• Internal Code :
  • Subject Code : 92440
  • University : University of Technology Sydney
  • Subject Name : Nursing

Complex Patient Plan of Care

Table of Contents






The report that we are going to make primarily deals with the potential diseases such as: Firstly comes to the aspect of the Hyponatremia and then comes to the disease named as the bilateral leg spasms. In addition to this we are also going to state that this two physiological disease are currently faced by the patient named Alice McCullam. Other than this we are also going to make a vivid and a detailed account about the symptoms that the two mentioned disease have and then we are also going to provide certain detail about the care plan that the concerned nurse is going to chalk out in order to treat or handle the concerned patient (that is Alice McCullam in this case) in an effective manner (Shah, 2019).


Identification of health problems

It is an evident fact to be mentioned in this report that the two crucial Physiological diseases that are being diagnosed in the body of the concerned patient (that is Alice McCullam in this case) are as follows: Firstly comes the Hyponatremia and secondly comes the Bilateral Leg Spasms and the symptoms that are being faced is detailed in the below mentioned portions.


It is quiet an evident fact to be mentioned in this report that the concerned nurse has noticed that the Sodium level in the blood samples of the concerned patient (that is Alice McCullam in this case) is quiet low in nature and that is one of the factor which helps the nurse in coming to the conclusion that the patient that is Alice McCullam in this case is facing the disease of Hyponatremia. In addition to this there are some other symptoms that the concerned patient (that is Alice McCullam in this case) is facing and they are as follows: Firstly the concerned patient (that is Alice McCullam in this case) is having frequent Nausea and vomiting, secondly the concerned patient is also facing the issue of confusion in the mind which is one of the symptom for the Hyponatremia, then comes to the issue of the loss of energy and drowsiness which in turn is making the health condition more worse, the concerned patient ( that is Alice McCullam in this case) is also facing with the issue of the muscular spasms and weakness and that is one of the vital symptom of the Hyponatremia in the concerned patient, in addition to this it is also an evident fact to state that the concerned patient ( that is Alice McCullam in this case) is facing the problem of the restlessness and the factor of the irritability and that is quiet an extreme symptom of the Hyponatremia and the last two symptoms that are observed by the concerned nurse are as follows: Firstly the seizure symptoms and the extreme one is the coma which might finally leads to the death of the concerned patient ( that is Alice McCullam in this case). In addition to this the diagnoses also revealed the fact that the fact that the sodium content in the body of the concerned patient (that is Alice McCullam in this case) gets diluted and that is quiets a dangerous situation of the Hyponatremia. Other than this it is also detected that the cells of the patient’s body (that is Alice McCullam in this case) is getting swelled and that in turn leads to the various types of the health disorders. It is also an evident fact to state that there is a chance that the level of the water in the body of the concerned patient (that is Alice McCullam in this case) gets rise beyond the level of the prescribed range and that is quiet dangerous for the health of the concerned patient (that is Alice McCullam in this case). In addition to this it is found that the Sodium level in the blood of the concerned patient falls below the level of the 135mEq/L which is quiet life threatening in nature. Other than this the risk factor of the concerned patient (that is Alice McCullam in this case) is quiet high in nature because of the age factor as the age of the patient is 74years (Sivakumar, 2020 ).

Bilateral Leg Spasms

The diagnoses that is made by the concerned nurse also revealed the fact that the concerned patient (that is Alice McCullam in this case) is also facing from the diseases that is called Bilateral Leg Spasms and because of that it is revealed that the leg muscles of the concerned patient (that is Alice McCullam in this case) is becoming tight (that means it is losing the flexibility) and that in turn leads to the pain which is quiet harmful for the patient. In addition to this it is also revealed the main causes of such kind of disease are as follows: Firstly due to the fact of the dehydration in the body, then comes the fact that there is a scenario where there is abnormalities in the electrolytic level in the body of the concerned patient (that is Alice McCullam in this case). The last factor is the abnormality in the metabolic activities in the body of the concerned patient (Lin, 2020).

