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Written assessment Written Assessment – Clinical Case Study Report Weight: 50% of the total unit mark Length: 2000 words ± 10% Task The objective of the clinical case study report is to gain...

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Written assessment
Written Assessment – Clinical Case Study Report 
Weight: 50% of the total unit mark
Length: 2000 words ± 10%
 
Task
The objective of the clinical case study report is to gain comprehensive knowledge about kidney disease and its management.  In this case study report you will focus on the stages of chronic kidney disease (early detection to end stage kidney diseases)  and the assessment and management of each stage.  Within the Moodle unit HSNS265 “Case: Glenda; Glenda is from the Tiwi Islands.
Your assignment needs to be structured according to the conventions of academic writing following  American Psychological Association(APA) - 6th Edition - commonly refe
ed to as APA 6  and include an introduction, an integrated conclusion and subheadings as required. You must write in essay style: do notuse dot point format.
Your response needs to be supported by recent evidence based resources. This could include information from your texts or from other peer reviewed sources.
In this case study report you will present the clinical case of Glenda and discuss her kidney disease and management at each stage of her chronic kidney disease; this will include:
The assessment and management of each of the stages of Glenda’s chronic kidney disease. Consider for each stage of her kidney disease; the pathophysiology, health priorities, interdisciplinary team approaches, health promotion strategies, health concerns and communication strategies that you would apply to Glenda, her family and wider community.   
Rationale (Based on Unit Learning Outcomes 1 – 5)
This activity will allow you to demonstrate your ability to:
1. demonstrate an understanding of the renal system including related anatomy and physiology, pathophysiology, diagnostics, pharmokinetics, pharmodynamics, the quality use of medicines and complementary therapies;
2. demonstrate and apply comprehensive renal assessment and evidence based clinical reasoning skills in theory, clinical and simulated environments;
3. demonstrate the capacity to integrate and relate principles of ethical and legal practice within a team approach to person centred care;
4. learn and apply reflective practice and intra and interprofessional communication strategies that facilitate the delivery of safe and effective quality care across diverse settings;
5. plan and implement person centred primary health care and health promotion strategies related to renal health and wellbeing.
This  assignment is important because it will enable you develop a greater understanding of the stages of kidney disease, as well as, apply a patient centred care approach to undertaking the assessment and management of each stage. You are also required to apply your critical thinking skills to the case study and show your capacity to identify, interpret, and critically analyse issues raised by the case study. This assignment is the third assessment within the unit.  The concepts that you are exploring will assist in building your knowledge in relation a registered nurse's accountability and responsibility for caring for patients with chronic kidney disease.
It should contain the following sections:
Introduction - Set the scene for chronic kidney disease, Glenda's chronic kidney disease.
Provide a Case Description- Provide pertinent information about  Glenda  - This usually begins with presenting signs and symptoms, medical history, (family history, if relevant), social history, medications, results of physical examination and/or nursing assessment, final diagnosis, treatment, nursing care provided, and outcomes.
Discussion - Critique the care, assessment and management for Glenda at each stage of her chronic kidney disease. You may include any care that may not have been effective within the case study and provide any recommendations that would have improved her care.  Incorporate the relevant literature within your discussion. You can discuss any unusual aspects of the case and the care that is/would be provided to assist Glenda to manage her condition.
Conclusion - A succinct summary of the information provided to draw the case study to a close.
Reference list - APA 6 referencing style must be used. References should be as cu
ent as possible.  As a general rule of thumb, literature published before 2008 will not attract marks. However, older research literature can be used for the review where necessary, if you can justify the importance of the seminal work to be included. Follow the link at the top right of the page for further information and examples.
Glenda case begins here
Life on Bathurst Island with Glenda (part 1)
PAGE 1
Life on Bathurst Island...
Glenda comes to the clinic
Glenda is a 56 year old Aboriginal woman who presents to her local health clinic at Wu
umiyanga, to see the doctor. Glenda is complaining of an itchy face. The doctor is cu
ently at Milikapiti on Melville Island providing a morning clinic and is available by phone. He will return later that day. On request from the doctor you take blood so that it can be transported to the Darwin pathologist on the morning plane. Results will then be available in the evening.
Review 
Subjective data
· Glenda does not feel like eating and has not eaten for a week (anorexia)
· Complains that she has been vomiting (nausea)
· Feels a little bit confused
· Itchy face (pruritus)
· Tired 
Objective data
· Temperature – 36.5
· Pulse rate – 89 beats per minute
· Respiratory rate – 20 resp per minute
· Blood pressure – 156/ 97 mmHg
· Oxygen saturation level – 96% at room ai
· Blood glucose level – 6
· Urine analysis – positive protein trace
Laboratory data
· Creatinine clearance rate: 8.2 mL/min
· Serum creatinine level: 1132/umol/L
· Urea level: 45 mmol/L
· Sodium 128
· Potassium level: 6 mmol/L
· Haematocrit: 0.20
· Bica
11.5
· Anion Gap:20
· Ca 1.98
· P04 5.4
· PH – 6.1
Glenda's story continues (part 2)
PAGE 1
Fe
uary 2010: Glenda's journey
Fe
uary, 2010: An unexpected journey for Glenda
Part of your role as a Registered Nurse at the remote clinic is to find the necessary medical records to document the clinical care.
It is also essential  to look at the care that Glenda has been receiving by the community nurses, any past admissions and her medical history as part of your comprehensive health assessment.  In particular you look at the nursing report from 2010 in the notes, you then look further in the co
espondence to find the discharge summary from Royal Darwin Hospital.  You need to interpret the past medical history to assist you with her latest admission.  
12/2/2010: 1010hrs Nursing report
Glenda Kerinaiau presented to the clinic complaining that her eye lids felt swollen and she felt sick. On physical examination she has generalized swelling, including on the face, feet, ankles and hands.  When she walks she complains of stiffness and pain in her knees and elbows. Glenda’s family states she was unwell about two weeks ago with a sore throat. Pain relief given as per medication chart with effect. Observation attended as per obs chart awaiting medical review.
(S Jones RN 35416)
Observations attended on admission
· Temperature – 38.8
· Pulse rate – 98 beat per minute (resting pulse rate)
· Respiratory rate – 22 resps per minute
· Blood pressure  - 180/100mmHg
· Oxygen saturation level – 96% at room ai
· Blood glucose level – 6mmols
· Urine analysis:  Rust-colored urine, tested positive for blood, protein  
Nursing history
· Smoking –  20 cigarettes per day
· Alcohol – binge drinks fortnightly, 4 or more drinks
· Diet - eats a traditional diet of seafood, bush tucker, fruit  and vegetables.  Cu
ently drinks water about 2-3L per day, 3 cups of tea and 500mL of Coca Cola per day,
· Physical activity - exercises, walking everywhere usually at minimum pace, weight within healthy weight range.
· Immunisation – flu vaccination & pneumococcal vaccination up to date 
13/2/2010: 1410hrs Nursing report
Glenda prepared for transfer via RFDS (fixed wing) to Royal Darwin Hospital for further investigation. Handover given to bed manager – Nurse Manager at Royal Darwin Hospital. All paper work including nursing transfer, medical letter are with transfe
ing RFDS nurse. Glenda's NOK has been notified of transfer.   
(S Jones RN 35416)
 
