NUR2102 - Clinical Skills for Nursing Practice Assignment

Assignment Task

Brief 

Written care study analysis for people with musculoskeletal, endocrine, respiratory, circulatory conditions and people with pain and infection. You may refer to the case studies in your residential laboratory manual for more information.

Choose 2 of the following case studies for your case study analysis

Rationale

Registered Nurses are required to think through the different aspects of patient care to arrive at a reasonable decision regarding the diagnosis, and treatment of a clinical problem for the person in their care.

Task detail

Case study 1

Ms. Chris Brown (date of birth 29/09/1986), was diagnosed at age 8 with type 1 diabetes. She has been admitted with moderate dehydration and unstable glucose levels associated with Quinsy which he has had for the past four days. She has not been able to eat very much for a couple of days and over the past 24 hours has only had sips of liquids. She hasn't been able to swallow tablets so hasn't been able to have pain relief and is in considerable pain.
Chris did have several episodes of tonsilitis as a very young child, however, a tonsillectomy wasn't considered appropriate. She then 'grew out of it' until a couple of years ago when and she has had worsening tonsilitis 3-4 times per year. She is currently waiting to see a specialist about having her tonsils removed. Chris reports an allergy to Penicillin causing anaphylaxis. She has no other medical conditions. Chris is currently afebrile but her partner, Michelle, states she has witnessed Chris having rigors over the past 24 hours.

Questions 

1. Briefly describe the pathophysiology for one of the medical diagnoses 

2. List two signs and symptoms that assist in identifying the nursing diagnosis from the medical condition selected for question 1

3. List two nursing diagnosis from the NANDA list

4. List two priority nursing interventions that are required for Chris Brown based on the signs and symptoms and nursing diagnosis you selected for questions 2 and 3 

5. Develop rationales for Chris Brown for each of these two nursing interventions listed in 

Case study 2

Mrs. Xia Wang (date of birth 14/02/1931), UR number: 226984, recently suffered a fall and fractured her left femoral neck. She has since had a hip replacement to repair the fracture and has arrived on the ward post-operatively. Mrs. Wang is originally from the Jiangxi province of China, migrating to Australia with her husband (now deceased) when they were in their 20s. She has 2 children and several grandchildren and great-grandchildren. Her family all live near her nursing home and visit her regularly.
Mrs. Wang's medical history includes hypertension, rheumatoid arthritis in both hands, osteoporosis, and urinary tract infections. She suffered a cerebrovascular accident (CVA) ten years ago which left her with mild urinary incontinence and mild left hemiplegia, she uses a wheelie walker and is usually independent when mobilising. She is also slightly forgetful.

Questions

1. Briefly describe the pathophysiology for one of the medical diagnose

2. List two signs and symptoms that assist in identifying the nursing diagnosis from the medical condition selected for question 1 

3. List two nursing diagnosis from the NANDA list 

4. List two priority nursing interventions that are required for Xia Wang based on the signs and symptoms and nursing diagnosis you selected for questions 2 and 3

5. Develop rationales for Xia Wang for each of these two nursing interventions listed in question 

Case study 3

Mr. Ken Burns (date of birth 15/10/1956) has been admitted with chest crackles, shortness of breath, high respiratory rate, high work of breathing, and low saturations. He has copious green sputum and a moist cough. He has poor urine output. He is unable to eat or drink due to shortness of breath and was ordered 2 L on nasal prongs, but keeps removing them. He has been ordered high flow. He has been diagnosed with community-acquired streptococcus pneumonia (due to his chest x-ray, sputum, and observations), he is in the hospital every few months and is known to the hospital. He has been diagnosed with chronic heart failure, atrial fibrillation, and hypertension.

Questions 

1. Briefly describe the pathophysiology for one of the medical diagnoses 

2. List two signs and symptoms that assist in identifying the nursing diagnosis from the medical condition selected for question 1

3. List two nursing diagnosis from the NANDA list

4. List two priority nursing interventions that are required for Ken Burns

Case study 4

Master Jamie Peel (date of birth 24/12/2013) has an anaphylactic allergic to peanuts. He has a history of mild asthma triggered by peanuts. Jamie was at school when he accidentally ate peanuts. He has had an injection of his EpiPen (300 microg EpiPen Jr) by the nurse at school. He is now in the emergency department (ED) with a slight wheeze. Jamie's inhalers have been via a spacer. Jamie continues to be lethargic and is on 2 hourly vital signs, he is having regular salbutamol and ipratropium via a metered dose inhaler and spacer. He has an order for IV fluids for dehydration. Oral fluids are to be encouraged.

Questions

1. Briefly describe the pathophysiology for one of the medical diagnoses 

2. List two signs and symptoms that assist in identifing the nursing diagnosis from the medical condition selected for question 1 

3. List two nursing diagnosis from the NANDA list 

4. List two priority nursing interventions that are required for Chris Brown based on the signs and symptoms and nursing diagnosis you selected for questions 2 and 3

5. Develop rationales for Jamie Peel for each of these two nursing interventions listed in question 3

Case study 5

Dr. Narendra Singh (date of birth 01/12/1956), was brought in by ambulance to the emergency department. He is complaining of 10/10 chest pain radiating down his left arm and into his jaw. Has been diagnosed with refractory angina. He has a history of 3x myocardial infarctions and peripheral vascular disease. He has chest crackles, shortness of breath, high respiratory rate, high work of breathing and saturation of 90%. He is on a fluid restriction of 1.5 L per day.

Questions

1. Briefly describe the pathophysiology for one of the medical diagnoses 2. List two signs and symptoms that assist in identifying the nursing diagnosis from the medical condition selected for question 1 

3. List two nursing diagnosis from the NANDA list 

4. List two priority nursing interventions that are required for Narendra Singh based on the signs and symptoms and nursing diagnosis you selected for questions 2 and 3

5. Develop rationales for Narendra Singh for each of these two nursing interventions listed in question 3 

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