NUR2203: Sarah Browna Case Study - Nursing Assignment Help

Assignment Task

Assignment Objectives

1. Demonstrate the use of research evidence for nursing practice applied to the care of a surgical patient
2. Augment skills in clinical decision making and reasoning through synthesising and analysing information required to care for a surgical patient 
3. Apply appropriate assessment, problem solving, planning, prioritising of interventions to care for the selected client scenario chosen
4. Demonstrate the nurse’s role in monitoring and implementing prioritised nursing interventions in response identified patient needs
5. Demonstrate the ability to communicate specific patient care issues succinctly according to scholarly writing and referencing conventions
Assessment Purpose

Standard 1: Thinks critically and analyses nursing practice.
RNs use a variety of thinking strategies and the best available evidence in making decisions and providing safe, quality nursing practice within person-centred and evidence-based frameworks.
Standard 4: Comprehensively conducts assessments. RNs accurately conduct comprehensive and systematic assessments. They analyse information and data and communicate outcomes as the basis for practice.
Standard 6: Provides safe, appropriate and responsive quality nursing practice.
RNs provide and may delegate, quality and ethical goal directed actions. These are based on comprehensive and systematic assessment, and the best available evidence to achieve planned and agreed outcomes.
Standard 7: Evaluates outcomes to inform nursing practice.
RNs take responsibility for the evaluation of practice based on agreed priorities, goals, plans and outcomes and revises practice accordingly

Case Study

Sarah Browna 66 year old retired teacherhas been admitted for an openright hemicolectomy. Sarah presented to her GP with a three month history of generalised abdominal pain and occasional diarrhoea.  A colonoscopy found a mass in the ascending colon. Initial pathology of the biopsy showed apoorly differentiated adenocarcinoma of the ascending colon. Please refer to the following pre and post-operative assessment data to answer the assignment questions. 

Pre-operative clinical data

Postoperative clinical data
Sarahreturned from theatre at 1700 following an open right hemicolectomy for a poorly differentiated adenocarcinoma of the ascending colon with lymph node metastasis in two out of 28 dissected lymph nodes.  You are the nurse looking after Sarah on the night shift.  You have arrived on the ward at 2100 and will be looking after Sarah on the night shift. 

Task description

This assignment requires you to consider the case scenario ofSarah Brown who has undergone a laparotomy.
Your answer will concentrate on the first 24 hours of post-surgical care.
Subheadings are required for each question

1. Provide an INTRODUCTION (approximately 100 words) 
An introduction will provide clear scope about the direction of your assignment.  This includes providing some background to your essay (not restating the case) and defining the issues that you will be addressing in your discussion. 

Part A: Use template provided at the end of this document: Maximum 2 pages (10 font)
This section will focus on the first 24 hours of post-surgical care. Prioritisation of care is required. 
This part of the assignment asks you to formulate a plan of care including the following 4 elements: 
• Assessment
• Potential clinical issues
• Interventions (independent nurse initiated interventions and collaborative interventions)
• Rationales (supporting the interventions)
Using the provided plan of care template, identify priority clinical issues, and nursing interventions (refer to the example provided)
1. Gather ASSESSMENT:Analyse the case scenario and document appropriate assessment data from the case study. Consider the clinical data you have been given BP, RR, urine output and the data that is missing e.g. Respiratory rate = 12 but what is the depth / quality/ breathe Sarah’s breathing
2. Identify FOUR (4)PRIORITY clinical problems for Sarah. Justify each problem based on the data collected and analysed from Sarah’s clinical assessment data. e.g. at risk of severe pain
3. IdentifyNURSING INTERVENTIONSrelated to the clinicalissues.For each of the FOUR clinical issuesprovide nursing interventions (with rationales) e.g. Encourage deep breathing exercises hourly
4. Provide RATIONALES to support your interventions along with supporting relevant referenced literature / research.   For the intervention: Encourage deep breathing exercises including use of the spirometry hourly; provide a rationale: further promotes normal lung expansion and increases oxygen levels, is useful in preventing pneumonia and atelectasis

Part B: Analysing and discussing the case to identify potential clinical issues (1100 words)

1. Discuss Sarah’s co-morbidities including smoking, cardiac heart disease, obstructive sleep apnoea (OSA) (previous MI, hypertension and hypercholesterolemia) in the context of having a general anaesthetic (GA) and specific to the 24 hour postoperative period. 
2. ChooseTWO (2)potential clinical complications related to the co-morbidities that could arise in the 24 hour period. 
3. Discuss the relevant assessment/s and interventions the nurse would initiate to identify and prevent clinical deterioration. Provide rationales for your actions/ interventions and support with academic literature

Part C: Discharge planning (700 words)
1. Plan and prioritise discharge advice and a plan for Sarah
2. In the discharge plan, consider the appropriate post-operative education for Sarah including the surgical procedure.  Concisely provide a discharge plan and education around medication, prevention of post-operative complications, psychosocial issues, and lifestyle modification
3. Refrain from merely providing generic information.  Be succinct and appropriate in your advice but also critically evaluate the information in the case and specifically relate this to your discharge plan.  
 

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