Care Study of Client with Gestational Trophoblstaic Diseaes

In: Science

Submitted By dansowah
Words 17052
Pages 69
-[

\

UNIVERSITY OF CAPE COAST
SCHOOL OF NURSING

MSC. ADVANCED NURSING PRACTICE

COURSE: ADVANCED CLINICAL PRACTICUM I AND II IN SPECIALTY AREA

COURSE CODE: NUR 822S and NUR 829S

PATIENT / FAMILY CASE STUDY
(A NURSING PROCESS APPROACH)
ON
A CLIENT WITH GESTATIONAL TROPHOBLASTIC NEOPLASM

BY: CHARLOTTE LAMPTEY
SN/ADN/15/0030

AUGUST, 2016

CONTENTS * PREFACE

* ACKNOWLEDGEMENT

* INTRODUCTION

CHAPTER ONE:
OVERVIEW OF CLIENT SITUATION
I. Literature review of gestational trophoblastic neoplasm

CHAPTER TWO: COMPREHENSIVE HOLISTIC ASSESSMENT OF PATIENT/FAMILY
I. Patient’s medical and personal history including review of the systems
II.Physical examination
III.Diagnostic evaluation
IV.Nutritional assessment V. Psychosocial history
VI. Patient developmental assessment
VII.Spiritual assessment
VIII.Quality of life assessment
IX.Admission of patient

CHAPTER THREE: ANALYSIS OF DATA

CHAPTER FOUR: COLLABORATIVE PLAN OF CARE
I. Presumptive medical diagnosis
II.Nursing diagnosis
III.Evidence-based interventions
IV.Additional diagnostic procedures warranted but not done
Medication to be ordered

CHAPTER FIVE: DISCHARGE PLAN
I. Community service and resource needed
II.Client education plan
III.Plans for follow-up of care

CHAPTER SIX: EVALUATION PLAN Termination of care

* SUMMARY

* CONCLUSION

* REFERENCE PREFACE
The patient / family care study is an essential and relevant study undertaken on the patient and the family by a final year nursing student as part of the required curriculum to complete the Master of science in Advance Nursing Practice program
Advanced Practice Nurses (APN) play a pivotal role in assisting patients through the disease process. From the time of diagnosis through the…...

Similar Documents

A Client Based Study

...Knowledge and Skills for Nursing Practice Part Two Written Assignment. A Client Based Case Study. The aim of this essay is to demonstrate the assessment process of a patient using the Roper Logan and Tierney (RLT) model of nursing framework, and to show how the nursing process works alongside this model. This will be established by including a holistic history of the patient and also by considering how the RLT model is applicable to this patient. The discussion of one nursing intervention will follow, showing how the nursing process is applied to patient care. The patient will be referred to as Mr Frederick Valentine to protect the patient’s anonymity as stated in the Nursing and Midwifery Council Code of Conduct (2008) guidelines. The plan for a patient’s appropriate care should be looked at holistically (NMC 2008), taking into account all of the aspects of the person as a whole. Holistic care incorporates the physical, psychological, emotional, spiritual economic and social factors when assessing, planning, delivering and evaluating care (Scriven 2010). The patient, Mr Valentine, was suffering from gradually fading vision. He had noticed that in bright light his vision was significantly worse, and he was finding it hard to read and also to watch television. Mr Valentine attended an appointment with his optometrist and was then referred to the Eye Centre at a local hospital. The optometrist had found that Mr Valentine was suffering from a cataract. The Eye......

Words: 255 - Pages: 2

Case Study for a Distant Client

...Case Study Report for a Distant Client Lois Myers COUN5290 March 3, 2013 Dr. Rita Smith Case Study Report for a Distant Client This study will discuss a recent client who as accessed this firm in an online/technology based manner. This client will be receiving counseling through email/web based technology, and will not be attending face-to-face counseling sessions. Client History The client’s name is Alistair Tarling. His birth date is December 6, 1964. He currently lives in Rockford, IL. The client is a recently immigrated Brisith national, who is married to a US Citizen. His wife is a US Civil servant and is currently in a secure position at work. Alistair is seeking career counseling to help find a career that suits his identity and desires. He is seeking something to help people and remain unnoticed. He does not want to meet for face-to-face counseling currently and will be handling all communication through web-based technology. Alistair has been given the Myers-Briggs Type Indicator, and the Strong Interest Inventory. Assessment Results The results from the Myers-Briggs Type Indicator are as follows; 1) on the Extraversion to Introversion scale, Alistair scored a 26, putting him very clearly on the Introversion side; 2) on the Sensing to Intuition scale, Alistair scored a 15, putting him moderately on the Intuition side; 3) on the Thinking to Feeling scale, Alistair scored a 16, putting him clearly on the feeling side; 4) on the Judging to......

