Mrs Salimah Abdallah a 44 year woman, wife, mother and devout Muslim has been re – admitted to the hospital with an elevated temperature and productive cough, after having a haemorrhoidectomy one week ago.
You are the admitting nurse and during the admission discover that Mrs Abdallah developed the cough after spending the week after surgery in bed. Mrs Abdallah states that she is finding difficult to walk small distances before becoming breathless and experiencing sharp pain in her lung whilst breathing in. She rates this pain 5/10 and denies taking any analgesia.
You ask Mrs Abdallah about her normal sleep routine and discover that she has not slept properly for days and feels exhausted. She is pale, drawn with dark circles under her eyes and complaining of fatigue.
Due to decreased appetite and energy levels, Mrs Abdallah has been eating very little Halal food. You ask Mrs Abdallah about her toileting habits. After telling her husband to leave the room, you learn that she has not opened her bowels for the entire week as she is frightened it will be painful and that she will bleed a lot.
Mrs Abdallah normally cares for her five children aged 2 – 7 years of age. Her husband works 6 days a week in his own Halal butcher shop.
PART A: (S / NYS)
Working in collaboration with the RN the following Nursing Diagnosis’ are formulated for Mrs Abdallah.
• Ineffective Airway Clearance related to viscous secretions and shallow breathing.
• Sleep Pattern Disturbances related to cough, pain, and orthopnoea.
• Constipation related to reduced fluids, inactivity and fear of pain defecating.
• Acute Pain (anal) related to recent surgery and constipation.
• Activity intolerance related to breathlessness and malaise.
• Your task is to provide five (5) nursing interventions (selected activities) for each of the Nursing Diagnosis provided within the scope of the EN.
• Each nursing intervention identified, must be supported with a rationale. Remember rationales are the scientific principle given as the reason for selecting a particular nursing intervention and is linked to critical thinking.
• Please include in-text references to support you rationales within the body of the care plan.
• A reference list must be provided at the end of the assignment using the APA system. A minimum of five (5) references including prescribed text is required (websites such as Wikipedia and google will not be counted)
• Ineffective Airway Clearance related to viscous secretions and shallow breathing. Please provide 5 nursing interventions & rationales. (S / NYS)
• Sleep Pattern Disturbances related to cough, pain, and orthopnoea. Please provide 5 nursing interventions and rationales. (S / NYS)
• Constipation related to reduced fluids, inactivity and fear of pain defecating. Please provide 5 nursing interventions and rationales.
(S / NYS)
• Acute Pain (anal) related to recent surgery and constipation. Please provide 5 nursing interventions and rationales. (S / NYS)
• Activity intolerance related to breathlessness and malaise. Please provide 5 nursing interventions and rationales. (S / NYS)
PART B: (S / NYS)
Please discuss in your understanding of the evaluation phase of the nursing process. (S / NYS)
Explain in how you will maintain the client’s cultural safety whilst applying the nursing process. (S / NYS)
Discuss your understanding of the concept “person centred care” and provide 4 examples of how you can implement person centred care for Mrs Abdallah.
(S / NYS)
The care plan focus for Mrs Abdallah is on the acute care of this client. Once she is significantly improved, the nurse will plan for discharge. Please identify four (4) areas of discharge teaching for Mrs Abdallah. (S / NYS)
Mrs Abdallah exhibits signs of respiratory distress. State four (4) signs indicating that her condition is deteriorating into an emergency situation? Outline what is the role of the EN in this situation. (S / NYS)
State the rationale for ensuring that pain assessment is undertaken in a non-judgemental manner. (S / NYS)
Identify four (4) non-pharmacological interventions that may be used to promote sleep in hospitalised clients. (S / NYS)
Part C: (S / NYS)
Two days after admission to hospital, Mrs Abdallah becomes hypotensive and confused following a bowel action.
Identify four (4) potential risks Mrs Abdallah may experience related to these signs and symptoms and outline risk prevention strategies you will implement to monitor Mrs Abdallah’s safety and wellbeing (S / NYS)
List 4 potential risks
Risk prevention strategies
Indicate how you will maintain Mrs Abdallah’s privacy and dignity during his hospitalisation. (S / NYS)
You are required to answer all of the following questions and if applicable support your work with a reference. Remember to read the question.
You will be required to achieve a Satisfactory Result in all parts of each question of this case study.