NUR331 2022 Assessment Task 2 Information Booklet
NUR331 2022 Assessment Task 2 Information Booklet
Assessment name: Complex Care Task 2 Case study
Marking Criteria measured: Application of an advanced assessment to a complex patient and consider investigations for the case.
Application of pathophysiology to the case to identify the complex care needs.
Use of evidence to inform the complex management and RN responsibilities for the care of a complex patient.
Application of principles of equity, self-determination, rights and access to support patients with disadvantage.
Analysis of the safety and quality of care provided to a complex patient, and RN actions required to adhere to NMBA practice standards and NSQHS standards.
Communication in academic and clinical contexts with the appropriate use of sources to support the writing.
Length: 2500 words
Estimated time to complete task: 25 hours
Weighting: 50%
Individual/Group: Individual
Formative/Summative: Summative
How will I be assessed: 5-point grading scale using a rubric. See the rubric on Canvas.
Due date: 1 pm on the 14th of September 2022 (Wednesday).
Presentation requirements: This assessment task must:
Be a written academic case study containing headings
Times New Roman size 12 and 1.5 line spacing
Use APA 7th referencing for citing academic literature
Be submitted in electronic format as a word document via Turnitin
Task description: The goal of this case study is for you to use the template provided (in a separate document) to present a response to a clinical scenario in which you demonstrate evidence-based principles for the assessment and care of a patient who suffers from complex health problems.
What you need to do: Download the Task 2 Response Template. You will use this template to complete five (5) parts of the assignment.
Complete the body system (secondary) assessment, identify necessary investigations and the rationale for them, and explain the pathophysiology of the abnormal findings.
Explain the pathophysiology of the abnormal results of patient investigations being sure to use supporting academic resources.
Explain the implementation and the evaluation of two high priority interventions and the actions to ensure care is patient-centred.
Apply the NSQHS standards to a later episode of poor-quality care that the patient experienced. Although the NMBA practice standards are identified in the marking criteria, you do not need to apply the NMBA standards in this assignment. You only need to apply the NSQHS standards.
Considerations:
Make sure you draw on the best available evidence to support your assessment. Peer-reviewed journal articles must be no older than 5 years old, unless it is seminal research. Textbooks should be no older than 7 years old.
Make sure you use references from credible peer-reviewed sources which are applicable to the patient (human), the pathophysiological condition, and the topic (nursing).
Use the databases available from the library.
This is a short answer written piece written in academic language: you should write using third person language.
Make sure you use correct terminology and accepted abbreviations within your assessment.
The case study assignment is an individual assessment Task. You may work collaboratively with other students to understand concepts in this course, but your answers must be your individual research, interpretation, and application of the materials.
See the rubric on the Canvas for this task.
Resources needed to complete the task: APA 7th Referencing guide
APA | Referencing Guides and Academic Integrity | University of the Sunshine Coast (usc.edu.au)NUR331 Task 2 Response Template
Case Scenario
Identification
Mrs. Rhonda McKenzie, 75 years old.
Situation
Rhonda is in the emergency department, presenting with shortness of breath and discomfort in the upper back.
Background
Allergies: - glyceryl trinitrate
Medications: metformin 500mg BD, aspirin 100mg OD, atenolol 100mg OD, sliding scale actrapid before meals (the dose is dictated by the BSL reading).
Past history: stable angina, type 2 diabetes mellitus
Last ate & drank: last night, cold pizza
Events:
Rhonda presented to the emergency department at 4am as she was feeling short of breath, had pain between her shoulder blades, and could not sleep. She was triaged a category 4 and has only now been brought through to a bed.
Assessment
Temperature = 36.2C
Pulse rate = 125 beats per minute
Respiratory rate = 30 breaths per minute
Blood pressure = 105/80 mmHg
Oxygen saturation = 90% on room air
GCS = 15, fatigued, light headedBGL = 12.5 mmol/L
Rhonda weighs 95kgs, and she is 163cm tall.
Inspection pale facial colouring, clammy skin
Palpation slight peripheral oedema, delayed capillary refill (4 seconds)
Percussion no dullness or hyperresonance in the lungs
Auscultation air entry equal into both lungs
Subjective information
Rhonda lives in her van with her dog Max. The van is parked at the beach, and she ran out of petrol a week ago. Rhonda is recently homeless, as her landlord sold the house she was renting and she cannot afford to rent another place locally as the costs have gone up. Rhonda has received multiple parking fines and has not had money to pay for her medications, and she also ran out of her atenolol, aspirin, and actrapid last week. Two years ago Rhonda left her husband Mike, as it was an abusive relationship. She has no children or immediate family available to support her. Rhonda is a recipient of the aged pension; she has no superannuation. Rhonda is anxious about Max (her dog) as he is in the van.
Recommendations
Please complete the required investigations for the patient, and a doctor will be around after the handover.
Please refer to NUR331 Task 2 Response Template for the detailed questions that you need to answer.
Part 1
This part presents a series of questions to respond to in a short answer format. Completing these short answer questions will lead to the completion of the body systems assessment of the patient and an identification of the pathophysiology of the patients condition. Additionally, questions guide an assessment of the lifestyle and social factors of the patient, and their patterns of healthcare use.
The Unfolding Scenario
Investigations
The RN captured an electrocardiogram (ECG) from the patient (Figure 1). The RN interprets the ECG on the way to showing it to the Emergency Consultant. The RN identifies ST elevation in leads V2, V3, V4, and V5.
Part 2
In this part of the assignment, you are required to explain the pathophysiology of the patients condition as indicated by the information in the patient ISBAR handover (above) and the ECG (Figure 1).