Words: 885 - Pages: 4

A Study on Skin Care

...“A STUDY ON WOMEN’S BUYING BEHAVIOUR AND BRAND LOYALTY TOWARDS SKINCARE PRODUCTS” 1. Name : 2.Age in Years : (Please Tick your age group) 18-20 21-25 26-30 31-35 36-40 41 and older 3.Marital Status: (Please √) Unmarried Married 4.Educational Qualification Less than SSC SSC/HSC Graduation Post Graduation 5.Occupation: (Please √) Student Homemaker Service Own Business Professional 6.Monthly Family Income in Rupees: (Please √) Below 10,000 10,000 to 25,000 25,001 to 50,000 50,001 and Above 7. Are you familiar with the word ―Brand Loyalty‖? (Tick any one) Yes No 8.Have you purchased any brands of skincare products like moisturizers, facial masks, Under-eye creams, etc. lately? (Please tick) Yes No 9. Are you especially loyal to a particular brand of Skincare products? (Please tick) Yes No 10.Out of the list of the following categories of brands of Skin Care Products, Which ones are those that you purchase /use consistently/ repeatedly? Please tick the brand for every category of product you use. ( i.e. if you use one product of a brand as face mask and another of the same or another brand as moisturizer...

Words: 1145 - Pages: 5

Risk Perception of Gestational Diabetes Among Pregnant Women

...During pregnancy usually at around 28 weeks or later many women are diagnosed with gestational diabetes (Pepe, 2004). It is a serious condition with health implications for mother and baby. Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy (Sugaya, 2005). Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. Based on recently announced diagnostic criteria for gestational diabetes, it is estimated that gestational diabetes affects 18% of pregnancies (National Diabetes Data Group, 2009). According to WHO (2011), GDM affects 3-10% of pregnancies, depending on the population studied, and is growing in prevalence. The World Health Organization criteria as a guide to the severity of hyperglycemia, mentioned that there is a significant increases in the incidences of the more severe grades of GDM in parturient born in the Mediterranean region, Asia, the Indian subcontinent, Egypt, and Arabic countries. Babies born to mothers with GDM are at increased risk of problems typically such as being large for gestational age, low blood sugar, and jaundice (Khan, 2004). Women with GDM are at increased risk of developing type 2 diabetes mellitus after pregnancy (Gabbe, 2010). Up to one-third of affected women have diabetes or impaired glucose metabolism at their......

Words: 1598 - Pages: 7

Care Study

...Background Patient A has authorised consent to the writer of this case study to share the detail of their condition. It has been ensured the information provided does not allow the recognition and follow up of this individual. The patient chosen for this portion of assignment is a 47 year old male who lives with his wife and two kids. He works part-time as a customer service manager and attends the practice every six months for a regular check-up, however due to his recent knee surgery; he has been unable to do so. This patient struggles with his weight and suffers from high blood pressure. This condition damages the blood vessels, forcing the heart to work faster which would eventually lead to heart failure (Gregson 2001). To treat his condition, this patient takes ACE inhibitors every day. He also suffers from arthritis and takes Azathioprine as a source of medication. He has no allergies, smokes 10 cigarettes a day and consumes 25 units of alcohol a week. Patient A consumes fizzy beverages during and after his meals and snacks on sweets in between. Due to his poor oral hygiene and high consumption of sugar in his diet, he has developed caries in his lower left 6. It is evident that sugar consumption mostly in sticky form between meals increases the risk of caries (Felton 2009). His poor oral hygiene is reflected on the number of restorations present within his mouth, mostly in his pre-molars and molars. He also has a porcelain bonded crown present on the lower right......

