Due Date: Wednesday 16th September
\nWeighting: 50%
\nTime limit: 10 minutes maximum & Maximum of 10 PowerPoint slides (9 for content, and 1 for your reference list). You also need to include your notes under the slides,
\n2. Assessment 1 Case Study Information
\nMs Aaliyah Abimbola; a 56-year old female who emigrated from Africa 20 years ago. Ms Abimbola is a single parent with three female children, ages 14, 17 and 18. You are working on the respiratory ward and have been allocated to Ms Abimbola who has been admitted with exacerbation of COPD. Ms Abimbola presented to A&E via ambulance at 8AM after experiencing acute shortness of breath while preparing breakfast this morning.
\nBased on the information provided in this case study, you are required to discuss your initial assessment of Ms Abimbola using Steps 1 and 2 the Levett-Jones\u2019 (2018) Clinical Reasoning Cycle (CRC) before interpreting the information (Step 3 CRC) you have been given to identify 3 nursing care priorities (Step 4 CRC) for Ms Abimbola.
\nThe key components of Assessment 1 are to:
\n\u2022 Discuss the key elements of Step 1 of the CRC and why it is important by:
\no developing and presenting a concept map of Ms Abimbola and her situation
\no Including evidence to support the content of your concept map
\n\u2022 Discuss the key elements of Step 2 of the CRC and why it is important.
\n\u2022 Discuss the pathophysiology of COPD and how Ms Abimbola’s S&S reflect the underlying pathophysiology of the condition.
\n\u2022 Interpret the information you have been given about her condition (Step 3 of the CRC) and identify three priority nursing issues you must address for Ms Abimbola (Step 4 of the CRC). Justify why they are priorities and support your discussion with evidence.
\n\u2022 Discuss the potential impact of COPD on Ms Abimbola\u2019s three most important activities of daily living. Link your discussion to the Roper-Logan & Tierney model.
\n3. Tips and Advice for Success
\nDiscussion:
\n\u2022 There is much further depth required to meet the criteria on rubrics when you are being asked to critically discuss and critically analyse. This moves beyond merely ‘describing’ events or processes and requires you to make much deeper links that are supported by theory and evidence-based literature.
\no For example, you may include the pathophysiology of a disease process, but unless you can explain the link between the patient and their conditions, this does not demonstrate sufficient critical analysis or understanding
\n\u2022 Your discussion needs to utilise high quality academic sources to support your arguments, and refrain from using consumer websites
\nSlides:
\n\u2022 Avoid text heavy slides which can detract from the meaning being presented on the slide. Stick to your main points (e.g., 3-5 points per slide), and verbally explore the points further.
\n\u2022 Try to use diagrams, pictures\/images or schematics which can break the slides up, as well as aid visual learners. However, these need to be relevant to the discussion
\n\u2022 Ensure all slides and diagrams are referenced
\n\u2022 Consider the use of an appropriate font type, colour and size to ensure ease of reading for the audience.
\n\u2022 Proof read your work for grammatical errors, spelling mistakes or issues with punctuation. Remember, this is a piece of academic writing and needs to be at a high standard.
\nOral presentation:
\n\u2022 Avoid simply reading from your notes\/slides
\n\u2022 Ensure your discussion flows logically, i.e. you should still introduce your presentation, the discuss your main arguments and then finish off with a conclusion
\n\u2022 Be succinct but include everything that you need to include. Remember, you have a time limit and you do not get the option to deliver your information in another capacity
\n\u2022 Practice, practice, practice, and only start recording when everything is ready to go and you are confident
\nMs Aaliyah Abimbola
\nBackground information for the assignment.
\nYou are the RN on a morning shift on the respiratory ward of a large inner-city hospital. At 10:30 AM you receive a patient from the Emergency Department.
\nThis is the hand-over you receive.
\nI My name is Catriona and I am the A&E RN who has been caring for Ms Aaliyah Abimbola. Thank you so much for taking this patient so quickly. We\u2019re so busy we haven\u2019t time to do much for her apart from get her ready to bring up here.
\nS Ms Abimbola is a 56-year-old woman with a past history of COPD who was admitted to A&E via ambulance at 8am today in acute respiratory distress. She became acutely short of breath this morning while making breakfast and called an ambulance.
\nB I only got the chance to ask her a few admission questions before I was told to bring her up here. She was able to tell me:
\nShe saw her GP two weeks ago due to increasing shortness of breath and fatigue and he gave her \u2018some breathing medication\u2019 (inhalers). She has had to use these with increasing frequency since then. Ms Abimbola has been working at the flour mill 50 hours per week recently. This has made it tough to look after her three daughters because she\u2019s a single parent. She has a medical past history of moderate sleep apnoea for which she uses CPAP to sleep overnight, Type 2 Diabetes and hypertension diagnosed 3 years ago. She has never smoked but has a long history of severe exposure to industrial dust. Her children are at school but the oldest one knows she\u2019s in hospital.
\nA On arrival in A&E she was acutely short of breath with an expiratory and inspiratory wheeze. Her Sat\u2019s were 93% on room air & her GCS was 15. We haven\u2019t had time to do much for her apart from give her a couple of nebulisers. She has an interim medical diagnosis of acute exacerbation of COPD
\nR Medical orders:
\n\u2022 5mg salbutamol nebuliser as necessary, repeat every 20 minutes for 1 hour. O2 therapy to maintain SpO2 92%.
