NRSG259: Mr Dinh Nguyen Diagnosed with Multiple Sclerosis (MS) Six Years Ago – Nursing Assignment Help
Case Study
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Write My Essay For Me!Mr Dinh Nguyen is an 83 year old widower who was diagnosed with Multiple Sclerosis (MS) six years ago. Four years ago he was diagnosed with osteoarthritis– which is now controlled on medication.
The Nguyen’s migrated from Vietnam in 1976. Dinh lives alone in his own two story home where he has lived with his wife, Ngoc, until she died twelve months ago. Dinh has remained independent since then, however with his ongoing grief and increasing isolation he has noticed a marked decline in his health with ongoing worsening exacerbations of his MS. Dinh and Ngoc did not have children, thus Dinh has no immediate family. However, he has a brother, Bao and his family, living close by. Dinh, however does not want to involve them in his daily life as he does not want to be a bother to them.
Dinh has a small income from his self-managed superannuation and is careful with his money. This allows him some measure of financial independence, however, because of reduced investment returns, finances are now only just covering his expenses. He tries to go on a holiday once a year, but was unable to this year due to his altered mobility.
Dinh has been experiencing some blurred vision, numbness in his face, and an “electric shock” type of feeling when he moves his head and neck, often travelling down his back and into his legs, impacting his movement and gait severely. This is making tasks such as cooking, showering, and dressing difficult, particularly bending down to do up his shoe laces. Dinh has also started to experience some episodes of urinary incontinence. Because Dinh perceives that his disease process is worsening, he is starting to wonder how he can face the uncertainty of his future.
Current Medications
Panadol Osteo 6/24 Oral prn (maximum 6 per day)
Teriflunomide 14mg Oral daily
Prednisolone 25mg Oral BD (during an exacerbation)
Part A – identifying three nursing care priorities
Identify the three nursing care priorities using the first four steps of the Clinical Reasoning Cycle
Consider the patient – describe facts and contents. This is the first stage of the clinical reasoning cycle, the nurse begins to gain an initial impression of the client’ situation.
Collect cues/information – review the information, gather new information and recall knowledge;
Process information – to interpret, discriminate, relate, infer, match the data and predict an outcome.
Identify problems/issues – synthesise all the information that has been collected and processed in order to identify the most significant patient problems or issues. You only need to identify three (3) issues for this assignment.
Part B: Having identified all of the nursing care priorities, choose the top priority of care and then discuss using the remaining 4 steps in the Clinical Reasoning Cycle
Establish goals – setting up the goal with the patient (demonstrating dignity) for the particular nursing issue. The goal should be specific, measurable, achievable, realistic and timely (SMART).
Take action – showing your nursing interventions/strategies with the relevant rationale(s) for each intervention.
Evaluate outcomes showing the expected outcomes and how you would evaluate them (objectively and subjectively). These should relate to your Goals. Think about using both objective and subjective data to evaluate the effectiveness of the nursing actions.
Reflection – what you have learned from this process and what you could have done differently.
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