present a comprehensive discussion and justification identifying two (2) care priorities within a clinical scenario using the Levett-Jones’ Clinical Reasoning Cycle.?Students are required to provide critical analysis and justification of the care priorities using appropriate academic references.
Assessment Task One: Case Study One
Multiple factors influence the care of patients with chronic conditions. As a Primary Heath Care nurse, it is important that care given is prioritised based on both clinical and patient needs. Prioritisation of the patient needs for care is integral to daily nursing practice.This requires integrating and collaborating different aspects of patient needs in order to maximise care activities and the effectiveness of nursing interventions.
This case study is designed to demonstrate the integration of various principles of managing care of patients with chronic conditions. Students will be expected to identify and discuss two PRIORITIES OF CARE and apply the clinical reasoning cycle to these as a means of justification. Please refer to the subject outline and marking rubric when answering this question.
Peter Mitchell is a 52 year old male with morbid obesity and type 2 diabetes who was admitted to the medical ward with poorly controlled diabetes, obesity ventilation syndrome and sleep apnoea. Peter was referred by his GP after he presented with symptoms of shakiness, diaphoresis, increased hunger, high BGL levels and difficulty breathing whilst sleeping. Peter has been a smoker for approximately 30 years and smokes approximately 20 cigarettes per day.
On his previous admission, Peter was seen by a dietician and commenced on low energy, high protein diet (LEHP) to assist with weight reduction. His GP had previously discussed weight loss with Peter however he had never wanted to do anything about it as it seemed ‘too hard’. Peter was also reviewed by the physiotherapist and was commenced on light exercises which he was to continue at home on discharge.
Peter has been discharged home, with referral to community care unit for ongoing support and follow up, after four weeks in the medical ward to manage his weight and clinical comorbidities.
Past medical history
· Obesity (weight 145kgs with a BMI of 50.2m2). ?
· Type 2 diabetes (Diagnosed 9 years ago) ?
· Hypertension ?
· Depression (Diagnosed three months ago by GP). ?
· Sleep apnoea ?
· Gastro oesophageal disease reflux disease?Social History?Peter is an unemployed male who receives government benefits. Peter lost his job three years ago as a fork lift driver at the Moranbah coal mine in far North Queensland. Peter states that he has always been a ’biggish guy’ with his ‘normal weight’ sitting at around 105kg but since starting insulin and losing his job he has gained a significant amount of weight. ?
Consequently, because of his weight issues Peter has difficulty finding work due to fatigue and feeling generally ‘uncomfortable’ about his size. Peter is a divorcee who lives alone, his two sons live in the same state but live in different cities and rarely visit him. He is socially isolated because he is embarrassed by his size and he rarely goes out. Peter is also finding it increasingly difficult to perform activities of daily living (ADLs). Peter realises that he is in the prime of his middle age life and is motivated to lose weight and quit smoking but isn’t sure where to start.
· Insulin Novomix 30 B D (34units mane & 28units nocte) ?
· Metformin 500mg BD ?
· Lisinopril 10mg daily ?
· Nexium 20mg daily ?
· Metoprolol 50mg BD ?
· Pregabalin (Lyrica) 50mg nocte Last observations on discharge ?
· Weight 145kgs ?
· Height 170cms ?
· BP 180/92mmHg ?
· RR 23 Bpm ?
· HR 102 Bpm ?
· Sp02 95% on RA ?
Presentation The part of innovation as an elective apparatus for guideline of English outside dialect students increments as teachers perceive its conceivable outcomes to make both autonomous and community oriented learning situations in which understudies can secure, submerge and rehearse another dialect (Butler-Pascoe, 1997). Using the Internet, word processors, computer games mixed media, and practice programs, understudies can take part in individualized direction intended to meet their particular needs and take part in agreeable undertakings that will encourage correspondence with peers in their classrooms and all through the worldwide group. This examination centers around the capability of computer games as an effective apparatus for outside dialect guideline and securing. This is a critical theme for some reasons, the slightest of which is that such huge numbers of individuals don't generally comprehend this medium and respect it in the most exceedingly terrible conceivable way. What numerous pariahs of the computer game culture don't comprehend is that computer games can be an expressive and intriguing medium that can without much of a stretch contend with the best that different mediums bring to the table, and, similar to an expressive medium before them, computer games have experienced a brutal trial by the individuals who are extremist, ignorant and preferential against this medium. This paper gives an incredible chance to clarify why PCs and computer games can take an imperative part in dialect learning, and why in that we have a phenomenal chance to teach, our youngsters as well as the populace everywhere through computer games. Computer games can give the capacity to shape occasions, conditions and positions in a way which isn't achievable through some other medium. As indicated by Larson (1999) and Li (1999), "the value-based nature and the academic significance of some cutting edge videogame-based intuitive advances make videogames a practical vehicle for remote dialect learning". This postulation intends to achieve the accompanying targets: to make the peruser mindful of new learning methodologies and conceivable outcomes for a wide range of students; to find understudies' perspectives on the practicality of videogames for dialect learning and direction; to propose another scope of exercises that can be performed in a classroom utilizing videogames. This proposal initially talks about discoveries from different research considers, and additionally ebb and flow dialect showing approachs, so as to clarify how video recreations can add to dialect securing by assessing a few computer game sorts and stressing that "virtual pet", reproduction and "RPG" (Role playing amusements) are helpful for dialect procurement. It additionally gives different example exercises that can be performed in the ESL classroom utilizing computer games in their own particular right. Besides, the unique circumstance and members are exhibited and also an examination instrument, after which the information is investigated and given a translation lastly educational ramifications are displayed. Part 1: Literature survey This part right off the bat endeavors to clarify why videogames can be appropriate for taking in a dialect in view of a few examinations that are depicted straightaway. Besides, it likewise plots how videogames are gradually being fused into the field of training. Thirdly, it furnishes the perusers with an outline on videogames and modding lastly how educators can profit their lessons from modding and how it can be utilized as a part of the ESL/EFL classroom. 