HNN217: Nursing - Community Nursing Practice - Case Study Assessment Answer

Nursing Case Study Assignment

Assignment Task

Community health nurses play an important role in delivering health education to clients. The purpose of this assessment is to provide you with the opportunity to demonstrate your knowledge of health education provided by the community health nurse and its role within health promotion.

Assignment question: Using Anne Giovanni’s case study, discuss the role of the community health nurse in planning evidence-based health promoting interventions relevant to one knowledge deficit about asthma in an effort to improve her health outcomes.

STUDY 1

Anne has returned to the clinic one week after her last appointment, and seems to be able todemonstrate back to you how to effectively take her reliever medication with a spacer after youhave provided her with some education and a demonstration. She has also been provided with ascript for a preventer (Seretide) and you explain to her the benefits of using this daily.She has some questions about the information you have provided her with regarding breastcancer awareness and cervical cancer screening. Before leaving, Anne admits that she has aboyfriend, and, when asked about family planning, she states that her and her partner use the“withdrawal method”.

STUDY 2

Anne Giovanni is a 23 year old Italian woman who has lived with her grandmother and her caton the outskirts of town for the past 10 months. Anne works at the local Catholic primaryschool as a graduate teacher teaching the prep class. She is grateful that her grandmother hasprovided free accommodation but is not happy with some of her restrictions. For example hergrandmother insists she attend weekly mass with her and insists that she is not allowed tosocialize at night without supervision. Anne was recently hospitalised overnight due to anexacerbation of her asthma. Anne feels that she has “managed fine” since she was firstdiagnosed three years ago, despite several hospital admissions during the year.In a follow up appointment with her General Practitioner Anne demonstrated a lack ofunderstanding of her condition, including her asthma triggers and how to manageexacerbations. As a consequence the GP referred her to you for health education.Your assessment of Anne reveals that Anne is unsure what triggers her asthma butacknowledges it has been worse since moving in with her grandmother. She tells you she nowuses her puffer three to four times per day and does not use a spacer as recommended becausethey are “too big and ugly to carry around” and are “pointless anyway”. Anne has never takena preventer for her asthma. When her asthma “flares up really bad” she just keeps taking herpuffer until she feels better or ends up in hospital. Anne tells you she doesn’t know whatexacerbates her asthma, but she has heard that it gets worse with exercise, and avoids it in aneffort to prevent attacks. When you ask Anne to demonstrate her puffer technique, you seeshe is putting the inhaler in her mouth without shaking it before taking a puff.Your inquiries about other aspects of Anne’s health reveal that she has never had a pap smearand does not practice breast awareness.

Asthma attack is a common among people who are allergic to certain conditions, scents and even chemicals. Usually asthmatic individuals don’t know how to manage their conditions. Therefore, it is the role of a nurse to deliver a participative evidenced-based, health promoting interventions; in this case for Anne Giovanni. This paper also illustrates how the education will be delivered.

Anne Giovanni case study

A nurse’s responsibility in the provision of participative evidenced-based is by assuming the role of being an ambassador of good health. In this case study, Anne Giovanni’s nurse needs to take the obligation of caring for the wellness of Anne. The nurse will have to provide advisory services to Anne. For example; the nurse needs to advice Anne on asthma symptoms such as breathing difficulty, cough, tight chest and wheezing (Leviton & Gutman, 2010). By so doing, Anne will be able to know the signs of sudden attack and quickly respond. Perhaps being a care giver to Anne would seem to be the rightful duty of the nurse. However, Anne is staying with her Grandma who also needs her company and Anne is not hospitalized, making it more appropriate for the nurse to advice Anne on what kind of Asthmatic intervention she should consider (Eneli, Skybo & Camargo, 2008). One of the interventions that the nurse is likely to prescribe is that whenever Anne gets an attack, she should seek for an appointment with an asthma nurse or doctor within 24 hours of experiencing an attack. The asthma nurse will discuss any appropriate changes that may be made if necessary in order to manage the Anne’s condition. This may include the dose of preventive treatment Anne is using as well as the inhaler. According to the case study, Anne is unsure of the trigger factor of the asthmatic attack she often experience. Therefore, it is the duty of the nurse to educate Anne on all factors that can trigger an Asthmatic attack (Coffman et al. 2003). Generally, research has found out that no one really knows what causes Asthma. The nurse will definitely educate Anne on this. The education here will be provided on a one-on-one basis where the nurse talks to Anne at a personal level. This form of education is described as participatory as Anne will be allowed to ask questions and share her experience with the nurse on how the attacks affect her life, daily routine and even studies (Robertson-Malt, 2010).

It is imperative that the nurse will have to demonstrate to Anne on how best to use the inhaler since her puffer technique is poor as have been cited in the case study. In her evidenced-based education, the nurse will demonstrate to Anne how to shake the inhaler before use (usually 3 to 5 shakes), removing the seal or cap, and breathing out, but away from the inhaler, bringing the inhaler close to her mouth and then start breathing slowly. This would be followed by removing the inhaler from the mouth, holding one's breath for utmost 12 seconds and then breathing out finally. Notably, the nurse will emphasize to earn that without shaking the inhaler, the vapor is unlikely to come out (Boyd et al. 2009). The nurse will educate her that exposure to specific triggers like allergies and cold could be the cause of Asthma. The nurse will also share with her on real life experience that have been reported and how such people cope up with asthmatic attack. Therefore, to reduce the frequency of her asthma attack, she needs to exercise more often, contrary to her belief that exercise exacerbates her asthma (CDC, 2011). It is only through education that Anne will learn from the nurse that for any health condition, physical exercise is usually a good remedy. Physical exercise makes the body active and improves blood circulation (Akinbami et al. 2011). This reduces the airway constrictions and one is likely to take in more oxygen. When Anne avoids exercise, the airway constricts consequently causing airway constrictions, which increases asthmatic attacks (Rotter et al. 2010). The nurse is likely to inform Anne that prevention is better than treating an attack. In her case, the nurse will help her understand that there is normally a warning sign before an attack. Therefore, by using her blue reliever more frequently, she will be able to monitor changes in her peak flow as indicated by the meter readings. Other symptoms that she will be told to be on the lookout is waking up in the middle of the night (Moorman, Rudd & Johnson, 2007). These are serious warning signs that the nurse will tell her never to ignore as part of the nursing preventive education. This will enable Anne develop her personal Asthma action plan through the help of the nurse. However, if the symptoms worsen, Anne will have to book an urgent appointment with a physician as stated earlier in this paper (Powell, 2002).

Conclusion

The nurse’s obligation is to act like an ambassador of good health. The nurse will have to provide advisory services to Anne. The nurse will advise Anne on asthma symptoms such as breathing difficulty, cough, tight chest and wheezing among others. Generally it is the duty of the nurse to educate Anne on all factors that can trigger an Asthmatic attack that she is likely to be a victim too. Other than that, Anne will be engage in a participatory discussion with the nurse where she will be taken through asthma incidences and she will be allowed to ask questions and share her experience with the nurse on how the attacks affect her life. Evidenced-based education will be done through demonstrations by the nurse on how to use the inhaler.