NURS1000 - Foundations of Clinical Practice: Case Study 2023-2 Assignment Answer

Read the following information and then answer the questions below within this template.

Antonio Rodrigues was born in Queensland in 1972 (DOB: 06/12/72) Patient Number A12345678. He was an only child and was found to be profoundly deaf. In 1982, his family moved to Perth as they thought he would be better educated at a special school for deaf children.

In 1992 he found that he loved to work with theatre set designs and subsequently went to a tertiary college to learn to be a carpenter. After completing his trade diploma, he set himself up in a small business doing carpentry jobs.

He married Maria in 1997 when they discovered she was pregnant with their daughter Isabella. In 2013 Maria and Antonio divorced, and Isabella went to live with her mother as Antonio entered a relationship with Raymond. Antonio and Raymond are very fond of Isabella and regularly invite her and her two children to their home at 5 Short Street, Doubleview.

At Maria’s insistence, Antonio gave up cigarette smoking in 2009 after he developed “hay fever” with no known allergen determined. In 2017 he was diagnosed with Type 2 Diabetes. He was not very compliant with his diet and blood glucose regulation and rapidly developed poor sight and hypertension. In 2019 he discovered that he had almost no feeling in his feet (neuropathy) after he was found to have a needle embedded in his right foot. This resulted in the amputation of his second toe. In 2019, he also had a cataract removed from his right eye, and the left cataract was removed in 2020.

On Monday 31 ^st of July 2023, he presented to his doctor with an infected right foot. He thought he had a minor infection of a crack in his heel. The doctor discovered that he had a stone embedded in his heel and removed it before sending him to the hospital for admission.

On admission to Curtin Hospital, Ward 3 Room 14 it was decided that Antonio needed surgery to remove all the dead tissue in the wound and antibiotics to combat the infection. He felt “hot” to the touch (Temperature 38.5°C) and quite unwell. His heart rate was 105 beats per minute, his respiratory rate was 22 breaths per minute, and his blood pressure was 160/90 mmHg.

After the surgery, Antonio was confined to bed for five days. He had to have his leg elevated to reduce the swelling. His vital signs returned to normal levels after he commenced the antibiotics (T 36 ⁸ , HR 86, RR 18, BP 140/86). Antonio was very unhappy as he disliked attending to his meals, hygiene and elimination needs in the bed, and he felt that the staff were never available to assist him when he needed them. He told Raymond that most of them did not recognise his hearing disability. He was feeling very tired because the nurses kept waking him to check his vital signs.

On the 6 ^th August, he was allowed to move around using crutches, and he began his transition to go home on Monday 7 ^th August. Antonio will not be able to weight bear for four weeks. When he gets home, he will have a visit from a Community Nurse every day to have the wound dressed.

Answer the questions below on this template and put your word count after each of your answers.

• The word count does not include the question but does include your in-text references.
• The total word count is 600 ± 10%. You must put a reference list at the end of the document.

A Registered Nurse asks a Student Nurse to complete a Gordon’s Functional Health Assessment on Antonio to prepare for his person centred care planning.

After considering the information presented in the case study, identify four relevant Functional Health Patterns (General assessments) requiring further investigation (Focused assessments) for Antonio? Include evidence-based rationale to support this answer.

After considering the information presented in the case study, identify four relevant Functional Health Patterns (General assessments) requiring further investigation (Focused assessments) for Antonio? Include evidence-based rationale to support this answer.

According to Marjorie Gordon Functional health pattern (1987), firstly,it is important to understand the Health Perception-Health Management Pattern to comprehend Antonio's experience of quitting smoking in 2009 due to "hay fever" with no recognised allergy (Karaca, 2016). His exact symptoms should be examined in detail, together with his respiratory health and any potential concerns from his smoking history (Israel et al., 2020). Second, Antonio's Type 2 Diabetes diagnosis in 2017 and his disregard for dietary and blood glucose control measures call for a study into the Nutritional-Metabolic Pattern. To find any gaps in diabetes care that might have been linked to his recent medical issues, it is critical to evaluate his current dietary practices and glycemic control (Fang, 2020). The third pattern, Activity-Exercise, is crucial since Antonio's post-surgery reduced mobility, and four weeks of using crutches may affect his levels of physical activity. For planning his recovery and averting additional issues, it is imperative to assess his present level of activity (Gengo e Silva Butcher & Jones, 2021). Finally, considering Antonio's prior cataract surgeries and current complaints of feeling "hot" and sick, the Cognitive-Perceptual Pattern should be evaluated. As these symptoms may indicate underlying concerns, this evaluation will assist in finding any unresolved visual impairments and determine whether he accurately perceives the temperature and discomfort (Van den Bergh et al., 2017).

