Identify: Mr David Smith, HRN: 123456, DOB: 26/03/1948
Situation: David is a 72 year old Caucasian man from Wellington. He has been admitted to the CDU medical ward with Acute Kidney Injury (AKI) secondary to Pyelonephritis. He has a 1/52 history of fever, fatigue, decreased urine output, increased urgency and R) flank pain. He has now been transferred to the CDU Medical ward for continuing care.
Background: David is a widower and lives in Wellington. He lives alone in a single story home but his daughter lives close by and helps out when needed. He is independent with his cares. He has an extensive past medical history including: T2DM, Ex-smoker (quit 5 years ago), HTN, Hyperlipidaemia, chronic kidney disease stage 3 (Baseline eGFR 40 ml/min/1.73m2), chronic venous leg ulcer to L) leg, anxiety. No known declared allergies (NKDA). He is obese (BMI 30) and drinks 1 bottle of wine every night.
Assessment: Airway: Own, patent Breathing: RR 22, Sats 94% on RA. Circulation: HR 96 bpm, BP 160/95 mmHg, Bilateral pitting oedema to his calves. Disability: GCS 15/15, 2/10 pain to R) flank, feels tired and a bit worried. Exposure: Temp 38.4 oC David looks unwell. He is restless and has a flushed appearance. His urine is dark in colour and offensive smelling. He has urinated 100 ml into a urine bottle since admission to hospital 4 hours ago. David had 2 x IVC’s inserted to both ACF’s and is tolerating a diabetic diet. He last opened his bowels this morning.
Pathology (on admission)
WBC — 15.0 x 109/L (4.0-11.0)
urea — 14 mmol/L (3.0-8.0)
serum creatinine — 213 µmol/L (60-100)
eGFR — 25 mL/min/1.73 m2 (90-120)
• Routine ward assessment and observations
• Strict fluid monitoring
• MSU for MC & S
• Diabetic diet and fluids as tolerated
• Pain management
• TED stockings and DVT prophylaxis
• Intravenous sodium chloride 1000mls over 8 hours
• Intravenous frusemide 80mg STAT
• Oral paracetamol 1g QID, S/C morphine 2.5mg, 4 hourly PRN
• Usual medications: Metformin XR 1gm BD, Ramipril 10mg OD, Simvastatin 20mg OD
• Devise a plan of care for your patient
Using the template attached to complete this Assessment and, based on the handover you received at the beginning of your shift today, other information included below and current reliable evidence for practice, address the following tasks.
Do not make up or assume information in relation to or about David. Only use what you know from the information you received today.
Task 1: Assessment
Based on the case scenario and in grammatically correct sentences identify:
• Three (3) priority nursing assessments you would conduct at the commencement of your shift
For each assessment you have identified explain:
• Why it is necessary for David’s condition and nursing care?
• What consequences can occur if this assessment is not completed accurately?
• What chart or document could you use to assist with/record your assessments?
(Approximately 350 words)
Based solely on the handover you have received and using the template provided, complete a nursing care plan for David. Your plan must address the physical, functional and psychosocial aspects of care.
Five (5) nursing problems have been provided for you. For each nursing problem on your care plan you need to identify;
• What it is related to?
• Goal of care
• Rationales for interventions
Notes for Task 2 only
• Dot points may be used in the care plan template
• Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
• Rationales must be appropriately referenced
(Approximately 1000 words)
Task 3: Patient education
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or prevention of reinfection or deterioration on discharge.
Patient education and discharge planning starts on admission and you need to provide David with education during your shift in preparation for discharge home.
• Explain two (2) important points/topics you will need to include in David’s preparation for discharge to aid healing and prevent further illness.
For each education point identified provide:
• One (1) strategy to assist David to implement the education into his daily routine.
(Approximately 350 words)
Task 4: Documentation
An important legal requirement of nursing practice is to effectively and succinctly document relevant information, actions and outcomes related to patient care and provide an accurate reflection of the health status of the patient, their responses to care and the patient’s perspective.
• Make an entry into David’s patient progress notes documenting the successful implementation of your nursing care plan.