Identification and Development of Appropriate Rationalized Nursing Interventions

Nurses should be able to improve capacity by adapting to living and sustainable care and planning while making changes for the concerned patient. In this way, temporary role change is generally less the comparison with the role of a lasting change associated with someone else who is often associated with independent and self-respecting patients less that can lead to changes in life and increased dependence. Examples of temporary role changes include return information that prohibits someone from working and that patients are unable to care for a suitable child due to physical or mental problems such as a broken leg or substance abuse; An example of the lasting role of change is paralyzed because the child is neglected and the primary patient is paralyzed by the lack of power to act as a result of neglect. Also, temporary role changes can often create anxiety and stress (Guerrero, 2019).

After a comprehensive assessment of Alice McCallum and his response to the role change, the design of the appropriate nurse plan for the individual patient and their needs were assessed. This includes helping nurses and patients to recall their actual feelings about this loss in a recognized relationship and involving the patient to identify their true expectations and then the nurse can help the patient respond to the role and respond permanently and temporarily. Feel the ventilation and encourage and assist patients to identify and identify real goals and set realistic expectations of what they can do even after some change and loss.

All these changes threaten human homeostasis. For example, the concerned patient needs to be able to deal effectively with psychological,physical, economic, and social changes in adaptive and healthy way with coping life. Moreover,life changes can be categorized as permanent or temporary, significant as physical and emotional and social, and face to face or adult. Regardless of the specific changes, all changes need to be made. These changes affect not only individual patients, but also family units, groups, populations, and communities around the world.

The patterns of temporary and permanent change are physical divisions that occur as explosive bombs and episodes of despair or grief, respectively; the pattern of social, physical, and psychological can include treatment for muscle weakness and bilateral leg spasms.

In this way, nurse work with physicians and other specialists, as well as care teams that work together to determine the interventions needed for specific patient. The nurse intervention falls into three main categories that determine the caring professional for the patient's intervention:

Dependent: This nursing intervention needs a doctor's order for the concerned patient, is that ordering a prescription for a new medication.

Interdependent: Nurse can work without input or supportive intervention from others. Also, she carries out this intervention by includingeducating patientto manage the importance of the medication as prescribed to her.

Collaborative: The nurse works with several members of the care team to perform the intervention. In this case, the nurse carries out this intervention include patients being prescribed pain medication by a physician recovering from knee surgery, medications prescribed by a nurse, and provided physical therapy exercise by a specialist (Lairdet al. 2015).

Identify the Intended Goals of Care and Patient Outcomes

Although nursing interventions are broadly applied in the management of chronic pain, a meta-analysis with clinical trials has shown that the results of this study are inconclusive. This particular study was unable to make a decision because it did not include various therapeutic interventions. Along with that, clinical practice guideline andinternational organization for determiningquality control suggestedadding the non-pharmacological interventions in pain management. In this way, the role of the nurse is crucial in this situation. Moreover, nurse has the experience, skills, experience,professionalism, and responsibility to play a leading role in the care of chronic pain patients. The quality of life of the patient depends on her.

The fifth step in the process is to evaluate the results, try to explain the results, and evaluate the results of the evidence presented (intervention). The result can be psychosocial (improved quality of life, better patient care, treatment of depression and anxiety), physiological (reduced complications, and improve health) or functional improvement. Besides, the process of evaluation and results can occur through self-evaluation, observation and reflection. Depending on the results obtained, the results of the study can be compared with similar results at the local, regional, national or international levels (McCaffrey& McConnell,2015).

For the classification to be effective, it must allow physicians to arrive at an accurate diagnosis and apply appropriate therapy. A standard that you must make valid and available over time must inform you. Unfortunately, as shown in the selected (and biased) cases, the existing CDA does not rely on these values. In part, these errors can be accurately described because many physicians feel that it is not possible to diagnose any disease when applying the data available in the CDA. However, certain standards must be met before proceeding with CDA, which in itself is a weak point and does not necessarily stop diagnosis and treatment. In our analysis, the most serious error was the failure to resist acute hyponatremia as a first step. The second weak point is the misconception that nurse can detect mild to moderate ECF volume contraction through physical examination supported by regular laboratory data (Jones, Shaban & Creedy, 2015).

