Task Overview
This task provides an opportunity to explore a specific case study encompassing all the units' learning outcomes, your theoretical learning and application of clinical nursing skills within this unit. This task will assess your understanding of conducting a comprehensive assessment of Boris introduced within the HSNS264 Moodle site (Module 4 Case study 1) who has TB, or Fiona, as per the case study below. You will be required to provide a comprehensive overview of relevant patient care and management- such as an in-depth understanding of the patient's condition, risk factors, related anatomy and physiology, pathophysiology, relevant diagnostics and treatments. Develop a nursing care plan and provide a relevant educational teaching plan prior to discharge from hospital.
Instructions
Explore either the Boris or Fiona case study, and consider a comprehensive assessment of their condition and the relevant patient care, medication treatment and management required. Provide a detailed discussion of related anatomy, physiology and pathophysiology. Discuss the pharmacological management of either condition, including the pharmacodynamics of the medications. Develop a nursing care plan prioritising his care and any relevant patient teaching prior to his discharge from hospital.
Assessment 2
1. Analyse and interpret relevant objective and subjective data and explain them based on the pathophysiological changes associated.
2. Evaluate and critique any pharmacological management that might be prescribed for the patient
3. Identify nursing diagnoses relevant to the case study and develop a nursing care plan with rationales (Do not use tables for nursing care plan)
4. Discuss any education topics relevant to the patient prior to his discharge from hospital.
5. Adhere to UNE general academic writing and presentation
6. Demonstrate broad research of the topic from peer reviewed resources which are current and follow APA referencing standards
Case Study 1
Tuberculosis (TB)
Boris Vasilescu of Romanian heritage is a 62 year old factory worker. He has had an ongoing productive cough for 5 months with intermittent chest pain, experiencing night sweats, extreme tiredness, recently coughing up blood stained phlegm. His wife Magda has reported that he won’t eat the meals she cooks as a result; he has lost 10 kg from when his symptoms first started.
Upon presentation to hospital he is exhibiting the following physical symptoms: sharp chest pain, clammy skin, unilateral crepitation (crackling), shortness of breath, a respiratory rate of 20 breaths/min, temperature 38°C, oxygen saturation is 98% on room air, Pulse 110, BP 130/76, Weight 70kg.
He has had a chest X-ray showing upper lobe and cavity infiltrates suggestive of TB. A few days later - Boris has been diagnosed with active TB. He has been given appropriate antimicrobial medications upon discharge from the hospital.
Refer to medication chart below
Boris Medication chart page 1
Boris Medication chart page 2
Look at the following Chest X-ray

On follow up , one month after discharge from the hospital his wife Magda discloses that he does not always take his medications, correctly or on time and she was worried about his long term health. Boris states that he started to feel better after a week or two of taking his medications and in his view were no longer necessary.