NSB132 Integrated Nursing Practice: Clinical Case Study Assessment Task 2 Answer

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NSB132

Integrated Nursing Practice: On-Campus ASSESSMENT TASK 2

Assessment Task 2

Assessment name:Clinical Case Study
Task description:This assessment requires you to choose one (1) priority problem impacting both of the two (2) cases. Then by applying your knowledge of evidence-based nursing practice and following the steps below demonstrate your understanding as to how to plan and evaluate person centered care for each person in the case studies.
What you need to do:Step one
Select ONE (1) priority problem (from the list below) which will be relevant to both of the case studies (cases are at the end of the task description).
Priority health problems: (Choose 1 only)
  1. Pain
  2. Compromised safety: Falls risk
  3. Impaired hydration
Step 2
Using peer reviewed, current and relevant literature to support your responses, address the following points in relation to your chosen problem:

Identification and Interpretation of Assessment Data: Identify assessment data related to the chosen problem in each of the case studies. Explain what physiological changes have occurred for the people to experience the identified assessment data.

Discuss the similarities and differences between the presenting assessment data for each case demonstrating your understanding of age and developmental based differences in the assessment data.

Development of Goal for Care using SMART Framework: From the position of your chosen priority problem, and using the SMART framework, write a goal of care to address the chosen problem.

The goal needs to consider the uniqueness of the cases and be relevant to the priority problem and the context of the case studies. The SMART framework headings can be used to present your goal. Supporting evidence is not required for this task.

Evidence-Based and Person Centred Interventions to Address the Goal for Care:

Choose TWO (2) evidence-based interventions (at least one
must be nurse initiated) to address the goal of care.
Justify your choice of intervention and discuss how the two
(2) interventions need to be modified to meet the unique
needs of the people in each of the cases based on their age and developmental differences.



d) Evaluation of the Efficacy of Interventions:
Discuss how a nurse would evaluate the efficacy of the two interventions and identify the expected positive changes in assessment data. In your response discuss similarities and differences in the approach to evaluating the cases based on their age and developmental differences.
Note: for c) the same two interventions will be recommended for both cases, but you need to discuss how these would be modified to suit the needs of the individual.
This is an individual assessment
Length:1500 words (± 10%; excludes reference list, includes in text referencing)
– using academic writing
Estimated time to complete task:Approximately 25-30 hours
Weighting:40%
How will I be assessed:7 +/- point grading scale using a rubric
Presentation requirements:There are four (4) parts to this assessment. Headings can be used to structure your responses.
Your assignment must be written in CiteWrite APA 7 style and prepared as follows:
  • Make your own cover sheet with the assessment title, your name, student number, tutor name and word count.
  • Include a ‘footer’ on each page with your name, student number, unit code and page number.
  • 2 cm margins on all sides, double-spaced text
  • Use font, such as Times New Roman, Arial or Calibri; font size 12
  • CiteWrite APA 7 style referencing. Note it is a requirement that you include page numbers for all in-text references
  • Conventions of academic writing with a comprehensive response to each task is required. Formal essay style with an introduction and conclusion is not necessary but each response needs to follow conventions of English grammar i.e. the response to each task must use correct and logical paragraph structure that supports the development of your discussion.
  • Use of appendices, figures or tables, and dot points are NOT
acceptable


Learning outcomes assessed:
  1. Apply and integrate knowledge of the key NMBA Registered Nurse Standards for Nursing Practice, National Safety and Quality Health Service Standards, and National Health Priorities to enable effective clinical decision making, planning and action.
  2. Apply the underpinning knowledge of anatomy, physiology and pathophysiology to support evidence-based decisions for planning and action.
  3. Apply clinical reasoning and decision-making frameworks and beginning level communication skills to the development of foundational person-centred care plans for individuals across the lifespan.

