NUR241 - Mrs Sadie Mangle Case Study - Nursing Assignment Help

Assignment Task

Task goal: The goal of this case study is for you to identify the role of the registered nurse / registered midwife in evidence-based assessment and care of individuals experiencing health alterations when access to healthcare is suboptimal or compromised. You also articulate the role of the nurse in encouraging access to, and participation in healthcare.

Task description: Present a response to a clinical scenario demonstrating appropriate assessment, management and discharge of an individual experiencing
health alterations.

What you need to do:

In 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 (starting in February, 2021) will select Clinical scenario 1.
• Students in Group B (starting March, 2021) will select Clinical Scenario 2.
• Midwifery students will select Clinical scenario 3.

Step 2: Secondary assessment of the patient
Detail the secondary assessment and investigations appropriate for this patient.

Step 3: Explain the pathophysiology of the health alteration
Explain the pathophysiology that explains the patient assessment findings and underpins the interventions.

Step 4. Implementation and evaluation
Select, justify and describe two (2) essential interventions and describe the nursing / midwifery actions required to implement and evaluate it.

Step 5. Plan the patient discharge
Select and describe nursing / midwifery actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare.

Additional notes
Select interventions that corrects the pathophysiological change within the patient. Patient monitoring actions (completing vital signs and fluid balance charts) is considered as assessment or evaluation, it is not an intervention.

Clinical Scenario
Identification Mrs Sadie Mangle, 82 year old, retiree. Situation Mrs Mangle found in collapsed in the front yard by neighbours Scott & Charlene at 8:30am. She had weakness in the right arm and leg, facial droop and was “talking nonsense”. The patient is admitted to the Medical Ward with an ischaemic CVA.

Background Allergies: penicillin

Medication: Metformin, actrapid, atorvastatin, ACE inhibitors
Past illnesses: T2DM, hypercholesterolaemia, hypertension
Last meal: Dinner the previous night.
Events leading up to presentation: recent episodes of abnormal
sensation that resolved within the hour.

SpO2: 95% RA (room air)
HR: 95, strong pulse
BP: 200/110
T: 35
GCS: 14 (confused to time, place, person)
BGL: 10 mmol/L
Cap. Refill Time: 2 seconds, flushed face
CT: ischaemic stroke

Other information
When Mrs Mangle was found she was in her pyjamas without her dressing gown. This is unusual as normally she is up and dressed, walking with Alby at 6am. Alby was inside the house calling out to Sadie. It is suspected that Mrs Mangle collapsed during the night while letting her dog, Bouncer, go to the toilet. Mrs Mangle is now bed bound due to weakness in the right side (failed on bed mobility test). Mrs Mangle is unable to change positions in bed. The physiotherapy review is pending.
Mrs Mangle requires a modified diet due to delayed swallow (assessed by a speech pathologist this morning). The patient is exhibiting “word salad” where the patient is selecting incorrect words.

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