Acute Alterations in Health in Complex Care Environments NURS13141

Unit Code: NURS13141

Unit Title: Acute Alterations in Health in Complex Care Environments

Assessment 2: Case study

Type: Case Study

Due Date: 16:00PM (AEST), Wednesday 4^th June 2025 (Week 12)

Extensions: Available as per policy

Return to Students: 16:00PM (AEST) Wednesday 25^th June 2025

Weighting: 50%

Length: 1200 words +/-10% (excluding cover page and reference list)

Unit Coordinator/s: Ingrid Wise (Lead), Danielle Le Lagadec and Wendy

Augutis

Learning outcomes assessed

1. Explain the pathophysiological changes that occur when a person experiences acute alterations in health.


2. Apply the decision-making framework for nursing (Nursing Midwifery Board Australia (NMBA) 2020) to prioritise and justify care for the person experiencing acute alterations in health.


3. Examine the role of the nurse and other members of the interdisciplinary team in the care of a person in a complex care environment.


4. Analyse and apply the best available evidence for safe quality practice for a person experiencing an acute alteration in health.

Aim

The aim of this assessment is for you to demonstrate your knowledge regarding the management of a person with an acute alteration in health. Read the following case study to answer this assessment task.

Case Study Mr Peter Harrison

Time and Location: 07:30 hour, Cardiac Ward

You are a graduate RN assigned to the care of Mr Peter Harrison. The night duty nurse gives you the following ISBAR handover at the bedside:

Identity:

This is Mr Peter Harrison, a 70kg, 67-year-old male who identifies as male. His UR number is 654321, and his date of birth is 14/08/1957.

Situation:

Peter was admitted to the Cardiac Ward at 22:00 hours last night following presentation to the Emergency Department with ongoing chest pain. After treatment in the ED, Peters symptoms were partially relieved, and he was diagnosed with unstable angina. Overnight, Peter began to experience additional symptoms, including nausea, abdominal discomfort, and deep, laboured breathing. His capillary blood glucose readings have been steadily increasing, reaching 26.4 mmol/L, and urinalysis results are positive for ketones and glucose.

Background:

Peter has a history of Type 1 Diabetes Mellitus (T1DM), hypertension, and hyperlipidaemia. His T1DM is managed with multiple daily insulin injections comprising insulin aspart on a sliding scale before meals and 15 units of insulin glargine at night. Peters glycaemic control has been inconsistent, attributed to irregular dietary habits and hospitalisation. Peter also takes Ramipril 10mg daily and Atorvastatin 20mg daily. Peter lives alone, works part-time as a taxi driver, and occasionally walks for exercise. He is a non-smoker, drinks socially, and has no known allergies.

Assessment:

Peter appears pale and diaphoretic, and states he is feeling increasingly fatigued. He reports nausea and abdominal pain (3/10), and you note he demonstrates some signs of confusion. Observations are as follows:

• Respiratory Rate (RR): 26 breaths/min (deep, laboured)


• SpO2: 94% on room air


• Blood Pressure (BP): 132/76 mmHg


• Pulse Rate (PR): 92 bpm (regular)


• Temperature: 1C


• Capillary Blood Glucose: 4 mmol/L


• Capillary Blood Ketone: 1 mmol/L


• Urinalysis: Positive for ketones and glucose


• Arterial blood gases: indicate metabolic acidosis (HCO3 14 mEq/L; PaCO2 34 mmHg), with a pH of 7.2, and an elevated anion gap (13 mEq/L).

Recommendations:

Peter requires immediate intervention. As the RN on duty you are required to take appropriate action.

Instructions

Please follow the steps below to complete this assessment task.

1. Please identify and discuss on four (4) appropriate, priority nursing interventions to manage Peters current health concerns. Each intervention should be discussed in detail, focusing on its importance, rationale based on the pathophysiological changes, and evidenced using appropriate literature. Approximately 250 words per intervention (LO1, LO2, LO4).
   
   
   
   • Use the headings Nursing Intervention, Rationale and Evidence under each action point.
   
