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Transcript

Preparation Task (10 minutes)

Research Task (30 minutes)

Analysis Task (30 minutes)

Create Task (20 minutes)

Hear from a professional in this role to see how they might approach this task.The following pages are a detailed model answer for the work simulation on Care Planning, geared towards a student interested in becoming a Nurse.

Document and Present (15 minutes)

Reflection Task (10 minutes)

Expected Outcome

Model Answer

Simulation

PREPARAtion task

For COPD

For Hypertension

  • Increased shortness of breath or difficulty breathing
  • Persistent or worsening cough, particularly with mucus production
  • Cyanosis (bluish discoloration of lips or extremities)
  • Chest pain or tightness
  • Fatigue and decreased ability to exercise

  • Severe headaches
  • Dizziness or lightheadedness
  • Blurred vision
  • Chest pain or pressure
  • Sudden nosebleeds

  • Unexplained weight loss or gain
  • Excessive thirst and frequent urination (signs of hyperglycemia)
  • Fatigue or confusion
  • Numbness or tingling in hands and feet (neuropathy)
  • Sores or infections that are slow to heal

Warning Signs for Mr. Joe Biggs

Given Mr. Joe Biggs' medical conditions (COPD, hypertension, and type 2 diabetes), the following warning signs should be closely monitored:

For Type 2 Diabetes

Simulation

research task

Disease Understanding and Management

  • Management Guidelines: Use bronchodilators, inhaled corticosteroids, and supplemental oxygen. Encourage pulmonary rehabilitation and smoking cessation
  • Common Complications: Respiratory infections, lung failure, and heart failure
  • Nurse's Role: Monitor respiratory status, manage oxygen therapy, teach inhaler use, and educate about exacerbation prevention

COPD

  • Management Guidelines: Administer antihypertensive medications (ACE inhibitors, beta-blockers). Encourage low-sodium diet and regular monitoring of blood pressure
  • Common Complications: Heart disease, stroke, and kidney damage
  • Nurse's Role: Regular BP monitoring, medication adherence support, lifestyle counselling (diet, exercise)

Hypertension

  • Management Guidelines: Use oral hypoglycemic agents or insulin therapy. Emphasise a balanced diet, blood sugar monitoring, and exercise
  • Common Complications: Diabetic neuropathy, retinopathy, cardiovascular disease
  • Nurse's Role: Monitor blood glucose, provide foot care, educate about diet and medication management, prevent complications, administer insulin as appropriate

Type 2 Diabetes

Simulation

Analysis Task

Analysis Task - Patient's Needs

Healthcare Needs:

  • Regular monitoring of blood pressure, blood glucose, and lung function
  • Medication management for all chronic conditions
  • Diet management to control both hypertension and diabetes
  • Oxygen therapy and respiratory care for COPD

Psychosocial Needs:

  • Emotional support due to the burden of managing multiple chronic illnesses
  • Education on lifestyle changes (smoking cessation, dietary modifications)
  • Access to social support and mental health counselling to manage potential anxiety and depression

Challenges

  • Ensuring adherence to multiple medications
  • Encouraging lifestyle changes (e.g., diet, smoking cessation) which can be difficult for older patients
  • Preventing complications from the interplay between diabetes and hypertension
  • Managing potential isolation and reduced mobility due to COPD
  • Managing a life-limiting illness with no cure

Simulation

Create Task

Physical Care

Comprehensive Care Plan

Pharmacological Symptom Management

Non-Pharmacological Management

Nutrition and Hydration

Involvement of Multidisciplinary Team

Psychosocial Support

Education about Condition

Discharge Planning

Physical Care:

  • Administer bronchodilators and antihypertensive medications
  • Monitor oxygen saturation levels and provide supplemental oxygen as needed
  • Conduct daily blood glucose monitoring and adjust insulin/oral medications as required

Pharmacological Symptom Management:

  • COPD: Inhalers (e.g., Albuterol), corticosteroids (e.g., Prednisone), and mucolytics
  • Hypertension: ACE inhibitors (e.g., Lisinopril), beta-blockers (e.g., Metoprolol)
  • Diabetes: Oral hypoglycemics (e.g., Metformin) or insulin therapy

Non-Pharmacological Management:

  • Breathing exercises and pulmonary rehabilitation for COPD
  • Encourage smoking cessation and offer counselling/support programmes
  • Teach stress-reduction techniques (e.g., mindfulness) to manage hypertension

Nutrition and Hydration:

  • Low-sodium, heart-healthy diet to manage hypertension
  • Carbohydrate-controlled diet for diabetes, focusing on whole grains, lean proteins, and vegetables
  • Ensure adequate hydration, avoiding sugary or high-sodium beverages

Involvement of Multidisciplinary Team:

  • COPD Specialist Nurse: For advanced management of COPD
  • Endocrinologist/Diabetes Specialist Nurse: For specialised diabetes care
  • Dietitian: To design a meal plan addressing hypertension and diabetes
  • Respiratory Chest Therapist: For breathing exercises and oxygen management
  • Social Worker/Psychologist: For psychosocial support, including mental health counselling
  • Physical Therapist: To maintain mobility and strength despite COPD limitations

Psychosocial Support:

  • Provide access to mental health resources (e.g., counselling) to address anxiety, depression, and emotional strain
  • Engage in support groups for chronic illness management
  • Address concerns of social isolation by encouraging community or family engagement

Education about Condition:

  • Teach Mr. Biggs about proper inhaler use, medication adherence, and signs of exacerbation (e.g., shortness of breath, chest pain)
  • Educate about dietary changes, the importance of blood pressure and glucose monitoring, and foot care
  • Encourage self-monitoring of COPD symptoms and lifestyle modifications (smoking cessation)

Discharge Planning:

  • Ensure Mr. Biggs understands his medication schedule and follow-up appointments
  • Set up home care services if needed for monitoring blood pressure and blood glucose
  • Provide clear instructions for emergency signs that require hospital admission (e.g., difficulty breathing, chest pain, confusion)

Simulation

Document and Present

Care Plan Documentation

Mr. Joe Biggs Care Plan Summary:

  1. Medical Conditions: COPD, Hypertension, Type 2 Diabetes
  2. Physical Care: Daily monitoring of vital signs, lung function, blood glucose
  3. Pharmacological Management: Administer bronchodilators, antihypertensives, and oral hypoglycemic agents
  4. Non-Pharmacological Management: Pulmonary rehab, breathing exercises, smoking cessation support
  5. Nutrition and Hydration: Low-sodium, carbohydrate-controlled diet, fluid balance
  6. Multidisciplinary Team: COPD Nurse Specialist, Endocrinologist or Diabetes Nurse Specialist, Dietitian, Respiratory Therapist, Psychologist, Social Worker
  7. Psychosocial Support: Mental health resources, support groups
  8. Education: Medication adherence, self-monitoring, dietary changes
  9. Discharge Plan: Home care setup, clear emergency instructions

Simulation

Reflection Task

Self-Evaluation

Challenges:

  • Balancing multiple complex conditions and ensuring integrated care
  • Creating a diet plan that simultaneously addresses hypertension and diabetes
  • Straightforward Aspects:
  • Implementing standard care for each chronic illness (COPD, diabetes, hypertension) based on guidelines
  • Recognising the role of the multidisciplinary team
Enhancement of Day-to-Day Nursing:
  • This exercise deepened my understanding of managing chronic comorbidities and coordinating holistic care
  • I gained valuable insights into balancing physical care with psychosocial support, improving patient-centred care