Nur250 assess 1 s2 2017 rosie(2) Australia

NUR250 Medical Surgical Nursing 1 S2 2017

Before you begin NUR250 Assessment 1 It is strongly recommended that students revisit and ensure they understand the University and Unit policies and guidelines related to academic integrity, plagiarism, submission, extension, late submission and resubmission.

The Unit Coordinator cannot be held responsible for information about Assessment 1 that students’ access outside of the NUR250 Learnline site.

This includes information students may access from other students, whether enrolled in the unit or not, using social media tools such as Facebook and/or friends and/or colleagues they may discuss their assignment with.

The Unit Coordinator is the person to contact if you have any questions or queries about Assessment 1

NUR250 Assessment 1 Topic:

Nursing care of a patient in a medical surgical setting

Due date:

By 1500 (3pm) Monday 4th September (Semester Break Week)

Length:

2000 words + 150 for words on template

Contribution to overall grade: 40% Assessment purpose

Learning objectives

Assessment 1 is the only written academic assignment in NUR250 for students to demonstrate they:  Are developing the ability to locate, interpret, integrate, synthesize and apply nursing knowledge from NUR250 to a relevant nursing practice scenario in medical surgical settings  Are developing appropriate critical thinking, clinical reasoning and sound clinical decision making processes and strategies essential for safe, evidence-based and competent nursing practice in medical surgical settings  Are able to focus their attention to the needs of the individual patient as the key concern of nursing practice in medical surgical settings  Are able to explain and justify or defend their nursing care decisions  Have a developing understanding of the role and scope of practice of the registered nurse in the Australian health care context  Are progressing towards the level of professional written communication required for nursing practice in Australia  Are demonstrating ethical and professional practice by adhering to the University’s academic integrity standards and plagiarism policy

This assessment addresses the unit learning outcomes; 1, 2, 3, 4 and 5

NUR250 Medical Surgical Nursing 1: Assessment 1 S2 2017

Preparation 

Completion of study materials from weeks 1 to 6 with participation or review of online collaborate sessions and pre-recorded lectures.

Presentation 

On the Assessment 1 template located in the Assessment 1 folder on NUR250 Learnline

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As a computer generated document in Word format.

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1.5 spaced using Arial, Times New Roman or Calibri font in size 11 or 12

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In clear, coherent Australian English that demonstrates progression towards the standard for written communication for professional nursing practice in Australia

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Using appropriate professional terminology

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Contents page, title page, introduction and conclusion are NOT required

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Unless otherwise indicated, no acronyms, abbreviations and/or nursing jargon

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Unless otherwise indicated, grammatically correct sentences and topic paragraphs are required. Dot points only accepted in the nursing care plan

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No more than 10% over or under the stated word count o

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Note: Headings, any task information copied in and in-text citations are included in the word count.

150 words have added to the word count to account for the headings within the nursing care plan template

Use of trade names is not acceptable. Only generic terms or names are to be used when referring to specific medications or other prescribed treatments or resources that may be used in nursing practice

Referencing Students are reminded of their academic responsibilities and professional nursing practice requirements when using the work of others in assignments.

Reminder marks are allocated for academic integrity. See the marking criteria for Assessment 1 for full details.

Breaches of academic integrity will be lodged on the University system and may have serious consequences for students.

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All information is to be interpreted and restated in your own original words demonstrating your ability to interpret, understand and paraphrase material from your sources

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CDU APA 6th referencing style is to be used for both in-text citations and end of assessment references.

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All resources for NUR250 assignments should be from quality, reliable and reputable journals relevant to nursing practice and the Australian healthcare industry or reputable, reliable, professional websites.

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All resources must be dated between 2010 and 2017

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Do not use any health facility or local health service policies or procedures

Markers must be able to access ALL your resources therefore ensure they can be accessed via CDU databases or freely available by internet search.

There must be at least 8 peer-reviewed journal articles and/or evidence based practice guidelines cited in your assignment.

Only 1 current Australian medication textbook and 1 current Australian medical surgical nursing textbook to be referenced (Lemone set of 3 textbooks will be counted as 1 textbook).

Please complete the assessment task on the next page.

NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2017 2

Assessment 1: Nursing care of a person in a medical surgical setting

Meet Rosie You will be caring for her today

Source: sciencesource.com

Shift handover: Rosie, a 76 year old female, is being admitted to your ward from emergency department with acopia and falls for investigation following a fall at home.

Vital signs on admission: blood pressure 150/95, heart rate 110 beats per minute, respirations 20 breaths per minute, SpO2 90% on room air.

On examination in emergency department Rosie was found to have haematomas to her left eye and bilaterally on her knees and a small superficial laceration to her left eye that was sutured in emergency department. A CT of her head and x-rays shows no apparent fractures or abnormalities.

Prior to admission Rosie has been having an increasing number of falls at home over the past few months. She denies dizziness, pain or loss of consciousness contributing to the falls. She states she “just goes weak and falls down”. She reports she sometimes feels quite anxious and breathless post fall.

Rosie has a medical history of hypertension and hypercholesteremia. Rosie, however, is a poor historian claiming “my memory is not quite as good as it once was”.

