NUR341 – Assessment 3 Case Study Task

NUR341 - Assessment 3 Case Study Task

Read the clinical scenario and the answer the assessment questions in an essay format.

Clinical Scenario

You are working in a community clinic as a registered nurse. Your next patient is Ms Florence ‘Flo’ Ljukuta and her husband Lionel. Flo is 70 years old, and Lionel is 84 years old. Flo is the primary carer for her husband who has physical disabilities due to a stroke and was recently diagnosed with dementia. Flo would normally attend the clinic regularly, but you notice in her records she has not presented in nearly 12 months. The last entry on the eHealth record is a hospital visit due to a fall last year.

When Flo and Lionel arrive, you notice that Flo is limping and they both appear underweight. You also notice Flo and Lionel looking untidy wearing clothes which appear to be dirty, which is very unusual for them. You read both Flo and Lionel’s medical file and identify no services are currently linked to them and Flo is looking after a lot of family in her house.

When you ask Flo, what has brought her in, Flo tells you she has a wound on her right foot which she has been dressing at home for three months, but it is not getting better. Flo tells you she hasn’t seen a doctor about her foot earlier because it was only a small wound and she didn’t want to trouble anyone. Flo also stated because she doesn’t drive, she is finding it difficult to catch public transport with Lionel. She can’t leave him at home because he sometimes becomes agitated and upset plus the children are so busy looking after their little ones, she doesn’t want to bother them. 

ParameterAssessment data
Patient profileFlorence ‘Flo’ Ljukuta 70-year-old female from Alice Springs
Presenting complaintDiabetic foot wound
History of complaintSmall wound appeared over 3months ago, unsure what caused it. Applying pawpaw ointment and dry dressing every few days.
PhxHypertension, Type 2 diabetes, Angina, Hypercholesteremia, Asthma, Osteoarthritis. Complete hysterectomy 30years ago for treatment of endometrial cancer.
AllergiesNil Known Allergies
MedicationsAspirin 100mg manePerindopril 2mg maneMetformin XR 2g maneGTN 600mcg tablets S/L prnOsteo paracetamol 1330mg TDSCodeine 60mg QLD as required for acute painAtorvastatin 40mg maneSalbutamol inhaler 2-4 puffs PRN
Ethnicity/languageAboriginal. Speaks Waramungu, Walpiri, Eastern and Western Arrentre, English
Alcohol useFew wines or beers with family and friend 3-4 times per week
Tobacco useSmoker ½ packet per day/ whole family smokes. Regular exposure to campfire and passive smoke
Drug useNil
Home environmentCurrently lives in town camp in 3brd house with extended family. Approximately 13 family members staying at the house. Flo’s husband who requires assistance due to physical deficits from a stroke. Lionel has dementia, always needs supervision as he likes to walk off and becomes disorientated easily. Lionel needs prompting to eat/drink and assistance to wash and dress. Adult daughter and her 4 teenage boys Adult daughter and her 2 toddlers Adult son and his partner and their new baby Adult son
Work environmentRetired 10 years. Previously manager of community health clinic
StressCurrently eldest daughter receiving treatment for breast cancer. States she is doing very well. Teenage boys have been a little naughty – two are heading to boarding school soon. Eldest son is working in the mines ‘FIFO’ which helps financially.
EducationVET level certificate
Economic statusFamily land and house in remote community but staying in town to be with children and support needs for husband
Religion/spiritualityBaptised Catholic by missionaries when young
ADLsIndependent
IADLsDoes not drive anymore due to decreased vision (diabetic retinopathy). Starting to develop cataracts. Had glasses a few years ago but they don’t help much now.
Cognitive functionNo concerns identified
DietDiabetic diet when able
Sleep5-6 hours a night, broken sleep. Gets up several time to assist Lionel with toileting. Falls asleep in the chair whilst watching TV most evenings
Health check upsLast checkup 11months ago
Vital signsTemp 36.8oC, HR 84bpm regular, Resp 24, SpO2 93% RA, BP 145/80, BGL 11.0 mmols/L, Pain 6 out of 10
NeurovascularBilateral feet appear normal colour, cool to touch, cap refill >3sec, Pedal pulse diminished bilaterally, Numb sensation bilaterally, Weak strength but full range of movement. Skin to heels very dry and cracked.

Assessment Questions

Question 1: Aged care services and interdisciplinary care to maintain independence (recommend 1250words)

Students must:

  • Identify TWO (2) aged care services/packages
  • Identify TWO (2) interdisciplinary referrals
  • Detail the goal or purpose of each of these services/packages/referrals
  • Provide a rationale for each service/referral you have selected
  • Explain how each service/referral relates to Flo’s presentation
  • Explain the impact of Flo’s geographical location may have on accessing these services and interdisciplinary referrals

Hint: you can identify services in your local area to help increase your knowledge of services you will be referring to in your local health network.

Question 2: Medication management (recommend 750words)

The older person is vulnerable to adverse drug events. Examining Flo’s medication history answer the following questions.

  • Identify and describe Three (3) factors in the case study which increases the risk of an adverse drug event
  • Choose TWO (2) medications and describe:
    • what is the indication for each medication?
    • any potential complications that Flo may experience while taking this medication
  • Two (2) nursing actions or health promotion you would implement to minimize adverse drug events.

Please note: if a student details more than the requested volume of factor, the marker will address and mark only the prescribed amount as outlined.

Presentation guidelines

  • Complete the footer with last name_student number_NUR341_ Assessment 3
  • Format your assessment with size 12 Arial/Calibri or similar font, 1.5 spacing
  • Complete spelling and grammar check using English (Australia) default
  • A minimum of 5 peer reviewed journals or texts no more than 5 years old
  • Use CDU APA 7th referencing style
  • 2000word limit: recommend Part 1 (1250 words) and Part 2 (750 words). The end-of-text reference list is NOT included in the word count.
  • Save the final version of your paper using the filename of last name_student number_NUR341_ Assessment 3 and submit as a word document
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