The Psychopathology of the Person Experiencing Shock - Nursing Assignment Help

Assignment Task

Task

• This supplementary assessment aims to identify your understanding of the pathophysiology of the person experiencing shock and your ability to recognise clinical manifestations of deterioration, identify the deteriorating person’s physiological and compensatory mechanisms and describe appropriate nursing management needed to respond to acute deterioration.
• Part A
• You are required to provide written responses to a series of questions. Your response to each question should be guided by the suggested word length as indicated in the parentheses and needs to be evidence based.
• No introduction of conclusion is required for this assessment task, however your responses must be written in an academic format with supporting evidence. In-text referencing and reference list presentation must comply with APA 7th ed. (2020) guidelines.
• For guidance on standards for assessment preparation, including referencing, please see Assessment Preparation GuidelinesPart B
• You are required to develop a plan of care for Mrs Evans that is based on the immediate acute care phase of her injuries. This plan must be person centred and related to Mrs Evans.
• For this assignment, using the template provided, your care plan must have:
• Two (2) priority actual or potential problems specific to Mrs Evans clinical scenario.
• A person centred, achievable, realistic and timely goal for each problem.
• Two (2) nursing interventions that address the cause of each problem.
• An evidence based discussion supporting your interventions.
• This discussion should provide an explanation of the best practice and evidence as to why these are the most appropriate interventions to address the cause of Mrs Evans problems, rather than a generic overview of the intervention.
• No introduction of conclusion is required for this assessment task, however your responses must be written in an academic format with supporting evidence. In-text referencing and reference list presentation must comply with APA 7th ed. (2020) guidelines.
• CONSIDER THE PATIENT SITUATION
• Mrs Evans is a 31-year-old female involved in a motor vehicle incident, where the car she was driving was T-boned on the front passenger side at a speed of about 70km/h by a truck. The car was shunted into a brick wall.
• Mrs Evans car suffered significant deformity to both sides of the vehicle and she was extricated from the car as her left leg was trapped under the dashboard. She has a significant laceration to her right temporal region, which is currently bandaged with no strike through bleeding.
• Her initial vital signs at the scene were:
• BP 115/75 HR 108bpm
• RR 24 breaths per minute
• SpO2 96% on 6 litres/min via a Hudson mask
• It took the fire crew 40 minutes to cut her from the vehicle. On route to the hospital, her vital signs were:
• BP 87/66 HR 126bpm
• RR 32 breaths per minute
• SpO2 97% on 6 litres/min via Hudson mask
• On arrival to you, you assess the following:
•  
• A – c-spine collar insitu, airway patent – able to open her own, and no obstructions noted, teeth intact.
• B – tachypnoeic – 36breaths/min, increased WOB, decreased breath sounds right lower lobe, nil added sounds.
• C – tachycardic 132bpm and hypotensive 88/64, weak thready radial pulse, cool peripheries, 1 x IVC left CF, NaCl 0.9% infusing on free flow.
• D – Mrs Evans is drowsy but rouses to voice, she is orientated to person place and time, but cannot recall the accident, moving all 4 limbs to command, PEARLA.
• Pain to left leg 8/10 on movement
• E – clothes removed, covered in a warm blanket. Manual in line stabilisation maintained and pt log rolled to visualise posterior – no obvious external bleeding seen.
• Left femur grossly swollen. Some bruising evident across lower abdomen
• Part A
• Process the information related to Mrs Evans and provide an evidence based discussion related to the type of shock she is experiencing including how her injuries could contribute to this shock state. (600 words)
• Identify and define the determinants of cardiac output and describe how they work together to maintain mean arterial pressure (MAP) and how this relates to hypovolemic shock. (400 words)
• Identify three (3) signs and symptoms Mrs Evans is exhibiting that demonstrate she is deteriorating and provide an evidence based rationale for each. (600 words)
• Part B
• Nursing Problem 1 Goal (SMART) Intervention 1 Intervention 2 Discussion (300 words)
• Nursing Problem 2 Goal (SMART) Intervention 1 Intervention 2 Discussion (300 words)
• Part B Rubric
• Criteria HD D C P N

