Assessment Case Scenario Explained for Students (Easy Guide)

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Original Question

Assessment 2 – Case Scenario Emily Murray is an 83-year-old woman of middle eastern origin diagnosed with moderate Alzheimer’s disease, hypertension and hypercholesterolemia. A change in mental status and worsening cough has prompted hospitalisation from a residential aged care home. She moved into the care home two years ago after her husband died. She has two grown daughters, but only one lives locally. Although Emily initially struggled with her husband’s death, she has now made new friends at the aged residential home and adjusted to life there. On admission to the general ward, she is hypernatremic, with elevated Blood Urea Nitrogen (BUN) and creatinine. She has not been eating well and has lost 5 kg in the last three months. This is her third admission in five months with similar symptoms. Each time, she was given IV fluids and sent back to the care home within a few days. On this current admission, she begins to exhibit dysphagia. She failed a bedside speech evaluation and underwent a formal swallow evaluation. The result of the swallow study showed abnormal swallowing, which prompted the speech pathologist to recommend a diet of pureed food and honey-thick liquids. Mrs Murray rejected the modified diet. Mrs Murray was upset as to why she could not eat what she was used to eating. Her daughters said their mum was upset because she associated the pureed food with a loss of independence and dignity. Mrs Murray never completed an advance directive, nor did she designate anyone as a health care power of attorney. During a meeting with Mrs Murray and her daughters, they agreed that modifying her diet or placing a feeding tube would go against their mother’s values. Her daughters said their mother ran a successful restaurant as a chef, and they know she loves to eat. Because of their mother’s values regarding food, Mrs Murray’s children said her quality of life takes precedence over length of life. Mrs Murray said she prefers to continue with her regular meals despite the associated risks. Mrs Murray and her daughters also agreed that while they want any distressing symptoms to be managed, they want a do-not transfer to the hospital order, a do-not-resuscitate order, and no artificial food and fluids order to be added to her care plan. Based on Mrs Murray’s wishes, the acute care team has determined that Mrs Murray’s needs are better met by the specialist palliative care staff, and they have made the referral to ensure her desires are incorporated into her care plan. She is currently on IV fluids, and the specialist palliative care staff has now taken over her care. As a member of the specialist palliative care staff, identify what actions you would take and develop a plan of care for Mrs Murray using the template provided. Consider the patient’s situation Explain Mrs Murray’s illness trajectory. (Consider the factors that will influence her illness trajectory). (Approx. 300 words) Cues 1. 5. 2. 6. 3. 7. Collect cues/information Identify relevant cues related to current information. (Approx. 100 words) 4. 8. 4 Priority Cues Explanation 1. 2. 3. Process Information Identify four (4) priority cues and explain why the cues are a priority for Mrs Murray. Reference/s needed. (200 words) 4. Student Name: (enter your name) Student Number: (enter your number) NURS2004 Assessment Item 2 DiagnosisIdentify the problems Identify one (1) nursing diagnosis for Mrs Murray. (100 words) SMART Goal 1Establish (SMART) Goals Identify one (1) goal of care for Mrs Murray that is linked to the nursing diagnoses. (100 words) Intervention 1 for SMART Goal 1 Rationale Intervention 2 for SMART Goal 1 Rationale Select a course of action Outline three (3) nursing interventions for the identified goal that will assist Mrs Murray to meet her desired outcomes. Provide brief evidence- based rationales for each intervention. intervention. (400 words total) Intervention 3 for SMART Goal 1 Rationale Student Name: (enter your name) Student Number: (enter your number) NURS2004 Assessment Item 2 OutcomeEvaluate Explain the process for evaluating the desired outcomes in the scenario. (100 words) Ethical issue 1 Explanation Ethical issue 2 Explanation Reflection Outline and reflect on three ethical issues relevant to Mrs Murray’s situation. Provide brief explanation. (200 words) Student Name: (enter your name) Student Number: (enter your number) NURS2004 Assessment Item 2 Ethical issue 3 Explanation

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