1. - Videogames and Research Utilizing computer games to teach has for quite some time been a much idea of objective, yet once in a while an accomplished one. In spite of the fact that computer games may not yetbe ready to teach clients in a substance region adequately, dialect students may profit by computer games. Instructive programming designers have attempted to display a significant measure of substance and setting without giving up the level of control diversion players anticipate. Almost no examination has particularly focused on dialect obtaining through computer games; be that as it may, different investigations completed throughout the years in a few colleges of the U.S, England and Sweden with understudies of various majors, and in addition current dialect showing procedures bolster the utilization of computer games to learn dialect. Strangely, in one investigation Hulstijn and Laufer (2001) found that dialect procurement may rely on the "level of involvementin an assignment", and computer game players are regularly very inundated in diversion play, an attribute that may empower them to obtain dialect, since computer games frequently contain at the same time introduced aural and printed dialect. Another examination done by Prensky (2006) proposes that "videogames enable students to investigate and unravel dialect at their own pace". Amid amusement play students may utilize one information channel to unravel the other in light of the fact that videogame players have a lot of controlover the diversion play (different in-diversion decisions can be made, recreations can be delayed, activities can be rehashed, and discussions can now and again be started available to the players' own particular no matter what. "Dornyei and Clement (2001, p.399) asserted that "one of the principle premises for utilizing computer games to teach has been to tackle students' inspiration". In spite of the fact that, inspiration is a critical component in dialect learning, inspiration alone does not ensure the obtaining of a dialect. This was expressed in another investigation performed by Prensky (2004) who discovered that a standout amongst the most troublesome things instructors needed to do was to go for a harmony between computer game cooperation and taking in its dialect which may come about excessively strenuous for a few players' intellectual capacities. All things considered, Brett (2001) stresses in his exploration that the regular redundancy which is presentin computer games, for example, the steady set-up of little fights in pretending amusements and the incessant utilization of intuitive menus in virtual pet and reproduction diversions, enables a dialect student to be ceaselessly presented to the objective dialect and makes more open doors for procurement to happen rather than other media, for example, motion pictures or books, which frequently don't reuse a similar vocabulary or syntax, making obtaining more troublesome and moderate paced. Strangely enough, the reiteration in computer games enables a dialect student to utilize their own particular activity to utilize known dialect (semantic setting, vocabulary or punctuation) to decipher obscure components through steady introduction. Moreover, Crawford (2003, p.261) made a dazzling disclosure in his examination when he expressed that "a videogame gives players a valuable sensation connect to its dialect" bringing about players giving an aggregate physical reaction to activities incited. Add up to Physical Response (TPR)activities are utilized as a part of request to associate the dialect thing whether, vocabulary or syntax, to a physical activity, ideally making thelanguage simpler to get a handle on, which is very comparable in videogames where players perform on-screenactions that may serve to interface the dialect they figure out how to their local dialect. 2. - Video Games and Education Computer games bring out various feelings in individuals. Some may see them as just a device of stimulation, while others should seriously mull over them pointless and devices of terrible impact. Scholastics, for example, Gee (2005, p.13), will state that "computer games are another type of intuitive media deserving of scholarly multidisciplinary contemplate" paying little heed to what videogames might be, they are an unmistakable yet engaging route for youths to invest their energy. It does not shock anyone that numerous instructors and educators are attempting to add computer games to their lessons and educational module plan both to get and hold the consideration of understudies, also to upgrade the course substance and amiability. Numerous business, pharmaceutical, and graduate schools in northern Europe are actualizing computer games, for example, Kristen's Cookies, Dexter and Objection as a feature of their educational program, while different schools present all the more monetarily known titles, for instance Brain Age and Trauma Center to their science and math courses. As per Hogg's exploration (2006) completed in some European colleges, understudies' inspiration and in this way reviews, have taken off exponentially rather than droop since the execution of computer games in their educational program. Computer games have turned out to be progressively broad in their utilization, both as a diversion and as an instructive apparatus. ESL instructors ought to be no special case and have the capacity to make utilization of this innovation to help understudies in showing sentence structure focuses as much as in building up understudies' talking capacity. 3. - Video Games and Modding For more than twenty years there have been numerous endeavors at planning instructive programming with every one of them bringing about disappointment and consequently a feeling of sadness won through a significant part of the instructive programming group. Luckily, the rise of new models have made instruction and amusement recreations quit rivaling each other. In the event that we take a gander at the present amusement computer games, numerous will be not at all like the recreations predominant in the late 90's when instructors and diversion designers initially collaborated trying to embed counterfeit learning minutes inside recreations. In those days, in-amusement universes were generally settled and did not have much profundity at all, empowering the player just to play out the activity of a pre-customized story. Today, in any case, as indicated by Hansson (2005) diversions are apparently more open-finished, with a significant number of them urging players to play a dynamic part in the development of the amusement itself using different 'mod' instruments. The term 'mod' means alteration, in videogame terms 'mod' alludes to a client made extra to an officially existing amusement. For instance, one of 2007's top rated computer games, "The Sims 2" does not decide any unequivocal objective or winning result. Or maybe, the amusement presents itself as an open-finished "virtual doll house" in which clients play out and share stories with each other should they decide to. Because of the tremendous adaptability of this diversion, a large number of players>GET ANSWER