Nrsg259 Miller’S Functional Consequences Theory: Assessment Answer

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Case Study

Mr Dinh Nguyen is an 83 year old widower who was diagnosed with Multiple Sclerosis (MS) six years ago. Four years ago he was diagnosed with osteoarthritis– which is now controlled on medication.

The Nguyen’s migrated from Vietnam in 1976. Dinh lives alone in his own two story home where he has lived with his wife, Ngoc, until she died twelve months ago. Dinh has remained independent since then, however with his ongoing grief and increasing isolation he has noticed a marked decline in his health with ongoing worsening exacerbations of his MS. Dinh and Ngoc did not have children, thus Dinh has no immediate family. However, he has a brother, Bao and his family, living close by. Dinh, however does not want to involve them in his daily life as he does not want to be a bother to them.

Dinh has a small income from his self-managed superannuation and is careful with his money. This allows him some measure of financial independence, however, because of reduced investment returns, finances are now only just covering his expenses. He tries to go on a holiday once a year, but was unable to this year due to his altered mobility.

Dinh has been experiencing some blurred vision, numbness in his face, and an “electric shock” type of feeling when he moves his head and neck, often travelling down his back and into his legs, impacting his movement and gait severely. This is making tasks such as cooking, showering, and dressing difficult, particularly bending down to do up his shoe laces. Dinh has also started to experience some episodes of urinary incontinence. Because Dinh perceives that his disease process is worsening, he is starting to wonder how he can face the uncertainty of his future.

Current Medications

• Panadol Osteo 6/24 Oral prn (maximum 6 per day)
• Teriflunomide 14mg Oral daily
• Prednisolone 25mg Oral BD (during an exacerbation)

Assessment Task 1 – Written Assignment – Care Planning: Individual Discussion

Description: This assessment is designed to measure your ability to identify and prioritise the most important nursing care issues for a client.

Two theoretical frameworks underpin your assignment: Miller’s Functional Consequences Theory to identify the influences impacting on the older person and their level of function and Levett-Jones’ Clinical Reasoning Cycle as the tool to drive the process of identifying and assessing, implementing and evaluating care. Students need to demonstrate how the dignity of the older person is maintained and how the cultural background of the older person is considered, throughout the process of assessment and care provision.

Students are required to review a provided scenario. From this scenario, use the first four steps of the Levett-Jones Clinical Reasoning Cycle (i.e., considering the patient; collecting cues and information, processing information and identifying problems/issues) to identify three nursing care priorities. A rationale needs to be provided for each nursing care priority identified.

From these three priorities, and using the Miller’s Functional Consequences Theory, identify the most important care priority to discuss. The discussion needs to focus on the steps of establishing nursing care goals, taking action, evaluating outcomes and reflecting on the care process identified..