Decreased Mobility, Shortness of Breath on Minimal Exertion - Medical Science Assignment Help

Assignment Task:

Task:

Supplementary Assessment Task – Case Study
Assessment name: Supplementary Assessment Task - Case study

• Marking Criteria measured: Utilisation of an appropriate patient assessment framework to identify the abnormal signs and symptoms of the person in the case study.
• Application of evidence to explain the actions the registered nurse /registered midwife may take to implement and evaluate one (1) essential intervention to care for the patient in the case study.
• Encouragement of access to, and participation in healthcare using the Social Justice Framework and the professional codes and standards to underpin the actions of the registered nurse / registered midwife in patient discharge.
• Academic writing evidences academic integrity in the application of the APA7 referencing style.
• Length: 1000 words
• Estimated time to complete task: 15 hours
• Individual/
• Group: The case study assignment is an Individual Assessment Item.
• Formative/
• Summative: Summative
• How will I be assessed: Limited grades rubric.
• You will be notified of your final grade: Supp Pass or Supp Fail
• Due date: Friday the 23rd of July at 11:59pm
• Submission details: Safe Assign in NUR241 Blackboard
• Supplementary Assessment Submission Portal
• Presentation requirements: This assessment task must:
• Times New Roman Size 12 Justified 1.5 line spacing
• Use APA7 referencing for citing academic literature
• be submitted in electronic format as a word.doc document via SafeAssign.
• 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 three clinical scenarios, you will study only one. Please follow the steps below:
• Step 1: Secondary assessment of the patient
• Detail the secondary assessment and investigations appropriate for this person (400 words).
• Step 2: Select the essential intervention
• Select one (1) essential intervention from the following list:
• administration of Frusemide,
• administration of nitrolingual spray,
• Falls risk management,
• Thromboembolism prevention
• Step 3: Implementation and evaluation
• Describe and justify the nursing actions required to implement and evaluate the chosen essential intervention (400 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 (200 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.
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• Alternate Clinical Scenario
• Identification Peter Kelly, 71 years of age.
• Situation Admitted to the medical ward for increased peripheral oedema and reduced mobility. The patient has been admitted with stable angina pectoris. The patient has been walking to the cafeteria, but called for help due to chest pain.
• Background Allergies: nil
• Medications: digoxin 250 micrograms OD, atorvastatin, metformin
• Pass medical history: congestive cardiac failure, cardiomegaly, type 2 diabetes mellitus, hyperlipidaemia,
• Last ate: lunch in ED
• Events:
• Decreased mobility, shortness of breath on minimal exertion (walking to the bathroom), chest pain on mobilising more than 1 minute, pitting oedema, alopecia on the lower legs, purple discolouration to the lower legs
• Lifestyle:
• The patient is a taxi driver, he works 6 nights a week. The patient has a very poor diet, he snacks a lot from vending machines. He can perform all ADLs but it increasingly takes him a long time.
• Social:
• Peter had to move out of his house when he divorced his now ex-wife. Pam. Peter rents out a room from Blanche.
• Peter is estranged from his family. Peter goes to the RSL every Friday to meet with other Vietnam Veterans.
• Patterns of healthcare use:
• Peter doesn’t have a GP as his last one left town 4 years ago. Peter doesn’t remember to take his medications regularly. Peter doesn’t like going to the ED, but often does, because he hasn’t found a GP in town that he likes.
• Assessment The patients a flushed face, with jugular vein distension at the neck
• Vital signs:
• RR = 24, SpO2 = 91% RA (crackles on lower and middle lobes on auscultation without a wheeze),
• HR = 110, BP = 135/80 mmHg, S3 heard on auscultation
• T = 37.0
• GCS = 15, Alert
• BGL =12 mmol/L (lower than normal for Peter)
• Nil pain when resting, chest pain on continued mobilisation.
• Investigations:
• ECG shows sinus tachycardia
• CXR shows enlarged heart, nil other abnormalities
• BMI = 40
• Blood tests:
• LDL cholesterol = 7.5 mmol/L
• triglycerides = 5 mmol/L
• Troponin tests in ED this morning were negative
• The patient has been admitted to the medical ward with a medication chart. On it are the patient’s regular medications and Nitrolingual spray 400 micrograms PRN, Frusemide 40mg BD, and clexane 40mg Subcut BD.
• Conduct a secondary survey of the patient and identify the abnormal findings the patient has.
• Explain the actions of the RN may take to implement and evaluate the chosen essential intervention required to care for the patient in the case study
• It is now 5 days later. The patient has had their condition stabilised and it is time to discharge the patient.
• Discharge the patient ensuing that the elements of the social justice framework are upheld.

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