Application of Evidence to Explain the Actions the Registered Nurse - Nursing Assignment Help

Assessment name:

Assessment Task 3 Case study

Marking Criteria measured:

Utilisation of appropriate assessment frameworks to identify the pathophysiology of the condition in the case study.

Application of evidence to explain the actions the registered nurse take to implement and evaluate two (2) interventions to care for the patient in the case study.

Critical appraisal of evidence supporting nursing practice applicable to the patient in the case study.

Application of the ICN codes of ethics to the actions of the registered nurse / registered midwife in patient discharge.

Encouragement of access to, and participation in healthcare using the Social Justice Framework to underpin the actions of the registered nurse in patient discharge.     

Academic writing evidences academic integrity in the application of the APA7 referencing style. 

Length:

1800 words 

Estimated time to complete task:

25 hours

Weighting:

50 %

Individual/ Group:

Individual

The case study assignment is an Individual Assessment Item. 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.

Formative/

Summative:

Summative

How will I be assessed:

5-point grading scale using a rubric

Presentation requirements:

This assessment task must:

• Times New Roman Size 12 Justified 1.5 line spacing
• Use APA7 referencing for citing academic literature under 5 years only.
• be submitted in electronic format as a word.doc document via SafeAssign.
• Please use a heading to indicate which case study you are providing a response to. 
• Do not copy the actual questions into your assignment document 

• No Introduction or Conclusion is required as this is not an essay.   

Task goal:

The goal of this case study is for you to identify the role of the registered nurse in evidence-based assessment and care of individuals experiencing health alterations when access to healthcare is suboptimal or compromised. You also articulate the role of the nurse in encouraging access to, and participation in healthcare.

Task description:

Present a response to a clinical scenario demonstrating appropriate assessment, management and discharge of an individual experiencing health alterations. 

What you need to do:

In this task you will conduct a case study. There are clinical scenarios, you will study only one. Please follow the steps below: 

Step 1: Identify your allocated clinical scenario

• Students in Group A (starting in February, 2021) will select Clinical scenario 1. 

Step 2: Secondary assessment of the patient

Detail the secondary assessment and investigations appropriate for this patient (400 words).

Step 3: Explain the pathophysiology of the health alteration  Explain the pathophysiology that explains the patient assessment findings and underpins the interventions (300 words).

Step 4. Implementation and evaluation 

Select, justify and describe two (2) essential interventions and describe the nursing actions required to implement and evaluate it (800 words).

Step 5. Plan the patient discharge

Select and describe nursing actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare (300 words).

Additional notes

Select interventions that corrects the pathophysiological change within the patient. Patient monitoring actions (completing vital signs and fluid balance charts) is considered as assessment or evaluation, it is not an intervention. 

Identification

Mrs Sadie Mangle, 82 year old, retiree.

Situation

Mrs Mangle found in collapsed in the front yard by neighbours Scott & Charlene at 8:30am. She had weakness in the right arm and leg, facial droop and was “talking nonsense”. The patient is admitted to the Medical Ward with an ischaemic CVA. 

Background

Allergies: penicillin

Medication: Metformin, actrapid, atorvastatin, ACE inhibitors Past illnesses: T2DM, hypercholesterolaemia, hypertension Last meal: Dinner the previous night.

Events leading up to presentation: recent episodes of abnormal sensation that resolved within the hour.

Assessment

RR: 22

SpO2: 95% RA (room air)

HR: 95, strong pulse

BP: 200/110

T: 35

GCS: 14 (confused to time, place, person)

BGL: 10 mmol/L

Cap. Refill Time: 2 seconds, flushed face

CT: ischaemic stroke

Other information

When Mrs Mangle was found she was in her pyjamas without her dressing gown. This is unusual as normally she is up and dressed, walking with Alby at 6am. Alby was inside the house calling out to Sadie. It is suspected that Mrs Mangle collapsed during the night while letting her dog, Bouncer, go to the toilet.

Mrs Mangle is now bed bound due to weakness in the right side (failed on bed mobility test). Mrs Mangle is unable to change positions in bed. The physiotherapy review is pending.  Mrs Mangle requires a modified diet due to delayed swallow (assessed by a speech pathologist this morning). The patient is exhibiting “word salad” where the patient is selecting incorrect words.

The patient has not been incontinent, but has a pad in place for now. Mrs Mangle has a normal western diet low in fibre, high in fats and carbohydrates, moderate alcohol intake, but she does not smoke. Normally she sleeps little and is usually independent with ADLs. Mrs Mangle and her husband Alby chief recreation is walking and gossiping with neighbours.

Mr Mangle lost his license for medical reasons (partial blindness), they both live on the pension and have minimal savings. They own their own home, this is a high set building with 12 steps to the front door. You have been told that Mike, from next door is dropping in to keep an eye on Alby every day. Mrs Mangle seems frustrated in her attempts to communicate, she is often found crying. 

Recommendations

Complete a secondary assessment of the patient including investigations and link the findings to the pathophysiology.

Select, justify and describe two (2) interventions and describe the nursing actions required to implement and evaluate them.

Select and describe nursing actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare.