IMS407 Assessment item 1- Clinical Reasoning Cycle Complex Scenario

Assessment item 1 - Clinical Reasoning Cycle Complex Scenario

Value: 50%

Due Date: 29th March 2023

Return Date: 21st April 2023

Length: 1800 words

Group Assessment: No

Submission method options: Turnitin Assignment Portal

TASK

This assessment task requires you to utilise the case study provided on the NRS387 subject Interact2 site and use the template provided under assessment 1 to address each of the following points:

Describe provide an overview of the scenario (consider the person and context. Location people situation (approx. 150 words)

Collect Cues Collect relevant assessment cues and identify additional assessment data that may be required (approx. 100 words)

Process Information compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference/s needed (approx. 250 words)

Synthesise Identify the main clinical issues for the patient. Identify and provide an overview of the pathophysiology of the main health challenge evident in the case study. Reference/s needed (approx. 250 words)

Establish goals -identify three (3) person-centered desired outcomes for this patient that are relevant to the scenario (approx. 200 words)

Select a course of action outline three (3) nursing interventions, one (1) for each goal, that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. Reference/s needed. (approx. 150 words/intervention, 250 words/rationale)

Evaluate outcomes Explain the process for evaluating the desired outcomes in this scenario (approx. 150 words)

Reflect reflect on what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it) (approx. 300 words)

You are to support your work with academic sources, use in-text references and provide a reference list.

All sources must be correctly referenced in-text and in the reference list in accordance with APA 7th Edition referencing style.

SUBJECT LEARNING OUTCOMES

This assessment task will assess the following learning outcome/s:

be able to identify and apply assessment frameworks and techniques to the care of infants, children, adolescents, adults and older people in a simulated environment.

be able to identify and demonstrate selected evidence-based nursing interventions to promote safety, healing and caring in practice for infants, children, adolescents, adults and older people in a simulated environment.

be able to apply the Clinical Reasoning Cycle to interpret assessment findings, plan, justify and evaluate care in the context of complex clinical scenarios in a simulated environment.

GRADUATE LEARNING OUTCOMES

This task also contributes to the assessment of the following Charles Sturt Graduate Learning Outcome/s:

Academic Literacy and Numeracy (Skill) - Charles Sturt Graduates demonstrate the literacy and numeracy skills necessary to understand and interpret information and communicate effectively according to the context.

Professional Practice (Knowledge) - Charles Sturt Graduates possess the knowledge and understanding of the discipline and the nature of professionalism required for the given profession or discipline in contemporary societies.

PRESENTATION

All items of assessment must be word processed and not handwritten. In addition:

Leave 2 cm margins and double line space your work

Font must be 12pt, unless otherwise indicated.

All pages must be numbered.

Student name and number must be included in the header or footer of every page of every assignment.

A title page must accompany your written assessment task and include the subject name and code, title of the assessment task, due date, lecturers name, student name and student number.

Assessment must be uploaded as a MS WORD document.

REQUIREMENTS

Referencing

Correct and consistent referencing is an important component of producing professional and credible academic work. Marks will be awarded for high quality referencing.

Please refer to the following text for information on how to reference your paper:

American Psychological Association (APA). (2019). Publication Manual of the American Psychological Association (7th ed.). APA.

Students may also access CSUs Academic Referencing Tool (ART) which provides detailed referencing examples for the referencing style - APA 7. This resource can be accessed via the library website.

NRS387 Assessment Task 1: Clinical Reasoning Cycle Complex Scenario

Instructions

This template has developed for you to use to complete Assessment Task 1: Clinical Reasoning Cycle Complex Scenario.

It includes the case scenario information and space for you to complete each part of the assessment task. The portions of the template that you must complete are highlighted in yellow.

Please refer to the Subject Outline for details on the task, marking criteria and standards, presentation and referencing requirements.

Make sure that you add a reference list to the end of this document and include in-text referencing to acknowledge your sources throughout the document in accordance with the referencing requirements in your Subject Outline.

