, Winifred Logan and Alison Tierney (1980). It is the model used on the ward as it facilitates individualised and holistic nursing care. In conjunction with the nursing process it is possible for nursing interventions to be planned, implemented and evaluated following the initial assessment with the patient to identify actual and potential problems for each of the activities of living. The initial assessment provides a baseline for future assessments, as assessment is an ongoing activity, beginning on admission and continuing until discharge. From the initial assessment breathing was identified as a problem for the patient. Other problems were identified however; due to the confinements of this assignment breathing will be the only problem discussed.Breathing is perhaps the only activity of living that most individuals perform independently throughout their entire lifespan (Roper et al., 1980). We inhale to obtain oxygen and exhale to expel carbon dioxide. Gaseous exchange occurs within the alveoli of the lungs, the respiratory organs. The mechanism of breathing is an involuntary action controlled by the autonomic nervous system. Oxygen is essential to maintain life, as it is required on a cellular level for aerobic respiration from which energy is obtained. In order to plan the care Jack is to receive, a comprehensive assessment of his breathing needs to be obtained. The nursing process is an organised, systematic method of delivering care that enables individualised care to actual problems or to prevent problems...

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