1-7 Scenario As you begin work on your dissertation proposal,

2 actual chronic problems identified are hypertension control and asthma management. now Identify and prioritise TWO (2) goals for care of the patient in planning the nursing care (ensure these are SMART goals); Describe and justify TWO (2) evidence-based nursing interventions you would implement for EACH of the identified goals; and Predict expected outcomes and describe how these would be evaluated for each nursing intervention. case study Identification: James Clark is a 68-year-old cisgender man who is travelling around Australia with his wife Geraldine on the “trip of a lifetime” with a 4WD and caravan. They left Queensland 5 months ago. When he unhooked the caravan last night, he noticed tingling in his left arm, and he felt short of breath. He sat quietly for 30 mins and the feeling passed. James really doesn’t like to make a fuss. He woke up during the night to go to the toilet and felt dizzy. Geraldine has insisted he get checked at the hospital before they start the drive across the Nullarbor Plain. Situation: You are working in an Adelaide ED and James is a patient in the sub-acute area. Observations: His vital signs are BP 135/90mmHg, HR 95 BPM regular, RR 22, SaO2 97 % on RA. Temp 36.9 degrees. His ECG has no acute changes (No ST elevation or ST depression). Air entry is equal in both lung bases and no crackles or wheeze evident. He has a superficial wound on his left lower leg (5 cm x 5 cm) that he states was “a scratch from a piece of firewood that I mishandled but it’s been there for a month now”. There is no elevation in his troponin blood level and his GCS 15/15 and CT head is normal. Background: James has had asthma since childhood with periods of exacerbation of asthma related to seasonal pollen in the air and infrequent chest infections. James has brought his medication in to the clinic and shows you a list of the medication he takes (he states he “doesn’t really know what all his medications do”). These are James’ medications: Metoprolol Hydrochlorothiazide Zinc Caltrate Symbicort – daily Salbutamol – PRN Responsibility: You have been allocated the care of James and decide that James could benefit from nursing interventions about his chronic health concerns. stick to this criteria Exceptionally high standard as evidenced by a clear and comprehensive identification and appropriate prioritisation of goals for the patient’s care Exceptionally high standard as evidenced by an insightful and succinct description of FOUR nursing interventions appropriate for the specific health care needs of the patient in the case study. Exceptionally high standard as evidenced by synthesis and accurate integration of high quality, credible evidence to provide a comprehensive and considered rationale for each nursing intervention; regular reference is made to the specific needs of the patient in the case study Exceptionally high standard as evidenced by a clear and succinct identification of expected outcomes and insightful discussion of a range of ways the outcomes could be evaluated with reference to the case study

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