Nocturnal Enuresis

This assignment will critically discuss the nurse’s role in assessment and care planning for a patient in a case study. Confidentiality which is required by the NMC (Nursing Midwifery Council, 2008) and the Data protection Act (1998) will not be broken through out the assignment because the case study used is a scenario not a fictional character. The care plan will focus on Jean’s incontinence needs using The Roper, Logan and Tierney model (2000).

Nurse’s care for several patients in a day and it is important to understand the patient as a whole person to treat them effectively. The purpose of this assignment is to explore a patient’s disease to understand the nursing judgments and interventions involved, the medications for this diagnosis, and to understand the disease. The patient described in this paper will be referred to as Jonathan to ensure patient confidentiality.

is not receiving enough nutrients such as protein and vitamins that are crucial to wound healing, which impedes healing of the pressure ulcers (Myers, 2012). Last but not least, he has sexual dysfunction that can be detrimental to his psychosocial well-being. He is physically unable to achieve erection and orgasm. Appendix A is provided at the end of the paper to show an example of nursing care plan for physiological issues.

Father gets up once during night to empty his bladder and mother reports problems with bladder leakage from stress incontinence(Johnson family, personal communication, June 24, 2012).

Susan Ambrose is a 35-year-old nursing student, a single mother with two children, and she works part-time as a nursing technician at night in the local hospital. Over a period of 6 months, Susan has had increasing problems sleeping. She has had trouble getting to sleep at night and also, at times, waking up in the middle of the night. She is feeling exhausted most of the time now and is having trouble functioning and studying for her courses. Her friends tell her to just see her physician for sleeping pills. In addition, she is now in what is thought to be the hardest semester in her nursing program. Her grade is presently a 2.5, but she is used to getting 3.5s and 4.0s. In addition, her youngest child has developed chronic ear infections―ah, the joys of being a mother and a nursing student.

There is quite a singificant psychological component here with some psychophysiological insomnia related to his underlying anxiety. Moving forward, treatment of this will be of paramount importance. Alongside this, there are some sleep hygiene strategies that he can work on and we have discussed these in detail and I have given him some written information for this. Alongside this, we have also started discussion about a sleep study to assess whether or not there is any other underlying sleep disorder that could be contributing to his sleep difficulties and also his unrefreshing sleep even on nights when he is sleeping

The new patient to the clinic is a 27-year-old Native American female who is a mother of two girls, ages 11 and 8 years old. The patient was referred from her primary care doctor after a routine checkup. The notes in the patients chart forward from the doctor stated that the patient is unable to sleep at night due to recurring nightmares. Which is causing the patient to be very irritable, difficultly concentrating, and having high levels of anxiety. The anxiety is causing the patient to be easily overwhelmed, always worried and feeling hopelessness. Also, the patient is noticing memory gaps which are making her have a lack of mental energy throughout the day.

Most urologists do surgically repair many congenital anomalies in children, but the more complex problems are often referred to urologists with specialized training in pediatric urology. The importance of urologic problems seen primarily in women (stress urinary incontinence, interstitial cystitis, urethral diverticula, etc. is being increasingly recognized. The diagnosis and therapy of urinary incontinence constitute a significant portion of most urology practices. New therapies, both surgical and non-surgical, are being constantly developed every day.

His mother stated that Jose’s pregnancy, and delivery were normal. Mother recalls that Jose developmental milestones were reached appropriately, including basic motors skills such as crawling, walking and fine motors skills such as writing. She also recalls that Jose was a physically active child, preferring to climb, jump and run the majority of time. According to client and mother, he has never taken any prescribed medication, suffered any accidents or required hospitalizations. Jose reports fatigue and/or loss of energy very often. It takes him a lot of effort get out of his bed every morning. The lack of energy has been affecting him for more than two years. Furthermore, Jose reports eating more when he is satisfied throughout the day. He recalls that he started overeating since he was approximately twelve years old. Jose experiences difficulty sleeping, with intensified symptoms of insomnia sleeping an average of 4-5 hours per night. He doesn’t recall when he started experiencing insomnia. Jose began abusing alcohol when he was thirteen, drinking five beers at a party and becoming intoxicated. In the present time he abuses alcohol every other week. Jose also reports usage of cigarettes and marijuana since he was fifteen, and still continues to use both substances occasionally. Cigarettes are used more often, and varies from eight to ten per month. He eats brownies made of marijuana, every month or so. Jose reports that father his

These nursing interventions include controlling noise levels for patients during the night, controlling lights, regulating room temperatures to increase comfort, encouraging patients to engage in physical activities during the day, making patients to abstain from alcohol and caffeine consumption, and avoiding day-time napping. According to studies conducted to show whether sleep hygiene nursing interventions improved sleep, inconsistent outcomes were found. Since the intervention was easy to apply, some studies found it to have medium scientific quality while others found it to have little effects on the patients (Hellström & Willman, 2011).

(Ladwig, 2012-2014) Potential Nursing Intervention for diagnosis R/T LHI #1: To assist Mr. H, and help to identify significant health needs. The alternate approach used to address his personal needs, such as lifestyle changes, adequate nutrition, compliance with regular blood glucose check and Insulation administration and education on proper footwear. (Ladwig, 2012-2014) Potential Nursing Intervention for diagnosis R/T LHI#2: Teach Parent and children the importance to report any changes in condition R/T skin integrity.

his parents – who he says, worry a lot about his moodiness and irregular sleep

The staff has an understanding that timing is crucial in a young child’s life, a child will not retain information after a certain age, so it is important to address issues when they are detected rather than wait and cause more problems later on down the line. The structured daily routines are generally the same unless it is a holiday or a day to celebrate birthdays, so I will not include any of these special events.

Protocol and guidance writers are increasingly using evidence based practices within the development stage. Using guidance based on evidence assists health and social care professionals keep up to date, and prevents the need for vasts amount of personal research. Moreover, service users are more likely to accept advice given with the credence of evidence. The Open University (2014), (K101 Introduction to Health and Social care, Block 4, Making Care Safer, 2015) shows some practical information, from NICE, on managing children with nocturnal enuresis. The evidence based information provides a pathway for care workers to follow. However, evidence

As nurses we deal with several different patients in a day and it is important to understand the patient as a whole person to treat them effectively. The purpose of this assignment is to explore a patients disease to understand the nursing judgments and interventions that go with this patient, to understand medications for this diagnosis, and to understand the disease the patient was diagnosed itself. The patient described in this paper will be referred to as Jonathan to ensure patient confidentiality.