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HLTEN505C Contribute To The Complex Nursing Care Of Clients

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1. Analyse the following case study carefully and answer the questions

X, a 47 year old construction worker with a 36- pack/ year smoking history, is admitted to your floor with a diagnosis of r/o myocardial infarction. He has significant male- pattern obesity. (“beer- belly”, high Waist to Hip Ratio {WHR}), a barrel chest and reports a dietary history of high- fat food. His wife brought him to the ED as he complained of unrelieved “indigestion”. His admission vital signs were BP-202/124, PR- 96/min, RR- 18/min and T- 36.8 C. X was put on O2 2lt/ nasal cannula, an IV of D5W and he was given sublingual nifedipine in the ED. He was admitted to Dr. Graham’s service. He tells you he is fine in a loud and angry voice and demands a cigarette.
a) Revise whether these vital signs are reasonable for a man this age? If not, what concerns you ? State reasons.
b) Plan 5 priority problems associated with the care of a patient like X.
c) Propose 3 relevant nursing diagnoses for a cardiac patient like X.
d) Explain what laboratory tests may be ordered to investigate X’s condition?.
e) You call Dr. Graham’s resident who prescribes 10mg Morphine sulphate IV push q1hr prn for pain (burning). Explain the reasons for this order.
f) Analyse what special precautions you should follow when administering Morphine sulphate as IV push.
2. Explain briefly the importance of the following nursing interventions.
a) Subcutaneous administration of insulin
b) Administration of oral glycaemics
c) Blood Glucose Level Monitoring
d) Mid-stream specimen of urine
e) 24-hour urine collection/bladder washout
f) Removal of IDC
g) Contraceptives
h) Catheter specimen of urine
i) Glasgow coma scale/neurological observations
3. Provide examples of bioethical issues in nursing.
4. Formulate the two most important things you must do after you have given a client medication.
5. Propose the importance of not being judgemental in the nursing profession.
a) Building on your knowledge, provide examples of two situations where you would advocate for your patient. Identify and address potential conflicts of interest.
6. Demonstrate the best way to go about dealing with conflict between the clients’ wishes and the wishes of their family? 
7. Explain social justice principles in relation to the health care system.
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