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Nursing case study.

Nursing case study.

Case

Josephine Hayes is an 15 year old girl who has just arrive in emergency department after falling off her bicycle on the way to school. Josephine has a history of type 1 diabetes which was diagnosed when she was 12 years old. Josephine normally manages her diabetes herself and states that she understands how to look after. She seems defensive in the way she says this.
Josephine has sustained a fractured right radius, which will require to be set in a cast for 6 weeks. Her right arm is her dominant arm. She states 6/10 pain on rest and 8/10 on movement.
On examination, all vital signs are within normal limits except for her blood glucose level (BGL) which is 18mmol/L and her temperature which is 38.4 deg C.
You also notice a small wound on Josephine’s left toe which looks to be old, purulent, red and a little swollen. It is infected. When you ask Josephine about it, she states she has never noticed it before and must have got it when she fell of her bike.
When Josephine’s mum arrives to collect her, she asks to speak to you privately and voices concerns that Josephine’s diet is not as good as it could be for someone with her condition and she is frequently eating unhealthy snack food with her schoolfriends. Josephine has gained a significant amount of weight in the last 6 months

 

Task description:

 

For this essay, (adolescent case). Review your case. Using the clinical reasoning cycle you are required to assess, plan, implement and evaluate your care for the patient. After identifying the relevant assessment data you must identify one current problems for your patient. For the problem identified, list two (2) nursing interventions (independent) linking to your research of the literature. Include a one to two-line rationale for each intervention. Evaluation of the effectiveness of your interventions is essential.

 

What you need to do:

 

For your identified problems (Approximately 850 words): Briefly explain how it relates to the patient’s assessment data. You must demonstrate your understanding of the relevant pathophysiology to explain the link between the problem and the patient’s signs and symptoms. Identify TWO interventions to address each problem. Justify the interventions you will implement (explain what is involved in implementing the intervention, why it is suitable, any relevant special considerations relevant to the patient or situation) and support/justify the use of these interventions with reference to current evidence-based literature (a minimum of 5 current articles for each intervention). Outline the expected evaluation criteria/data that would indicate that each intervention is improving or resolving the identified problem.

 

 

 

Base your work on the information below relating it to the case.

 

The current problem and interventions have been identified here below for you to work on. Thanks

 

 

Current problems

 

 

1 – Pain score 6/10 while resting & 8/10 on movement

 

Interventions

1 – Encourage bed rest

Rationale

  • Reduce friction on fracture which promote healing

 

2 – Deep berating exercise/coughing

Rationale

  • Prevent respiratory infection

 

Evaluation

 

Pain score reduced 2/10 resting & 3/10 movement