\n\u2022 Needs to have an ABG and a sputum sample collected for MC&S.
\n\u2022 Monitor vital ob\u2019s half hourly and the respiratory medical team will be here soon to review her.
\n\u2022 Notify RMO if her condition gets worse.
\nYour initial assessment findings on the ward for Ms Abimbola are as follows:
\nMedications
\nMetoprolol 100mg daily, Aspirin 100mg daily, Atorvastatin 20mg mane, Glibenclamide (Daonil) 5mg orally daily before breakfast, Salbutamol sulphate (Ventolin) 100mcg inhaler as required for symptom relief (1-2 puffs as required), Fluticasone propionate\/salmeterol xinafoate (Seretide) 50\/25 inhaler (2 puffs BD)
\nCurrent vital observations:
\nBP 142\/96mmHg
\nHR 96bpm
\nRR 24 bpm
\nSpO2 93% on RA
\nT 36.7C
\nHealth assessment findings:
\nHeight 158cm, Weight 93kg,
\nTotal cholesterol level – 5.2mmol\/L
\nFasting BGL – 9.6mmol\/L
\nInspiratory and expiratory wheeze. speaking in short phrases taking 2-3 breaths between each phrase before continuing to speak.
\nAlert and orientated to time, place, and person.
\nFurther information you gather from her medical history and as part of her admission questions:
\nMs Aaliyah Abimbola is a 56 year old female who emigrated from Africa 20 years ago. Ms Abimbola is a single parent with three female children (ages 14, 17 and 18) living in the inner-west of Melbourne.
\nMs Abimbola went to her local health care clinic 2 weeks ago complaining of increasing shortness of breath and lack of energy. She says she was given some breathing medication (inhalers) by the doctor and told to take it easy for a few days. She has been struggling to get from the ground floor living area to the upstairs bedrooms without resting half-way to catch her breath. She says sometimes the medication helps her catch her breath but she still has to rest half way even with the medication.
\nMs Abimbola has been working at the local flour mill since she arrived in Melbourne from Africa 20 years ago. She has never smoked but says the dust at the flour mill often makes her cough. Her job for the first 3 years was filling bags with flour until that process became fully automated. She then got promoted to running one of the flour grinding machines. 2 years later she got another promotion to shift supervisor in the milling and packaging section. She says her clothes were always covered in white dust at the end of every shift. -I used to look like a ghost at the end on my shift. We all did!- The flour mill made it mandatory to wear a mask and other protective equipment when you’re working in the factory about eight years ago. However, Ms Abimbola has been working in the office for the last 6 years and no-one wears protective equipment in the office as it’s not necessary. She says there’s always a fine layer of dust on the paperwork in the office because the ‘flour just gets everywhere no matter how often you clean or how careful you are.-
\nMs Abimbola is currently averaging 50 hours\/week which means she needs to work on most weekends. Since the Covid 19 lockdown the factory has increased production to 24 hours a day 7 days a week. That means the office is also extremely busy. Ms Abimbola has always accepted any overtime on offer to help pay the rent for their house and cover the school fees for the Catholic school her children attend. She is adamant that she wants them to get a good education so they can make the most of the opportunities she never had in Africa. She has always been socially active within her Church community, but due to her increased working hours this has restricted her ability to attend mass and contribute to her community. She states that she needs to \u201cprioritise any free time I have so I can spend it with the kids, especially my oldest who is doing VCE this year\u201d. She has two close friends at church who help with looking after her children when she has to work late or on weekends.
\nMs Abimbola states that she tries to exercise when she has time and walks to the train station every day to get to work. It used to take 8 minutes each way but lately it takes at least 20 minutes including rest stops to catch her breath. She also does a lot of walking at the flour mill taking paperwork to the production supervisors and picking up reports for processing. However, she has had to ask one of the younger staff to get the reports and deliver the orders more and more over the last year or so as she get’s too short of breath when she walks too far too quickly.
\nMs Abimbola has not spoken to her husband since she and the children left him 6 years ago. She says he used to work at the flour mill but was sacked for being drunk at work eight years ago. He had a hard time finding work so drank heavily and became violent. She took the children and left him after he hit the middle child for spilling his coffee. She doesn’t know where he lives and has had no contact with him for over 4 years.
\nFamily history
\nHer father died from a stroke in 2005.
\nBrown, D., Edwards, H., Seaton, L., & Buckley, T. (2015). Lewis\u2019s medical-surgical nursing. Assessment and management of clinical problems (4th ed.). Chatswood, N.S.W.: Mosby\/Elsevier Australia.
\nBullock, S., & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Frenchs Forest, N.S.W.: Pearson.
\nBullock, S., & Manias, E. (2016). Fundamentals of pharmacology (8th ed.). Frenchs Forest, N.S.W.: Pearson.
\nJarvis, C. (2016). Jarvis\u2019s physical examination and health assessment (2nd Australian and New Zealand ed.). Chatswood, N.S.W.: Elsevier Australia.
\nLevett-Jones, T. (2018) Clinical reasoning: Learning to think like a nurse (2nd ed.). Frenchs Forest, NSW: Pearson.
\nMartini, F.H., Nath, J.L., & Bartholomew, E.F. (2017). Fundamentals of anatomy and physiology (11th ed.). Harlow, Essex: Pearson.<\/p>\n","protected":false},"excerpt":{"rendered":"
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