NSG 3300 Assignment: Case Study Analysis

NSG 3300 Assignment: Case Study Analysis

NSG 3300 Assignment: Case Study Analysis

Case Study Analysis

 Nurse practitioners diagnose clients with various conditions based on the presented symptoms. This case involves a 58-year-old electrician admitted to the emergency room following purulent drainage from his incision site. His cardiologist reported positive blood cultures. His admission reports indicate that he does not have any health insurance cover. Consequently, he is experiencing difficulties in paying for his medications. His wife accompanies him to the healthcare facility. This paper will discuss the pathophysiology of the disease. It will also cover self-care implications based on Maslow’s hierarchy of needs and Orem’s theory of self-care deficit theory. More so, it will capture the patient’s educational strategies and a plan of care based on the concept of self-care. Finally, it will include interdisciplinary collaboration considering nutrition, transition, financial implications, and discharge.

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Pathophysiology of the Disease

The pathophysiology of the purulent drainage from his incision site is associated with an infected wound. It entails excavating the skin, localized defect, or underlying soft tissue around an injury that pathogenic organisms have invaded. The body’s immune response is triggered by an infection resulting in tissue damage and inflammation. Additionally, an infection delays the healing process after undergoing a surgical procedure. In this case, purulent drainage from his incision site portrays an infection. The lab abnormalities that I would look for in this patient change the number of white blood cells. I expect to observe a significant increase in the number of white blood cells. This client has an infection, which is portrayed by purulent drainage from his incision site. An infection in the body leads to an elevation of white blood cells to fight disease-causing pathogens, particularly bacteria. According to Riley and Rupert (2015), the count of white blood cells in the body can double within hours following an invasion with bacteria.

Implications for Self-Care

The disease process affects the patient’s and his care provider’s ability to care for themselves based on Maslow’s hierarchy of needs and Orem’s theory of self-care deficit theory.

Application of Maslow’s Hierarchy of Needs

 Critical care required by patients in the ICU and emergency room is based on Maslow’s Hierarchy of Needs. This motivational theory states that individuals aim to address higher needs successively in a hierarchy as they strive to meet basic needs. These needs are represented in five levels in the form of a pyramid. People start meeting needs at the bottom of the pyramid, moving upwards. In other words, individuals begin with physiological, safety, love/belonging, esteem, and end with self-actualization needs.

 Similarly, this order applies to meeting patient’s healthcare needs. The patient starts by meeting physiological needs, which involve concerns about survival. This concern is expressed by his wife, who is at the bedside. Additionally, care providers meet this need by informing his wife about possible outcomes to empower her. Safety is the second need that critically-ill patients are interested in meeting. It involves concerns regarding the patient’s emotional well-being (Jackson et al., 2014). In this case, his wife is concerned with managing his condition by the care team to prevent it from worsening. Healthcare providers meet this need by assuring the wife about the efficacy of interventions being applied and giving her active emotional support. The third need entails love/belonging. In this case, the patient is concerned about the love and support that his wife will continue giving to him if his condition worsens. For example, the client wonders if his wife will continue staying with him in the emergency room if his length of hospital stay increases. The care providers meet this need by emphasizing the patient’s significance throughout his hospital stay. Additionally, they educate his wife on several strategies to help the patient cope with his new limitations and challenges. Esteem is addressed as the fourth need. It involves concerns about achieving the desired recovery-related goals (Jackson et al., 2014). The patient is wondering if he can return to vigorous activities soon. The care team addresses this need through some interventions, including cognitive rehabilitation. This strategy will accelerate the patient’s recovery and enhance his mastery skills. The last need is self-actualization, which involves the concerns about the patient’s capacity to reconcile the “new normal” with pre-morbid identity. It also entails the ability to cope with the potentially new identity. Healthcare providers address this need by encouraging the patient to participate in formal support groups to be encouraged to embrace his new identity.

Application of Orem’s Theory of Self-Care Deficit Theory

 The Self-Care Deficit Theory, also known as the Orem Model of Nursing, was developed to improve nursing quality in healthcare facilities in Dorothea E. Orem’s state. The Self-Care Deficit Nursing Theory states that all patients’ goal is to care for themselves (Irshad Ali, 2018). Additionally, this theory claims that patients recover more quickly when they perform their self-care. This theory was primarily applied in primary and rehabilitation care to encourage the patients to become independent. Therefore, the four major concepts of this model are applicable in the case of the 58 years old male patient.

