NURS 2021 : Mr Ranjeet Singh Case Study - Nursing Assignment Help

Assignment Task :

  Responding to Altered Health Care Needs - Adult FOP case scenario  
You are expected to provide a 3000-word written response to the below case scenario. Please ensure  you use the DMU Harvard referencing and adhere to the usual academic writing guidelines for this  assignment.  
Evidence from literature/clinical guidelines should be used to underpin/support your answers. Submit anonymously by 12pm Friday 5th March 2021 through Turnitin. 

Case scenario: 
Mr Ranjeet Singh is a 49-year-old food delivery driver who presents to his local Emergency  Department (ED) with a crushing central chest pain that radiates to his left arm. He also reports  feeling nauseated and seems very anxious. He has rapid breathing and is cold and clammy to touch. 
Mr Singh does not smoke. He drinks alcohol when not working, often about 20 units or more a week.  He works day and night shifts, and his eating patterns are irregular, tending to eat a large meal once  he has finished working after 11pm or before 6am, and he snacks on high calorie and high  carbohydrate-based foods while driving. 
Mr Singh has hypertension which he takes an angiotensin-converting-enzyme (ACE) inhibitor for. He  has a family history of cardiovascular disease (CVD), with his father having a first myocardial  infarction (MI) before he was 55 years old. On this occasion the emergency medical treatment given  was successful, but he went on to die of a MI before he was 65 years old.  
Mr Singh and his family were on their way to visit his brother, sister-in-law and children in  Nottingham when his chest pain began, and he arrived at the ED with his wife, mother and two  children. Mr Singh is employed on a zero hours contract and he is the only member of the family  whose work is income-generating. He very keen to be treated quickly so he can return to his job as a  delivery driver. 
His wife is extremely worried for Mr Singh and has been observed to be crying when she thinks no  one is looking. She has confided in a member of the nursing team that her anxiety levels have been  high since they began their journey today and she has described symptoms consistent with mild  agoraphobia having not been out of the house much at all since the national UK lockdown in March  2020. She has also mentioned that she is a full time carer for her mother-in-law since her diagnosis  of Alzheimer’s disease two years ago.  
Mr Singh’s mother presents as moderately confused, disoriented and anxious, and has been  observed to be wandering around the ED at times. She appears to respond well to her daughter-in law and becomes much calmer and contented for a period of time when she has physical contact  with her.  
Mr Singh’s children, who are ten and eight years old, are not fully aware of what is happening and  have asked a number of times when he will be allowed to leave, so they can go and visit their family.  
On admission, the following observations are recorded: 
• Respiratory rate: 26 breaths per minute at rest
• Oxygen saturation: 90 % on room air 
• Blood pressure: 172/92 mmHg 
• Heart rate: 115 beats per minute, regular, ST segment elevation noted on electrocardiogram  (ECG) 
• Temperature 36.80C 

A diagnosis of ST elevation myocardial infarction (STEMI) is made. 
In relation to the above scenario:  
1. Define and discuss the condition the patient is presenting with, including the relevant  related pathophysiology. (500 words) 
2. Using a systematic approach, discuss the assessment and the priorities of nursing care  related to the scenario demonstrate an understanding of the biopsychosocial factors that  may influence the patient’s care. (1500 words) 
3. Critically discuss the impact of acute illness on the patient and family. (1000 words) Specific guidance: 
Please familiarise yourself with the learning outcomes below, as these will be used to assess  your written assignment. 
1. Be sure to use the clinical definition in relation to your scenario and please research the  diagnostic criteria/manuals and consider relevant guidelines e.g. NICE guidelines. Ensure you  fully explain the definition and pathophysiology of the condition as well as identify risk  factors and commonly used prediction tools with up to date clinical/academic sources to  support your writing.  
2. You need to demonstrate a systemic assessment approach using the Resuscitation Council’s  (2015) ABCDE assessment method and explain the nursing priorities for the scenario  demonstrating an understanding of biopsychosocial factors. 
3. Critically discuss how the acute illness impacts upon the patient, family, carers etc. with an  understanding of how the nurses’ role can influence this. 
Learning Outcomes:
1. Utilise and develop existing knowledge and fundamental  nursing skills when responding to individual’s altered health needs  in your chosen field of practice
2. Demonstrate the ability to exercise effective decision making  in the early detection, assessment and management of  individual’s altered health care needs
3. Demonstrate, under supervision, the ability to proficiently  assess, plan, implement and critically evaluate evidence based  care for individuals with unexpected altered health needs in your  chosen field of practice
4. Demonstrate the importance of transferring knowledge and  skills to a variety of settings in order to respond to the altered  needs of individuals 
5. Identify and analyse the impact of working in partnership with  others on care provision in your chosen field of practice
6. Articulate how effective communication and interpersonal  skills positively contribute to the co-ordination and care delivery  of individuals with altered health needs. 
 
 

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