Appropriate problems identified and formulated correctly

• Weight 15% 2 priority nursing problems are identified are clear, concise and highly relevant to patient situation. Problem statement is formulated correctly. 2 priority nursing problems are identified and highly relevant to patient situation. Problem statement is formulated correctly.
• 2 nursing problems are identified and relevant to patient situation. Problem statement is formulated correctly.
• 2 nursing problems are identified and somewhat relevant to patient situation. Some minor errors in formulation of problem statement Potential problems are not relevant to patient situation. Problem statements formulated incorrectly.
• Patient-centred goal (SMART)
• Weight 10%
• 2 excellent, highly relevant and accurate nursing goals that relate to the identified nursing problems are included. Stated goals are clear, realistic and person centred. All elements of a SMART goal are included. 2 relevant and accurate nursing goals that relate to the identified nursing problems are included. Stated goals are mostly clear, realistic and person centred. All elements of a SMART goal are included. 2 suitable that relate to the identified nursing problems are included. Stated goals are moderately realistic and person centred. At least 4 elements of a SMART goal are included. A basic care plan that includes a goal that is relevant and achievable Stated goal is somewhat realistic and person centred and/or only incorporate only 3 elements of a SMART goal Inaccurate and/or poorly constructed nursing goal identified. SMART goal elements are not readily discernible.
• Interventions
• Weight 20% Astute selection of highly appropriate nursing interventions. Identification of highly appropriate nursing interventions.
• Identification of appropriate nursing interventions. Identification of basic nursing interventions. Nursing intervention do not match the desired goal
• Discussion of plan identifies link between cues, pathophysiology and chosen nursing interventions.
• Weight 35% Demonstrates an excellent conceptual understanding as evidenced by clear, complete and accurate discussion of links between cues, pathophysiology, and chosen nursing intervention. Discussions clearly justify actions. Demonstrates a very good conceptual understanding as evidenced by accurate and thorough discussion of the links between cues, pathophysiology and chosen nursing intervention. Discussions clearly justify actions. Demonstrates a good conceptual understanding as evidenced by mostly accurate discussion of the links between cues, pathophysiology, and chosen nursing intervention. Discussions justify actions. Demonstrates a satisfactory conceptual understanding at a basic level as evidenced by somewhat accurate discussion of the links between cues, pathophysiology, and chosen nursing intervention. Discussions regarding justification of actions are limited. Inaccurate/irrelevant or incomplete discussions of links between the cues, pathophysiology, and/or chosen nursing intervention. Discussions do not justify actions or are unclear
• Use of evidence and referencing to support discussion.
• Weight 10% Accurate referencing, including in-text citation placement, is used throughout task in APA 7th format with no errors Accurate referencing, including in-text citation placement and reference list. APA 7th format is used throughout with few minor errors. Accurate referencing, including in-text citation placement, in APA 7thformat is generally evident. Fairly accurate referencing in APA 7th is evident, both in-text and in the reference list, though minor errors are present in either or both areas. Many inaccuracies or omissions are evident/no reference list is provided.
• Academic language (grammar, punctuation), academic structure (layout)
• Weight 10% Demonstrates advanced written communication skills with evidence of: Sophisticated language including use of accurate terminology; highly effective sequencing and structure of paragraphs in body; very well constructed sentences and correct punctuation and spelling
• Demonstrates very good written communication skills with evidence of: Effective language, including use of accurate terminology; effective sequencing and structure of paragraphs in body; well-constructed sentences and very minor punctuation and spelling errors.
• Demonstrates sound written communication skills with evidence of: Sound language, including use of accurate terminology; largely logical sequencing and structure of paragraphs in body; soundly constructed sentences and minor punctuation and spelling errors.
• Demonstrates satisfactory written communication skills, with evidence of: Basic language, including sue of largely accurate terminology; logical sequencing and structure of paragraphs in body; satisfactorily constructed sentences and a number of punctuation and spelling errors. Demonstrates poor written communication skills with evidence of: Poor language, including use of inaccurate terminology; inconsistent sequencing and structure of paragraphs in body; poorly constructed sentences and significant punctuation and spelling errors.

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