Nursing Care of Patients with Complex Needs
(Please read the instruction in the file as well please use subheadings for all questions especially for Q2 Q3 and Q4 which is easier for marker to read through also send me the subheadings in middle of the processing)
Ms Anna Smith 24 years of age returned to her home in Sydney last week from a holiday in Bali with a friend. Anna consulted her local doctor as she felt unwell. She reported that she had a fever fatigue shortness of breath with minimal activity and a persistent non-productive cough. Her friend had no symptoms and Anna said that she and her friend did everything together including eating mostly the same meals. The only difference in the holiday was that she received a very small tattoo on her ankle (where as her friend did not).
The doctor sent Anna to the local hospital for diagnostic testing as she had a slight heart murmur (which she did not previously have a history of). The doctors at the hospital diagnosed bacterial endocarditis and advised Anna that she would need to be admitted to hospital to commence intravenous antibiotics to treat the infection. Anna was also advised that if her symptoms settled that she would be discharged home on long-term antibiotic therapy. Alternatively if her symptoms did not settle she would require surgery.
Anna was admitted to the cardiology ward and commenced on intravenous antibiotics two days ago via right PICC line. She was transferred to your ward (neurology) yesterday when she suffered a small right temporal lobe stroke.
Annas family live in rural Western Australia. She has a couple of close friends in Sydney who she met at University. Anna is currently single lives alone in a second-floor flat and works full-time as an accountant.
Please answer the following questions using academic language and format.
Introductions and conclusions for each question are not required.
There should be only one reference list containing at least 28 references predominantly recent peer-reviewed articles since 2011. A maximum of two text books can be used. It is crucial that the ALL references are consistent with content. No academic web site can be used in reference.
1. The family of Anna are visiting her and ask you to explain how she had a stroke at such a young age. (1100 words)
Your answer should include an explanation of the aetiology and pathophysiology of Annas illness.
Although your answer should be written in academic format (using APA 6) the language should be written as though you are explaining the concepts to someone who does not have a medical background but is an educated patient (e.g. not straight from a text book also not from hospital fact sheets which can be used for uneducated people to understand).
2. Identify and justify the important focussed assessments that you would perform on Anna using a systems approach. Please reference the literature to support your rationales (600 words).
3. Prioritise and discuss the two main complications that you would be worried that Anna may experience within the next four weeks. Please rationalise your answers (600 words).
4. Describe two specific nursing tools that you could use in your nursing care of a patient such as Anna. Outline the rationale for your selection and reference the literature to support your rationales (450 words).
For instance but please do not use these two tools. During Annas inpatient stay I would use the hospital anxiety and depression scale (Zigmond & Snaith 1983). This outcome measure is comprised of two sections one to measure anxiety and one to measure depression. As this patients illness has been sudden and the long term effects as yet unknown this patient is at risk of developing anxiety or depression and baseline assessment needs to be recorded to determine if a therapeutic intervention is required.