Order Description

this assessment has 3 parts essay academic format case study.
NO introduction and conclusion.
just USE topic sentences.
first part is about 280 words stating the 5 health priorities in an order form. number is

1. impaired gas exchange

2. risk for infection related to effective airway clearance ( pooling of secretion)

3. Knowledge deficit of the patient

4. potential risk for nutritional imbalance less than body requirements

5. activity intolerance as the patient is experience poor self management. there must be 3 highest priorities and two other least priorities.
part 1 should provide rationale for the last two priorities on why they are on the LEAST ones than the other first three and why it is still a priority.

part two is about 700 words and has to rationalise the first three priorities stated above in order form in a nursing focused manner, so about 270 words for each in this part. (Why they are being prioritised like that)

part 3 is about 450 words, outlining the role of the nurse in addressing patient health issues in relation to assessment or coordination of care based on the regulatory frameworks of nursing in AUSTRALIA and health department policies such as NMBA, NMCA, code of ethics and conduct, duty of care, nursing association etc…

referencing must be UTS Harvard referencing style. Use journals and literature with published date STRICTLY between YEAR 2010- 2014. 12 references please.


Part 1: Issues that would be given the Highest Priority

One of the most prominent symptoms that Jim is exhibiting is one-week of productive cough and an SOB that is more than the usual. Although Jim has visited a general practitioner for an oral AB, he is still experiencing some problems. Jim has had difficulty sleeping due to breathing problems. Mr. Jim also has a history of COPD and this means that the issue that should be given priority are those that are related to breathing problems. The practitioner needs to identify those issues and make them the priority areas because these are the most prominent symptoms that Jim is exhibiting.

The problem areas in order of priority include problems during breathing, increase of secretion, which may lead to infection that emanate from airways that are not effectively cleared. Another priority that the nurses need to focus on is the amount of information that Jim has about his problem. The nurse should start by addressing these same issues. The nurse should treat the impaired breathing to ease the discomfort that Jim experiences. This should be followed by clearing the airway to avoid any infection.

Since, Jim stays alone it would be important for the nurse to give him information about how he should take care of himself. Besides these issues, the nurse also needs to consider some health issues about Jim. Jim’s diet and any potential risk that nutritional imbalances may pose for his body’s requirements is another issue. Finally, it is important to consider whether the patient body can be able to tolerate activities. Jim’s condition provides the rationale for selecting the last priorities as the least ones. Hendry and Walker (2004) identify patient’s condition as a factor that impact priority setting.

Part 2: The Three Chosen Priority

The first priority issue in dealing with Jim would be impaired gas exchange, which could be caused by a number of issues. Some of the causes of impaired gas exchange could be impediment of the pulmonary arteries by different substances including serotonin. (Mohammed and Nonas, 2010). It may also be caused by a decrease in airflow in the airway mostly caused by constriction of the airways. In the case of Mr. Jim, the tar deposit due to smoking could be the cause of obstruction of the airways.

The rationale for giving impaired gas exchange a priority in this case is to ensure Mr. Jim experiences increased rate of respiration. Moreover, the process would ensure that he would be able to use his accessory muscles and the abdominal muscles for respiration (Staehr et al., 2012).  It is important to maintain an open airway for the patient especially if the patient has experienced trauma (Cartotto, 2012).  Impaired gas exchange would also points to some serious problems that would need to be identified and protected (Taylor et al., 2013). Some of these problems could include tracheal deviation, destruction of the lungs hematoma and other foreign materials in the mouth.

Another reason for giving this area priority is that improved gas exchange leads to improved lung expansion and this in turn leads to better exchange of gases. Improved lung expansion also ensures that the secretion produced do not block the airways. Mr. Jim is experiencing some wheezing in both his lungs and this warranty prioritizing checking whether there is impaired gas exchange. Mr. Jim has been diagnosed with chronic obstructive pulmonary disease that warrants checking exchange of gases because after some time the condition may lead to destruction of the lung (Blanco et al., 2010).

