Nursing Diagnosis, SMART Goals, and Interventions for Acute Care Patients

Case Study 1 Max Johnston

Select one of the case studies provided. You will then be required to demonstrate your ability to think critically, apply clinical reasoning and articulate your understanding of the underlying pathophysiology as they relate to the presenting signs and symptoms, potential complications, and your health consumers lived experience of this acute event. It is expected that you will make links to the diagnostic data provided to you in the profile selected.

1) Identify one nursing diagnosis that is an immediate priority for the nursing care of your chosen patient and discuss the rationale for the selection of this nursing priority using current health professional literature.

2) Identify one SMART goal that relates to achieving the expected health consumer outcome and discuss the rationale for the selection of this goal using current health professional literature.

3) Identify and discuss the rationale for the selection of six nursing interventions that you consider to be priorities in achieving the expected health consumer outcome.

This assessment will assess the following learning outcomes

1. Manage the nursing care needs of health consumers experiencing acute and/or complex illnesses, including palliative care

2.Interpret specific diagnostic tests

Max Johnston, 59 years old, is Principal of an 800-pupil Secondary School and finds his job very stressful. Max is married & has 3 adult children and 4 grandchildren living in different parts of New Zealand and Australia. He has at least weekly phone contact with his children and grandchildren. He has limited time for exercise but enjoys trout fishing, playing occasional rounds of golf, and watching motor racing on TV during weekends & holidays. Max drinks approximately 18 standard drinks/week and smokes 20 cigarettes/day

Case study 2: James Ruru

James Ruru is a 68 year old man diagnosed with prostate cancer 8 years ago. At that time he underwent prostatectomy and radiotherapy which left him with urinary incontinence controlled with continence products. His regular follow ups and PSA assessments revealed that he developed metastatic disease 2 years ago. Metastatic tumours where located in his lung and right 4th rib (posterior). James refused orchidectomy and hormone therapy and subsequently had 3 courses of immunotherapy. Has been instigated but at this time is considered palliative rather than curative. He is married with 3 adult children and 4 grandchildren living locally. He enjoys being with family and fishing. He is an ex-smoker with a 50 pack year history. He stopped smoking when originally diagnosed with prostate cancer