Clinical Decision-Making Among Critical Care Nurses Assignment

Assignment Task

Task

Safe and effective patient care relies on critical care nurses making clinical decisions based on sound pathophysiological knowledge and interpretative skills. In this task you will be asked to rationalise your assessment and management decisions for a critically unwell patient who presents with clinical deterioration. Integrating the use of generative artificial intelligence (AI) within this assessment task will help you critically engage with emerging technologies ethically and responsibly, to develop advanced evaluative judgement skills.

This assessment task has two parts.

• Part 1: Requires the critique of AI output and extended

• Part 2: Requires answers without using artificial

Case Study

Kay, aged 61, presents via ambulance to the emergency department after her husband reported difficulty in waking Kay this morning. Her husband reports Kay has had a cold over the past six weeks with a productive cough. She has been treated with oral antibiotics by her General Practitioner (GP).

Task Description

Part 1: Critique and extend AI answers

For questions 1-5 outlined in this assignment refer to the AI generated answers provided and for each question:

1. highlight the AI generated text that accurately answers the case study question and include references from supporting literature,
2. critique the AI generated text that does not accurately answer the case study question and support your critique with references from the literature,
3. extend and improve the AI generated answer by drawing on the literature, your own critical thinking, expertise, and clinical judgement. Support your answer with references from the

Question 1

Explain possible pathophysiological causes for each of Kay’s six listed initial assessment findings.

Question 2

Select five additional priority nursing assessments (excluding ECG, pathology, blood gas and chest X-ray) you would perform. For each assessment:

• explain your rationale for performing the assessment and describe possible findings, and
• describe nursing interventions you would implement in response to possible assessment

Question 3

You take an arterial blood gas analysis. The results are:

• pH 7.49
• PaCO2 25 mmHg
• PaO2 70 mmHg
• SaO2 96%
• HCO3 25 mmHg
• Lactate 1 mmol/L
• Na 145 mmol/L
• K 1 mmol/L
• Hb  120 g/L

i. Provide an overall interpretation of Kay’s arterial blood gas  

ii. Drawing on your knowledge of acid-base buffer systems and gas exchange, and Kay’s clinical presentation, provide explanations for any abnormal parameters.

iii. Explain the PaO2 and SaO2 results in relation to Kay’s medical history and clinical

Question 4

Two hours later you take another blood gas analysis because Kay’s oxygen saturations are dropping, and you have had to increase the FiO2 of oxygen delivered. The results are:

• pH 32
• PaCO2 48 mmHg
• PaO2 63 mmHg
• SaO2 90%
• HCO3 25 mmol/L

Hypothesise the most likely cause of this change in Kay’s acid-base and oxygenation, and anticipate the clinical changes you would expect to observe in Kay’s clinical presentation.

Question 5

Kay’s current oxygenation therapy requires reconsideration in response to her acute deterioration. Explain how her current oxygenation therapy should be escalated to ensure adequate respiratory function. Provide rationales for your answer.

Part 2 Answer without using AI

Please generate your own answers for questions 6 & 7 without using generative AI. Your answers to questions 6 & 7 contribute to the assignment word count.

Question 6

Kay has a portable chest X-ray which is provided below. Using a systematic approach, interpret the chest X-Ray and relate your interpretation back to Kay’s clinical presentation.

Question 7

Kay’s monitored rhythm abruptly changes.

• Provide an interpretation of this rhythm
• Outline possible reasons with physiological rationales for this new
• Describe potential consequences of this rhythm to Kay’s clinical state

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