Reference no: EM131594415 , Length: word count:1800

Written case study essay Assignment

Learning Outcomes -

• Develop an appropriate response to the acute nursing needs of a diverse range of clients.
• Utilise evidence based practice to identify and problem solve the needs of patients in acute situations

Assessment Instructions -

Dave Sawyer (DOB: 24/10/1991) is a FIFO worker who lives near Collie. Dave has just completed his rotation of night shifts and flown straight home for his R&R days. Dave decided to go into the nearby bush to collect wood for his indoor fire, as he was low on wood and the weather is cold. Whilst using his chainsaw, the chainsaw cut through one of the pieces of wood, and Dave didn't take his finger off the trigger in time, resulting in a jagged 10cm long, deep laceration to his right calf, running parallel with his tibia.

Dave went to ED, and on arrival Dave's observations were: T-36.7°C, HR-89bpm, RR-20pm, BP-139/68mmHg, O₂-95% RA, pain score 9/10. Dave was given opioid analgesia for his pain, the wound dressed, and he was reviewed by the ED doctor. It was arranged for Dave to undergo surgery for debridement and skin flap to repair the laceration. Dave is allergic to elastoplast (causing pruritus and welts), is not on any medications, and has no other medical problems.

You are looking after Dave on his return to the ward post-operatively at 11:45hrs. Doctor's post-op orders are for routine observations, dressing to stay intact for 72hrs, keep leg elevated, and neurovascular observations four-hourly. He is awake and alert, and he has a dressing on his right calf, with minimal sanguineous ooze evident. Dave's observations on return to ward are: T-36.1°C, HR-66bpm, RR-16pm, BP-109/71mmHg, 02-95% RA, and pain score 2/10. Dave was given prophylactic Cefoxitin 2g IV during surgery. Dave's anaesthetist has prescribed Paracetamol lg IV/P0 6 hourly, Ibuprofen 200-400mg PO TDS, Tramadol SR 100mg PO BD, and Cefoxitin 2g IV/ IM 6 hourly for 2 further doses. IV Compound Sodium Lactate 1L is running at a six-hourly rate into Dave's left arm.

Students are required to research and write an essay with headings, directly relating to the above scenario. Using the nursing process, outline the nursing management for your patient post-surgery (using all headings in the assignment criteria), discussing all care in general, but focussing on the two (2) prioritised nursing diagnosis/ problems. As well as the information in the Unit Plan, please review Learning material/ Module 1/ Nursing process for lecture material that students have been given, regarding the nursing process and plan of care; and Learning material/ Module 1/ Assignments for further information about the assessment.

In preparation for the assignment, students are encouraged to make a list of all assessment data -including objective and subjective, considering all of the body systems, and functional health/ ADLs, post-operative specific, surgery-specific, patient-specific, and what further information would be required to be assessed. From this list, students are encouraged to develop a list of actual and potential issues/ problems/ risks for all assessment data, from which they should identify which of these are their two prioritised issues, and what method was used to prioritise these. Then students are encouraged to complete nursing care plans (similar to the sample NCP) for each of the two diagnoses. This planning material is for student's personal assignment planning only, and should not to be submitted with their essay. All of the information in this planning will then need to be discussed in the essay in academic writing style.

Students have the option of formatting their essay management section with headings as: Assessments, Diagnosis, Planning, Implementation, Evaluation; OR Assessments; Diagnosis, Diagnosis Priority 1 - ... (with subheadings for Planning, Implementation, Evaluation), Diagnosis Priority 2 - ... (with subheadings for Planning, Implementation, Evaluation). The choice is yours, however the assignment must flow smoothly and read logically for the marker.

Presentation

• Format in accordance with School of Nursing & Midwifery guidelines (see BB Assessment tab).
• Academic writing style.
• Appropriate sentence structure, word use, grammar and spelling (this is an ELP specified unit).
• Logical flow.

Introduction (100-150 words)

• A general overview of the topic and definition of terminology
• An outline of the paper

Body of essay

Background of condition (200 words)

• From the information given above, and general information about the condition.
• This should be given as an iSoBAR handover (can be with iSoBAR headings, or in paragraph format in iSoBAR sequence). This handover should be given as though you are updating the nursing team you are working with, after completing the first set of post-op observations as given in the scenario.
• For the iSoBAR handover, students may use first person to introduce themselves and their patient, however ali other information in the essay and background is to be in third person academic style.

Management (1000-1200 words)

• Using the nursing process, outline the nursing management for this patient post-surgery, discussing all care in general, but focussing on two (2) priority nursing diagnosis/ problems.
• Ensure that each part of the nursing process is discussed within the essay, showing depth to show critical thinking and coverage of each section.
• Assessment - Students should demonstrate that they have looked at all of the assessment data (see preparation paragraph above). Students are not to assume or make up assessment data. Discuss the assessment findings that have been given, what other assessments that would be done, what appropriate assessment tools (eg Falls Risk, Braden Scale and Pain Assessment) would be used, and if any findings are not within normal parameters, students should identify this, and give a rationale why this is so.
• Nursing diagnosis - After analysing all of the assessment data and patient's responses that students have gathered above, students should consider the actual and potential nursing problems/ issues, and demonstrate why they have prioritised the two diagnoses that they have (eg use of primary survey, use of first-aid DRSABCD, actual v potent(al, etc) - this should demonstrate the student's ability to prioritise, not just choosing two that they wish to discuss. Students should discuss the two (2) prioritised nursing diagnoses in-depth (focus should be on post-operative care).
• Planning - Students should demonstrate their planning of care with SMART goals (specific, measurable, achievable, realistic, and with timeframe), advising of planned outcomes and criteria that are required. Includes psychosocial outcomes and patient involvement in identifying planned outcomes.
• implementations - Interventions and actions taken to meet the planned outcomes and achieve the SMART goals. This can be nursing interventions, referral to multidisciplinary team (nurse needs to ensure multidisciplinary team member has followed up). Each intervention should include the rationale why this intervention is required, and supported this with rationale (reference - see care plan in preparation). This also includes documentation in all areas required (which will become measured criteria from SMART goal as evidence in evaluation section).
• Evaluation - Evaluation of planned goals occurs throughout the entire nursing process, but is discussed at the end. Students should demonstrate whether planned outcomes and goals were met (or not). If not, then why have they not been met, and whether re-evaluation is required at a later date, or plans changed. Students need to demonstrate how they know whether planned outcomes have been met - what is the evidence that goals have been met, what tools were used, where this is documented (usually documentation as evidence).

Potential complicationis and post-operative education (300 words)

• Outline the potential complications that the nurse and patient should be aware of.
• Outline the post-operative education would need to be provided to your patient, in order to promote a successful recovery.

Involvement of the interdisciplinary team (100 words)

• Discuss all of the members of the interdisciplinary team, and which particular members that would be involved in your patient's management of care, including what service that they will provide.

Conclusion  (100-200 words)

• Provides an overview of the assignment
• No new material introduced

Referencing

• Minimum of 15 current and credible academic references using a variety of sources (including a minimum of 4 journal articles and minimum of 2 quality websites).
• All sources are up to 5 years old (electronic) or 8 years old (texts).
• Recent, quality sources used - Wikipedia and dictionary.com will not be accepted as a reference source!
• Medical dictionary used for medical terminology.
• In-text and end-text referencing per current ECU referencing guidelines - APA style.

Attachment:- Assignment Files.rar