Joan Deveree Case Study - Urinary Frequency and Lower Abdominal Pain - Nursing Assignment Help

Assignment Task:

Case Study: Joan
Joan Deveree is a 72-year-old who presented to the emergency department with her daughter after a collapse at home. Joan has urinary frequency and lower abdominal pain. Joan’s daughter indicates she has had malaise, decreased appetite and intermittent chills for three days.

Joan lives with her daughter and is normally independent. Joan was recently admitted to hospital with a fractured left neck of emur after a mechanical fall. Joan was discharged from the hospital one week ago.

Joan’s medical history includes hypertension, ischaemic heart disease, hypercholesterolaemia, type 2 diabetes mellitus, cerebrovascular accident 2012, open radial left nephrectomy 2011, right utereric stent 2014, renal dysfunction. Medications include Omeprazole 20mg mane, Simvastatin 10mg nocte, Aspirin 100mg mane, Frusemide 40mg mane, Carvedilol 3.125mg mane, Spironolactone 12.5mg BD, Vitamin D 1000units mane.

Question 1
What further history and nursing assessment is required? Provide a rationale for each (10 marks).

Question 2
Discuss Joan’s clinical assessment findings based on the underlying physiological response (20 marks).

Question 3
Interpret the above blood results and provide a physiological rationale for any abnormality (15 marks).

Question 4
Discuss how the physiological alterations associated with ageing can potentially impact on assessment and management of the patient (20 marks). 

Question 5
Based on the change in Joan’s clinical presentation, discuss how alterations to normal physiology will influence tissue oxygen delivery and how this will impact on organ function (15 marks).

Question 6
Focusing on priorities of care, provide a rationale for ongoing medical management and subsequent nursing care of this patient. The management should include evidence-based practice (15 marks). 

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