• Discuss two basic nursing care skills that a nurse would offer to Antonio during his hospitalisation. Using critical thinking processes, state clearly the rationale for selecting these two skills. Check essential textbooks for a reference. (Approximately 150 words)
• Name one risk management tool a nurse could implement to assist in managing Antonio’s care while in hospital. Include evidence-based rationale to support this answer. (Approximately 150 words)
• After a final assessment by Doctor Elizabeth Stevens, Antonio is to be sent home for ongoing wound care.
• Consider the communication strategies that should be implemented in the community to ensure that Antonio can communicate with the Community Nursing Organisation.
• Provide one example of an important communication strategy and and link this to recognised strategies for assisting deaf people in health care. (Approximately 100 words)

Complete the following ISOBAR handover tool using the information available in the case study to enable the Discharge Nurse to give a handover to the Community Nurse. (Not included in word count)

References

Fang, M. (2020). Trends in diabetes management among US adults: 1999–2016. Journal of General Internal Medicine , 35 , 1427-1434. 

Fang, M. (2020). Trends in diabetes management among US adults: 1999–2016. Journal of General Internal Medicine , 35 , 1427-1434. 

Gengo e Silva Butcher, R. D. C., & Jones, D. A. (2021). An integrative review of comprehensive nursing assessment tools developed based on Gordon's Eleven Functional Health Patterns. International Journal of Nursing Knowledge , 32 (4), 294-307. 

Gengo e Silva Butcher, R. D. C., & Jones, D. A. (2021). An integrative review of comprehensive nursing assessment tools developed based on Gordon's Eleven Functional Health Patterns. International Journal of Nursing Knowledge , 32 (4), 294-307. 

Griswold, L. H., Griffin, R. L., Swain, T., & Kerby, J. D. (2017). Validity of the Braden Scale in grading pressure ulcers in trauma and burn patients. Journal of Surgical Research , 219 , 151-157. 

Huang, C., Ma, Y., Wang, C., Jiang, M., Yuet Foon, L., Lv, L., & Han, L. (2021). Predictive validity of the Braden scale for pressure injury risk assessment in adults: A systematic review and meta‐analysis. Nursing Open , 8 (5), 2194-2207. 

Israel, A., Feldhamer, E., Lahad, A., Levin-Zamir, D., & Lavie, G. (2020). Smoking and the risk of COVID-19 in a large observational population study. MedRxiv , 2020-06. 7

Israel, A., Feldhamer, E., Lahad, A., Levin-Zamir, D., & Lavie, G. (2020). Smoking and the risk of COVID-19 in a large observational population study. MedRxiv , 2020-06. 

Karaca, T. (2016). Functional Health Patterns Model–A Case Study. Case Studies Journal ISSN (2305-509X) Volume , 5 .

Kushalnagar, P., Paludneviciene, R., & Kushalnagar, R. (2019). Video remote interpreting technology in health care: Cross-sectional study of deaf patients’ experiences. JMIR Rehabilitation and Assistive Technologies , 6 (1), e13233. 

Lipsky, B. A., Senneville, É., Abbas, Z. G., Aragón‐Sánchez, J., Diggle, M., Embil, J. M., & International Working Group on the Diabetic Foot (IWGDF). (2020). Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes/metabolism Research And Reviews , 36 , e3280. 

National Association of the Deaf. (2023). Video Remote Interpreting. 

Van den Bergh, O., Witthöft, M., Petersen, S., & Brown, R. J. (2017). Symptoms and the body: taking the inferential leap. Neuroscience & Biobehavioral Reviews , 74 , 185-203. 

Van den Bergh, O., Witthöft, M., Petersen, S., & Brown, R. J. (2017). Symptoms and the body: taking the inferential leap. Neuroscience & Biobehavioral Reviews , 74 , 185-203. World Health Organization. (2021). World report on hearing . World Health Organization. 

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