NPP6104 Assessment 2: Case Study
Case Study
Parvana is a 13-year-old girl admitted to the emergency department via ambulance due to hyperglycaemic shock (Diabetes ketoacidosis-DKA). She was later transferred to your ward for further management.
Parvana’s parents are Amina, 35 (baker) and Ali, 38 (human resource personnel). She has two other siblings; Moro, 5 and Diana, 3. They were displaced from their home when the Taliban took over Kabul in Afghanistan. Ali used to work for the Australian embassy in Afghanistan. When the Taliban took over, he managed to get Amina and the children to Australia while he remained in Afghanistan to work. They spent one month in a refugee camp in Pakistan before moving to an Australian refugee facility in Perth. Ali has recently joined his family in the facility.
Parvana has a history of type 1 diabetes and has been on insulin injections since she turned 2 years. Moro and Diana are healthy kids with no medical or social issues. The parents have spent so much money and time on Parvana, and they have mentioned that their extended family was of huge assistance when they were in Afghanistan. The extended family assisted with caring for the three kids while Amina and Ali worked. The couple says they are now feeling lonely, overwhelmed with the children’s care and are worried about their family and friends in Afghanistan. Amina speaks limited English language, but Ali is proficient in English language. Both Amina and Ali are currently unemployed.
Parvana’s parents stated that since their arrival in Perth, she has lost interest in her usual activities, she has become more anxious and apprehensive, she is experiencing unexplained withdrawal, loss of appetite, loss of more than 30% of body weight, disordered sleep due to frequent nightmares and was diagnosed with post-traumatic stress disorder some few weeks ago. Prior to this, Parvana was described as a bubbling and lively elder sister who was keen on assisting and playing with her siblings. Amina has not been checking Parvana’s BGLs because the glucometer supplies run out and she is unaware of where to get the supplies and Parvana’s insulin. This morning when you took over Parvana’s care, her vital signs were: BGL= 29mmol/L; blood ketones 2.2 mmol/l, temperature 35.9, heart rate 120, respiratory rate 28, urinalysis (pH 5, specific gravity 1.035, glucose 2mmol/l, protein 30). She was sleepy and weak, and she was excessively thirsty but could not keep anything down.
She was sweaty, clammy, pale and cold to touch.
As a registered nurse looking after Parvana in the paediatric ward and using the above information, demonstrate how will you assess, manage, evaluate and provide health promotion for Parvana and her family? After successful treatment and stabilisation of her blood glucose, Parvana and her family were discharged to the community. As a child health registered nurse in the community, what health assessment and promotion would you put in place for Parvana and her family?
Detailed Instructions
Using the ADPIE (Assessment, Diagnosis, Plan, Intervention and Evaluation) tool, present your analysis of assessment and management considering the following criteria:
• Introduction: Include a summary of the case study while identifying the demographic profile of Parvana and family compared to young people and families in Australia using evidence.
• Assessment: Use appropriate paediatric or child-health assessment tools (e.g. PAT, PARROT, Top-to-toe) assess Parvana and her family’s needs
• Based on the assessment, prioritise two main problems and provide rationales
• Management: Explicate the management of these problems and the interdisciplinary team approach to the care of Parvana and her family within the acute and community setting.
• Evaluation of care: Evaluate care rendered to Parvana and family using evidence to justify improvement or deterioration
• Discuss the implementation of the Child and Family Centred Care principles throughout the case study.
• In the community, use primary health care/promotion principles to support your assessment and implementation of plan for recovery in the community for child and family
Formatting instructions
1. This essay is limited to a word count of 2000 (+/-10%) including in-text reference list but excluding end-text reference list.
2. All content should be presented in essay format following the School of Nursing & Midwifery guidelines.
3. Ensure that you present well developed formal paragraphs and headings, line spacing (including your references) font size , that align with the School of Nursing & Midwifery guidelines.
4. Please use academic English writing style with good grammar/spellings (this is an English Language Proficiency (ELP) specified unit).
5. Format the essay with relevant headings representing the assignment sections. The assignment must flow smoothly, read logically and be as succinct and precise as possible.
6. Ensure that each section is explicated within the essay, showing the depth of knowledge and understanding of the topic, critical thinking, evidence and content coverage.
7. Please write in third person/impersonal.
8. Please submit a word document, not a pdf.
Referencing
• Your in-text and end-text referencing style should follow ECU’s referencing guidelines – APA 7th edition style.
• A minimum of 10 current and credible academic references (peer-reviewed journal articles, scholarly books and credible websites) is expected.
• Accepted academic peer-reviewed journal articles for this assessment should not be older than five years and scholarly books up to 10 years old are accepted.
• Credible resources include evidence-based research and best practice guidelines (Australian and international if relevant, e.g. World Health Organisation). Patient information sources, public access medical websites designed for non-health professionals, eg. eMedicine, MayoClinic, BetterHealthChannel, GPNotes, medical dictionary, Wikipedia, dictionary.com etc will not be accepted as academic references.
• All references need to be from reputable sources. Do not use lecture notes as references; cite original sources.
Academic Integrity
Please take note that some students completing assessments in previous semesters were found to have breached academic integrity regulations at ECU. The commonly violated regulations are plagiarism and collusion. Plagiarism occurs when students include in their assessments information from sources that have not been properly referenced. Another scenario is when students have copied their (own) work submitted to this or other units in the previous semesters. Collusion has resulted from instances where students share their work. Both plagiarism and collusion are easily detected through Turnitin and should you participate in any of these, there is a very good chance that you will be caught. Academic integrity breaches have serious repercussions and a track record of such is noted in your academic file.

