Explain and justify or defend their nursing care decisions
Explain and justify or defend their nursing care decisions
Nursing care of a patient with a medical condition
Length: 2000 words ± 10% + 100 words to account for the headings in the template. Markers will stop reading at the maximum allowable word count. This word count includes the text in the template provided to you.
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 This assessment addresses the unit learning outcomes;
1, 2, 3, 4 and 5
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S1 2020
policy
Preparation
• Timely completion of study materials including weeks 1-6 with participation or review of online collaborate sessions, pre-recorded lectures or internal classes.
Presentation Guidelines
• On the Assessment 1 template located in the Assessment 1 folder on NUR250 Learnline
• As a computer generated document in Word format.
• 1.5 spaced using Arial or Calibri font in size 11 or 12
• In clear, coherent Australian English that demonstrates progression towards the standard for written communication for professional nursing practice in Australia.
• Written in third person narrative.
• Using appropriate professional terminology
• Contents page, title page, introduction and conclusion are NOT required
• Unless otherwise indicated, no acronyms, abbreviations and/or nursing jargon
• Unless otherwise indicated, grammatically correct sentences and topic paragraphs are required. Dot points only accepted in the nursing care plan.
• No more than 10% over or under the stated word count. Marking will cease at the 10% over mark.
o Note: Headings, any task information copied in and in-text citations are included in the word count. 100 words have been included in 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.
• 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
• CDU APA 7th referencing style is to be used for both in-text citations and end of assessment reference list.
• All resources for NUR250 assignments should be from quality, reliable and reputable journals relevant to nursing practice and the Australian healthcare industry. Please DO NOT use patient information leaflets.
• All resources must be dated between 2010 and 2020
• There must be at least 10 peer-reviewed journal articles and/or evidence-based practice guidelines cited in your assignment.
• Do not use any health facility or local health service policies or procedures
• Only 1 current Australian medication textbook and 2 current Australian medical surgical nursing textbooks to be referenced.
Please complete the assessment task on the next page.
Assessment 1: Case scenario one
Shift handover:
Identify: Mr Robert Lalara, HRN: 123456, DOB: 20/01/1978
Situation: Robert is a 42 year old Indigenous man from a remote community. He has been admitted to the CDU medical ward with chest pain and a ‘racing heart’. His ECG shows Atrial Fibrillation (AF).
Background:
Robert lives in a single-story home with his wife, 4 children and 2 grandchildren. He is independent with his cares.
He has an extensive past medical history including:
T2DM, smoker (10 per day), HTN, hyperlipidaemia, rheumatic heart disease and mitral valve regurgitation.
No known drug allergies (NKDA).
Assessment:
Airway: Own, patent
Breathing: RR 18, oxygen saturations 96% on room air.
Circulation: HR 115 bpm (irregular), BP 120/80 mmHg. His ECG shows Atrial Fibrillation (AF)
Disability: GCS 15/15, 2/10 central chest pain, feels tired and a ‘bit worried’.
Exposure: Temp 37.0 oC
Recommendations/Read back:
Medical orders
• Repeat ECG
• Pain management
• TED stockings and DVT prophylaxis
Medication orders New medications:
• Digoxin 125mcg PO STAT
• Rivaroxaban 20mg OD PO
Usual medications:
• Ramipril 10mg OD PO
• Simvastatin 20mg OD PO
Assessment 1: Case scenario two
Shift handover:
Identify: Ms Laura Purple, HRN: 123678, DOB: 16/09/1960
Situation: Laura is a 59 year old Caucasian lady from Darwin. She has been admitted to the CDU medical ward with Bronchitis. She has a 1/7 history of dyspnoea.
Background:
Laura lives in a two-story home with her husband. She is independent with her cares.
She has a past medical history of:
Asthma, T2DM, smoker (20 per day), hyperlipidaemia and obesity.
No knowndrug allergies (NKDA).
She is obese (BMI 30) and drinks 1 bottle of wine every night.
Assessment:
Airway: Own, patent
Breathing: RR 28, Sats 93% on room air. Expiratory wheeze noted.
Circulation: HR 115 bpm, BP 130/90 mmHg.
