NRS387: Clinical Reasoning in Nursing 5

Assignment Overview

Task

For this assessment task, you are required to write a scholarly document responding to the following case study and topic questions.

Case Study

A 70-year-old female patient with a history of Chronic Obstructive Pulmonary Disease (COPD) presents to the emergency department with severe respiratory distress. She is exhibiting:

• Tracheal tug

• Tachypnoea with significant work of breathing (respiratory rate: 30 breaths/min)

• Hypoxia and peripheral cyanosis (oxygen saturation: 85% on room air)

• Hypotension (BP: 90/60 mmHg)

• Signs of confusion

• Self-positioning into the tripod position

Topics to Respond To

1. Communication Strategies (Approx. 300 words)

Discuss two (2) evidence-based communication strategies that a Registered Nurse can apply when supporting a patient experiencing anxiety and confusion during a respiratory emergency.
The response must focus on:

• Patient safety

• Building trust
  Include one supporting example from your student RN experience or from relevant literature.

2. High-Flow Nasal Prongs (Approx. 300 words)

Explain:

• One (1) indication for administering high-flow nasal prongs in mild respiratory compromise

• One (1) contraindication for this intervention
  Your answer must also describe how high-flow nasal prongs promote safety and healing.

3. Nursing Responsibilities for Chest Drains (Approx. 300 words)

Discuss two (2) key nursing responsibilities when caring for a patient with a chest drain.
Explain how these responsibilities help to:

• Ensure patient safety

• Minimise the risk of complications

4. Managing the Deteriorating Patient (Approx. 700 words)

Outline the immediate steps a Registered Nurse would take when managing the deteriorating patient described in the case study. Your answer must address:

1. The role of the Rapid Response Team

2. Oxygen administration and airway management

3. Patient positioning and continuous observation monitoring

4. How these interventions contribute to patient safety and prevent further deterioration

Assessment Requirements Summary

This assessment required the student to produce a scholarly document in response to a clinical case study involving a 70-year-old female patient with Chronic Obstructive Pulmonary Disease (COPD) experiencing severe respiratory distress. The student was expected to address four key topics:

1. Communication Strategies – Identify and discuss two evidence-based communication strategies a Registered Nurse (RN) can use to support a patient experiencing anxiety and confusion during a respiratory emergency, with a focus on patient safety and building trust. An example from practice or literature was required.

2. High-Flow Nasal Prongs – Explain one indication and one contraindication for using high-flow nasal prongs in patients with mild respiratory compromise, including how this intervention promotes safety and healing.

3. Nursing Responsibilities for Chest Drains – Discuss two key nursing responsibilities when supporting a patient with a chest drain and explain how these responsibilities ensure patient safety and minimise risks of complications.

4. Managing the Deteriorating Patient – Outline the immediate steps an RN would take in the case of a deteriorating patient. This includes the role of the Rapid Response Team, oxygen administration and airway management, patient positioning and continuous monitoring, and an explanation of how these interventions promote safety and prevent further deterioration.

The assessment had word guidelines: 300 words for the first three topics and 700 words for the fourth, emphasizing evidence-based practice, clinical reasoning, and patient-centered care.

Approach by the Academic Mentor

The Academic Mentor guided the student through a step-by-step process to complete the assessment effectively:

1. Understanding the Case Study

   • The mentor first helped the student analyse the patient scenario, identifying key clinical signs (e.g., tracheal tug, tachypnoea, hypoxia, hypotension, confusion).

   • The student was instructed to highlight priority concerns such as airway, breathing, circulation, and patient safety.

2. Structuring Responses for Each Topic

   • Communication Strategies: The mentor guided the student to research evidence-based communication techniques (e.g., clear instructions, calm reassurance) and link them to patient safety and trust-building.

   • High-Flow Nasal Prongs: The mentor helped the student identify clinical indications and contraindications, explaining physiological rationale and safety considerations.

   • Chest Drain Responsibilities: The mentor encouraged the student to focus on monitoring, infection prevention, and complication management.

   • Deteriorating Patient Management: The mentor instructed the student to organize the response logically: role of the Rapid Response Team, oxygen therapy, airway management, positioning, and continuous observation, linking each to safety outcomes.

3. Incorporating Evidence and Examples

   • The mentor emphasized supporting answers with literature or examples from clinical experience, reinforcing academic rigor.

   • Students were guided on proper referencing to maintain credibility.

4. Drafting and Reviewing

   • The mentor assisted the student in drafting each section within the word count, ensuring clarity, coherence, and relevance to patient-centered care.

   • Feedback was provided to refine explanations, particularly on how interventions directly enhance patient safety and reduce risk of deterioration.

Outcome Achieved

• The student produced a well-structured scholarly document addressing all four topics.

• Each section contained evidence-based explanations, linked to clinical reasoning and patient safety.

• Word limits were adhered to, with clear organization and logical flow.

• The assessment demonstrated the student’s understanding of nursing responsibilities, emergency care, and effective communication strategies.

Learning Objectives Covered

1. Apply evidence-based communication strategies in high-anxiety, emergency scenarios.

2. Understand indications, contraindications, and safety principles for high-flow oxygen therapy.

3. Identify and execute key nursing responsibilities in managing chest drains.

4. Respond appropriately to deteriorating patients, including collaboration with emergency teams.

5. Integrate clinical reasoning, patient safety, and professional judgment into practice.

6. Develop scholarly writing skills in a healthcare context, supported by references and evidence.

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