12/2/2010: 1010hrs Nursing report
Glenda Kerinaiau presented to the clinic complaining that her eye lids felt swollen and she felt sick. On physical examination she has generalized swelling, including on the face, feet, ankles and hands.  When she walks she complains of stiffness and pain in her knees and elbows. Glenda’s family states she was unwell about two weeks ago with a sore throat. Pain relief given as per medication chart with effect. Observation attended as per obs chart awaiting medical review.
(S Jones RN 35416)
Glenda's story continues (part 2)
PAGE 2
Glenda was diagnosed with Post Streptococcal Glomerulonephritis and treated at Royal Darwin Hospital. She was then transfe
ed back to the Tiwi Islands. The nursing discharge letter was addressed to the clinic nurse and included:
 
Glenda’s follow up includes a monthly health check by the community nurse which includes blood pressure monitoring and urine analysis.  
Glenda’s follow up includes a monthly health check by the community nurse which includes blood pressure monitoring and urine analysis.
The Nurse Manager at Royal Darwin renal ward has asked you the registered nurse to go over to the Tiwi Islands for two days to assist with health staff education to detect and manger chronic kidney disease she provides you with a USB with the two lectures below:
One session will be to the community nursing staff, to assist them to manage and educate the community:
Understanding how to care for Glenda (part 3)
PAGE 1
Putting the patient at the centre of care
During this admission Glenda is transfe
ed from the clinic to Royal Darwin hospital for further investigation.  She is admitted to the renal ward under the care of Nephrologist Dr Pell. When Glenda a
ives in the Darwin emergency department they are prepared for her a
ival, they insert a vas cath, order a portable x-ray, ECG and EUC & she is then urgently sent to the hemodialysis unit & is placed on hemodialysis that evening. She is scheduled for surgery in one week to have fistula formation in her Left arm.  
Who is Glenda?
Glenda is from Wurankuwu, a small settlement on Bathurst Island sixty kilometres from Wu
umiyanga.
Glenda lives there with her extended family including her two sisters, one of her sons and his four children. Glenda has five children, three girls and two boys. Her eldest daughter died in a car accident on the island when she was only fifteen years of age. Glenda's remaining four children all live in the Northern Te
itory. Her daughter lives in Darwin with her family, while her three sons live on the Tiwi Islands with their families. Glenda moves around the Tiwi Islands regularly to visit family, and attend meetings, cultural events and special occasions.  
Glenda is quiet; she speaks both English and Tiwi. Glenda attends haemodialysis three days per week as an outpatient at the Nightcliff renal unit. She lives with her daughter in Darwin who is her main carer and who also transports Glenda to and from the outpatient dialysis clinic. 
Whilst on dialysis, Glenda covers herself with a blanket to try to keep warm in the air conditioned unit, and usually falls asleep for the five hours of her treatment.
One day when she
ings Glenda for her dialysis, Glenda's daughter Roseen asks you, 'When can my
Answered Same Day Apr 09, 2020 HSNS265