PLEASE DELETE ALL INSTRUCTIONS AND TEXT THAT ARE IN ITALIC (just leave the first column in the table empty if you do not delete the instructions and italic text, your word count will be approximately 500 words over the word count)

Student Name: Enter your name

Student Number: Enter your number

Subject Code: NRS387

Subject Name: Clinical Reasoning in Nursing 5

Assessment item: 1

Assessment title: Clinical Reasoning Cycle Complex Scenario

Due date: 29th March 2023

Word count (excluding reference list and tables):

Assessment Task 1: Clinical Reasoning Cycle Complex Scenario (1800 words)

Describe

Provide an overview of the scenario (consider the person and context. Location people situation 150 words Describe

Collect cues

Collect relevant assessment data and identify additional assessment data that may be required.

100 words

Process Information

compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference needed.

(The number of boxes is not an indication of the number of assessment findings required)

250 words Collect cues Process information

Normal/ Abnormal The finding indicates ..Additional assessments required

Synthesise

identify the main clinical issues for the patient.

75

Main clinical issue

Outline the pathophysiology of the presenting health challenge.

Reference needed 175 Pathophysiology

Establish (SMART) goals

Identify three person-centred desired outcomes for this patient that are relevant to the scenario 200 Goal 1

Goal 2 Goal 3

Select a course of action

Outline 3 nursing interventions that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. Reference needed in the rationale 150+250

Evaluate outcomes Explain the process for evaluating the desired outcomes in this scenario. 150

Select a course of action (intervention)

Intervention 1 for goal 1

Intervention 2 for goal 2

Intervention 3 for goal 3

Rationale 1

Rationale 2

Rationale 3

Evaluate outcomes

Outcome 1

Outcome 2

Outcome 3

Reflect

Consider what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it)

300 Reflection

References (start on a new page)

MARKING CRITERIA AND STANDARDS

Criteria

High Distinction

(85 - 100%)

Distinction

(75-84.5%)

Credit

(65-74.5%)

Pass

(50-64.5%)

Fail

(0 - 49.5%)

Marks

Describe

provide an

overview of the

scenario

You have used a

holistic approach

to analyse the

patient situation,

and derived

components of the

patient's context

that will impact

care.

(7.1 - 8 marks)

You have used a holistic

approach to examine the

patient situation.

A description of the facts

and the patient's context

has been included.

(6.1 7 marks)

You have used a

holistic approach

to describe the

patient situation.

The facts and

the patient's

context have

been included.

(5.1 6 marks)

You have

described the

patient situation,

including some

aspects of the

patients social

circumstances.

(4 - 5 marks)

You have not

described the

patient situation

or you have

paraphrased

the content of the

case study to

describe some of

the facts.

(0 3.9 marks)

/8

Collect cues

Collect relevant

assessment cues

and identify

additional

assessment tools

that may be

required.

Relevant assessment cues have been identified, following an analysis of the case study. Identified cues have been presented systematically. Additional relevant assessment tools have been identified to address subtle cues. A rationale for additional assessment tools is included.

(9.1 - 10 marks) Relevant assessment cues have been identified, following an analysis of the case study. Identified cues has been proiritised systematically. Additional relevant assessment tools have been identified to address subtle cues.

(7.6 9 marks) Relevant assessment cues have been identified. Some

subtle cues have

been overlooked.

Identified cues have been

Presented systematically.

Additional relevant

assessment tools

have been identified.

(6.6 7.5 marks) Relevant assessment cues have been identified. Some cues have been missed but will not impact immediate care. Additional relevant assessment tools have been identified. (5 - 6.5 marks) Relevant

assessment and

important cues

have been missed.

Additional relevant

assessment tools

have not been

identified or

additional

assessment tools of questionable

relevance to the

case study.

(0 4.9 marks) /10

Processing

Compare any

abnormal

assessment

findings with

normal or

expected findings

and describe why

the findings are

of importance

Recognises subtle

deviations from

expected patterns

in identified cues

and assess why the

findings are of

importance.

Supported by high

quality references.