   
   
   


2. Please outline one (1) collaborative intervention involving the multidisciplinary healthcare team. Identify an appropriate specialist or member of the multidisciplinary team and discuss what you would request of them. Justify why they should be involved in the management of Peters sudden deterioration in health, support your decision with appropriate evidence from the literature. Approximately 200 words (LO2, LO3, LO4)

• Use the headings Multidisciplinary Intervention, Rationale and

Evidence under each action point.

Literature and references

In this assessment use at least 7 contemporary references (7 years or less) sourced from the CQUniversity library to support your discussion. You may also use seminal scholarly literature where relevant. Suitable references include peer-reviewed journal articles as well as textbooks and credible websites. When sourcing information, consider the 5 elements of a quality reference: currency, authority, relevance, objectivity, and coverage. Grey literature sourced from the internet must be from reputable websites such as government, university, or peak national bodies: for example, the Australian College of Nursing, the Australian Association of Social Workers, Australian Bureau of Statistics, Australian Institute of Health and Welfare. Note, that websites such as StatPearls, Life in the Fastlane, and Wikipedia are not suitable for this assessment task. Lecture notes are not primary sources of evidence and should not be used in this assessment.

Requirements

• Use a cover page for your assignment that includes in the following information:
  
  
  
  • Student name
  
  
  • Student number
  
  
  • Unit code and name
  
  
  • Assessment type
  
  
  • Due date
  
  
  • In-text word count
  
  
  
  


• Use a conventional and legible size 12 font, such as Times New Roman, with 0 line spacing and 2.54cm page margins (standard pre-set margin in Microsoft Word).


• Include page numbers on the top right side of each page in a


• Indent the first line of each paragraph 1.27cm (standard pre-set indent in Microsoft Word).

• An introduction and conclusion are not required for this


• All questions (Steps 1 and 2) in the Instructions of this assessment must be attempted and clearly answered to pass this assessment task.


• Write in the third-person


• Use formal academic, discipline-specific, professional and inclusive


• Use Microsoft Word English (Australia) spelling and grammar


• Paraphrase and summarise information acknowledging the original source (referencing) to avoid Please avoid direct quotes in this assessment.


• Headings are utilised in this


• Follow academic writing conventions: spell out contractions in full; introduce abbreviations and acronyms; spell out numbers for zero through nine and use numerals for numbers 10 and above.


• All work submitted must be your own


• Start your reference list on a separate page to the body of your


• Use the seventh edition American Psychological Association (APA) referencing style. The CQUniversity Academic Learning Centre has an online APA Referencing Style Guide.


• The word count is considered from the first word of the case study to the last word of the case The word count excludes the cover page and reference list but includes in-text references and direct quotations.

Resources

1. You can use unit-provided materials and other credible sources (e.g., journal articles and books) to reference your The quality and credibility of your sources are important. Please note, that lecture notes are not peer-reviewed primary sources of evidence.


2. We recommend that you access your discipline-specific Nursing Resource Guide


3. You may like to manage your citations and reference list. Information on how to use academic referencing software (EndNote) is available at the CQUniversity Library website should you wish to learn how to use it.

4. For information on academic writing and referencing, please visit the Academic Learning Centre Moodle site. The Academic Communication section has many helpful resources, including information for students with English as a second


5. You may wish to submit a draft to


6. Submit at least one draft before the due date to review your Turnitin Similarity Score before making a final submission. Instructions are available here.

Academic Integrity

1. You must abide by the principles of academic integrity (see Student Academic Integrity Policy and Procedure). Completion of this assessment with another party or sharing of responses is not permitted at any time.


2. The use of any generative artificial intelligence is not permitted in this

Submission

Submit your assessment via the unit Moodle site in Microsoft Word format only.

Late penalties of 5% per day, or part thereof, of the available marks, may be applied as per the Assessment Policy and Procedure (Higher Education Coursework).

Contact TASAC if you experience technical issues submitting your assessment:

• Phone toll-free 1300 666 620


• Email tasac@cqu.edu.au

Marking Criteria

Refer to the marking rubric on the Moodle site for details on how marks will be assigned. Assessment re-attempt is not available for this Assessment task.

Minimum Pass Criteria

• You must achieve a cumulative grade of at least 49.5?ross all assessments to pass this unit.

• In order to be eligible for a supplementary assessment, all assessment tasks must be reasonably attempted in this unit.