NSB236 - The Deteriorating Patient Case Study - Physiology and Pathophysiology - Nursing Assessment Answer

Assessment Task:

NSB236 Nursing Assessment Answer

What you need to do:

In order to undertake this essay, you will need to research the topic using current and relevant peer-reviewed literature and review of:

The lecture and tutorial material associated with the relevant topic.

Your knowledge and understanding related to:

1. The physiology and pathophysiology of the primary diagnosis and associated clinical data identified within the chosen case study;

2. The physiological assessments are relevant to the features within the case study.

3. Refer to blackboard resources available under assessment 1

Task Outline

1. Identify two (2) signs or symptoms of clinical deterioration related to the neurological injury sustained by Mr Collins and using current and relevant literature critically discuss how the neurological injury causes the manifestations of these signs or symptoms.

2. Using the case study information (Mr Collins) identify one (1) priority problem that needs to be addressed in order to prevent further clinical deterioration. The priority problem should be justified and supported through the application of contemporary research.

3. Identify and critically discuss three (3) interventions that directly address the priority problem you have identified, using evidence from current, relevant and peer-reviewed literature. (Note: a maximum of 1 can be related to a pharmacological intervention). You must explain the links between the clinical data from the case in order to justify why have selected these three interventions as priorities to address the problem statement.

4. Using current, relevant and peer-reviewed literature discuss how you would evaluate the efficacy of the recommended interventions and specify expected data that would be observed if the interventions were effective.

Supplementary assessment case study

Situation: Randall Collins (72 years of age) has been admitted post operatively to the high dependency neurosurgical unit. Mr Collin’s was diagnosed with a subarachnoid haemorrhage (Hunt Hess grade 3; CT scan reports Fisher scale grade 3 subarachnoid haemorrhage) with Terson syndrome, and has undergone a surgical coiling of an aneurysm on the left middle cerebral artery.

Background: Increased frequency of generalized headaches at home. Wife reports he was in the kitchen getting some Panadol, called out to the wife and collapsed on the kitchen floor. She called triple 000 and the patient was brought into the hospital via Ambulance.

Past medical history: Hypertension, Ischemic heart disease, coronary artery bypass graft [CABG] (triple vessel disease) in 2013, atrial fibrillation (onset post-CABG), osteoarthritis.

Assessment; Day 2 postoperatively: Mr Collins is cared for in a busy and fully occupied 4 bedded bay. On assessment, he is found to be responding inappropriately to questions, appears confused and is disorientated to person, place and time. His speech characteristics are consistent with dysarthria. He has vomited once this morning and appears to be in some discomfort – holding his head and grimacing.

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