(9.1 - 10 marks)

Recognises patterns and

deviations in the

identified cues and

describe why these

findings are of

importance. Supported by

quality references.

(7.6 9 marks)

Recognises

obvious patterns

and deviations in

the identified

cues. Deviations

from

expectations

have been

identified and

supported by

references.

(6.6 7.5 marks)

Obvious patterns

and deviations in

the identified

cues have been

identified. A

description of the

importance of

these findings are

included with

limited

referencing.

(5 - 6.5 marks)

Patterns and

deviations from

expectations are not

clearly identified. Or

there is no

description of the

importance of these

findings. No

references.

(0 4.9 marks)

/10

Synthesise

Identify the main

clinical issues for

the patient and

outline why this

is an issue for the

patient.

You are able toidentify and

interpret the main

clinical reason

behind the

patients current

state and has

analysed the

patterns in the

patients cues to

provide an in depth

rationale as to why

this is an issue for

the patient.

(10.6 - 12 marks)

You are able to identify

and interpret the main

clinical reason behind the

patients current state and

has explained the

patterns in the patients

cues to provide a

rationale as to why this is

an issue for the patient.

(9.1 10.5 marks)

You are able toidentify the main

clinical reason

behind the

patients current

state and have

described the

patterns in the

patients cues to

provide a

rationale as to

why this is an

issue for the

patient.

(7.6 9 marks)

You have

identified the

main clinical

issues and

outlined why this

is an issue for the

patient.

(6 -7.5 marks)

You have not

identified the main

clinical issues for

the patient and/or

not outlined why

this is an issue for

the patient.

(0 5.9 marks)

/12

Outline the

pathophysiology

of one

presenting

health challenge

You have analysed

the

pathophysiology of

the presenting

health challenge.

(9.1 - 10 marks) You have explained the

pathophysiology of the

presenting health

challenge.

(7.6 9 marks)

You have

described the

pathophysiology

of the presenting

health challenge.

(6.6 7.5 marks)

You have outlined

the

pathophysiology

of the presenting

health challenge.

(5 - 6.5 marks)

You have not

provided any

outline or

description of the

pathophysiology of

the presenting

health challenge.

No supporting

referencing.

(0 4.9 marks)

/10

Establish SMART

Goals

Using SMART

goals process,

identify and

prioritise three

(3) desired

outcomes for the patient according to clinical urgency. Provide a rationale for

your desired

outcomes. You are able todevelop and prioritise three SMART goals for

the patient according to clinical urgency.

Comprehensive and in depth rationale is provided for each

desired outcome.

(9.1 - 10 marks)

You are able to demonstrate prioritisation

of three SMART goals for

the patient according to

clinical urgency.

Comprehensive rationales is provided for each desired outcome.

(7.6 9 marks)

You are able to prioritise three SMART goals for

the patient according to

clinical urgency.

A complete rationale is

provided for each desired

outcome.

(6.6 7.5 marks)

You have identified three SMART goals for the patient

according to clinical urgency. A rationale is provided for each

desired outcome.

(5 - 6.5 marks)

You have not been

able to identify and

prioritise three (3)

desired outcomes,

using SMART goals

process, for the

patient according to clinical urgency and /or no rationale is provided.

(0 4.9 marks)

/10

Select a course

of action

Outline one (1)

evidence based

nursing

intervention,

with rationale to

address each

goal. These

interventions

should be

prioritised

according to

clinical urgency. Three relevant

Nursing interventions have been identified and expertly supported by high quality up to date evidence which has been integrated

seamlessly into the

nursing care of the

patient.

(10.6 - 12 marks)

Three relevant nursing

interventions have been

identified supported by

high quality up to date

evidence which has been

integrated into the

nursing care of the

patient.

(9.1 10.5 marks)

Three relevant nursing

Interventions have been

identified and supported by good quality up to date evidence which has been included in the

nursing care of the patient.

(7.6 9 marks)

Three relevant nursing intervention have been identified

and supported by up to date evidence.

(6 - 7.5 marks)

The nursing

interventions are

not relevant and/or not evidence based.