Solution

Soumi answered on Apr 12 2020
135 Votes
Running Head: GLENDA’S CASE STUDY
1
GLENDA’S CASE STUDY
2
ESSAY ON GLENDA’S CASE STUDY
Table of Contents
3Introduction
3Case Description
5Discussion
7Conclusion
8References
Introduction
The following article mainly focuses on Chronic Kidney Disease (CKD) that has prevailed in Australia and worldwide in the recent past. Evidences of CKD are quite prominent in the world and they have shown varying symptoms and pathophysiology. Cu
ently, this essay charts out the description and various stages of the disease with respect to the case study of Glenda, who is a 56 years’ old Aboriginal woman from Australia. Further, this essay also describes the conditions of Glenda, reflecting from her data throughout the different stages, considering her emotional aspects and predominately providing her with health and person-centred care.
Case Description
CKD is often refe
ed to as the condition that reduces kidney function without any specific disease. According to Webster, Nagler, Morton and Masson (2017), it is the process of partial or complete damage to kidney over time. However, specific markers such as presence of urinary protein, blood spots and albumin are the main indication for the stage of kidney damage. Recently, there are about five different stages of CKD based on the level of damage with regard to its function and these stages are measured using Glomerular Filtration rate (GFR). GFR defines as the amount of blood cleared by kidney per minute. Although GFR is not measured directly, but can be estimated by creatinine levels in body that are gender, age specific. Headley et al. (2017) further discussed that in severe cases, kidney function might completely deteriorate and the individual at that point can no longer be treated but leading to renal failure and death.
As discussed by Drawz and Rahman (2015) the renal failure occurs due to the complete or partial loss of nephrons that are unable to regenerate and cause tissue scar. Consequently, further loss in the nephrons have secondary consequences damaging the cardiovascular system, increased blood pressure, blood volume and swelling in the body due to the failure in the removal of toxic substances in the body. Webster, Nagler, Morton and Masson (2017) discussed the five main stages of CKD that occurs due to loss of nephrons. Stage 1 is refe
ed to as with high GFR levels with slight kidney damage, stage 2 has moderate decrease levels of GFR, stage 3 and stage 4 has minimal levels of GFR and finally, stage 5 has no GFR where complete damage of kidney occurs.
As estimated by Collins, Foley, Gilbertson and Chen (2015), recent research on CKD focuses on the occu
ence of CKD throughout the world rising public health issues. In many countries, as no proper treatment available for the patients there are increased chances of death of the patients every year. However, in developed countries, transplantation therapies, dialysis renal replacement therapies are available to reduce the complications in patients. Mills et al. (2015) compared the prevalence to CKD across the world and showed indigenous population of Australia has highest reported CKD in the world and in specific woman are being more affected than men and seeking for therapies. Hence, these rural populations are becoming vulnerable to the disease and need to be supported with proper treatment that makes a way for their betterment.
Presently, in this case of Glenda, a 56-year-old indigenous woman from Small Island in Australia was reported with the various symptoms initially at the local clinic. According to the clinical data available, she is complaining of itchy and swelling face, nauseated and has anorexia with repeated vomiting. Upon examination by the GP, Glenda was found to have blood glucose level, temperature, pulse rate, oxygen saturation in normal range; however, she has indications of hypertension with high blood pressure (BP). GP further has suggested her to provide urine sample to check creatinine levels.
However, the laboratory reports showed normal or reportable range of creatinine levels. Further, her case history pointed at the repeated incidence of symptoms such as swollen eyelids, swelling of hands, legs and faces, discomfort in walking and stiffness in joints. She was admitted to Royal Darwin hospital with the issue of high BP, tachycardia, with the signs of presence of protein and blood in urine; and was diagnosed with the infection of Streptococcal Glomerulonephritis, further received the treatment for the same. Although, she was discharged, was considered for cardiac and respiratory tests to check for the chronic obstructive pulmonary disease (COPD). Her sputum was collected for test to diagnose the chances of COPD along with information about her health history and...
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