In this case, this is the most obvious evidence as it is lead to actual problem: Sepsis related to the infection & Potential problem and Deep vein thrombosis that can be potentially dangerous because of eventual haemo dynamic collapse. Although laboratory tests are preferred, the clinical situation is more common in this case, which do not recover and can lead to adverse outcomes. Furthermore, it should be a diagnosis of exclusion and should only be considered if there is an adrenal, thyroid and pituitary deficiency.

Another problem to remember is that traditional theoretical theory often relies on generalizations rather than reliable data. This case is referred to the requirement to find hyperkalaemia to diagnose Alice McCallum’s disease and assume Improved significantly with IV 0.9% Sodium Chloride with nil motor dysfunction and GCS E4V5M6 under circumstance.In short, the current CDA Standard Architecture provides a sequence of classifications of isolated clinical and / or laboratory parameters. They develop the hyponatremia method, in the pathophysiological context, and do not consider the clinical risk of hyponatremia. These limitations are important for the nurse who deal with hyponatraemic patient and may need them to select varied approaches (Slemon, Jenkins, & Bungay, 2017).


The Cure Plan of the nurse in order to handle the concerned patient (that is Alice McCullam in this case) who is suffering from Hyponatremia and Bilateral Leg Spasms have several phases and they are as follows: Firstly it involves the phase of the assessment of the disease in a very effective manner, then comes the phase of the Diagnosis of the disease in a proper way so that proper treatment can be carried out and the patient gets cured at a very fast pace, then in the third phase comes the planning of the way by which the treatment will be done , then comes the aspect of the implementation of the plan in a proper way and the ;last but not the least is the aspect of the evaluation (Bridges, 2020).


Guerrero, J. G. (2019). Practice Rationale Care Model: The Art and Science of Clinical Reasoning, Decision Making and Judgment in the Nursing Process. Open Journal of Nursing, 9(2), 79-88.

Jones, T., Shaban, R. Z., & Creedy, D. K. (2015). Practice standards for emergency nursing: An international review. Australasian Emergency Nursing Journal, 18(4), 190-203.

Laird, E. A., McCance, T., McCormack, B., & Gribben, B. (2015). Patients’ experiences of in-hospital care when nursing staff were engaged in a practice development programme to promote person-centredness: A narrative analysis study. International journal of nursing studies, 52(9), 1454-1462.

McCaffrey, G., & McConnell, S. (2015). Compassion: a critical review of peer‐reviewed nursing literature. Journal of Clinical Nursing, 24(19-20), 3006-3015.

Slemon, A., Jenkins, E., & Bungay, V. (2017). Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry, 24(4), e12199.

Bridges, E., Altherwi, T., Correa, J. A., & Hew-Butler, T. (2020). Oral hypertonic saline is effective in reversing acute mild-to-moderate symptomatic exercise-associated hyponatremia. Clinical Journal of Sport Medicine, 30(1), 8-13.

Falhammar, H., Lindh, J. D., Calissendorff, J., Skov, J., Nathanson, D., & Mannheimer, B. (2019). Antipsychotics and severe hyponatremia: A Swedish population–based case–control study. European journal of internal medicine, 60, 71-77.

Lin, B., Sivakumar, K., Yacoub, H., Varrato, J., Walsh, A., & Romano, A. (2020). Stiff Limb Syndrome: A Rare Variant of Stiff Person’s Syndrome (4487).

Shah, A., Sabir, S., Artani, M., Salam, O., Khan, S., & Rizwan, A. (2019). Significance of hyponatremia as an independent factor in predicting short-term mortality in patients with hemorrhagic stroke. Cureus, 11(4).

Shields, L. B., Iyer, V. G., Zhang, Y. P., & Shields, C. B. (2019). Missed thoracic myelopathy: Do not throw the hammer away yet. Surgical neurology international, 10.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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