Case Study: Jenny Peterson

Chronic diseases are the kind of illnesses that do not disappear quickly and cannot be cured only by medication or vaccination. A chronic disease persistently affects the health condition of a patient at least for three months (Chang & Johnson, 2018). Therefore, proper care should be provided to these patients with the help of professional nurses. Epilepsy is one of the chronic diseases that affect mostly the elderly and young people. In this following essay the epileptic condition of Jenny Peterson who has been recently found experiencing seizure attacks and as a single mother her disease puts pressure over the financial situation as well. Hence, this essay will discuss about the proper nursing priorities for her health care. The medication process and the nursing care models would also be discussed in the essay to identify the necessary health care policies of this disease.

Jenny Peterson is a single mother who lives in a suburb with her daughter and works in a hotel as a receptionist. Her husband is not supportive of her in both the way that is emotionally and financially; however, Jenny’s parents are supportive enough to her and lives two suburbs far from her residence. One car accident sent Jenny to the intense care unit of a hospital, and after that she was sent to a rehabilitation facility. After three months she faced her first seizure, and her diagnosis leads to find her epileptic condition, and she was medicated with Sodium Valporate. The nurse should have the proper knowledge of these medicines and the doses of use of these medicines in epilepsy (Bryant & Knights, 2018). At first, her seizures were under control; however, with time it got uncontrollable; thus she took sick leave from her workplace and working on her treatment. Jenny and Samara found to have a several cold, nausea and other residual diseases in this period. Though Samara is now in good health condition, Jenny is not well and tired with occasionally nauseous feelings. Her concern is about future of Samara as she is left with almost no sick leave and her health condition would not let her join to work, and she is about to go out of money. In Jenny’s case it can be seen epilepsy a chronic disease could not be cured or controlled by medication thus the health care professionals should be able to take other health care measures to avoid further seizure attacks of Jenny. This disease severely affected Jenny’s mental health as well as the financial condition gets worse with time, and thus she wanted to stop her medication and start working again for Samara’s future.

Nursing Priorities for Health Care of Epileptic Patients

A nurse should consider patient’s situation, gather and evaluate information, identify the patient’s problem, set care plans and take action on the basis of that planning and lastly evaluate the outcome and reflect on the learning and new experience, all these factors are co-related and termed as the Clinical Reasoning Cycle OR CRC (Croft et al., 2018). CRC would be helpful in the critical analysis process of Jenny’s situation for the nurse.

Here the nurse appointed for Jenny’s health care should prioritize her health first to avoid any future adverse conditions and also to prevent her seizure attacks the nurse should consider her mental states. In order to lessen Jenny’s seizure attacks the nurse should try to decrease her depressions of life and maintain a relationship with her. This could gain her trust and help her to open up about herself with her nurse, and it could help her know her and help the nurse to take measures for Jenny’s health care. Trust gaining would be a key factor by which the nurse gathers information about Jenny to further care planning in accordance with CRC. It also creates a positive effect on Jenny’s mind that could help lessen her depression and negativity that causing the seizure attacks more and more (Guzys & Petrie, 2017). The nurse should also support her family with positive conversations so as to establish a positive impact over them which could be the foundation of Jenny’s positive mindset build up as well. 

The nurse should also be able to maintain and prioritize the privacy of the patient as well as respect to the patient’s dignity is one of the health care priorities. This would be helpful in the relationship build up between the nurse and Jenny. The nurse would also prioritize the self-respect of Jenny as she is a single mother and these factors would be the foundation of the relationship. Moreover, in Jenny’s case, she needed to be observed in a daily or more effectively hourly observation is required as she faces seizure attacks often. Jenny takes the Sodium Valporate 200 mg and Lamotrigine 200 mg daily to sustain against these seizure attacks, and the nurse should prioritize her medication process as well to prevent her seizure attacks and maintain a healthy condition of Jenny (Lubkin & Larsen, 2018). Samara and Jenny also faced several residual diseases in this period of Jenny’s seizure attacks; thus it could be an added concern for the health care professionals for the treatment process. The nurse should also consider the health condition of Samara along with Jenny as Jenny is unable to look after Samara in her recent state properly. In addition to this concern the nurse should be able to evaluate the situation of Jenny and plan the care process which is the part of her learning in the CRC system. In order to maintain all these factors the nurse should be experienced and maintain the nursing standards of Nursing and Midwifery Board of Australia and that are standards for practice, codes of conduct and codes of ethics (Nursingmidwiferyboard.gov.au, 2019). In Australia, the Government use the Primary Health Care model which depends on the five factors such as preventive, rehabilitative, promotive, supportive and curative (Health.gov.au, 2019). In order to maintain all these factors, the nurse needs to consider the relationship factor as well.

Clinical Reasoning Cycle

On the other hand for the proper medication of Jenny, the nurse needs to have pharmacological knowledge, as well as the emergency conditions, need first actions with appropriate medication and other primary pharmacological strategies as well. In order to maintain Jenny’s good health and to prevent her seizure attacks the nurse needs to develop knowledge about her daughter as well and also needed to prioritize her health condition to avoid adverse impact over Jenny’s mental health. According to Josephson et al., (2017) depression and negative thought process have a significant effect over the epileptic seizure attacks; thus these factors should be avoided for these patients. However, the pathophysiological aspects of these two different age group patients are different, hence the nurse should be able to intervene the different aspects of their illness and proper care and medication as well (McCance et al., 2018).

