Reference no: EM133620366 , Length: word count:1500

Integrated Nursing Practice

Case Study

You are a student nurse on placement with Community health centre in Armidale. You are scheduled to visit Mr Frank Burns (69 year-old male) for pulmponary rehab at home. Mr Burns has history of COPD, smoker and currently lives with his wife Mary (61 years old) and grandson John (21 years old). You and the RN arrive at Mr Burns' home to attend the rehab session. However when you arrive, Mr Burns and his grandson John are unwell.

John Burns: is a 21 year old male, currently living with his Grandfather. He has arrived at Armidale to begin studying at the University. He recently travelled to South Africa to see his Mother and Sister. He has 2 month history of productive cough (no haemoptysis noted), which was treated as bronchitis at the time. He now has a fever, night sweats, fatigue, and decreased appetite. John states his symptoms have increased over the past few days, and has noticed some pleuritic chest pain intermittent 34 out of 10, and weight loss 5kgs. You notice he is talking in short sentence interrupted by a cough, with an increase in work of breathing (WOB). Johns observations: temp 38.7, RR 22, HR 115, 02 Sats 95%.

Frank Burns: COPD- which requires home oxygen 2 Lt, and regular puffers. Frank states he has had a cough (productive) for the past 5 days. He has Increased shortness of breath (more so then normal), talking in phrases and is using his puffers but with no effect.

Mary Burns: Is active as usual, no symptoms noted. She states she has to read to the pre-school children at the library this afternoon and helps deliver the lunch time meals with meals on meals, but is worried Frank and John have flu or COVID and doesn't want to spread it to the children or the elderly.

All three have tested negative to COVID-19 by home swab.

The RN tells you, she is worried John has TB (Tuberculosis), and referrers all three patients to Emergency department, after phoning the hospital staff to let them know possible cases of TB are coming in.

Question 1. Discuss the nurses' role in infection control, the precautions that are necessary of patients with TB and explain why Mary (who is asymptomatic) is also being referred to the hospital for assessment.

Question 2. Reflect on the situation above- Critically discuss the nursing management of both John and Frank. In your discussion you need to include, diagnostic, treatment and briefly outline the priorities of care.

Question 3. Discuss the purpose of health promotion and pulmonary rehab, and evaluate why pulmonary rehab is beneficial to Frank who has COPD.

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