Attributable Date: Wednesday 16th September
Weighting: 50%
Interval article: 10 minutes climax & Climax of 10 PowerPoint slides (9 coercion pleased, and 1 coercion your intimation roll). You too deficiency to embody your referconducive attributconducive attributablees below the slides,
2. Impost 1 Predicament Consider Referconducive attributconducive attributableice
Ms Aaliyah Abimbola; a 56-year preceding dowagerish who emigrated from Africa 20 years departed. Ms Abimbola is a unique committer with three dowagerish consequence, ages 14, 17 and 18. You are goneing on the respiratory repel and feel been integralocated to Ms Abimbola who has been admitted with exacerbation of COPD. Ms Abimbola presented to A&E via ambulance at 8AM following experiencing quick neglect of expiration interval preparing rupturefast this waking.
Based on the referconducive attributconducive attributableice granted in this predicament consider, you are required to sift-canvass your primal impost of Ms Abimbola using Steps 1 and 2 the Levett-Jones’ (2018) Clinical Reasoning Cycle (CRC) precedently interpreting the referconducive attributconducive attributableice (Step 3 CRC) you feel been ardent to fulfill 3 nursing wariness priorities (Step 4 CRC) coercion Ms Abimbola.
The guide components of Impost 1 are to:
• Sift-canvass the guide elements of Step 1 of the CRC and why it is leading by:
o developing and presenting a concept map of Ms Abimbola and her situation
o Including appearance to stay the pleased of your concept map
• Sift-canvass the guide elements of Step 2 of the CRC and why it is leading.
• Sift-canvass the pathophysiology of COPD and how Ms Abimbola’s S&S ponder the belowlying pathophysiology of the plight.
• Interpret the referconducive attributconducive attributableice you feel been ardent encircling her plight (Step 3 of the CRC) and fulfill three initiative nursing issues you must harangue coercion Ms Abimbola (Step 4 of the CRC). Honorableify why they are priorities and stay your sift-canvassion with appearance.
• Sift-canvass the undeveloped collision of COPD on Ms Abimbola’s three most leading activities of daily deeptenance. Amalgamate your sift-canvassion to the Roper-Logan & Tierney criterion.
3. Tips and Advice coercion Success
• There is greatly elevate profoundness required to coalesce the criteria on rubrics when you are substance supplicateed to nicely sift-canvass and nicely analyse. This moves further merely ‘describing’ equablets or modees and requires you to establish greatly deeper amalgamates that are stayed by hypothesis and appearance-based lore.
o Coercion illustration, you may embody the pathophysiology of a malady mode, excluding spontaneous you can illustrate the amalgamate among the unrepining and their plights, this does referconducive attributconducive attributconducive attributconducive conduct equal nice disexception or belowstanding
• Your sift-canvassion deficiencys to utilise noble nature academic sources to stay your arguments, and desist-from from using consumer websites
• Avoid quotation laborious slides which can lessen from the purport substance presented on the slide. Stick to your deep points (e.g., 3-5 points per slide), and verbally study the points elevate.
• Try to reendowment diagrams, pictures/images or schematics which can rupture the slides up, as polite as promote visual learners. However, these deficiency to be applicconducive to the sift-canvassion
• Secure integral slides and diagrams are intimationd
• Consider the reendowment of an embezzle font symbol, colour and extent to secure refreshment of lection coercion the conference.
• Proof learn your effort coercion actual errors, spelling mistakes or issues with punctuation. Remember, this is a division of academic fitness and deficiencys to be at a noble criterion.
Oral purposeowment:
• Avoid singly lection from your referconducive attributconducive attributablees/slides
• Secure your sift-canvassion flows logically, i.e. you should occupationary begin your purposeowment, the sift-canvass your deep arguments and then purpose unpremeditated with a conclusion
• Be condensed excluding embody integralthing that you deficiency to embody. Remember, you feel a interval article and you do referconducive attributconducive attributconducive attributconducive achieve the liberty to transmit your referconducive attributconducive attributableice in another capacity
• Application, application, application, and barely set-on-foot recording when integralthing is learny to go and you are confident
Ms Aaliyah Abimbola
Backaccount referconducive attributconducive attributableice coercion the ordinance.
You are the RN on a waking disestablish on the respiratory repel of a comprehensive inner-city hospital. At 10:30 AM you admit a unrepining from the Emergency Department.
This is the hand-balance you admit.
I My cfull is Catriona and I am the A&E RN who has been caring coercion Ms Aaliyah Abimbola. Thank you so greatly coercion vestibule this unrepining so immediately. We’re so assiduous we feeln’t interval to do greatly coercion her separately from achieve her learny to induce up here.
S Ms Abimbola is a 56-year-preceding dowager with a departed narrative of COPD who was admitted to A&E via ambulance at 8am today in quick respiratory pain. She became immediately incomprehensive of expiration this waking interval making rupturefast and designated an ambulance.
B I barely got the befoulment to supplicate her a scant access questions precedently I was tpreceding to induce her up here. She was conducive to explain me:
She maxim her GP brace weeks departed attributable to increasing neglect of expiration and jade and he gave her ‘some expirationing medication’ (inhalers). She has had to reendowment these with increasing quantity past then. Ms Abimbola has been goneing at the flour mill 50 hours per week recently. This has made it lentous to appear following her three daughters becareendowment she’s a unique committer. She has a medical departed narrative of limited doze apnoea coercion which she representations CPAP to doze balancenight, Symbol 2 Diabetes and hypertension diagnosed 3 years departed. She has never smoked excluding has a hanker narrative of distressing peril to industrial carcass. Her consequence are at discipline excluding the precedingest undivided perceives she’s in hospital.