You can choose any progress note format but your documentation must:
Demonstrate person-centred care
Adhere to the legal and professional standards for documentation
Appropriate professional language must be used – legally recognised abbreviations may be used in this task but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
Advancement Project: Assistance for Syrian Refugees Conceptual Syria is a nation that has been attacked by war. The occupants have lost their occupation and numerous individuals have fled because of the shocking condition of the nation. For success or some negligible feeling of tranquility to return, huge changes must happen. By building up a focal improvement plan, USAID and different members can help returning natives in recapturing a real existence encompassed by serene conditions. As a major aspect of this arrangement, resettlement and remuneration must happen. Similarly significant, retraining, financial combination, and transportation help will be required. Without these essential advances, a zone that has encountered the obliteration brought about by common war will keep on being a land that makes struggle for its inhabitants, however internationally. Catchphrases: Syria, Civil War, Central Development Plan Presentation Sun Tzu stated, “The preeminent craft of war is to curb the adversary without battling.” This procedure isn’t reflected through common wars that have attacked various nations around the globe. With inside fights and individuals battling their very own neighbors, a great deal of obliteration has happened. For Syrians, the outline of war is very genuine. The destruction that has happened has an aftereffect of inside doing combating will require a ton of improvement and recovery. These procedures might be effective if tranquil arrangements can be come to stop the fights that have prompted such catastrophe. The progressions that must happen are tremendous and should incorporate the whole nation’s populace. Through these changes, a focal arrangement is expected to address resettlement and remuneration, just as retraining, financial reconciliation, and transportation help. Foundation During the fierce Syrian common war (2011-present), more prominent than 300,000 individuals have been slaughtered and 1.5 million injured to date, prompting an evacuee emergency which has been without parallel, as the individuals who endure that contention have progressively looked to escape from that blockaded country and start their lives somewhere else. This has incited an outcast emergency which has been uncommon in world history, and one which has put significant worry upon ‘have’ countries, particularly in Europe, to take in those dislodged by this war. In any case, as of late, this multi year-long clash has gotten plentiful universal consideration of a sort which has focused on the probability that the war might be before long reaching an end. As reported by Syrian president Bashar al-Assad, and supported Steffan de Mistyra, United Nations ‘Unique Envoy’ to Syria, the contention – which saw the incorporation of Assad’s powers and the ‘rebels,’ yet the Islamic State, U.S., Israel, and Russia, also – may have been “won” by Assad, particularly following “basic military additions made by government powers” all through 2017 (Al-Doumy, 2017, p. 1). Specifically, as of September 2017, after the Syrian capital of Aleppo was caught by Assad’s administration system, promotion just the “Idlib region” was still under the influence of the restriction, implying that such control – and a last ‘triumph’ for the Syrian state – might be close within reach (Al-Doumy, p. 1). Current ‘certainties on the ground,’ however they are gloomy, speak to a basic purpose of debate among worldwide guide organizations. Specifically, the United Nations has detailed that in spite of “decreased viciousness” in Syria all through 2017, the warring gatherings in that country have kept on executing “unimaginable wrongdoings” against the Syrian non military personnel populace, including – per the UN report – the Syrian government’s utilization of “concoction weapons” against regular folks (UN, 2017, p. 1). A report by the United Nations Office of the High Commissioner for Refugees (2017), has mounted strident analysis against the Syrian state, especially for its utilization of “sarin [gas]” as a major aspect of an airborne barrage in northern Hama and southern Idlib, in April 2017, which prompted the passings of more than eighty regular folks (UNHCR, 2017, p. 1). This battle – eminent for the merciless strategies utilized by the Assad government – explicitly focused on “medicinal offices” in this ‘rebel’- held zone, prompting an “extreme debilitating” in these zones’ capacity to give help to the people in question, a point which the report focused on prompted a “subsequent increment” in the quantity of regular citizen losses this unconscionable government assault caused (UNHCR, p. 1). The United Nations report additionally reprimanded the Assad system for utilizing “weaponized chlorine,” in Hamah and Damascus, which when joined with the utilization of sarin, speak to numerous and egregious infringement of both “universal philanthropic law and the Convention on Chemical Weapons,” which was marked by Syria in 2013 (UNHCR, 2017, p. 1). All