Words: 2102 - Pages: 9

Care Study

...This assignment reflects on one day’s care delivered to a patient during my practice as a healthcare support worker (HSW). It presents anatomy and physiology of the urinary system and focuses on the patient’s catheter use, urinalysis, regular intake of medication and legal issues associated with delivery of care to the patient without mental capacity to make crucial decisions in his life. For the purpose of this care study, I use the pseudonym Chris for the patient in order to protect his identity and maintain confidentiality (NMC, 2008). There is also a legal obligation under Data Protection Act (1998) not to disclose patient’s personal details. Chris is a 73 year old male, who I worked with in a residential home for people with learning disabilities and challenging behaviour, where he was residing. Chris has been diagnosed with a learning disability (LD), which means that he has significantly. reduced ability to understand new or complex information and learn new skills (Department of Health, 2002). He has a reduced ability to cope independently due to recent leg amputation and the LD. Amputation is the surgical removal of a limb or body part (Mosquera, 2010). It was performed on Chris’s right leg above the knee to relieve the recurring pain caused by a severe case of peripheral artery disease (PAD). The PAD is a form of peripheral vascular disease in which there is partial or total blockage of an artery, caused by deposits of fat built up along its walls (Patient......

Words: 6993 - Pages: 28

Lawn Care Case Study

...1. Lawn Care currently believes they are the manufacturer of the highest-quality grass seed and fertilizer in the world. They believe their product is so superior it should practically sell itself, with this superior product they can focus solely on the product and remove the service and expertise needed to properly apply and maintain the product. They add no extra value other than the product itself once they product is delivered the client experience ends in their eyes. The order winners would be Quality, Dependability, and Flexibility at eh beginning of the article but Quality/Performance flexibility/Material Quality come into question later since it is not being applied by professionals. Speed and cost are not discussed but could be winners in well if they have fast order turnaround time and a reasonable selling price. 2. They are completely missing the opportunity for better customer service and additional product sales by not offering a service delivered by experts. 3. To reverse negative trends, the company must focus on adding customer installations, improving service delivery and consistency, turnover, and improving communication/education with customers. Lawn Care must also focus on more profitable sales—placing considerably less emphasis on "residential selling" as a means to acquire new customers until the commercial services side is built up and strong. They must increase customer retention through improved customer experience and continuously......

Words: 317 - Pages: 2

Gestational Diabetes and the Effects It Has on Mothers and Neonates

...Case study – Gestational Diabetes and the effects it has on mothers and neonates As midwifery becomes more complicated and the numbers of women becoming pregnant, who present with or develop medical conditions which can impact on the health of themselves and their babies increases; it is important midwives are knowledgeable in order to recognise and help manage the risks and complications that may arise as a result of these conditions. Furthermore able to discuss these risks with expectant mothers and their families, to ensure women are able to make informed decisions about care which they receive, even if choices available to them are restricted as a result of the condition which they are suffering from. For this case study I have decided to explore diabetes and the affects it has on care mothers and their babies require antenatally, during the intrapartum period and postnatally. As 87.5% of pregnancies affected by diabetes are due to the development of gestational diabetes (NICE,2008) and therefore the most common type, I have decided to focus on gestational diabetes, although many of the guidelines put in place are similar when caring for women who have diabetes prior to becoming pregnant. With no previous medical experience prior to embarking on my midwifery degree, I had limited knowledge of gestational diabetes and the impact it can have on women physically and emotionally; especially if left undiagnosed or the care they receive is lacking. I wanted to gain a......