Disability: GCS 15/15, 2/10 sharp chest pain on inspiration Exposure: Temp 38.6 oC
Recommendations/Read back:
Medical orders
• Chest X-ray ordered
• Administer medications as charted
• Commence oxygen therapy
• TED stockings and DVT prophylaxis
Medication orders New medications:
• Prednisolone 25mg OD PO
• Azithromycin 500mg OD PO
Usual medications:
• Ipratropium bromide MDI 21mcg INH
• Salbutamol MDI 100 mcg PRN INH
Assessment 1 Tasks:
Choose from one of the patients handed over to you. Using the template provided in the Assessment 1 folder and, 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 tasks.
Task 1: Consider the patient
Based on the case scenario and in grammatically correct sentences:
• Define the patient’s current medical condition/disease.
• Explain the pathophysiology of the disease.
• Discuss how the current presentation relates to the patients past medical history?
(Approximately 500 words)
Task 2: Care plan
Based solely on the handover you have received and using the template provided, complete a nursing care plan for your chosen patient. Your plan must address the physical, functional and psychosocial aspects of care.
Three (3) nursing problems have been provided for you. For each nursing problem on your care plan you need to complete the following sections:
• What it is related to?
• Goal of care
• Interventions
• Rationales for interventions
• Evaluation
Notes for Task 2 only
• Dot points and single line spacing may be used in the care plan template.
• Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
• All rationale must be appropriately referenced (Only the rationales need to be referenced in the care plan).
(Approximately 500 words)
Task 3: Patient education
Discharge planning
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or prevention of reinfection or deterioration on discharge.
Patient education and discharge planning starts on admission and you need to provide your patient with education during your shift in preparation for discharge home.
• Explain two (2) important points/topics you will need to include in the patient’s preparation for discharge to aid healing and prevent further illness.
For each education point identified provide:
• One (1) strategy to assist the patient to implement the education into their daily routine.
(Approximately 500 words)
Task 4: Medication
Choose two (2) medications that your patient has been prescribed (one (1) from their new medications list and one (1) from their usual medications list) and discuss the following:
How does the medication work?
Why has your patient been prescribed this medication? Discuss any side effects that could affect the patient.
(Approximately 500 words)
Your assignment must include a reference list after the completion of the tasks and a key if you have used abbreviations in task 2.
NUR250 Assessment 1 Marking Rubric S1 2020
5-7.5
Excellent 3-5
Satisfactory 0-3
Needs Development
Criterion:
Task 1: Consider the patient Explains clearly, succinctly and specifically the pathophysiology of the patient’s disease, considering past medical history. Explains the pathophysiology of the patient’s disease, considering past medical history with some clarity. Explains the pathophysiology of the patient’s disease but the discussion is not clear and/or does not link to the case study.
Criterion:
Task 2: Care planning Develops individualised, comprehensive nursing care plan relevant to the case study using the clinical reasoning cycle. All rationale is referenced. Demonstrates strong
critical thinking skills Develops individualised, comprehensive nursing care plan relevant to the case study using the clinical reasoning cycle. Most rationale is referenced. Demonstrates emerging critical thinking skills. Care plan has been completed using the clinical reasoning cycle, but it is not individualised or comprehensive. There is a discourse between the sections of the care plan. No critical thinking skills displayed.
Criterion:
Task 3: Discharge planning Demonstrates a high-level ability to provide relevant and comprehensive patient education. Provides specific patient education discussing two topics with an implementation strategy.
Demonstrates a satisfactory ability to provide relevant and comprehensive patient education; discussing two topics with an implementation strategy. Discussion lacks detail and/or is not person centred care
Poor interpretation of task or Education is provided but it is not specific to the patient. No implementation strategy is identified.
Criterion:
Task 4:
Medication
Provides excellent, relevant and specific discussion about medications. Side effects are discussed. Demonstrates strong critical thinking skills. Provides a satisfactory discussion about medications. Discussion is not specific. Side effects are identified. Demonstrates emerging critical thinking skills.
Provides a limited discussion about medications. Side effects are not identified and/or Discussion is not specific to the case study. No critical thinking skills displayed.
Referencing 4-5
All ideas supported with intext citations and there is a complete and accurate reference list.
No errors detected in CDU APA 7th format.
Referencing guidelines met. 2-3
Some ideas supported with intext citations and there is a complete reference list.
A few errors detected in CDU
APA 7th format. Referencing guidelines met with errors. 0-1
Many references are missing and there are many errors in CDU APA
7TH format. Referencing guidelines not met.
Presentation 4-5
No errors with grammar, syntax, sentence and paragraph structure.
