NRSG366 Partnerships in Chronicity
Assessment Task One Scenario
Joe Thomas is a 47 year old Indigenous Australian, who was diagnosed with chronic
kidney disease two years ago. Joe currently lives alone since separating from his
wife. He has not seen his two children since 2006. He is currently receiving a
Disability Support Pension.
Joe is 175cm tall and weights 110kg and has a 9 year history of Type 1 diabetes &
long standing hypertension. He also has bilateral diabetic retinopathy and a left leg
ulcer. As a result, he is no longer able to drive and is not as independent as he
would like to be. In addition, Joe is reluctant to undertake regular BGL monitoring
and does not take his insulin at a consistent dose or time.
Joe was working as a travelling sales representative however is now unable to drive
as his eyesight has deteriorated over the past 18 months. He is having difficulty
walking around as he has very swollen legs, thus has no regular physical activity.
His renal function is currently being monitored by his renal specialist, however this
has been deteriorated significantly over the past two weeks and commencement of
peritoneal dialysis is likely to occur soon. His current eGFR is approximately 36
mL/min/1.73m
2
. As a result of fall down the stairs of his unit, he has developed
cellulitus in his lower left leg. He is being treated has been prescribed 2 grams
cephazolin twice daily for 14 days.
You are administering the IV antibiotics at home via IV infusion and Joe suddenly
develops respiratory distress. You complete a set of observations – they are:
• T: 37.2C
• P: 96 (thready)
• R: 24 (shallow with basal crackles)
• BP: 195/120
• SaO2: 91% on room air
• BGL: 7.5 mmol/L
• Most recent HbA1C : 86 mmol/mol (6 weeks ago)
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NRSG366 Partnerships in Chronicity
Semester 2, 2013
Instructions for Assessment 1
The purpose of this assessment is to undertake a holistic and comprehensive client
assessment, demonstrating your ability to prioritise health issues within a client’s situation.
These instructions are linked to the NRSG366 Assessment 1 Scenario – Joe Thomas
Please submit as a word document with pages numbered & your name on front page
Please submit a marking criteria with your Assessment 1.
This assessment consists of a 1400 word written discussion that requires you, the student,
to:
• Identify and prioritise the clinical issues identified within the clinical scenario on
patient Joe Thomas. (Suggest 300 words)
• Link the issues to care provision by using critical analysis (need to use evidence
base references – not information found via data based searched on google).
(Suggest 900 words)
• A brief Introduction and Conclusion is required. (Suggest 100 words on each)
• The development of a concept map is also mandatory and additional to the 1400
words. Please use word for creating this concept map – do not use MINDJET