(0 5.9 marks)

/12

Evaluate

Explain the

process for

evaluating

outcomes of the

nursing

interventions.

Clear, relevant and

accurate measures

have been identified and described to

evaluate the desired outcome for each goal.

(9.1 - 10 marks) Clear and relevant

measures have been

identified to evaluate the

desired outcome for each

goal.

(8.1 9 marks)

Relevant measures have

been identified to evaluate the desired outcome for each goal.

(6.6 8 marks)

Relevant measures to evaluate the

outcomes have

been listed.

(5 - 6.5 marks)

Evaluation of the

desired outcome

has not been

identified.

Evaluation of

desired outcome is

superficial and/or

not relevant.

(0 4.9 marks) /10

Reflection

Reflect on what

you have learned

from completing

this task and how it will contribute to your future

nursing practice.

You have identified

and evaluated

significant learning

outcomes and

reflected critically

on them in a deep

and significant way. You have related the

reflection to your

learning experience

and influence on

your future nursing

practice.

(7.1 - 8 marks)

You have evaluated

significant learning

outcomes and reflected

on them in a significant

way. You have related

your reflection to your

future nursing practice.

(6.1 7 marks)

Your reflection evaluates

Learning outcomes and

how it will influence and

contribute to your future

nursing practice.

(5.1 6 marks)

You reflect on learning outcomes form completing this

task and how it will contribute to your future nursing practice.

(4 - 5 marks)

Student makes little attempt to

personally relate

events during the

learning experiences and makes few attempts to critically analyse these situations.

Few attempts are

made to examine

the reasons why the learning experience did not work out well or explore alternatives to find

ways as to how they

could have been

improved. No supporting reference.

(0 3.9 marks) /8

Communicates

Professionally

(Academic

writing and

presentation).

Language features

and structures are

used to convey

meaning effectively, clearly, unambiguously,

concisely, and in a

formal academic

style, with few

spelling, grammatical, or punctuation errors.

Presentation guidelines have

been followed.

(4.6 - 5 marks) Language features and

structures are used to

convey meaning

effectively, clearly,

unambiguously, and in a

formal academic style,

with occasional minor

spelling, grammatical, or

punctuation errors.

Presentation guidelines

have been followed.

(4.1 - 4.5 marks)

The meaning is

apparent to the

reader, although

text contains minor errors in spelling,

grammar, word choice, and/or structure, and

lacks clarity occasionally.

Presentation guidelines have been followed.

(3.5 - 4 marks)

The meaning is

apparent to the

reader, although

text contains

many errors in

spelling, grammar, word choice, and/or

structure, and lacks clarity occasionally.

Presentation

guidelines have

been followed.

(2.5 - 3.4 marks)

Presentation

guidelines have not

been followed with

multiple errors.

Frequent, intrusive

errors in spelling,

grammar, punctuation, word

choice and/or

structure prevents

the meaning from

being apparent to

the reader.

(0 2.4 marks)

/5

Uses evidence to support and

build knowledge

in practice

(Academic

referencing).

The assessment is

supported by & related to a wide

variety of peer

reviewed references which include journal

articles, professional

manuals and documents,

textbooks, and

module readings.

Referencing is

comprehensive,

demonstrates

academic integrity,

and is error free for

the APA 7th ed.

style conventions.

(4.6 - 5 marks)

The assessment is supported by & related to a variety of peer reviewed references which include journal articles, professional manuals and documents, textbooks, and module readings. Referencing is comprehensive,

demonstrates academic

integrity, and conforms to APA 7th ed. style

conventions, with one or

two errors.

(4.1 - 4.5 marks)

The assessment is supported by at least 15 peer reviewed references from module readings,

textbooks, and professional manuals and

documents. Referencing is comprehensive and mostly accurate

according to APA

7th ed. Style conventions.

Up to 5 minor errors or

omissions in style and

formatting choices have no impact on the

transparency and

traceability of the source, or the demonstration of

academic integrity.

