Mr Vinh Nguyen
Mr Vinh Nguyen is a 48-year-old male, who emigrated from Vietnam over 30 years ago. He currently lives with his mother-in-law and son (age 21) in the Inner West City of Sydney. Mr Nguyen presented to his GP clinic following a fall in his kitchen this morning, after becoming “lightheaded and dizzy while making breakfast”.
Following the review of his laboratory tests and assessment results, Mr Nguyen has been diagnosed with Type 2 diabetes mellitus.
He has since been referred to you, the practice nurse, for a care plan to manage his condition and improve his overall health.
Based on the information provided in this case study, you are required to present your oral assessment using the guidelines below.
Please ensure you go to the next section for more information about Mr Nguyen.
GUIDELINES FOR STUDENTS
The key components of Assessment 1 are:
• Step 1 and 2: Consider the patient situation and identify the key elements of assessment by:
o developing and presenting a concept map of Mr Nguyen and his situation;
o discussing in detail, the pathophysiology of the disease and how Mr Nguyen’s signs and symptoms reflect the underlying pathophysiology;
o identifying the key elements including new and current information;
o Including evidence to support the content of your concept map.
• Step 3 and 4: Process patient information, identifies relevant activities of living impacted, and identifies nursing issues for the patient:
o Interpret and analyse the information you have been given about his condition;
o Identify and prioritise 3 nursing issues you must address for Mr Nguyen, and justify why they are priorities and support your discussion with evidence;
o discuss the potential impact of the disease on Mr Nguyen’s 3 most important activities of living. Link your discussion to the Roper-Logan and Tierney model.
• Steps 5 and 6: Establish goals and take action:
• Identify 3 SMART goals with comprehensive discussion of the desired outcome, within a suitable time frame;
• Identify interventions to achieve the above goals. The interventions should:
• be both nursing and patient based;
• consider both pharmacological and non-pharmacological management;
• recognise strategies to empower and education Mr Nguyen to take initiative to alter his lifestyle factors
• Steps 7 and 8 – Evaluation and Reflection:
• Consider what strategies/aspects would determine that the patient and nurse interventions have been successful or effective for Mr Nguyen?
• Include your conclusion here, and part of that should include an overall statement of what have you learned from doing this case study (what has been learnt, what went well, and what could have been improved)
Mr Vinh Nguyen – Case Study Information
You have been provided with the following case study about Mr Vinh Nguyen, who presented to his GP clinic following a fall in his kitchen this morning, after becoming “lightheaded and dizzy while making breakfast”.
Mr Vinh Nguyen is a 48-year-old male, who emigrated from Vietnam over 30 years ago. He currently lives with his mother-in-law and son (age 21) in the Inner West City of Sydney. His wife passed away 6 years ago due to complications from lung cancer.
Mr Nguyen works full time as a civil construction labourer and is currently working overtime most weekends, averaging 50 hours/week. He states that he “needs the extra income to support his son, who lost his job due to COVID-19”. He has been feeling dizzy and lightheaded now for a few days, but this morning was the first time he had fallen over. He had been feeling more fatigued over the past few weeks, but attributed this to his long working hours, as well as “being up all hours during the night to urinate”, which was impacting on his sleep.
He smokes 3 packs of cigarettes per week, and drinks 2 beers every evening with his dinner as this is the “only way he can relax”. Recently, he has taken to drinking more beer in the evenings as he “was always feeling so thirsty, and only beer could quench this thirst”. Due to his long working hours, and as his mother-in-law and son cannot cook, the family eat takeaway 6 times/week and then go to his sister’s house for dinner every Sunday.
He has a past medical history of gout, asthma, and hypothyroidism, for which he is on daily thyroxine hormone replacement. He is currently awaiting a sleep study for possible Obstructive Sleep Apnoea (OSA).
Following the review of his laboratory tests and assessment results, Mr Nguyen has been diagnosed with Type 2 diabetes mellitus. He has been prescribed metformin 500mg BD, with a review of dosage scheduled for 4 weeks’ time.
He has since been referred to you, the practice nurse, for a care plan to manage his condition and improve his overall health.
Family history:
• Father passed away in 2015 due to an AMI.
• Mother had lung cancer in 2017 and is in remission currently. She resides in Vietnam.
Medications:
• Thyroxine 100mcg daily
• Salbutamol 2 puffs PRN
• Budesonide 500mcg daily
• Allopurinol 500mg daily
• Ibuprofen 400mg PRN for gout attacks
Current vital observations:
• BP 102/65 mmHg
• HR 106 bpm
• RR 20 bpm
• SpO2 98% on RA
• T 36.7C
Health assessment findings:
• Height 1.6m, Weight 90kg, excess abdominal fat evident. Waist circumference 105cm
• Total cholesterol level – 9.2mmol/L
• Current BGL – 23.5 mmol/L (last meal 6 hours ago). No blood ketones present
• Urine dipstick showed glucose, no ketones
• Alert and orientated to time, place, and person. GCS 15
• Cool, dry hands and feet. Dry mucous membranes
• CRT 3 seconds
4. Concept Mapping
CONCEPT MAPPING
Step 1 and 2 of the assessment task requires you to create a concept map outlining the patient situation and identify the key elements of assessment.
A concept map is a diagram that depicts suggested relationships between concepts. Concept maps are generally used to organise and structure knowledge.
A concept map typically represents ideas and information as boxes or circles, which it connects with labeled arrows, often in a downward-branching hierarchical structure.
The relationship between concepts can be expressed using linking phrases such as -causes-, -requires-, -such as- or -contributes to-
GENERAL TIPS AND GUIDELINES
Discussion and using Evidence:
• There is much further depth required to meet the criteria on rubrics when you are being asked to critically discuss and critically analyse. This moves beyond merely ‘describing’ events or processes and requires you to make much deeper links that are supported by theory and evidence-based literature.
o For example, you may include the pathophysiology of a disease process, but unless you can explain the link between the patient and their conditions, this does not demonstrate sufficient critical analysis or understanding
• Your discussion needs to utilise high quality academic sources to support your arguments (such as journal articles), and refrain from using consumer websites
Slides:
• Avoid text heavy slides which can detract from the meaning being presented on the slide. Stick to your main points (e.g., 3-5 points per slide), and verbally explore the points further.
• Try to use diagrams, pictures/images or schematics which can break the slides up, as well as aid visual learners. However, images used need to be relevant to the discussion
• Ensure all slides and diagrams are referenced using in-text citation
• Consider the use of an appropriate font type, colour and size to ensure ease of reading for the audience.
• Proof read your work for grammatical errors, spelling mistakes or issues with punctuation. Remember, this is a piece of academic writing and needs to be at a high standard.
Oral presentation:
• Avoid simply reading from your notes/slides
• Ensure your discussion flows logically, i.e. you should still introduce your presentation, the discuss your main arguments and then finish off with a conclusion
• Be succinct but include everything that you need to include. Remember, you have a time limit and you do not get the option to deliver your information in another capacity
• Practice, practice, practice, and only start recording when everything is ready to go and you are confident
