Integrate Clinical Nursing Theory intoPractical Knowledge Assignment

Purpose: This assessment task is designed to develop the students ability to integrate theory into practical clinical knowledge through the use of a patient case scenario.

Description: This assessment task allows students to demonstrate theoretical knowledge around pathophysiological changes in disease, pharmacological management of disease, planning nursingcare and evaluating care. Students are required to answer the case scenario questions provided.Students should attempt all questions in the case study:

You are just starting your shift as a graduate nurse and you are about to review your first patient, William Tran is a 33 year old man who has been admitted to the surgical ward - high dependencyarea post the formation of a temporary ileostomy. During admission, it is documented that Williamhas a past history of Crohns disease ulcerative colitis and multiple hospitalisations for Crohnsrelated illnesses including malabsorption and weight loss (55kg).He is prescribed Prednisolone, Metronidazole, Balsalazide. He is also on a narcotic analgesiainfusion (Morphine 60mg in 60 ml with Normal Saline 0.9%, equaling concentration of 1mg/ml) with acontinuous infusion rate of 3ml/hr and a patient controlled analgesia demand dose of 2mg. Prior totransfer to the ward he was prescribed and administered a loading dose of intravenous morphine(5mg). His social history reveals he has been partnered for 10 years. Extended family live inVietnam.

1.1 Describe the pathophysiology of acute pain. How does this differ from chronic pain? Includein your answer the pathophysiological effects of narcotic analgesia as a treatment option foracute pain. Demonstrate links to Trans case. (400 words)

When you arrive at Trans bedside, you notice that he is difficult to rouse and non-verbal. His eyesare closed. You take an initial set of vital signs: Temp 35.8, Pulse irregular 110 bpm, BP 98/55, RR

1.2 Discuss THREE types of nursing assessments in order of priority that would be appropriatefor Trans deterioration (excluding vital signs) and provide a description of each of these inthe context of Trans complaint with rationale as to why these would be your priority.

1.3 Discuss THREE nursing interventions (may include one pharmacological) you would initiateand provide rationale as to how these would improve physiological outcomes of Transproblem. Nursing interventions would include nursing activities or actions thatthe nurse could initiate in response to nursing assessment findings.

1.4 Discuss the administration (including administration, benefits, risks and contraindications) ofMorphine for Trans pain. Include in your explanation what education you should provide toTrans on commencement of the patient controlled analgesia (PCA

1.5 Report the major side effects of intravenous morphine apply your findings to Trans case.

Explain why this finding would need to be reported immediately to the Doctor.