NURS12160: Acute Alterations in Health Assessment 1

Assessment 1

Learning Outcomes Assessed

1. Identify the National Health Priority Areas (NHPA) and discuss their impact on a person's acute health status.
5. Determine the nursing role in each phase of the perioperative period.

Aim

The aim of this assessment is for you to demonstrate your ability to discuss the care and management of a patient with an acute health condition and examine a relevant National Health Priority Area (NHPA), while discussing its impact on perioperative nursing care.

Scenario

John is a 53-year-old male who presents with obesity, a BMI of 38 and a strangulated, painful
right inguinal hernia. His medical history is comprised of obstructive sleep apnoea and is managed with home a Continuous Positive Airway Pressure (CPAP) machine. John is admitted for an emergency inguinal hernia repair under general anaesthesia. You are a second-year student nurse allocated to support John's care throughout his perioperative period.

Please answer the following three questions relating to the scenario:

1. Identify the National Health Priority Area (NHPA) relevant to John's condition and how it impacts his acute health status. Discuss how this NHPA influences pre-operative care planning and discuss two (2) pre-operative nursing assessments required for obesity- related risk management in the post-operative period (approximately 300 words).

2. Identify two (2) nursing interventions required during John's surgery to minimise obesity- related risks in the intraoperative phase of the perioperative journey. Provide a rationale for each intervention (approximately 300 words).

3. Discuss three (3) nurse-led interventions required in the postoperative period to support John's recovery and prevent common complications associated with obesity following intra-abdominal surgery. Provide a rationale for each intervention (approximately 400
words).

Brief Summary of the Assessment Requirements

This assessment focuses on applying theoretical knowledge to the perioperative care of a patient with an obesity-related acute condition. Students must demonstrate an understanding of:

1. National Health Priority Area (NHPA)

• Identify which NHPA is relevant to the patient scenario.
• Explain how the NHPA affects the patient’s acute health status.
• Discuss how this NHPA shapes pre-operative nursing care planning.
• Describe two pre-operative nursing assessments specifically related to obesity-risk management.

2. Intraoperative Nursing Interventions

• Identify two evidence-based nursing interventions required during surgery.
• Provide a clear rationale showing how each intervention minimises obesity-related surgical risks.

3. Postoperative Nurse-Led Interventions

• Discuss three postoperative nursing interventions essential for recovery.
• Explain their rationales and how they prevent obesity-related postoperative complications.

Overall Aim of the Assessment

To evaluate the student’s ability to:

• Discuss acute care needs for a patient with obesity and complications (hernia).
• Link these needs to a relevant NHPA.
• Demonstrate understanding of nursing responsibilities across pre-operative, intraoperative, and postoperative phases.

How the Academic Mentor Guided the Student (Step-by-Step Approach)

Step 1: Understanding the Scenario

The mentor began by helping the student break down the scenario:

• John, 53 years old, obese, BMI 38
• Acute condition: strangulated inguinal hernia
• Medical history: obstructive sleep apnoea (OSA)
• Undergoing emergency surgery under general anaesthesia

This step helped the student identify risk factors and clinical relevance.

Step 2: Identifying the Relevant NHPA

The mentor guided the student to recognise that Obesity is the NHPA linked to John’s condition.
Together they analysed:

• How obesity increases surgical risks
• How it affects anaesthesia, airway management, wound healing, and OSA
• Why obesity is a national health priority in Australia

This provided the foundation for answering Question 1.

Step 3: Pre-Operative Care Planning

The mentor helped the student outline:

• How obesity influences the preoperative plan
• Key assessments such as:
  1. Respiratory assessment (sleep apnoea, airway complications)
  2. Cardiovascular/metabolic assessment (BP, diabetes risk, circulation)

The mentor emphasised linking each assessment to postoperative risk prevention.

Step 4: Intraoperative Interventions

To address Question 2, the mentor guided the student to:

• Identify obesity-related intraoperative risks (airway, oxygenation, pressure injuries, positioning issues)
• Select two interventions such as:
  • Safe patient positioning and pressure area care
  • Optimised ventilation strategies
• Provide rationales using clinical reasoning

This taught the student how to justify nursing decisions with evidence.

Step 5: Postoperative Nurse-Led Interventions

For Question 3, the mentor supported the student in analysing postoperative priorities:

• Respiratory care (risk of atelectasis, OSA complications)
• Early mobilisation (prevent DVT, respiratory issues)
• Wound monitoring and care (reduced healing capacity in obesity)

The mentor guided the student to write rationales connecting each intervention to obesity-related risk factors.

Step 6: Structuring the Written Responses

The mentor provided guidance on:

• Word count distribution
• Academic tone
• Logical flow
• Using clinical reasoning
• Linking back to NHPA and perioperative phases

This ensured clarity and alignment with marking criteria.

Final Outcome

By following the mentor’s structured approach, the student completed:

• A well-organised response of approximately 1,000 words
• Clear identification of the relevant NHPA
• Thorough discussion of pre-operative assessments, intraoperative interventions, and postoperative nursing strategies
• Strong rationales reflecting understanding of acute care and perioperative nursing
• Responses that were clinically accurate, evidence-informed, and relevant to the scenario

Learning Objectives Achieved

Through the guided process, the student successfully met the learning outcomes:

LO 1:

Identify the National Health Priority Areas (NHPA) and discuss their impact on acute health status The student recognised obesity as the NHPA and explained its effect on John’s condition, risks, and overall perioperative care plan.

LO 5:

Determine the nursing role in each perioperative phase. The student demonstrated knowledge of:

• Pre-operative assessments
• Intraoperative nursing interventions
• Postoperative management and complication prevention

Additional Learning Achievements

• Strengthened clinical reasoning
• Improved understanding of acute surgical patient management
• Ability to link national health priorities to everyday nursing practice
• Knowledge of safe and effective perioperative care for high-risk patients

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