Words: 1973 - Pages: 8

Critical Care Case Study

...Critical Care Case Study Crystal Meyer Mohave Community College Nursing 222 Mrs. Michelle Christensen April 1, 2014 Critical Care Case Study ADMISSION TC is a 61-year-old English speaking Caucasian female born on April 29, 1952. She weighs 99.7 Kg and is 5 feet, 5 inches in height with a BMI of 35.84. On March 5, 2014, TC was brought into the emergency department after her daughter-in-law called 911 when she found TC unresponsive at home in her bathroom. When paramedics arrived, she was found to be cool, pale, and diaphoretic with oxygen saturations in the high 70’s. Emergency responders placed a non-rebreather high flow oxygen mask and her oxygenation began to improve with saturations in the low 90’s. Upon arrival to the emergency department, TC’s vital signs were as follows: T 97.4; P 97; BP 120/95 mm Hg; RR 15 per minute; and O2 sats of 98% via NRB oxygen mask on 8L. A chest x-ray (CXR) revealed no abnormality and lungs were determined to be grossly clear. However, TC was checked for a pulmonary embolism via a pulmonary artery angiogram with IV contrast and found to have a large clot burden with a small saddle embolism. TC also complained of right ankle pain. An X-ray of her right ankle revealed a distal tib/fib fracture, which was presumed to be related to her fall during her hypoxic episode. With these findings, TC was admitted to the Intensive Care Unit of Kingman Regional Medical Center and placed on an NPO diet in preparation for placement of an inferior......

Words: 4071 - Pages: 17

Southern Care Hospital Case Study

...Southern Care Hospital Case Study Susan Lawyer MSPM 6102/ACCT 6691/ACMG 6691 Walden University March 8, 2015 Southern Care Hospital Case Study “It is the Project Manager's (PM’s) job to make sure that the project is properly planned, implemented, and completed” (Mantel, 2011). “The PM is responsible to the project team, to senior management, to the client, and to anyone else who may have a stake in the project's performance or outcomes” (Mantel, 2011) and manage any conflict which is likely to occur between any or all of these groups. The PM is a facilitator, supervisor, coach, time manager, budget manager, encourager and most of all the main communicator of the current state of the project. Pure project organization is typically used for large scale, expensive long term projects. Examples include the building of an airport, stadium or shopping mall. Pure projects require project participants to be away from their normal work, which becomes troublesome when working with part time project team members. In this case, the pure project organizational structure would not be an ideal fit and is therefore being eliminated from consideration. “Functionally organized projects are embedded in the functional group where the project will be used. This immediately corrects some of the problems associated with pure projects. First, the functional project has immediate, direct, and complete contact with the most important technologies it may need, and......

Words: 1053 - Pages: 5

Hlten503B Contribute to Client Assessment and Developing Nursing Care Plans

...Implement and monitor nursing care for clients with acute health problems. Contribute to complex nursing care of clients. Administer and monitor medications. Administer and monitor IV meds. Assessment 2 Post-op Case Study Assessment 2 Question 1. Identify a minimum of 5 nursing actions, in order of priority you would perform related to above information. Mrs Abu has had a considerable change in her vital signs (blood pressure lowered, her pulse is rapid, her respirations increased and temperature has dropped) form the baseline taken before surgery. These findings alone would be reported to the Registered Nurse and monitored. But because of the changes in vital sings, coupled with Mrs Abu reporting light-headedness and nausea, plus her significant blood loss form the surgical wound, you would be assessing for hypovolemic shock which can be life threatening. As the nurse you would be seeking assistance immediately, assessing her airway, breathing and circulation. Applying oxygen, applying pressure at the surgical site and continuing to monitor (airway, breathing, circulation) and vital signs until help arrives. Mrs Abu should be given nil by mouth as she may return to surgery (Gulanick, Myers, Klopp, Galanes, Gandishar & Puzas 2003, p.329). Question 2. Complete the interventions and rationale in Mrs Abu's care plan related to the following diagnosis |Nursing Diagnosis |Interventions |Rationale ...

Words: 2084 - Pages: 9

Public Health Care Nurse Case Study

...Public Health Care Nurse Case Study As a public health nurse, I can identify certain risk factors based on client information. These risk factors include habits and routines that can negatively affect a person. Furthermore, genetic factors and environmental conditions play a key role (Harkness & DeMarco, 2012, p. 68). In this public health care nurse case study, a young female suffers from malnourishment, substance abuse, economic duress, and poor living conditions. Emotionally, she is in distress and is now seeking assistance. Additionally, I am assuming that she might be homeless and lacking family support. Questions to Consider when Interviewing the Client While interviewing the client, I would ask myself which public/social services might best fit this young female’s needs. I would also mentally start addressing her sexual habits and considering when she last had a full physical assessment with laboratory tests and was checked for sexually transmitted diseases (STDs). I would also be concerned about her psychological condition and if she suffers from any mental illness. Additionally, I would reflect on how to establish a safe environment for the patient. How to Assist the Client during Planning Identifying the stage of prevention is required to help a person in need. This female needs a secondary prevention. This measure identifies, plans around, and reduces the impact of a current disease (Harkness & DeMarco, 2012, p. 90). As a public health nurse,......

