Apply clinical reasoning and critical thinking to develop a plan of care.

Whilst this written assessment will predominantly cover content provided through the renal and endocrine focused workshops there will be knowledge required that was learnt throughout this subject inclusive of workshops, clinical labs, simulations and your own self-directed learning through your pre & post session preparation.This is an individual assessment task based on a patient clinical scenario where you are expected to apply clinical reasoning and critical thinking to develop a plan of care. <!--ASSESSMENT OVERVIEW-->Assessment Overview

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Purpose

The purpose of this assessment task is to:

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• Reveal your level of understanding of the content that was provided in the workshops, clinical labs, simulations and your self-directed learning through your pre & post session preparation. 

The knowledge that you have gained from the unit will have provided you with the theoretical underpinning of caring for a patient with acute and chronic conditions using evidence-based practice. Your newly found skills will provide the foundation for safe practice in the preparation and administration of medications and the ability to work with your mentor to intervene using clinical reasoning in a timely manner.  This developed practice underpins the Registered Nurse Standards for Practice. 

 learning outcomes

Learning outcomes 1, 2, 3 & 4 align to this task

1. Articulate critical thinking and clinical reasoning related to evidence-based nursing practice in the assessment, planning, implementation and evaluation of the treatment and management of acute and chronic conditions from the infant to the older adult;  

2. Demonstrate understanding related to the nursing standards, nursing code of conduct, code of ethics and legal considerations with the inclusion of digital health encompassing the care of the patient with acute and chronic conditions.  

3. Evaluate the pathophysiological concepts, processes, progression and complications associated with acute and chronic conditions of the cardiac, respiratory, endocrine and renal systems, linking pharmacological treatment options to inform person-centred care;  

4. Advocate the importance of cultural awareness within nursing practice, the engagement of the patient in decision making and the role of the interprofessional healthcare team.

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Assessment DETAILS

This assessment is from the material presented in the unit during the block.   It would be valuable to undertake your assessment preparation as you work through each of your workshop, clinical lab and simulation session content, by taking summary notes or reminders of the important points your facilitators have directed your focus to during your classes.Please note that if your assessment goes over the word count the information after this will not be assessed therefore make sure your word count is no more that 1650 words.  Likewise, if your word count is below the allocated word count you will not have sufficient information to contribute to your grade.The mini summaries provided via VU Collaborate learning space are also valuable tools in completion of this assessment. The written assessment task is related to a case scenario below.Through application of critical thinking and clinical reasoning you are to explore the following points: 

• patient’s history, presenting problems and the related pathophysiological processes to identify priority problems

• comprehensive assessment, i.e. specific observation, assessment tools and or tests

• formulate nursing interventions and or treatments, with rationales 

• consider relevance of specific nursing standards, code of conduct, code of ethics and legalities and relevant legislation

• adherence to cultural awareness and diversity considerations

 Scenario:

Lorenzo Russo, a 68 year old male of Italian heritage, has was admitted to your ward at 1445 hours yesterday with a 2 day history of vomiting and diarrhea related to food poisoning.  He has a past history of Type 2 Diabetes Mellitus, is a current smoker, increased BMI, and hypertension.  In your morning handover it is revealed that his IVC tissued (phlebitis) overnight and the staff have been unable to resite it as his veins were difficult to cannulate and the Registered Medical Officer (RMO) has been busy with a deteriorating patient. He has not received IV hydration since 0100 hours. His last urine output, at 2345 hours, was 70mls and it was concentrated/dark in colour.   A bladder scan at 0500 hours showed no residual urine.  His last episode of vomiting and diarrhea was at 0515 hours.  He has dry mucous membranes, poor skin turgor and cool peripheries indicating dehydration.  The morning RMO orders UECr blood tests and is preparing to recannulate for a stat IV bolus of Normal Saline (0.9% NaCl). It is now 0735 hours.

His recent vital signs at 0730 hours are:BP 90/60 mmHgHR 115 bpmRR 18 breaths per minuteSpO2 94% Room Air via finger probe and his SpO2 has consistently been 94-96% since admissionT 36.6 
 Utilising best practice research, contemporary evidence and the nursing standards to assist, students are encouraged to link any relevant Cultural considerations, Pathophysiology and Pharmacology to the case study patient to compliment any suggested nursing care and management. 

1. Based on your initial impression, other than dehydration, what do you think is NOW happening with Lorenzo? In your answer please provide relevant pathophysiology. 

2. What clinical impression, together with signs and symptoms, is Lorenzo presenting with that formed your impression of the condition you believe he is now suffering from and why do these signs & symptoms occur (the underlying pathophysiology)?

3. Discuss the nursing care and management, using evidence-based literature, required for managing and maintaining Lorenzo’s potential diagnosis (what do you think is now happening),  in a culturally safe manner, with rationales as to why this care is provided. Include relevant medical and pharmacological treatment options.

4. List two ACUTE potential problems that Lorenzo is at risk of due to this current condition that you think is occurring.  Provide rationales as to why these are potential risks and three nursing management preventative strategies for each of these problems.

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 essay structure

Your case-study essay should be structured as follows: Introduction

• Start by setting the context and providing relevant background information however keep this limited as there is no need to repeat the entire given scenario

• Summarise the main aim or points of the case-study by outlining the main ideas to be discussed, in the order they appear in the body of the essay

Body (You may type each question into the body and provide your response underneath.  The questions will not be included in your word count)

• Each paragraph should cover a single idea expressed in a topic sentence, followed by supporting evidence and examples from contemporary academic literature, including peer-reviewed journal articles.

  Conclusion: A summary of your appraisal.

• Sum up your main points

This is an academic assignment; therefore, academic standards inclusive of grammar, sentence structure, paraphrasing and APA 7th edition referencing for both in-text citations and referencing apply.All written assessments must align to the following academic standards:

• use high-level quality contemporary evidence-based literature to inform the discussion and critical analysis, date of evidence within five years;

• use of the third person, unless specifically indicated otherwise;

• APA 7th edition for in-text citations and reference list;

• the following structure: an introduction, body and conclusion or as per directions in the assessment instructions;

• adherence to the word count; ten percent allowed either side of word count;

• a 12 size font in either Arial, Times New Roman or Calibri;

• 1.5 line spacing; and

• submitted using an MS word document only.

All assessments should have a title page that specifies: 

• Unit Code & Unit Name

• Student Name

• Student Identification number

• Title of assignment

• An accurate word count that includes in-text citations, but excludes the reference section at the end of the essay

The academic learning hub is a useful service that can assist in the essay planning process. 

Instructions

 
To get started on your assessment task, please follow the below instructions.

1. Read through the case study, essay instructions and rubric for this assessment task

2. Use the above essay structure when writing your essay

3. Write your essay using contemporary evidence-based literature and alignment with academic standards

4. Refer to the RUBRIC when writing your assessment

5. Check for similarity using Urkund system  

6. Submit your work into the drop box before the due date by following the submission instructions below

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Assessment Criteria Students will be assessed against whether they provide a detailed, correct and complete answer to the questions utilising their clinical reasoning and critical thinking abilities. In collaboration with the assessment rubric, the following criteria will be used to grade this assessment task:

1. Application of clinical reasoning 

2. Critical appraisal of issues 

3. Adherence to nursing standards 

4. Inclusion of Pathophysiology evaluation 

5. Cultural awareness advocacy 

6. Professionalism demonstrating person-centred care