 Self-care is the first concept of this theory. It refers to the performance of activities, which individuals start and perform independently to maintain their health, wellbeing, and life (Irshad Ali, 2018). Self-care maintains human functioning and structural integrity to the human development of individual patients. Patients learn self-care through communication and interpersonal relations. The 58 years old patient can engage in self-care upon interacting with his care providers. The second concept is the self-care agency, which refers to individuals’ capabilities and powers that enable patients to participate in self-care. However, the “Basic conditioning factors” such as gender, health state, and age influence one’s capacity to participate in self-care activities (Irshad Ali, 2018). Adult care for themselves under normal circumstances. In this case, the patient’s capacity to participate in self-care is influenced by his health state and age. His self-care capacity is relatively low due to his deteriorating condition and his old age. Therapeutic self-care demand is the third key concept of the Orem Model of Nursing that is applicable. It refers to the total care activities required to address an individual’s known requirements for self-care (Irshad Ali, 2018). It is performed intentionally by some society members to benefit themselves or others. In this patient’s case, therapeutic self-care demand will be performed by his wife to benefit him. The last component of this model is self-care requisites. It defines the reasons supporting the occurrence of self-care activities (Irshad Ali, 2018). Self-care needs fall into three distinct categories, including universal, health deviation, or developmental self-care requisites. The self-care needs of this patient can be categorized into health deviation self-care requisites. Therefore, self-care activities are necessitated by the need to change the patient’s health state.

Patient Education Strategy

Patient care will be facilitated by educational strategies and a plan of care. First, this patient will be educated on how to participate in his self-care to maintain his functioning. The care providers will inform the patient on how to take care of his would by maintaining proper hygiene. Additionally, the client will be educated on how to self-administered the prescribed drugs to kill bacteria causing the infection. Secondly, education will equip this patient with capabilities and powers to enable him to act as a self-care agency. Consequently, he will advocate for the provision of safe and quality care, thereby facilitating healing. The care plan will also entail meeting the patient’s therapeutic self-care demand. It will focus on meeting all the care activities required to address an individual’s known self-care requirements. In addition to education, the family members, in particular his wife, will provide him with psychological support to enable him to engage in self-care. Lastly, the patient will be educated about self-care requisites to enhance his understanding of self-care activities’ benefits.

Interdisciplinary Collaboration

The holistic care required by this patient necessitates the collaboration of interdisciplinary team members. The patient is currently admitted to the emergence room to receive first aid services. However, he will later be transferred into the wards, where he will be attended to and cared for by primary care providers. According to Tartari et al. (2017), primary care providers participate in managing surgical site infections. Therefore, these practitioners will prescribe antibiotics to this patient to treat the infection. Additionally, they will dress the wound regularly to facilitate its healing. Secondly, nutritionists will be engaged in the care provision of this patient. They will recommend a proper diet rich in vitamins such as citric acids to boost the patient’s immune system, thereby facilitate healing. The management will be involved during the patient’s discharge due to challenges in settling his medical bills due to financial constraints and lack of a medical cover. A discount will be given to this patient, and the family will be required to pay the remaining amount before his discharge.

Conclusion

Overall, the purulent discharge from the site indicates an infection. The lab abnormalities, in this case, involve a substantial change in the number of white blood cells. The amount of these cells in the body is likely to double to fight this infection. Patient self-care can be based on Maslow’s hierarchy of needs and Orem’s self-care deficit theory. The five levels of Maslow’s hierarchy of needs were applicable in this patient. The patient’s needs were addressed in an order starting physiological conditions while self-actualization needs were met last. Additionally, the four key components of Orem’s theory of self-care deficit theory were applied in facilitating patient self-care. More so, the patient’s educational strategies and care plan were utilized to enhance his self-care. Finally, care provision involved an interdisciplinary collaboration of team members. Primary care providers were involved in caring for the patient upon being transferred from the emergency room to the wards. A nutritionist also recommended an appropriate diet rich in vitamins to boost the patient’s immunity. Finally, the management was involved in intervening during discharge due to the patient’s challenges in settling his medical bill.

References

Irshad Ali, B, H. (2018). Application of Orem Self Care Deficit Theory on Psychiatric Patient. Annals of Nursing and Practice. 5(1): 1093.

Jackson, J, C., Santoro, M, J., Ely, T, M., Boehm, L., Kiehl, A, L., Anderson, L, S., & Ely, E, W. (2014). Improving Patient Care Through the Prism of Psychology: applying Maslow’s Hierarchy to Sedation, Delirium and Early Mobility in the ICU. J Crit Care. 2014 Jun; 29(3): 438–444. Doi: 10.1016/j.jcrc.2014.01.009.

Riley, L, K., & Rupert, J. (2015). Evaluation of Patients with Leukocytosis. American Family Physician; 92(11):1004-1011.

Tartari, E., Weterings, V., Gastmeier, P., Baño, R., Widmer, A., Kluytmans, J., & Voss, A. (2017). Patient engagement with surgical site infection prevention: an expert panel perspective. Antimicrob Resist Infect Control; 6: 45. Doi: 10.1186/s13756-017-0202-3