Words: 725 - Pages: 3

Case Study - 03 - Care-Link

...TABLE OF CONTENTS 01. Executive Summary 02. Problem Statement 03. Suggestions Executive Summary Purpose – Purpose of this case study is to identify and analyze key problems in Training & Development. And find out what are the solutions and recommendations can provide to overcome such problems. Methodology – Find out what are the key problems, issues, in the management, and Training & Development. Findings – • No Policy regarding Training & Development • Training Expenditure was very high • Not Effective in-house trainings • Do not evaluate the trainer • Training Need Analysis is not done • Evaluation of Training is not done • No proper Learning Objectives • Lacking of documentation part. Recommendations – • Develop an organizational Training & Development policy. • Make an allocation of fund to Training & Development in the annual budget. • Conducting HR Audit annually or twice a year. • Analyze the competitors what to they are doing in Training & Development. • Get a survey or feedback from those who participated in the Training & Development programme. • Include Personal Development Plan in Training & Development. • Improve the documentation part. • Get ideas to improve the Training & Development from their agencies of 05......

Words: 1757 - Pages: 8

Nursing Care Study

...INTRODUCTION I first met Serena when I did my clinical placement in the Psychiatry of Old Age (POA) department in Eccles Street over a year ago where she attended as an out-patient once weekly. My preceptor and I have both agreed that Serena would be a suitable client for me to work with as we feel that knowing her from a previous work experience have provided me with an advantage to easily establish an effective therapeutic relationship with her. Also, Serena’s required interventions are within the scope of practice of a Level 3 student nurse under the An Bord Altranais guidelines. Serena is an 82-year old woman who lives in her north inner city Dublin home with her husband Dan. They have four sons who now have families of their own but are all supportive and are still very much present in their lives. Her only sister, Blair, lives in a nearby county but visits her twice a week. Her relationship with her family is identified as her main support system. Serena is known to the psychiatric services due to her long history of Bipolar Affective Disorder and previous suicide attempts, resulting to numerous psychiatric admissions. She was on lithium for approximately 18 years, which now resulted for her thyroid to become toxic and her kidneys to completely stop functioning. She has been recently diagnosed of End Stage Renal Failure (ESRF). This recent diagnosis has left her more anxious and depressed. As her family and the Community Mental Health Team (CMHT) from the POA......

Words: 2697 - Pages: 11

Gestational Diabetes Mellitus

...bread, potatoes and chapattis, fruit, dairy products, sugar and other sweet foods The food we eat turns into glucose (sugar) for energy The pancreas makes insulin (a hormone) to help glucose get into the cells of our body When someone has diabetes their body either doesn’t make any/enough or can’t use its own insulin as it should Glucose begins to build up in the blood Prevalence: WHO estimate in: 2000 = 177 million diabetic people 2025 = 300 million diabetic people = 9% global population IDF (international diabetes federation): 2 million diabetic people in UK with over 750,000 undiagnosed NICE: 650,000 women give birth in England & Wale each year and 2-5% (13,000-32,500) involves women with diabetes, of these: * 87.5% are Gestational Diabetes (GD) * 7.5% are Type 1 * 5% are Type 2 From 1997-2003 there was 74% rise in new cases in the UK with the West Midlands being one of the highest areas (News, 2009) Treatment: Aim: to maintain glycaemic control – regular monitoring is required Lifestyle: diet, exercise Medication – tablet or injection e.g. Insulin, rapid acting insulin analogues (Aspart, Lispro) and/or hypoglycaemic agents (Metformin and Glibenclamide) Diabetes health complications: Hypoglycaemia: Too much insulin; which can cause low blood sugar Symptoms: Paleness, shaking, hunger, sweating Specialist will advise what to do e.g. consume sugary soft drink Occasionally can cause loss of consciousness – an injection will be needed Diabetic......

Words: 2919 - Pages: 12