The other priority area that the nurse taking care of Mr. Jim should consider is whether he may be suffering from ineffective airway clearance (Carlotto, 2012). The problem is associated by the inability of the body to clear some of the tenacious secretion produced in cases where fluid intake is insufficient (Lima et al., 2013). Stasis of secretions is associated with decreased mobility and decreased cough effectiveness caused by decreased lung or chest wall expansion and depressant effect of some medications. One of the reasons that would guarantee this area as an area of priority is the fact that Mr. Jim has experienced a productive cough for one week. Jim is also experiencing some wheezing sound from both of his lungs something that could indicate that there were secretion in the airway. It is important to check whether there is ineffective, airway clearance because it helps the nurse to remove the secretion that Mr. Jim may not be able to remove without aid (Lai et al., 2011). It also enables the nurse to monitor the wheezing sounds produced by Mr. Jim and thus help in making it easy to detect any form of infection that may affect him.  Further, the practice helps in identifying accumulation of secretion and thus come up with ways of reducing some of the breathing problems that he experiences. By giving ineffective air clearance priority, the nurse aims at opening airways evident from normal sounds in breathing, normal rate and depth of respiration, and absence of dyspnoea.

It is also important for the nurse to consider the knowledge that Mr. Jim posess. This is particularly important because Mr. Jim has to take care of himself owing to the fact that he is a widower and stay alone which means that most of the time he has to take care of himself. Mr. Jim manages his own care and his disease and this means that it is necessary for him to understand fully his problem and his disease. He is also supposed to have enough knowledge on how he should manage his disease in the most effective way. The nurse can only be able to determine the type of information to provide to Mr. Jim only by determining the amount of information that he has on his condition as well as on taking care of himself.

The nurse by determining the information that Jim has will be able to decide additional information that Jim needs. Apart from addressing the preceding priorities, providing Jim with information will help him address the two priorities identified as the least important priorities in Jim’s case. Such information will assist Jim in managing his condition effectively and avoid any risks. Operating on information will ensure that Jim will take appropriate measures that will reduce his visits to health facilities. Nutritional information and the kind of activities to engage with is part of the information that Jim needs to have. Part 3: Role of the Nurse in Accordance to Nursing Codes

Nurses based in Australia are obliged to adhere to the code of Ethics for Nurses in Australia.  The code of ethics applies to the entire level of nursing professionals including nurses encompassing management, clinical, research domains, and education. The code of ethics stipulates that nurses have obligations of providing quality nursing care to entire people. Therefore, the code should guide the nurse in charge of Jim to receive and start making a follow up of his health condition. The second code states that nurses are obliged to display kindness and respect for self and others. The code therefore aims at establishing mutual understanding between nursing professional in health facility. The nurse in charge would then be obliged to show some kindness to Mr. Jim despite the fact that his condition was primarily caused by smoking. Despite the fact that smoking is  discouraged habit, the nurse is expected to receive the patient just like any other patients.

The third code states that nurses in Australia should value other people’s diversity. I other words, the code prohibited any form of discrimination. Nurses should attend to all patients from entire ethnic groups without any form prejudice. The fourth code implies that nursing professional have a duty to of providing health care and quality nursing features. In this case, then nurse in charge would consider providing the ultimate health care to mr. Jim. The nurse would be obliged to provide proper medication and even consider encouraging him that he would regaining his health under the nursing care.

The fifth code indicates that nurses should consider showing value of making informed decision-making process. In this case, the nurse in charge of the patient would have obligations of deciding services that need priorities and those that need less priority. The nurse would thus assess whether administering oxygen therapy would be ideal to save the life of the patient. Additionally, the nurse should also advise the patient on how to cope with his condition now that he lives alone with such a chronic condition.

The sixth code indicates that the nurses have a duty to administer the culture health care and safety when performing their duties. The nurse I charge will have ultimate obligation of ensuring the Mr. Jim is free from any hazards such as excessive dust and some that may worsen his condition. The seventh code indicates that nurses are obliged to display ethical management of information regarding the patient.

The nurse in charge would be obliged to ensure that she keeps confidential information regarding Jim’s condition to relevant party only. Additionally, the nurse would only releases information under the consent of the patient. The eighth code indicates that nurses are obliged to value economically, socially and ecologically sustainable environment that would promote patients well being (AHPRA, 2014). The nurse would assess social environment of the patient and establish appropriate strategies to help him retaining his good health.

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