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NRSG265 CASE STUDY Solution | NRSG265: Principles Of Nursing Assignment help

Case Study Analysis Mr Vinh Nguyen



Purpose of the presentation

  • Demonstrating case-understanding and critical thinking skills
  • Demonstrating a professional nursing approach to improve a patient’s health.

Areas to be covered

  • Patient’s assessments
  • Pathophysiology
  • Nursing diagnoses
  • Potential impact
  • SMART goals
  • Interventions and rationale
  • Evaluation and reflection

Principal elements of assessment Pathophysiology of the conditions

  • Probability of high psychological stress
  • Probability of having dehydration
  • Observation of hypotension
  • Observation of tachycardia that can be associated with hypotension (Hall & Hall, 2020).
  • Type 2 Diabetes (T2D)
  • Hypotension
  • Psychological stress

Rationale Persistence of T2D, hypotension and stress may increase health risks and reduce overall wellbeing (Hackett & Steptoe, 2017).

Bullock,            S.,        &          Hales,   M.        (2019).  Principles         of         pathophysiology.        (2nd     ed.).            Pearson.          pp        718-722. https://www.google.co.in/books/edition/Principles_of_Pathophysiology/N3_dBAAAQBAJ?hl=en&gbpv=1&dq=Bullock,+S.,+%26+Hales,+M.+(2019).+Principles+of+pathophysiology+(2nd+ed.).+Pearson.&pg=PP1&printsec=frontcover

Zhang, N. et al. (2019). Effects of dehydration and rehydration on cognitive performance and mood among male college students in Cangzhou, China: A self-controlled trial. International journal of environmental research and public health16(11), 1891. https://www.mdpi.com/16604601/16/11/1891

Hackett,           R.         A.,        &          Steptoe,           A.         (2017).  Type     2          diabetes          mellitus and psychological  stress—a           modifiable       risk       factor.  Nature Reviews            Endocrinology13(9),   547-560. https://www.nature.com/articles/nrendo.2017.64

Bertoglia, M. P. et al. (2017). The population impact of obesity, sedentary lifestyle, and tobacco and alcohol consumption on the prevalence of type 2 diabetes: Analysis of a health population survey in Chile, 2010. PloS one12(5), e0178092. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178092

Hall,      J.      E.,      &      Hall,     M.      E.      (2020).     Guyton      and      Hall      textbook      of      medical      physiology e-Book. Elsevier Health   Sciences. 14.    pp    171-173.

https://www.google.co.in/books/edition/Guyton_and_Hall_Textbook_of_Medical_Phys/H1rrDwAAQBAJ?hl=en&gbpv=1&dq=guyton+and+hall+medical+physiology&pg=PP1&pri ntsec=frontcover.

Hackett,           R.         A.,        &          Steptoe,           A.         (2017).  Type     2          diabetes          mellitus and psychological  stress—a           modifiable       risk       factor.  Nature Reviews            Endocrinology13(9),   547-560. https://www.nature.com/articles/nrendo.2017.64

Holland,      K.,      &      Jenkins,      J.      (Eds.).      (2019).      Applying      the            Roper-Logan-Tierney     Model   in Practice-E-Book.    -Elsevier    Health      Sciences.      pp                   17-20.


McCance,   K.   L.,   &   Huether,   S.   E.   (2018a).   Pathophysiology-E-book:   the   biologic   basis   for   disease                     in adults and children. Elsevier Health               Sciences.8.              pp.  1050-1055.


McCance,   K.   L.,   &   Huether,   S.   E.   (2018b).   Pathophysiology-E-book:   the   biologic   basis   for   disease                     in adults and children. Elsevier Health               Sciences.8.              pp.  1230-1235.


Kumar, K. P. et al. (2019). Adherence, satisfaction, and experience with metformin 500 mg prolonged release formulation in Indian patients with type 2 diabetes mellitus: a postmarketing observational study. International journal of general medicine12, 147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460999/

Jenkins,            D.         W.,       &          Jenks,   A.         (2017).  Exercise            and      diabetes:         a narrative          review. The       Journal of         Foot     and      Ankle   Surgery,           56(5),   968-974. https://www.sciencedirect.com/science/article/abs/pii/S1067251617304180

Gao, K., et al. (2017). Interactions between genetic polymorphisms of glucose metabolizing genes and smoking and alcohol consumption in the risk of type 2 diabetes mellitus. Applied Physiology, Nutrition, and Metabolism42(12), 1316-1321. https://cdnsciencepub.com/doi/abs/10.1139/apnm20170232

Umphonsathien, M. et al. (2019). Immediate and long‐term effects of a very‐low‐calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus. Food science & nutrition7(3), 1113-1122. https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.956

Okoro, E., & Adigwe, P. (2018). Therapeutic communication and client counseling: Toward a conceptual framework for strategic interpersonal engagement. Int. J. Bus. Soc. Sci9, 10-16. http://ijbssnet.com/journals/Vol_9_No_6_June_2018/2.pdf

Black,           B.           (2019).           Professional           nursing               E-Book:     Concepts        &               challenges.           Elsevier           Health          Sciences.9.         pp      217-219.


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Speaker Notes NRSG265 CASE STUDY Solution

Slide 2

The purpose of the study is to analyse a case scenario and implement existing knowledge and critical thinking skills to improve the patient’s overall health.

This presentation is going to show the health compilations of the patient, Mr Vinh Nguyen, discuss his diagnoses along with their pathophysiology, and suggest patient’s healthcare goals as well as effective interventions for delivering appropriate healthcare to the patient. The effectiveness of the interventions will be evaluated through a reflective approach.

Slide 3

The patient Mr Vinh Nguyen is a 48-year-old male, who has presenting conditions issues including fall, dizziness, lightheadedness, persistent thirst, sleep disturbance, and excessive urine excretion.

His health assessment findings show BGL 23.5 mmol/L (after 6hrs of meal), total cholesterol- 9.2mmol/L and excessive fat in the abdominal region.

His BP is 102/65 mmHg, RR 20 bpm and HR is 106 bpm

From the blood assessments, type 2 diabetes has been diagnosed, as he has significantly high blood glucose level. And a possibility of Obstructive Sleep Apnoea can be also observed, as he experiences sleep disturbances. His vitals shows that he is having hypotension, which can be the cause of his dizziness, fatigue, lightheadedness and fall.

Slide 4

The patient reports high work-stress, mental stress, which are proven to increase release of stress hormones, such as cortisol, epinephrine and nor-epinephrine. These stress hormones stop the active secretion of insulin from the pancreatic cells. Decreased insulin causes high blood pressure that result into Type 2 Diabetes.

Regular alcohol and tobacco abuse can cause dysfunction of pancreatic beta cells and induce insulin resistance. As the patient reports alcohol and tobacco abuse, he may develop this condition.

The patient reports stress for increase earning for his family. He also reports persistent thirst that can be a symptom of dehydration, which is a common symptom of Type 2 Diabetes. Excess urination in diabetes excretes high amount of essential ions, causing dehydration Psychological or emotional stress and dehydration can reduce the blood volume that finally may lead to low blood pressure.

Slide 5

The patient reports that he works overtime and feel stressed about earning more money, which depicts that he is experiencing psychological stress. He reports feeling thirsty for long hours that can be a symptom of dehydration, which is causing his hypotension. His heart arte shows to be increased that can be associated with hypotension.

The three main nursing diagnoses that should be paid attention include T2D, hypotension a psychological stress. It is needed to be intervened as soon as possible as persistence of T2D, hypotension and stress may increase health risks and reduce overall wellbeing.

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