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NRSG265 CASE STUDY Solution

NRSG265 CASE STUDY Solution

Case Study Analysis Mr Vinh Nguyen

NAME:

Introduction

Purpose of the presentation

  • Demonstrating case-understanding and critical thinking skills
  • Demonstrating a professional nursing approach to improve a patient’s health.

Areas to be covered

  • Patient’s assessments
  • Pathophysiology
  • Nursing diagnoses
  • Potential impact
  • SMART goals
  • Interventions and rationale
  • Evaluation and reflection

Principal elements of assessment
Pathophysiology of the conditions

Health information: Nursing diagnoses

Analysis of patient information

  • Probability of high psychological stress
  • Probability of having dehydration
  • Observation of hypotension
  • Observation of tachycardia that can be associated with hypotension (Hall & Hall, 2020).

Three major nursing diagnoses

  1. Type 2 Diabetes (T2D)
  2. Hypotension
  3. Psychological stress

Rationale

Persistence of T2D, hypotension and stress may increase health risks and reduce overall wellbeing (Hackett & Steptoe, 2017).

References

Bullock,            S.,        &          Hales,   M.        (2019).  Principles         of         pathophysiology.        (2nd     ed.).            Pearson.          pp        718-722. https://www.google.co.in/books/edition/Principles_of_Pathophysiology/N3_dBAAAQBAJ?hl=en&gbpv=1&dq=Bullock,+S.,+%26+Hales,+M.+(2019).+Principles+of+pathophysiology. +(2nd+ed.).+Pearson.&pg=PP1&printsec=frontcover

Zhang, N. et al. (2019). Effects of dehydration and rehydration on cognitive performance and mood among male college students in Cangzhou, China: A self-controlled trial. International journal of environmental research and public health, 16(11), 1891. https://www.mdpi.com/16604601/16/11/1891

Hackett,           R.         A.,        &          Steptoe,           A.         (2017).  Type     2          diabetes          mellitus and psychological  stress—a           modifiable       risk       factor.  Nature Reviews            Endocrinology, 13(9),   547-560. https://www.nature.com/articles/nrendo.2017.64

Bertoglia, M. P. et al. (2017). The population impact of obesity, sedentary lifestyle, and tobacco and alcohol consumption on the prevalence of type 2 diabetes: Analysis of a health population survey in Chile, 2010. PloS one, 12(5), e0178092. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178092

Hall,      J.      E.,      &      Hall,     M.      E.      (2020).     Guyton      and      Hall      textbook      of      medical      physiology e-Book. Elsevier Health   Sciences. 14.    pp    171-173.

https://www.google.co.in/books/edition/Guyton_and_Hall_Textbook_of_Medical_Phys/H1rrDwAAQBAJ?hl=en&gbpv=1&dq=guyton+and+hall+medical+physiology&pg=PP1&pri ntsec=frontcover.

Hackett,           R.         A.,        &          Steptoe,           A.         (2017).  Type     2          diabetes          mellitus and psychological  stress—a           modifiable       risk       factor.  Nature Reviews            Endocrinology, 13(9),   547-560. https://www.nature.com/articles/nrendo.2017.64

Holland,      K.,      &      Jenkins,      J.      (Eds.).      (2019).      Applying      the            Roper-Logan-Tierney     Model   in Practice-E-Book.    -Elsevier    Health      Sciences.      pp                   17-20.

https://www.google.co.in/books/edition/Applying_the_Roper_Logan_Tierney_Model_i/erKMDwAAQBAJ?hl=en&gbpv=1&dq=according+to+the+RoperLogan+and+Tierney+model&pg=PP1&printsec=frontcover.

McCance,   K.   L.,   &   Huether,   S.   E.   (2018a).   Pathophysiology-E-book:   the   biologic   basis   for   disease                     in adults and children. Elsevier Health               Sciences.8.              pp.  1050-1055.

https://www.google.co.in/books/edition/Pathophysiology_E_Book/K4lIDwAAQBAJ?hl=en&gbpv=1&dq=McCance,+K.+L.,+%26+Huether,+S.+E.+(2018).+PathophysiologyEbook:+the+biologic+basis+for+disease+in+adults+and+children.+Elsevier+Health+Sciences.&pg=PP1&printsec=frontcover

McCance,   K.   L.,   &   Huether,   S.   E.   (2018b).   Pathophysiology-E-book:   the   biologic   basis   for   disease                     in adults and children. Elsevier Health               Sciences.8.              pp.  1230-1235.

https://www.google.co.in/books/edition/Pathophysiology_E_Book/K4lIDwAAQBAJ?hl=en&gbpv=1&dq=McCance,+K.+L.,+%26+Huether,+S.+E.+(2018).+PathophysiologyEbook:+the+biologic+basis+for+disease+in+adults+and+children.+Elsevier+Health+Sciences.&pg=PP1&printsec=frontcover

