ASSESSMENT 1: INFORMATION SHEET AND CASE SCENARIOS FOR THIS ASSESSMENT YOU ARE GIVEN A CHOICE BETWEEN TWO (2) CASE SCENARIOS.
THE SCENARIOS ARE YOUR REFERRAL INFORMATION AND NO ADDITIONAL INFORMATION IS AVAILABLE. EACH STUDENT IS TO SELECT ONE (1) SCENARIO ON WHICH TO BASE THEIR ASSESSMENT. THE COMPLETED ASSESSMENT IS TO BE SUBMITTED THROUGH THE APPROPRIATE TURN-IT-IN DROP BOX ON THE NRSG366 LEO SITE. THE ASSESSMENT ONE MARKING CRITERIA IN THE UNIT OUTLINE IS TO BE USED TO GUIDE THE PREPARATION OF THIS ASSESSMENT.
For this assessment you are given a choice between two (2) case scenarios. The scenarios are your referral information and no additional information is available.
Each student is to select one (1) scenario on which to base their assessment. The completed assessment is to be submitted through the appropriate turn-it-in drop box on the NRSG366 LEO site. The Assessment One marking criteria in the unit outline is to be used to guide the preparation of this assessment.
When submitting your assessment, please do not use the scenario as part of your response.
Option 1: Epilepsy
Jessica Williamson is a 28 year old woman with a past history of epilepsy. Two weeks ago Jessica was out socially, drinking
alcohol at a dance club. Jessica experienced a seizure whilst on the dance floor. Upon arrival at the local Emergency Department,
paramedic staff reported that she had experienced a full tonic-clonic seizure that lasted for three minutes, during which she lost
consciousness. Jessica was assessed and admitted. During her hospitalisation, Jessica was stabilised and discharged from
hospital 1 week after the episode. Her discharge medications included an anticonvulsant.
On discharge Jessica was asked to attend her GP for follow-up.
Medical History
Jessica was diagnosed with epilepsy in late adolescence. Initially the seizures were very difficult to control using anticonvulsants
but her condition stabilised 5 years ago. Three months ago she weaned herself off her anticonvulsants as she wanted to fall
pregnant. During her hospitalization she was recommenced on her anticonvulsant.
Four years ago Jessica was diagnosed with Type 2 Diabetes Mellitus. Jessica was taught to control her blood glucose levels using
diet and oral hypoglycaemics, this is now decreasingly effective.
Her most recent observations include:
? BP: 150/90
? P: 115 regular
? Height: 158 cms
? Weight: 122 kgs
? BGL 12.9
Her current medications are:
? Epilim 1 gm BD
? Metformin 850mg BD
Social History
Jessica lives in a two-storey house with her current partner of six years, Martin. Jessica’s parents live overseas where her mother
has been posted for work. Jessica is an only child. She works as a real estate agent selling homes and covers a large geographic
area involving long and irregular work hours. This can involve her driving long distances and for long periods of time. Jessica
enjoys her work and the challenges of being independent at work and at home. Despite being advised by her GP that she must
not drive after suffering this recent seizure, Jessica continues to do so.
Current Issue
Following the follow-up appointment with the GP, the GP was concerned about Jessica’s seemingly poor acceptance of her
medical diagnoses and her compliance with the treatment regime for both her diabetes and epilepsy. Jessica indicated she did
not need any more prescriptions for her anticonvulsants at the moment.
Jessica is not particularly careful about monitoring her blood sugar levels. She says she often forgets, and tends to check when
she “feels fuzzyâ€.
As this is your first visit to Jessica in her home, justify and discuss the immediate plan of care for her.
Assessment Focus
You are the Registered Nurse from the Community Nursing Service.
You will be undertaking an initial visit to Jessica’s home.
Prioritise and provide a rationale for the activities you will undertake as part of this initial visit and identify two (2) priorities for
your follow-up visit.
Option 2: Chronic Pain
John Ryan is a 66 year old male with a history of chronic back pain related to spinal stenosis, and degeneration of the left hip. He has been reviewed in the Outpatient Pain Clinic on a monthly basis for the past 4 months, after a sudden increase in pain and changes in his level of activity. His pain specialist is concerned about his level of function at home and has referred John to the community nursing service for an initial assessment and review.
Medical history
John has spinal stenosis which was diagnosed in his early forties. He has significant pain in his lower back and hip, slight (L) leg weakness and slight loss of sensation in both his feet. He is generally fit, but slightly overweight.
His most recent observations are as follows:
? BP: 135/80
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