Immediate Management
Fortunately, there is a cath lab in the hospital to perform a percutaneous coronary intervention. The patient will require treatment to stabilise while waiting for transfer to the cath lab.
Part 3
In this part of the assignment, you are to explain one high priority intervention:
RN actions to implement intervention
RN actions to evaluate the intervention
Evidence that the intervention is safe and effective
RN actions to create patient-centred care through adherence to the social justice frameworkPart 4
In this part of the assignment, you are to explain a second high priority intervention:
RN actions to implement intervention
RN actions to evaluate the intervention
Evidence that the intervention is safe and effective
RN actions to create patient-centred care through adherence to the social justice framework
Patient critical event
After the PCI the patient was transferred to the coronary care unit (CCU) for monitoring. The CCU RN, Nurse Busy seemed distracted during the handover, as there was one of her patients was deteriorating and had to be MET called. This was nurse Busys first shift as a new graduate without the clinical coach supporting her. These are the notes taken by Nurse Busy during the handover:
1682754445Identification Bed 13
Situation PCI one stent
Allergies nil known
Medications aspirin, nitrolingual spray, metformin, actrapidSocial homeless
Assessment vital signs stable, no complaints from the patient
Plan continue to monitor, and social worker involvement for discharge planning
00Identification Bed 13
Situation PCI one stent
Allergies nil known
Medications aspirin, nitrolingual spray, metformin, actrapidSocial homeless
Assessment vital signs stable, no complaints from the patient
Plan continue to monitor, and social worker involvement for discharge planning
For the next 2 hours Nurse Busy had the deteriorating patient. The nurse working alongside Nurse Busy announced that she was going to dinner and told Nurse Busy to keep an eye on her patients. Nurse Busy was overwhelmed but had not had an opportunity to speak with the Team Leader as they were on the other side of the unit orienting a new staff member. As it was after hours, the clinical coach had gone home.
At 5:30pm, the patient complained of discomfort and shortness of breath. Nurse Busy grabbed the nitrolingual spray and directed the patient to open their mouth. Nurse Busy then sprayed 2 x pumps of nitrolingual spray under Rhondas tongue and left to get the ECG machine. On returning, Rhonda was pale, tachycardic, and had a hoarse voice and audible wheezes. Panicked, Nurse Busy pressed the MET button and called the Team Leader over to help. The patient was intubated and taken to the transferred to ICU for further management.
Part 5
In this part of the assignment, please consider the NSQHS standards and answer the provided questions to:
identify how Nurse Busy compromised the medication safety,
identify the factors that contributed to the compromised medication safety,
identify what actions were required by Nurse Busy to ensure safe medication administration, and
identify how other team members could have helped to ensure safe care.
Figure 1
ECG printout for Rhonda McKenzie
Burns, E. & Buttner, R. (2022). Patterns of ST Elevation. Life in the Fastlane. https://litfl.com/st-segment-ecg-library/
NUR331 2022 Task 2 Response Template
Part 1.
Using the information in the ISBAR handover to answer the following questions.
Conduct a focused assessment of the neurological system.
What information from the case scenario informs the neurological assessment?
What information do you need to complete the neurological assessment?
What neurological system investigations are required for this patient?
If the function of the neurological system has changed, why?
Conduct a focused assessment of the respiratory system.
What information from the case scenario informs the respiratory assessment?
What information do you need to complete the respiratory assessment?
What respiratory investigations are required for this patient?
If the function of the respiratory system has changed, why?
Conduct a focused assessment of the cardiovascular system.
What information from the case scenario informs the cardiovascular assessment?
What information do you need to complete the cardiovascular assessment?
What cardiovascular investigations are required for this patient?
If the function of the cardiovascular system has changed, why?
Conduct a focused assessment of the renal system.
What information from the case scenario informs the renal assessment?
What information do you need to complete the renal assessment?
What renal investigations are required for this patient?
If the function of the renal system has changed, why?
Conduct a focused assessment of the gastrointestinal system.
What information from the case scenario informs the gastrointestinal assessment?
What information do you need to complete the gastrointestinal assessment?
What gastrointestinal investigations are required for this patient?
If the function of the gastrointestinal system has changed, why?
Conduct a focused assessment of the integumentary system.
What information from the case scenario informs the integumentary assessment?
What information do you need to complete the integumentary assessment?
If the function of the integumentary system has changed, why?
What other factors need to be considered in the care of the patient? (Think about the social determinants of health)
Part 2.
Assess these results of investigations provided in the Task 2 booklet. What are the most likely causes of any abnormal results?
Part 3.
Consider the clinical needs of the patient based on the ISBAR. What are the evidence-based RN actions required to implement one high priority intervention safely and effectively?
What are the RN actions required to evaluate the safety and effectiveness of this intervention?
What specific RN actions are required to address the lifestyle or socioeconomic factors, or healthcare patterns of the patient, to achieve patient-centred care and adhere to the social justice framework?
Part 4.
What are the evidence-based RN actions required to implement another high priority intervention safely and effectively based on the ISBAR?
What are the RN actions required to evaluate the safety and efficacy of this intervention?
What specific RN actions are required to address the lifestyle or socioeconomic factors, or healthcare patterns of the patient, to achieve patient-centred care and adhere to the social justice framework?
Part 5.
Read the patient critical event in the Task 2 Booklet. Based upon the information provided respond to the following questions.
What actions or omissions by Nurse Busy compromised the safety and quality of care of the patient?
What contributory factors led to Nurse Busys actions or omissions?
What actions were required by Nurse Busy to adhere to NSQHS Standard 4?What actions of other team members could also have prevented this critical event?
