Reference no: EM132652454 , Length: 900 Words

HSNS263 Nursing Practice on Integrated Care - The University of New England

Assignment - Nursing: Family analysis and education

Length: 800 words, with additional appendices

Learning Outcome 1. demonstrate an understanding of the cardiac system including related anatomy and physiology, pathophysiology, diagnostics,pharmokinetics, pharmodynamics, the quality use of medicines and complementary therapies;
Learning Outcome 2. demonstrate and apply comprehensive cardiac assessment and evidence based clinical reasoning skills in theory, clinical and simulated environments;
Learning Outcome 3. demonstrate the capacity to integrate and relate principles of ethical and legal practice within an intra and interprofessional team approach to person centred care;
Learning Outcome 4. learn and apply reflective practice and professional communication strategies that facilitate the delivery of safe and effective culturally sensitive quality care across diverse settings;
Learning Outcome 5. plan and implement person centred primary health care and health promotion strategies related to cardiac health and wellbeing.

Task Your response needs to be supported by recent evidence-based resources. This could include information from your texts and from other peer reviewed sources. This assignment makes use of the Katrina and Trevor case studies which can be found on the Moodle home page.
• Outline the incidence/ prevalence and main causes of Hypertension in Australia
• Discuss the grading system for hypertension, Outlining the modifiable and non-modifiable features of the disease and their primary management included in each stage.
• As an appendix, present an evidence-based education plan for both Katrina and Trevor. The Patient Education Plan should include their cardiac medications. It should discuss all aspects of cardiac health (there are several problems including physical, social and psychological), and set goals to improve their health. The plan should include the interdisciplinary team. This needs to be in table format, with referencing throughout.

Case study of Trevor

Taking Trevor's history
You and the RN begin your assessment by taking Trevor's history. This is the information he gives you:
• He is a 61 year old man. He was born in Sydney and lived there until he was 50, when he and his wife, Susan, decided to move to this rural town (around 40,000 residents including a large Indigenous population). He is a smoker.
• He and Susan have four children, aged 23, 25, 27 and 30, who all live in Sydney.
• Trevor works as an architect, spending a lot of his work day at his desk. He and Susan like to spend their weekends either relaxing at home or visiting their family.
• Trevor doesn't really like physical activity and hasn't played any type of sport since he was a teenager at school. He tells you he is too busy and 'doesn't see the point'.
• He tells you he generally doesn't pay much attention to what he is eating. He says he eats whatever Susan cooks for him and when they go out for dinner (about twice each week), he usually orders steak and chips.
• He was told by a GP a few years ago to 'get checked out' for type 2 diabetes mellitus, but he has never followed up.
Assessing Trevor

You and the nurse begin a full physical assessment of Trevor. Here is some of the information you collect:
Trevor is 172cm tall and weighs 122kg.
Trevor's vital signs are:
• Blood Pressure (BP) 143/87mmHg
• Heart Rate (HR) 87 beats per minute (at rest, sitting on the examination bed)
• Respiratory Rate (RR) 24 breaths per minute (at rest, sitting on the examination bed)
• Temperature (Temp) 36.6oC
• Oxygen Saturation (SpO2) 94% on room air
• Heart sounds are normal: S1 and S2 heard clearly
• Lung fields sound diminished, but clear to bases
• Blood Glucose Level (BGL) 12.4mmol/L (about 4 hours after his last meal).

The doctor's opinion
With this information, the GP suspects Trevor has Ischaemic Heart Disease (IHD) and decides to send Trevor for a fasting BGL, HbA1C and serum cholesterol tests.

Focus for investigation
What is Ischaemic Heart Disease?
• Describe the aetiology, pathogenesis and clinical manifestations
• Which signs and symptoms can you see in Trevor's story that fit this disease?
What are the risk factors for IHD?
• Which ones can you find here in Trevor's history?
What tests can be done to diagnose IHD?
What other information would you like to collect in your assessment of Trevor (remember, you are in a GP office- think of the resources you have available to you there).
What complications (or potential complications) can arise from IHD? Relate these to how they might influence Trevor's story.

Focus for investigation
• What differences in cardiovascular anatomy and physiology might you find between an adult and paediatric patient?
• What are some differences in cardiac assessment findings you might find between an adult and a paediatric patient?
• What would normal findings be in a healthy child?
• What familial risk factors are there for cardiac disorders?
• Relate this to Katrina's story- can you find any here?

Attachment:- Family analysis and education.rar