Person-Centred Bio-Psychosocial Assessment of a Patient with Multiple Conditions

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• You must attempt all 3 questions.
• Each question is marked out of 50 to allow equal weighting to each of the learning outcomes.
• Total mark is out of 150.
• Each learning outcome must be passed at 40%.
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Time allowed: 2 Hours – you must submit your work within the 24-hour submission window – late submissions will result in a fail grade being awarded.

Jim Speaker is a 20-year-old male who has been admitted to the Accident and Emergency Department (AED) having fallen from a first-floor roof whilst undertaking some DIY with his father. Jim lives in the family home with his Father Mike, Mother Hayley and younger sibling Alexa in a purpose built, self-contained annex. Jim has Down Syndrome, Type 1 diabetes, asthma and mild learning difficulties. Jim is in his first year at college studying for a BTEC qualification.

On admission, following medical assessment, it is apparent that Jim has sustained a fracture to his right radius, some abdominal bruising and a scalp laceration (the paramedic handover reported no loss of consciousness). On admission Jim was too distressed to answer many questions therefore most of the medical assessment information has been gathered from his father Mike.

Jim has been to theatre for manipulation of the radial fracture and following an uneventful period in recovery, he has been transferred to your ward for observation with the intention of being discharged to the primary care team the next day. Jim was given analgesia before and after theatre.

On settling on the ward Jim was initially pain free but is now somewhat agitated and is reporting his current pain level in his right arm as 8 out of 10. Jim has refused to eat his evening meal stating that he is not hungry and is feeling nauseous after his anaesthetic. After completing some recent observations there are also signs that Jim is quite breathless at rest due to his asthma. A conversation with another nurse on the ward reveals that he is experiencing some anxiety about continuing with his college education now that he has had a fall. During his time in the AED his scalp laceration was sutured, and a dressing applied.

The nurse in charge of the ward has asked you to carry out a holistic assessment and then co-ordinate a care plan for Jim that focusses on one actual problem identified during the assessment, including relevant observations. Identified problems include:

• pain
• nausea
• breathlessness
• anxiety
• wound

Q1. Discuss the key principles of a person-centred bio-psychosocial assessment in relation to the scenario patient Jim. Then expand and explain how these key principles relate specifically to your one chosen problem. Word count = 600 maximum (LO. 3) (50 marks)

Q2. Discuss the role of the registered nurse when planning, implementing and evaluating care for Jim whilst relating this to your one chosen problem. Discuss how relevant theory is applied to clinical practice by utilising the information in the scenario. Word count – 800 maximum (LO.6) (50 marks)

Q3. Identify and Discuss the challenges faced when providing effective care for the scenario patient Jim and specifically the challenges of planning his discharge and transition to the primary care team. Word count 600 maximum (LO. 8) (50 marks)