NUR241 - Health Alterations, Shane Chigwell Case Study - Social Determinants of Health (SDH) - Nursing Assignment Help

Assignment Task

Task goal:

The goal of this case study is to identify ethical aspects of the role of the  registered nurse / registered midwife when providing care to individuals  with suboptimal or compromised participation in healthcare, and to plan  patient discharge that adheres to the Social Justice Framework.

Task description:

Present a response to a clinical scenario demonstrating appropriate  assessment and plan the discharge for an individual experiencing health  alterations with poor access to and participation in healthcare.

this task you will conduct a case study. There are three clinical  scenarios, you will study only one. Please follow the steps below:  

Step 1: Identify your allocated clinical scenario 

• Students in Group A ( will select  Clinical scenario 1.  

• Students in Group B will select Clinical Scenario 2.  

• Midwifery students will select Clinical scenario 3. 

Step 2: Holistic assessment of the patient 

Detail the holistic assessment to determine the patient’s access to, and  participation in healthcare using the template provided .

Step 3: Implementation and evaluation  

Select and describe nursing / midwifery actions to prepare the patient for  discharge utilising the social justice framework and professional codes  and standards to address the social determinants of health (SDH) that  impede the access to, and participation in healthcare.

Presented to ED 2 days ago. Shane was admitted to the medical ward  for uncontrolled hyperglycaemia. He is now ready for discharge.

Allergies: peanuts 

Shane Chigwell CaseStudy 

Background

Medication: metformin BD, Actrapid QID  

Past illnesses: T2DM, liver schlerosis, foot ulcers 

Last meal: lunch (tuna casserole) 

Events leading up to presentation: lethargy prior to episode of  confusion, found confused by his GrandmotherShane was first diagnosed with diabetes at the age of 20. He has  infrequent contact with his GP and has not seen a diabetic educator  for several years, as he has “not needed to go to hospital”. Shane has  been on Metformin since he was 20 and was started on Actrapid 2  years ago. Shane states that he is confused by his “blood sugar  machine” and uses it infrequently. Shane says that he gets his  Grandmother, Doreen to do his injections. Shane lives with Doreen, he is her registered carer. Doreen also has  T2DM, in addition to obesity, cardiovascular disease, and Transient  ischaemic attacks. Shane’s parents moved back to Western Australia  to take up jobs in the Mining Industry 4 years ago, he has not seen  them since.

 Shane admits to daily alcohol intake, cigarettes and weekly marijuana  use. Shane has a diet incorporating take away foods and energy  drinks. Doreen cooks a Sunday roast when she is able. Shane likes to  cook cheese toasties. Shane stays up late and sleeps late into the morning, as has been  unemployed for three and a half years since he was released from  prison. Shane sparingly attends to activities of daily living but is fully capable.  Shane lives on the outskirts of a regional town and relies on the  regional bus service to get into town for shopping. Where he lives  there are no dedicated walking or cycling tracks. Shane does not  engage in any recreational activities or social activities, but he likes  to chat to the people at the corner shop.  Shane dropped out of school at the end of grade 9 and admits to  reading difficulties. After leaving school he worked at a nursery for  some years. He has a healthcare card which reduces the cost of his  medications. Shane has no savings and has credit card debts along  with AfterPay debt. Shane does not have private health insurance.Shane has ongoing financial stress related to unemployment. Shane  feels socially isolated and would like to be in a relationship. Shane  sounds depressed when he is talking.Complete an holistic assessment of the patient to determine his social  determinants of poor health. Prepare the patient for discharge,  encouraging access to, and participation in healthcare

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