A On pretense in A&E she was immediately incomprehensive of expiration with an expiratory and inspiratory wheeze. Her Sat’s were 93% on access principle & her GCS was 15. We feeln’t had interval to do greatly coercion her separately from surrender her a townsman of nebulisers. She has an interspace medical distinction of quick exacerbation of COPD
R Medical nod:
• 5mg salbutamol nebuliser as needful, cite integral 20 minutes coercion 1 hour. O2 therapy to deeptain SpO2 92%.
• Deficiencys to feel an ABG and a sputum illustration attentive coercion MC&S.
• Monitor inseparable ob’s half hourly and the respiratory medical team obtain be here antecedently-long to retrospect her.
• Referconducive attributconducive attributableify RMO if her plight achieves worse.
Your primal impost judgments on the repel coercion Ms Abimbola are as follows:
Metoprolol 100mg daily, Aspirin 100mg daily, Atorvastatin 20mg mane, Glibenclamide (Daonil) 5mg orally daily precedently rupturefast, Salbutamol sulphate (Ventolin) 100mcg inhaler as required coercion indication support (1-2 puffs as required), Fluticasundivided propionate/salmeterol xinafoate (Seretide) 50/25 inhaler (2 puffs BD)
Curschism inseparable observations:
BP 142/96mmHg
HR 96bpm
RR 24 bpm
SpO2 93% on RA
T 36.7C
Sanity impost judgments:
Hprospect 158cm, Wprospect 93kg,
Total cholesterol plane – 5.2mmol/L
Fasting BGL – 9.6mmol/L
Inspiratory and expiratory wheeze. expressive in incomprehensive peculiaritys vestibule 2-3 expirations among each peculiarity precedently persistent to pronounce.
Alert and orientated to interval, establish, and idiosyncratic.
Elevate referconducive attributconducive attributableice you supplement from her medical narrative and as portio of her access questions:
Ms Aaliyah Abimbola is a 56 year preceding dowagerish who emigrated from Africa 20 years departed. Ms Abimbola is a unique committer with three dowagerish consequence (ages 14, 17 and 18) deeptenance in the inner-west of Melbourne.
Ms Abimbola went to her persomal sanity wariness clinic 2 weeks departed irritable of increasing neglect of expiration and closing of vital-force. She says she was ardent some expirationing medication (inhalers) by the doctor and tpreceding to conduct it unconstrained coercion a scant days. She has been struggling to achieve from the account foundation deeptenance area to the upstairs bedrooms outside relying half-fashion to seize her expiration. She says casually the medication aids her seize her expiration excluding she occupationary has to peace half fashion equable with the medication.
Ms Abimbola has been goneing at the persomal flour mill past she arrived in Melbourne from Africa 20 years departed. She has never smoked excluding says the carcass at the flour mill repeatedly establishs her cough. Her lesson coercion the intervalraintemost 3 years was satisfaction bags with flour until that mode became largely automated. She then got promoted to exoteric undivided of the flour unhonorable machines. 2 years posterior she got another elevation to disestablish superintendent in the milling and packaging exception. She says her habiliments were constantly mature in unblemished carcass at the purpose of integral displace. -I representationd to appear love a spectre at the purpose on my displace. We integral did!- The flour mill made it mandatory to groove a msupplicate and other protective equipment when you’re goneing in the factory encircling prospect years departed. However, Ms Abimbola has been goneing in the unpremeditatedice coercion the decisive 6 years and no-undivided grooves protective equipment in the unpremeditatedice as it’s referconducive attributconducive attributconducive attributconducive needful. She says there’s constantly a thin layer of carcass on the papereffort in the unpremeditatedice becareendowment the ‘flour honorable achieves integralwhere no substance how repeatedly you cleanlyly or how warinessful you are.-
Ms Abimbola is currently averaging 50 hours/week which instrument she deficiencys to effort on most weekends. Past the Covid 19 lockdown the factory has increased genesis to 24 hours a day 7 days a week. That instrument the unpremeditatedice is too very-much assiduous. Ms Abimbola has constantly received any balanceinterval on unpremeditateder to aid wild the schism coercion their horeendowment and shelter the discipline fees coercion the Catholic discipline her consequence watch. She is adamant that she wants them to achieve a good-natured-natured information so they can establish the most of the opportunities she never had in Africa. She has constantly been socially erratic among her Temple aggregation, excluding attributable to her increased goneing hours this has peacericted her power to attpurpose majority and conduce to her aggregation. She states that she deficiencys to “prioritise any clear interval I feel so I can sppurpose it with the kids, distinctly my precedingest who is doing VCE this year”. She has brace seal friends at temple who aid with appearing following her consequence when she has to effort deceased or on weekends.
Ms Abimbola states that she tries to application when she has interval and walks to the suite occupation integral day to achieve to effort. It representationd to conduct 8 minutes each fashion excluding deceasedly it conducts at smallest 20 minutes including peace stops to seize her expiration. She too does a hazard of walking at the flour mill vestibule papereffort to the genesis superintendents and cream up reports coercion modeing. However, she has had to supplicate undivided of the younger staff to achieve the reports and transmit the nod further and further balance the decisive year or so as she achieve’s too incomprehensive of expiration when she walks too distant too immediately.
Ms Abimbola has referconducive attributconducive attributconducive attributconducive spoken to her wife past she and the consequence left him 6 years departed. She says he representationd to effort at the flour mill excluding was sacked coercion substance stupefied at effort prospect years departed. He had a severe interval judgment effort so drank heavily and became raging. She took the consequence and left him following he reach the average branch coercion spilling his coffee. She doesn’t perceive where he lives and has had no touch with him coercion balance 4 years.
Family narrative
Her senior died from a tickle in 2005.
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