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The assessment task for this module requires you to write about a client/patient in whose care you have participated during a period in hospital.

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Contents Assessment Task 2 Appendix I 14 Appendix II 15 References 16 Bibliography 16 Assessment Task The assessment task for this module requires you to write about a client/patient in whose care you have participated during a period in hospital. It must focus on the client/patient's lived experience of the altered health status that preceded their admission to hospital as well as discussing the role of the registered nurse in meeting some or all of their health needs in an acute care setting. Submission Date - 28th February 2005 The Ward and Trust will not be mentioned by name in accordance with the NMC Code of Professional Conduct (2002). The client that will be named in this assignment has been given a pseudonym Paula Money, to protect her identity in accordance with the section 5 of the NMC Code of Professional Conduct (2002). This assignment will focus on a chronic illness and the patient/clients lived experience of this. The Roper, Logan and Tierney's model will be used to discuss the health needs of the client as it identifies and groups nursing activities in relation to the process of living (Roper et al 2001). The patient observed for this study had chronic obstructive pulmonary disease (COPD). It is the term used to describe conditions such as emphysema, chronic bronchitis, chronic airway obstruction, and irreversible asthma. (Unison Healthcare, 2003) The causes of this disease can be exposure to industrial pollutants or inherited genes, but is most common in those that smoke or have a past history of smoking. The disease results in debilitating breathlessness, decreased exercise tolerance, poor nutritional intake and often-social isolation. It is characterised by exacerbation's that can be triggered by viruses, atmospheric pollutants, and air temperature. The most important help, which patients with COPD who smoke can receive from nurses, is how to give up smoking. (NICE 2004) The patient, Paula Money, is a 63-year-old lady who had been diagnosed with Chronic Obstructive Pulmonary Disease (COPD) ...read more.


That it was not fair for them to have to go through the illness with her as they should be living their own lives. Paula managed with the increased package of care from social services and her children for a few months before the current admission, when she was hospitalised due to dramatic weight loss and fatigue. On this admission Paula's health was assessed holistically using Roper, Logan and Tierney's 12 Activities of Daily Living. Two of these activities have been further developed to discuss the nurse's role in enabling the patient to fulfil their life whilst they remain in hospital. See Appendix II for current admission details. Health need 1: Mobility As part of the holistic health assessment, nurses should ask their patients questions about the amount, type and frequency of the exercise they undertake. With a good understanding of the specific benefits for conditions they can then make recommendations for lifestyle changes that are relevant to the patients in their care. Prior to the current hospitalisation Paula said that she had been finding it increasingly difficult, because of her chronic breathlessness, to get around her house, even with the aid of her zimmer frame, and that the O2 masks and connections got in the way and also restricted her movement. Paula managed to exercise minimally and had resorted to exercising in the chair at home. The exercises had been given to her on a previous admission to hospital by the physiotherapists and, although they were aimed at increasing mobility, were still suitable for Paula's needs. They involved chest expansion exercises and stretching muscles that would otherwise become weak. She was reassured that this would be a benefit to her and the physiotherapists input would then begin the process of rehabilitation and to build her confidence. In hospital Paula was attached to oxygen 24 hours a day and had regular nebulisers to loosen the mucus for her then to expectorate. ...read more.


Through talking to Paula about her diet, and with the advice from both the medical team and the dietician, senna and lactulose were prescribed to alleviate her fear of constipation and also to allow the nurses to monitor input/output (Mallett and Dougherty 2000). Parenteral feeding was an option that was also discussed as part of the multi-disciplinary team. Paiva (2000) states the aim of this support would be to achieve weight gain, and to improve lung and respiratory muscle function enabling a faster recovery from the acute exacerbation. But, as an invasive procedure, it was decided that this would only be done as a last resort, as Paula was still able to eat small amounts. This essay has discussed the clients lived experience of a chronic disease. The development from an initial irritating cough, 11 years ago, which could not be cleared, and which was coped with in a busy life style. Through the gradual increase in breathlessness and increasing frequency of hospitalisation to stabilise the condition so that Paula was able to continue with her activities of daily living. Paula's lifestyle has been discussed holistically and her health needs identified and related to the nursing role and to how the registered nurse could meet those needs. Appendix I * 63 year old lady, divorced with 3 children * Worked as a Public House Trade all her life * Diagnosed 10yrs ago when hospitalised for the first time o Gave up smoking (10 to 15 per day) o Put pub on market and sold 18months later to get away from smoky atmosphere * 5 years ago hospitalised again and discharged with better mobility with frame o On O2 when discharged, increased steroids * 3 years ago moved to a bungalow as stairs in the house were becoming too much to cope with o Stopped working altogether and living solely on profit from the sale of the pub and house and benefits from the government * 1 year ago hospitalised again and now on fulltime O2 with further decreased mobility due to the increased shortness of breath on any exertion. ...read more.

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