(3.5 - 4 marks)

The assessment is

supported by at least 12 peer reviewed

references from

module readings,

textbooks, and

professional

manuals and

documents.

Referencing is

Comprehensive and mostly accurate

according to APA

7 th ed. style

conventions with

few minor errors.

Up to 8 minor errors or omissions in style

and formatting

choices that have

no impact on the

transparency and

traceability of the

source, or the

demonstration of

academic integrity.

(2.5 - 3.4 marks) The assessment is

supported by less than 12 peer

reviewed references

from module

readings, textbooks,

and professional

manuals and

documents, and/or

no references are

evident.

Referencing is not

accurate according

to APA 7th ed. style

conventions.

Errors or omissions

in style and

formatting choices

have an impact on

the transparency

and traceability of

the source, or the

demonstration of

academic integrity.

(0 2.4 marks) /5

Academic

Integrity

Turnitin report

indicates

adherence to

academic

integrity

principles and

referencing

conventions. Turnitin report indicates a clear attempt has been made to adhere to academic integrity and referencing conventions and avoid plagiarism. It is evident that the student has taken steps to show respect for and acknowledge others work appropriately, as per the Charles Sturt Academic Integrity Policy https://policy.csu.edu.au/document/viewcurrent.php?id=387.

SY

Turnitin report indicates the student has not adhered to the Academic Integrity

Policy.

US

SY/US

/100

Roger Taylor is a 76-year-old retired builder who lives in a two story building with wife, Mary, and 2 dogs. He takes the dogs for a walk most days, but the walks have become shorter and shorter as the left knee is becoming more painful. Roger and Mary have two adult sons who live locally and they have 4 grandchildren, two boys and two girls and most weekends he goes out fishing with his two grandsons. Roger is independent in ADLs, has his drivers licence and drives his car almost daily. He takes Mary shopping and every Friday they go out for a meal at the local bowling club. Roger wears glasses, hearing aids and a full set of dentures. He is 179 cm tall and weighs 96kg. He also drinks a couple of beers in the afternoon almost every day, but he has never been a smoker. Last Wednesday Roger was admitted for an elective left knee replacement.

Rogers medical history:

Polio as a child

Hypertension and

Diabetes mellitus

His medications are as follows:

Lisinopril 5mg daily

Cardura 4mg daily

Metformin 500mg nocte

On his admission his vital signs were

BP 135 / 84 mmHg

HR 78 bpm (regular)

RR 18 bpm

Temp 36.5C

Sats: 99% (RA)

Pain 5-6 /10, left knee

BGL 4.9 mmol/L

Alert

The operation went well and Roger returned to the ward in the evening. Post-operative Roger was prescribed:

PCA

Oxycotin 10mg bd

Paracetamol qidColoxyl with Senna 120mg nocte

The following morning after breakfast Roger was out of bed with the support of two physiotherapists.

Vital signs in the morning

BP 128/82 mmHg

HR 83 bpm (regular)

RR 18 bpm

Temp 36.8C

Sats: 97% (RA)

Pain 2-3/10, left knee

BGL 5.3 mmol/L

Alert

In the afternoon day one post operatively Roger started to become confused, restless and would not follow instructions. He was agitated and constantly trying to get out of bed. As Mary was visiting, she tried to get Roger to settle and have his evening meal with little success. The PCA was removed due to confusion.

Vital signs in the afternoon

BP 131/83 mmHg

HR 95 bpm (regular)

RR 21 bpm

Temp 37.1C

Sats: 98% (RA)

Pain not recorded

BGL 5.8 mmol/L

Alert but confused

Roger was given 2mg Ativan at bedtime and he settled for a while before becoming more agitated and continued to try to get out of bed. He was frequently urinating in a urinal during the night, approximately 100ml each time. In the morning a bladder scan was performed and urinary retention of 600ml was reported. A Foley catheter was inserted and secured, however as Roger was confused, he began pulling on the Foley catheter and frank blood was found in the urine.

You are the nurse that will take over care for Roger on the morning of the third day.

As a nurse follow the clinical reasoning cycle and write your answers in the template provided.