Charlie who is 43 years old reports abdominal pain for 5 days increasing in severity. Today Charlie has vomited three times and feels nauseas. It is reported that Charlie’s bowels have not opened

Scenario and questions for NUR2000 TLOSA –Adult– Sep 2022 Cohort

Scenario:

You have the following information given to you by your team leader and you are asked to complete a person-centred assessment before planning, implementing, and evaluating care for this person focussing on the three problems identified.

Charlie who is 43 years old reports abdominal pain for 5 days increasing in severity. Today Charlie has vomited three times and feels nauseas. It is reported that Charlie’s bowels have not opened for 9 days. They have declined any offer of food or drink.

Charlie works full time as a delivery driver and admits to poor routines regarding meals and takes very little exercise.

Charlie is reported to becoming increasingly emotional, agitated and is not very communicative

Past Medical history:

Reflux

BMI reported to be in the ‘overweight’ category.

Medication:

Omeprazole

Paracetamol

Simvastatin

Social:

Lives at home with family in rented accommodation.

Smokes cigarettes

Focus on the three problems identified:

Constipation

Pain

Agitation

Questions:

Q1. With reference to the scenario, discuss the evidence related to the nurse’s role in gathering information to inform a person-centred assessment. Word count = 600 guide (LO. 3)

Q2. In relation to the scenario, analyse the impact of bio-psycho-social factors on the three patient problems identified. Word count = 600 guide (LO. 3)

Q3. Discuss the role of the registered nurse when planning SMART goals for ONE of the identified problems in the scenario, implementing the evidenced based care for the patient and evaluating the care provided for the patient in the scenario. Word count = 800 guide (LO. 6)

Q4. Identify and discuss the challenges faced when implementing, or providing, effective evidenced based care for the patient in the scenario, including discharge planning, referral to other services and transition to the primary care team. Word count = 800 guide (LO. 8)

Q5. You are required to submit an accurate reference list (Edge Hill Harvard style) with this assessment. This is a required element.

Only include references cited in your answers.

Learning Outcomes:

(LO 3) Apply underpinning knowledge of bio-psycho-social factors when undertaking person centred assessment.

LO 6) Apply knowledge and understanding of the role of the registered nurse in providing and evaluating care.

LO 8) Evaluate the challenges of providing effective care, discharge, and transition across a range of settings.

Sample Answer (Plagiarised)

In this scenario, the nurse’s role in gathering information to inform a person-centred assessment is critical for developing a comprehensive care plan tailored to Charlie’s specific needs. The following steps outline the process and evidence-based practices for conducting this assessment:

1. Establishing Rapport and Trust

Evidence: Building rapport is essential to gather accurate information and ensure the patient feels comfortable sharing personal details. Studies show that a trusting nurse-patient relationship improves patient satisfaction and outcomes (Baillie, 2009).

• Actions: Introduce yourself, explain your role, and express empathy for Charlie’s situation. Ensure a private and quiet environment for the assessment.

2. Comprehensive Health History

Evidence: A detailed health history is fundamental to understanding the patient`s baseline health and current issues (Ball et al., 2019).

• Actions: Ask about the onset, duration, location, and characteristics of the abdominal pain. Inquire about the pattern and severity of nausea and vomiting, bowel movement history, dietary habits, fluid intake, and any previous similar episodes.

3. Physical Examination

Evidence: Physical assessment helps identify clinical signs that correlate with reported symptoms (Jarvis, 2019).

• Actions: Perform an abdominal examination, including inspection, auscultation, palpation, and percussion to identify any abnormalities such as distension, tenderness, or bowel sounds.

4. Psychological and Emotional Assessment

Evidence: Emotional and psychological well-being significantly impact physical health and recovery (Thomas et al., 2017).

• Actions: Assess Charlie’s emotional state, levels of stress, and mental health. Use open-ended questions to allow Charlie to express feelings and concerns. Evaluate for signs of anxiety or depression.

5. Lifestyle and Social History

Evidence: Understanding lifestyle factors such as diet, exercise, and work routines provides insight into potential contributing factors and areas for intervention (Whitney & Rolfes, 2019).

• Actions: Discuss Charlie’s work schedule, meal patterns, physical activity, and social support systems. Explore the impact of Charlie’s job as a delivery driver on health behaviors.

6. Identifying Priorities and Goals

Evidence: Person-centred care prioritizes the patient’s values, preferences, and expressed needs (McCormack & McCance, 2017).

• Actions: Collaborate with Charlie to identify primary concerns and goals for care.