Case Studies

Scenario 1: Henry
Situation
Henry is a nine-month-old boy admitted today to the emergency department with his mother for review of a two-day history of fever, cough, nasal congestion, difficulty swallowing (which Mum thinks could be related to a sore throat) and increased lethargy. He has been diagnosed with a viral upper respiratory tract infection (URTI).
Background
Henry has been unwell with a two-day history of fever, moist cough, blocked nasal passages and an apparent sore throat resulting in an overall reduced oral intake. Henry is normally very active and is breast fed 4 times a day with three solid meals per day and water by cup. Today his mother noticed that he is sleeping more than usual, appears to be avoiding swallowing so is dribbling more, is breast feeding for shorter periods and refusing other fluid, and is irritable when he is awake.
Henry lives with his parents, three-year-old sister who attends day care three days per week and has had similar symptoms five-days ago, and his grandparents. Henry has no other relevant medical history and is up to date with his immunisations.
Assessment
Weight: 9kg
Medical History: Nil significant, Nil allergies Current medications: Nil
Nutrition: Nil orally since arriving at ED. Mother reports Henry can tolerate short breast feeds but pulls away due to nasal congestions.
Oral mucous membranes are pale, fontanelle mildly sunken, skin turgor less than 2 seconds, last wet nappy 8 hours ago and no palpable bladder. Mother estimates he has had less than 50 mls of water and six short breast feeds in 24 hours. All solids were refused.
Assessment data: Temperature 38.7 0 C, BP 85/60, HR 140, R 54, SpO 100% on room air, moist cough, inflamed throat on examination.
His cheeks are warm to touch, and are flushed; extremities are cool to touch
Drowsy but rousable, cries when woken, sitting on mother’s lap or in cot. Appears lethargic.
Pain: 4/10 (observational pain scale used), occasional grimace and cries when awake and difficult to console.
Recommendations
Henry will be observed for the next 8-hours in hospital where you need to conduct the appropriate assessments and provide care. Intravenous fluid therapy (IVT) is not indicated.


Scenario 2: Gerald
Situation
Gerald is a 78-year-old man who was recommended to attend the emergency department 
with his wife by his General Practitioner (GP). Gerald has had a two-day history of painful ribs ‘from coughing’, sore throat and headache, productive cough, nasal congestion, difficulties breathing and increased lethargy. He has been diagnosed with a viral upper respiratory tract infection (URTI), and exacerbation of asthma.
Background
Gerald has been unwell with a two-day history of headache, sore throat, productive cough, blocked nasal passages and increasing difficulty breathing. Due to a sore throat, Gerald has not been drinking or eating for 24 hours. Today Gerald has followed his Asthma Action Plan which includes two puffs of Salbutamol every 30 minutes. He has taken two puffs of Salbutamol three times over the last two hours with little effect, and he has reported feeling increasingly drowsy.
Gerald lives with his wife, their son and daughter in-law and their two children (Alex 3 and Henry 9-months) who are both unwell with the same symptoms. Gerald has a history (20+ years) of Asthma but no history of admission to hospital due to exacerbation of asthma.
Gerald has no other relevant medical history and is up to date with his immunisations.
Assessment
Weight: 80kg
Medical History: Asthma, Nil allergies
Current medications: Budesonide inhaler (1 puff mane), Salbutamol (1-2 puffs PRN), Paracetamol 1g (PRN)
Nutrition: Normally full diet and is independent; reports low oral intake for the last 24 hours due to sore throat.
Oral mucous membranes are dry, skin turgor greater than 2 seconds, capillary refill delayed, has not voided for 8 hours and no palpable bladder. He estimates that he has had 500ml water in the last 24 hours and has had no other oral intake.
Assessment data: Temperature 37.5 0 C, BP 115/80, HR 110, R 24, SpO 97% on room air, audible wheeze on inspiration, moist cough, inflamed throat on examination.
His extremities are cool to touch.
Drowsy but rousable to light tough. Orientated to person, not always orientated to time and place.
Pain: Self report 5/10, location- painful ribs and headache; 7/10 pain in throat when he swallows
Mobility: Independent Elimination: Continent
Recommendations
Gerald will be observed for the next 8-hours in hospital where you need to conduct the appropriate assessments and provide care. Intravenous fluid therapy (IVT) is not indicated.


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