Kumar, K. P. et al. (2019). Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study. International journal of general medicine, 12, 147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460999/

Jenkins,            D.         W.,       &          Jenks,   A.         (2017).  Exercise            and      diabetes:         a narrative          review. The       Journal of         Foot     and      Ankle   Surgery,           56(5),   968-974. https://www.sciencedirect.com/science/article/abs/pii/S1067251617304180

Gao, K., et al. (2017). Interactions between genetic polymorphisms of glucose metabolizing genes and smoking and alcohol consumption in the risk of type 2 diabetes mellitus. Applied Physiology, Nutrition, and Metabolism, 42(12), 1316-1321. https://cdnsciencepub.com/doi/abs/10.1139/apnm20170232

Umphonsathien, M. et al. (2019). Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus. Food science & nutrition, 7(3), 1113-1122. https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.956

Okoro, E., & Adigwe, P. (2018). Therapeutic communication and client counseling: Toward a conceptual framework for strategic interpersonal engagement. Int. J. Bus. Soc. Sci, 9, 10-16. http://ijbssnet.com/journals/Vol_9_No_6_June_2018/2.pdf

Black,           B.           (2019).           Professional           nursing               E-Book:     Concepts        &               challenges.           Elsevier           Health          Sciences.9.         pp      217-219.

https://www.google.co.in/books/edition/Professional_Nursing_E_Book/J1GfDwAAQBAJ?hl=en&gbpv=1&dq=nursing+book&pg=PP1&printsec=frontcover

Speaker Notes NRSG265 CASE STUDY Solution - NRSG265 Assignment Help

Slide 1: The purpose of the study is to analyse a case scenario and implement existing knowledge and critical thinking skills to improve the patient’s overall health.

This presentation is going to show the health compilations of the patient, Mr Vinh Nguyen, discuss his diagnoses along with their pathophysiology and suggest the patient’s healthcare goals as well as effective interventions for delivering appropriate healthcare to the patient. The effectiveness of the interventions will be evaluated through a reflective approach.

Slide 2: The patient Mr Vinh Nguyen is a 48-year-old male, who has presenting conditions issues including falls, dizziness, lightheadedness, persistent thirst, sleep disturbance, and excessive urine excretion.

His health assessment findings show BGL 23.5 mmol/L (after 6hrs of meals), total cholesterol- 9.2 mmol/L and excessive fat in the abdominal region.

His BP is 102/65 mmHg, RR 20 bpm and HR is 106 bpm

From the blood assessments, type 2 diabetes has been diagnosed, as he has a significantly high blood glucose level. And a possibility of Obstructive Sleep Apnoea can be also observed, as he experiences sleep disturbances. His vitals shows that he is having hypotension, which can be the cause of his dizziness, fatigue, lightheadedness and falls.

 

Slide 3: The patient reports high work stress, and mental stress, which are proven to increase the release of stress hormones, such as cortisol, epinephrine and nor-epinephrine. These stress hormones stop the active secretion of insulin from the pancreatic cells. Decreased insulin causes high blood pressure that results in Type 2 Diabetes.

Regular alcohol and tobacco abuse can cause dysfunction of pancreatic beta cells and induce insulin resistance. As the patient reports alcohol and tobacco abuse, he may develop this condition.

The patient reports stress about increased earnings for his family. He also reports persistent thirst that can be a symptom of dehydration, which is a common symptom of Type 2 Diabetes. Excess urination in diabetes excretes a high amount of essential ions, causing dehydration  Psychological or emotional stress and dehydration can reduce the blood volume that finally may lead to low blood pressure.

Slide 3: The patient reports high work stress, and mental stress, which are proven to increase the release of stress hormones, such as cortisol, epinephrine and nor-epinephrine. These stress hormones stop the active secretion of insulin from the pancreatic cells. Decreased insulin causes high blood pressure that results in Type 2 Diabetes.

Regular alcohol and tobacco abuse can cause dysfunction of pancreatic beta cells and induce insulin resistance. As the patient reports alcohol and tobacco abuse, he may develop this condition.

The patient reports stress about increased earnings for his family. He also reports persistent thirst that can be a symptom of dehydration, which is a common symptom of Type 2 Diabetes. Excess urination in diabetes excretes a high amount of essential ions, causing dehydration  Psychological or emotional stress and dehydration can reduce the blood volume that finally may lead to low blood pressure.

Slide 4: The patient reports that he works overtime and feels stressed about earning more money, which depicts that he is experiencing psychological stress. He reports feeling thirsty for long hours which can be a symptom of dehydration, which is causing his hypotension. His heart rate shows to be increased which can be associated with hypotension.

The three main nursing diagnoses that should be paid attention to include T2D, hypotension psychological stress. It is needed to be intervened as soon as possible as the persistence of T2D, hypotension and stress may increase health risks and reduce overall well-being. 

 

 

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