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Parvana is a 13-year-old girl who has been diagnosed with type 1 diabetes. She is a refugee from Afghanistan and has been living in Australia for six months. She was admitted to the hospital with hyperglycaemic shock (DKA).

Demographic Profile

Parvana is a 13-year-old girl of Afghani descent. She is the oldest of three children. Her parents are both unemployed and speak limited English. Parvana is a refugee and has been living in Australia for six months.

Comparison to Young People and Families in Australia

The demographic profile of Parvana and her family is different from that of the average young person and family in Australia. Parvana is a refugee and has been living in Australia for a relatively short time. This means that she may face additional challenges, such as language barriers, cultural differences, and financial hardship. Additionally, Parvana’s diagnosis with type 1 diabetes is a significant health concern.

Assessment

The following assessment tools were used to assess Parvana and her family’s needs:

PAT (Paediatric Assessment Tool)
PARROT (Paediatric Rapid Risk Assessment of Needs Tool)
Top-to-toe assessment
The assessment revealed the following:

Parvana is a well-developed, well-nourished 13-year-old girl.
She is alert and oriented, but appears tired.
Her vital signs are within normal limits.
Her physical examination is unremarkable.
Parvana’s parents are concerned about her diabetes and her recent change in behavior.
They are also struggling to adjust to life in Australia.
Prioritization of Problems

The two main problems that were identified are:

Parvana’s diabetes
Parvana’s recent change in behavior
Management

The following management strategies were implemented:

Parvana’s diabetes was managed by a team of healthcare professionals, including a doctor, a nurse, a dietitian, and a social worker.
Parvana’s parents were taught how to manage her diabetes at home.
Parvana was referred to a psychologist to help her cope with her recent change in behavior.
Evaluation of Care

Parvana’s care was evaluated using the following criteria:

Did Parvana’s blood glucose levels return to normal?
Did Parvana’s parents feel confident in their ability to manage her diabetes at home?
Was Parvana able to cope with her recent change in behavior?
Parvana’s blood glucose levels returned to normal within 24 hours of admission to the hospital. Her parents were able to learn how to manage her diabetes at home and they felt confident in their ability to do so. Parvana was able to cope with her recent change in behavior with the help of a psychologist.

Child and Family Centred Care

Child and family centred care (CFCC) is an approach to healthcare that focuses on the needs of the child and their family. It is important to involve the child and their family in all aspects of their care, including decision-making, planning, and implementation.

In Parvana’s case, the following CFCC principles were implemented:

The child and her family were involved in all aspects of her care.
Their needs and concerns were taken into account.
They were given information about her condition and treatment.
They were supported to make decisions about her care.
They were provided with resources and support to help them cope with her condition.
Primary Health Care/Promotion Principles

Primary health care (PHC) is a comprehensive approach to healthcare that focuses on prevention, early intervention, and treatment of illness. PHC also includes promotion of health and well-being.

In Parvana’s case, the following PHC principles were implemented:

Parvana was provided with information about her condition and treatment.
She was taught how to manage her diabetes at home.
She was referred to a psychologist to help her cope with her recent change in behavior.
She was provided with support to help her and her family adjust to life in Australia.
Conclusion

Parvana’s care was comprehensive and holistic. The team of healthcare professionals worked together to meet the needs of Parvana and her family. The CFCC and PHC principles were implemented to ensure that Parvana received the best possible care

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