Assessment 2: Case Study on Holistic Nursing Care

Purpose: This is a case study based on a surgical scenario. Students will appraise an individual’s holistic health care needs and subsequent interventions and management to assist with the application of theory into practice.

Patient Case Study 2

Mrs. Jones, a 45-year-old female, was recently diagnosed with cervical cancer after experiencing abnormal bleeding and pelvic pain. Imaging has shown that the cancer is at stage 2, started in the uterus and it appears to have spread to the cervix. The surgical team has recommended a total hysterectomy to remove her uterus, cervix, and possibly surrounding tissues, depending on the findings during surgery.

Mrs. Jones was hesitant to sign the consent form as she did not understand why she needed a total hysterectomy. However, did eventually proceed to sign for the procedure as she was told to by her husband. She expresses concerns about undergoing a total hysterectomy. She confides that she is worried about the onset of early menopause and the impact it would have to her family. She is a practicing catholic and attends church each Sunday and prayer reading once a week. She cares for her grandchildren twice a week and volunteers at the local music group teaching piano to students.

Mrs. Jones has a medical history of type 2 diabetes, which she manages with diet and exercise. Her blood glucose levels are well-controlled, but she is aware that the stress of surgery could affect her blood sugar. Mrs. Jones works three-days week as a as a childcare worker and lives with her husband and cares for her daughter’s grandchildren (2 children aged 2 and 4 years old) two days a week. Her weight is 80kg and height is 145cm. Her observations post operative are as follows: HR: 120, BP: 105/55, RR: 22, Sa02: 97%, GCS 15.

Please answer the following:

1. Discuss how Mrs. Jones's Age, Occupation, Family Situation, and religious beliefs impact on her decision making in this case about the surgery (300 words)

2. Discuss and analyse the legal and ethical Considerations for Mrs Jones: Informed Consent, Confidentiality, and Privacy (300 words)

3. Describe and discuss the pathophysiology of 2 Common Surgical Complications (not including infection) following a total hysterectomy and how these complications may influence post operative care (600 words)

4. Mrs Jones has called the nurse to her bedside as she is experiencing pain. She has stated she has tried to reposition herself, but nothing is working. Her pain score is 7/10, she has sharp pain in her abdomen around the suture area. Her pain does not radiate anywhere. It has been present for about 20 minutes now. She is moving around the bed holding her abdomen crying in pain. Mrs Jones is ordered the following analgesic medication:

   • 1 gram of Paracetamol IVI

   • 2-5mg of IVI Morphine PRN

   • 400mg of Ibuprofen TDS

Purpose: Enables students to articulate their knowledge and understanding specifically in relation to nursing practice in the surgical environment.

Learning outcomes assessed: LO1, LO3, LO4, LO5, LO6

How to submit: Students will be required to upload their assessment into Turnitin.

Return of Assignment: Grades and feedback will be made available through Canvas in accordance with ACU policy

TASK DETAILS

• Please click on the file for more information about this assessment task:

• Please click on the file to download the assessment template for the case study template: Assessment 2 template-4.docx

• Please click here for a PDF copy of the 2 case studies: assessment 2 case study 202560-1.pdf

Brief Summary of Assessment Requirements

The assessment is a case study focused on a surgical scenario, requiring students to appraise the holistic health care needs of an individual patient, Mrs. Jones, who is undergoing a total hysterectomy for stage 2 cervical cancer. Students are expected to integrate theory into practice by analyzing multiple aspects of her care. The key requirements include:

1. Patient Decision-Making Influences (300 words) – Discuss how Mrs. Jones’s age, occupation, family situation, and religious beliefs impact her decisions about surgery.

2. Legal and Ethical Considerations (300 words) – Examine informed consent, confidentiality, and privacy in relation to her care.

3. Surgical Complications (600 words) – Describe and analyze the pathophysiology of two common surgical complications (excluding infection) post-hysterectomy, and their implications for post-operative care.

4. Pain Management – Evaluate a scenario where Mrs. Jones experiences post-operative pain and discuss appropriate nursing interventions, including the use of prescribed analgesics.

The purpose of this assessment is to enable students to demonstrate holistic nursing practice, clinical reasoning, and evidence-based interventions, aligning with learning outcomes LO1, LO3, LO4, LO5, and LO6.

Assessment Approach Guided by Academic Mentor

The Academic Mentor guided the student step by step as follows:

1. Understanding the Case – The mentor first helped the student review Mrs. Jones’s history, clinical findings, and personal context, emphasizing holistic care and the importance of integrating social, psychological, and spiritual factors.

2. Decision-Making Analysis – The mentor instructed the student to assess how age, occupation, family roles, and religious beliefs influence decision-making, encouraging reflection on autonomy, cultural values, and potential stressors.

3. Legal and Ethical Framework – Stepwise guidance was provided to explore informed consent, confidentiality, and privacy, ensuring the student linked each principle to the patient scenario and current nursing standards.

4. Surgical Complications Analysis – The mentor helped the student identify common post-hysterectomy complications such as hemorrhage and urinary tract injury, explain their pathophysiology, and relate these to post-operative monitoring and nursing interventions.

5. Pain Management Evaluation – The student was guided to interpret pain assessment data, prioritize interventions, and justify the use of paracetamol, morphine, and ibuprofen within safe dosing parameters.

6. Integration and Submission – Finally, the mentor assisted the student in structuring the report logically, ensuring clarity, appropriate word counts, and alignment with learning outcomes.

Outcome and Learning Objectives Achieved

Through this process, the student was able to:

• Demonstrate critical thinking in evaluating patient-specific decision-making factors.

• Apply ethical and legal principles in clinical nursing practice.

• Analyze pathophysiology of post-surgical complications and propose effective interventions.

• Develop practical pain management strategies tailored to patient needs.

• Integrate theoretical knowledge with real-world patient care, fulfilling LO1, LO3, LO4, LO5, and LO6.

The structured guidance enabled the student to produce a comprehensive, evidence-based case study report, demonstrating mastery of both theoretical concepts and practical nursing skills.

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