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The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health One aspect of their care will be discussed in relation to the nursing process The model used to provide an individualised programme of care will be discussed and critically analysed Jack the patient presented through Accident and Emergency to Ward D3 an acute medical ward specialising in respiratory medicine He was admitted due to an exacerbation of dyspnoea which was more significant over the last twenty-four hours The writer met Jack on admission to the ward Jack a 58 years old engineer is divorced with one daughter Jack is a smoker for the past thirty years he smokes twenty cigarettes a day He has a family history of lung cancer his father died two years ago from lung cancer Jack has a four-year history of dyspnoea He has also experienced a persistent cough productive of a small amount of yellow stained sputum The cause of these symptoms had not been determined as Jack has not visited his general practitioner in fifteen years In the twenty-four hours prior to his admission Jack noticed a considerable increase in his symptoms he was now dyspnoeic at rest and could not mobilise as it caused him considerable respiratory distress Jack called his daughter who in turn accompanied him to hospital The model used to plan Jacks care was the Activities of Living Model developed by Nancy Roper Winifred Logan and Alison Tierney 1980 It is the model used on the ward as it facilitates individualised and holistic nursing care In conjunction with the nursing process it is possible for nursing interventions to be planned implemented and evaluated following the initial assessment with the patient to identify actual and potential problems for each of the activities of living The initial assessment provides a baseline for future assessments as assessment is an ongoing activity beginning on
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