things considered, the Assad government isn’t the main gathering to fault in this progressing fiasco. The report likewise indicates “worldwide alliance airstrikes,” as by the United States and Israel, to repulse Islamic State (ISIL) powers from this nation, which have prompted an “inexorably disturbing number of [civilian] losses,” and inside dislodged countless Syrians (UNHCR, p. 1). The U.S., specifically, is condemned for its inability to “play it safe to secure regular people” in its invasion (p. 1). The delayed and ruthless nature of this contention, when joined with the recency of such atrocities, have brought about the United Nations looking for a “political arrangement” which would bring about a conclusion to “grave infringement of human rights and the laws of war” (p. 1). Be that as it may, it creates the impression that the universal network – particularly among the countries of Europe, which have taken in an extraordinary number of Syrian displaced people – is currently taking reports of the pending ‘end’ of the Syrian clash without needing any proof. In Germany, which took in excess of a half-million Syrian outcasts, its inside service has started to examine (and vote upon) proposition to start “coercively repatriating Syrian exiles once their refuge status slips,” as right on time as June 2018 (Traub, 2017, p. 1). Given the generally “quieted” universal reaction to the blistering UNHCR report (2017), is evident that worldwide specialists (particularly countries which have taken in Syrian outcasts), are happy to ignore the wrongdoings and maltreatment of the Assad system, and eventually, to “acknowledge,” while intolerable, “the villain they know” (Al-Doumy, 2017, p. 1). In Germany and different countries which have been hard-hit by the Syrian Refugee Crisis, particularly as has show in “political weight,” while the UNHCR rules which stipulate the progressions required for “safe return” and repatriation may “not happen for an age,” these countries are progressively hoping to treat the “part of the arrangement” adequate standard whereupon to legitimize mass repatriation (Traub, p. 1). Given the progressing military nearness of the United States in this country, America’s obligation to this area might be extraordinary. Ahead of time of mass repatriation of Syrian displaced people, particularly from Europe, it is important to make an advancement proposition whereupon such American help to ‘returning’ Syrian regular citizens might be shaped. Such objectives, be that as it may, must be in ‘arrangement’ with the objectives of the U.S. State Department, just as with the present White House, and will be executed by the United States Agency for International Development (USAID), a help association which is regularly entrusted with catastrophe aid ventures. Fundamentally, any arrangement taken by the United States must be adequate in extension to counteract further compassionate debacle in Syria, yet is probably going to not convey military order, nor will it be directed for a time of longer than two years, given the low ‘hunger’ of the American individuals to take part in delayed aid projects. In any case, as has been considered, there is a prominent requirement for the usage of this program; The United States has assumed a vital job in this contention, and keeping in mind that it has not executed the equivalent outrageous human rights maltreatment as the Assad government, it is basic for the U.S. – through USAID – to hold fast to two center ‘fundamentals’ of its universal guide mission, in Syria, by (1) Providing “life-sparing helpful help to spare lives and reduce enduring,” and (2) Accelerating a “quick [and] and tough recuperation by supporting occupations, markets and the arrangement of essential administrations” (USAID, 2017, p. 1). To this end, the accompanying area will show a center ‘treatment’ of a future undertaking, to be executed in Syria, as dependent upon a probable German choice (foreseen for June 2018) to command the repatriation of their 600,000 Syrian exiles. The accompanying segment will show the center parts of this improvement plan. Focal Development Plan The focal motivation behind this advancement plan is to give help to Syrians who will come back to Syria after the emergency, likely when June 2018, when Germany is foreseen to repatriate a huge number of Syrians to this country, dependent upon the foreseen end to eight years of threats. The center vector for such improvement will be committed restoration focuses, which will be set up related to (and under the insurance of) the U.S. army installation in northern Syria (Davison, 2017. Furthermore, such guide nearness will likewise be set up inside (or near) focuses of populace, where repatriated exiles will probably return. The accompanying segments will consider the objectives which will be looked for at these restoration focuses, which will fundamentally center after giving post-return help to the a huge number of Syrians who are foreseen to be repatriated. The planned approach which will be utilized at these recovery focuses is of a healing sort, by which indi>
Superior Essay Writers | Nursing care of a patient with acute on chronic renal failure was first posted on August 24, 2019 at 2:55 pm.
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