Rosie lives with her supportive husband, Joe who assists her as needed. Joe states “we have always looked after each other” since coming to Australia from Poland forty years ago. They have never had children and have very few friends or social supports preferring to rely on each other. They try to cook healthy meals a few times a week but are increasingly relying on heating frozen meals or snack foods for convenience.

Joe states he has to assist Rosie a bit more than usual as she seems to be “slowing down” and is becoming increasingly tired and fatigued. He is finding it especially difficult when she falls and is having to rely on the ambulance service to assist to get her up.

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Assessment 1: Based on the handover you received at the beginning of your shift today, other information included below and current reliable evidence for practice, address the following 5 tasks.

Do not make up or assume information in relation to or about Rosie. Only use what you know from the information you received today. _______________________________________________________________________________________________

Task 1: Patient assessment Assessment is one of the major roles of the registered nurse and is the first step in the nursing process to assist in planning and to facilitate mutually established goals and evaluate outcomes. In reality the nurse is continually assessing and re-assessing the patient throughout the continuity of care.

In grammatically correct sentences and topic paragraphs and using current, reliable evidence for practice 

Identify 3 specific nursing assessments that you would conduct as a priority for Rosie’s nursing care that you will undertake on Rosie’s admission to your ward.

AND For each assessment you have identified explain:  Why the assessment is relevant to Rosie’s care.  What consequences may occur if this assessment is not completed accurately?

(300 words, 10 marks)

Task 2: Care planning You recognise that Rosie may require assistance addressing her fundamental care needs.

Based solely on the handover you have received and using the template provided, select five (5) fundamentals of care from Week 1 learning materials and develop a plan of care for each one identifying:      

The related nursing problem The underlying cause or reason that the nursing problem is related to Goal of care Specific bedside nursing interventions you will do The rationales for your nursing interventions and actions Indicators that your plan is working

Notes for Task 2 only  Read beyond the set texts to prepare the nursing care plan. Appropriate resources students might find useful for the care plan ONLY is information on the JBI database  Dot points may be used in the care plan template  Rationales must be appropriately referenced (900 words, 40 marks)

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Task 3: Medication management Three important aspects of medication management by registered nurses is for the nurse to understand why a patient has been prescribed specific medications, understanding the nursing responsibilities and how to monitor the patient to ensure they are responding to prescribed medications as they should.

In grammatically correct sentences and topic paragraphs and using current, reliable evidence for practice, 

AND 

Briefly explain why Rosie has been prescribed: o Atorvastatin 20mg daily o Ramipril 10mg daily o Aspirin 100mg daily Identify and explain o The specific nursing responsibilities associated with administering each medication o How you will monitor Rosie for expected, side and adverse effects of each medication.

(300 words, 10 marks)

Task 4: Patient teaching Nurses are in a prime role to support and encourage healthy lifestyle changes and educate patients on healthy living to reduce the risk of morbidity and mortality of hypertension and hypercholesteremia.

You recognise part of your nursing role is to provide Rosie with education on the modifiable risk factors for hypertension and hypercholesteremia during her hospital stay.

Select one (1) of the diagnoses above and, in grammatically correct sentences and topic paragraphs,  AND 

Identify the specific information you will need to explain to Rosie about the topic Explain o Why the topic is an important aspect of Rosie’s care o How you will ensure that Rosie knows and understands why it is important and, if appropriate to the topic, what she needs to do

(200 words, 10 marks)

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Task 5: Clinical judgement and handover There are two (2) parts to Task 5.

Part A: When removing Rosie’s breakfast tray this morning you notice she has not eaten and ask her why. She states she slept badly overnight as she could not get comfortable lying down and she is feeling anxious about Joe being on his own. As a result she is now feeling nauseous and unwell. She denies pain apart from slight indigestion which she often gets lately but it usually goes away on its own. She is feeling irritable so you leave her to rest.

On your return you find Rosie extremely agitated and trying to get out of bed stating she has to call Joe. Visually assessing Rosie as you assist her back into bed you notice Rosie’s skin appears very pale and slightly bluish grey. She appears dyspnoeic and slightly breathless with shallow, rapid respirations. Her skin feels cool and moist and her ankles appear swollen.

On further assessment you find:  Respiratory rate is 28 - 32 breaths/minute  Oxygen saturations are 84% on room air  Heart rate 140 beats/minute.  Radial pulse is weak and thready and difficult to palpate.  Blood pressure is 90/80 mmHg but faint and difficult to detect clear margins.

In grammatically correct sentences and topic paragraphs, 

Identify o What you think is happening o Your immediate nursing actions and interventions o The reason for your actions and interventions

Part B: An important legal requirement of nursing practice is to effectively and succinctly communicate relevant information, actions and outcomes related to patient care and provide an accurate reflection of the health status of the patient, their responses to care and the patient’s perspective.

Once Rosie’s condition has been stabilised, the doctors arrange to transfer Rosie to the Coronary Care Unit for closer monitoring and management.

Using the ISBAR format, information from the handover you initially received and the additional information above: 

Write a written handover that clearly and succinctly outlines the important information the coronary care unit needs to know about Rosie

Your handover must:  Demonstrate person-centred care  Adhere to the legal and professional nursing standards for documentation  Be in appropriate professional language  Contain NO abbreviations or nursing jargon (Part A and B: 300 words, 10 marks)

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