HLT54115: National Health Priorities for Chronic Disease - Nursing Assessment Answer

HLT54115 Nursing Assessment Task

What are Australia current national health priorities for chronic disease? Use the following document to access information pertaining to this question.

World Health Organisation (WHO, ND), states that “60% of all human deaths are the result of a chronic disease. Chronic diseases are also the leading cause of human disability worldwide” (WHO 2016). How is Australia tackling chronic health priority areas listed in question 1. Use the following document to access information on strategies pertaining to this question.

HLT54115 Case study

Mr. Cross was brought into emergency ward with acute exacerbation of dyspnea. He is 81-years-old with COPD complicated by hypertension, depression, heart failure, coronary artery disease, diabetes mellitus, gastric ulcer, Vitamin D3 deficiency, hyperlipidemia and glaucoma., He has a >50 pack-year smoking history but quit at age 60. COPD was diagnosed 10 years ago and he is currently treated with pain controlling medications and home oxygen therapy at 2 liters per minute.

His other medications include:

• albuterol 90 mcg 1–2 puffs every 6 hours as needed;
• formoterol 12 mcg twice daily;

• aspirin 81 mg daily;
• lisinopril 10 mg daily;
• metformin 500 mg twice daily;
• omeprazole 20 mg twice daily;
• cholecalciferol 1000 international units daily;
• sertraline 200 mg daily;
• mirtazapine 30 mg nightly,
• oxycodone/acetaminophen 10/650 mg every 6 hours as needed;
• dorzolamide 2% solution 1 drop twice daily,

Mr. Cross. moved to an assisted living facility, his functional assessment revealed independence in his Activities of Daily Living (ADLs) with the exception of household chores and shopping resulting from his lack of mobility.

On admission to hospital Mr. Cross. had difficulty in talking because of his shortness of breath. Physical examination revealed vital signs of: T 38⁰C; P 114; BP 169/80; and R 30. He was observed to be experiencing moderate respiratory distress. Apart from his lungs, which showed poor air movement with bilateral expiratory wheezes, his physical examination was unremarkable.

A diagnoses of COPD exacerbation was made and systemic methylprednisolone sodium, ceftriaxone, and azithromycin administered. Initially, Mr. Cross was admitted to the ICU and placed on BiPAP overnight. Mr. Cross’s respiratory status gradually improved and he was discharged back to his assisted care facility after 3 days in hospital.

1. In the context of the enrolled nurse role provide some strategies that Mr Cross can use to be actively involved in self-management of his condition? 

2. In the context of the enrolled nurse role and using person-focused nursing practice, what would you do if you were taking Mr Cross observations and his BP was 140/90, P115, T 38OC and the BiPAP device was not improving his respiratory distress?

In the context of the enrolled nurse role how will you assist Mr. Cross in his acceptance of a palliative approach to care and his readiness for attitudinal and behavioural change that his physical health status is declining rapidly and that he needs to prepare for end of life health care?

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