All these factors would be justified by introducing another factor of nursing that is the holistic care policies. The spiritual aspect of health care needed to consider in this case as the holistic care consider the physical and mental health of a patient along with the spiritual aspect of care. Spiritual conversation puts a great impact and thus plays a crucial role in mental health development as well. However, the proper holistic care policies is not a regular practice within the nurses and according to NHS Australia the holistic care policies needed to be incorporated in the nursing education (About.healthdirect.gov.au, 2019).

There are several legislative acts and regulations in Australia found in terms of proper health care for the Australian personnel. All these acts needed to be properly maintained by the health care professionals as well. Health and Other Services Act 1995, Aged Care Legislation Amendment Act 2016, Australian Hearing Services Act 1991, subsections 8(4) to 8(8) and other legislation established by the Government of Australia in the field of proper health care management (Health.gov.au, 2019). All these legislative acts needed to maintain in terms of appropriate health case of Jenny as well by the nurse to keep healthy policies and the trust with Jenny (Forrester & Griffiths, 2015).

The nurse should also use different health care models in accordance to improve the health conditions of Jenny. Primary Health Care model is one of the most useful health care models; however, the use of Primary Health Care would not suffice in terms of Jenny’s condition as she faces a mental condition more than a physical one. According to NIH, the Primary Health Care does not deliver proper care in terms of mental or psychological illness, and thus the Four Quadrant Clinical Integration Model is more useful in mental illness as it considers both the psychological and physical condition in context to deliver proper care (Nimh.nih.gov, 2019). This health care model deals with the behavioral state and physical state of the patient, and it is more effective than the Primary Care model.

Holistic Care Policies

The nurse should be able to learn and evaluate Jenny’s case with the steps of CRC as he/ she would gain trust of Jenny by prioritizing her health condition, proper medication and positive conversation along with prioritizing her mental state. After that the nurse should be able to gather information of Jenny to plan a better health care process (Nursingmidwiferyboard.gov.au, 2019). In this case the proper planning would be prioritizing her and her daughter’s health. Positive conversations would be helpful in her mental health development. The nurse need to evaluate the outcome that is all these factors lessening Jenny’s seizure attacks or not and plan based on that evaluation.

As a nurse I need to contemplate on that evaluation and gather experience from this situation and use this experience to my future patients. The knowledge would help me to analyze and take primary decisions in critical conditions. It will also help me in creating relationship with my patients and thus improve my health care abilities in this kind of chronic diseases. In this manner the CRC system would be helpful for me to develop knowledge about these critical conditions of different patients.

Based on the above discussion it can be concluded that the nurse should consider the effects of depression over the patient’s mental condition and thus the epilepsy prevention must avoid negative conversations. The positive relationship between the nurse and the patient is one of the most useful aspects of health care in chronic disease such as epilepsy. However, the inclusion of different health care models other than the Primary Health Care model in chronic disease assessment is needed in Australian health care institutions as well. The holistic care policy is also one of the factors that should be integrated into the health care process. In the case of Jenny’s epilepsy all these factors should be prioritized by the nurse in terms of prevention of her seizure attacks. The nurse should maintain all these factors and devise a proper planning for Jenny’s health care in accordance with the Clinical Reasoning Cycle.  

References

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Bryant, B., & Knights, K. (2018). Pharmacology for Health Professionals (5th ed). Chatswood: Elsevier Australia. ACU Library: https://bit.ly/2Eh3Gcr

Chang, E., & Johnson, A. (2018). Living with chronic illness and disability. Principles for nursing practice (3rd ed) Sydney: Elsevier Australia. ACU Library: https://bit.ly/2EqR1o6

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2018). Thinking in pharmacy practice: a study of community pharmacists’ clinical reasoning in medication supply using the think-aloud method. Pharmacy, 6(1), 1. doi:10.3390/pharmacy6010001

Forrester, K., & Griffiths, D. (2015). Essentials of Law for Health Professionals (4th ed). Sydney: Elsevier Australia. ACU Library: e-book: https://bit.ly/2A3SblZ book: https://bit.ly/2RNbreg

Guzys, D., & Petrie, E. (2017). An Introduction to community and primary health care. New York: Cambridge University Press. ACU Library: https://bit.ly/2QLnawr

Health.gov.au. (2019). Department of Health | Legislation administered by the Minister for Health. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/health-eta2.htm

Health.gov.au. (2019). Department of Health | Primary Health Care in Australia. Retrieved from https://www.health.gov.au/internet/publications/publishing.nsf/Content/NPHC-Strategic-Framework~phc-australia

Josephson, C. B., Lowerison, M., Vallerand, I., Sajobi, T. T., Patten, S., Jette, N., & Wiebe, S. (2017). Association of depression and treated depression with epilepsy and seizure outcomes: a multicohort analysis. Jama neurology, 74(5), 533-539. doi:10.1001/jamaneurol.2016.5042

Lubkin, I., & Larsen, P. (2018). Chronic illness: Impact and interventions (9th ed). Burlington Ma.: Jones & Bartlett.ACU Library: https://bit.ly/2C7mE3N

McCance, K., Heuther, S., Brashers, V., & Rote, N. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed). St. Louis: Elsevier Mosby. ACU Library: e-book: https://bit.ly/2QM0vjL book: https://bit.ly/2EfRwR8

Nimh.nih.gov. (2019). NIMH » Integrated Care. Retrieved from https://www.nimh.nih.gov/health/topics/integrated-care/index.shtml

Nursingmidwiferyboard.gov.au. (2019). Nursing and Midwifery Board of Australia – Professional standards. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx