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Posted: July 17th, 2022

Pain management: Maida is in a lot of pain

35821/05 Implement, monitor and evaluate nursing care plans
Case Study
Student Name: Student ID:
Assessment Type:
Assessment Title: 35821/05 Implement, monitor and evaluate nursing care plans Case Study
Date: 25/07/2020 Student Name:
Cohort
:
May 2018 Open Colleges Student ID:
Attempt 1
In order to demonstrate competence in units of
competency within the HLT54115 Diploma of Nursing,
a combination of assessment tasks must be completed
to demonstrate an understanding of the underpinning
knowledge and required skills as outlined in the
National Training Package.
The following HLTEN004 Implement, monitor and
evaluate nursing care plans assessment must be
completed to form part of the evidence required to
demonstrate the underpinning knowledge for:
 HLTENN004 Implement, monitor and
evaluate nursing care plans
Timeframe:
This assessment must be completed by Week 60 in
your timetable.
Grading:
Each assessment task will be graded Satisfactory (S)
or Not Yet Satisfactory (NYS). A Satisfactory result in
each assessment task must be attained to receive a
competent outcome for the unit overall. For information
regarding reassessment refer to the Student
Handbook.
“I affirm that all work submitted within is my true and
original work unless otherwise credited”
Student
signature
:
Dat
e
25/07/202
0

If you have typed your name, please tick this box to
acknowledge that by including your name in place of a
signature above, it is deemed to be your signature for the
purpose of this assessment
Module 23
HLTENN004 Implement, monitor and
evaluate nursing care plans.
This is assessment 5 of 5
Deliverables/To do list:
1. Complete the assessment
coversheet by adding:
 Your full name
 Open Colleges Student ID
 Date
 Your Cohort (eg Feb 19)
2. Affirm that the work submitted is
your work, either by:
1. Signing the bottom of the
page (this can be an
electronic signature) or
2. Tick the affirmation box and
type your name.
3. Read the student instructions and
complete all parts to this
assessment.
4. Before submitting all parts of this
assessment into OpenSpace,
ensure you read and follow the
deliverables set out in this
assessment.
5. Save all documents using the
naming convention:
‘Your Surname_your open colleges
student number_assessment
number.doc’. For example:
“SMITH_E1234569_31135_01.doc.”
6. Save a copy of this assessment for
your own records and upload your
RTO 40049 | CRICOS Provider 03733E
35821/05 Implement, monitor and evaluate nursing care plans
Case Study v1.2 April 2020
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35821/05 Implement, monitor and evaluate nursing care plans
Case Study
Student Name: Student ID:
assessment into OpenSpace using
the relevant assessment upload link
in this module.
Background/Overview
This unit describes the skills and knowledge required to implement nursing care as outlined in a
person’s plan of care, evaluate outcomes of care provided, record and report progress. Within this
assessment, you are asked to demonstrate knowledge around specific aspects of Maida
LONGBRIDGE’s episode of care.
Instructions to the student
This assessment will comprise four (4) parts.
 Part A – Short answer knowledge-based questions relating to Maida Longbridge’s care
 Part B – Responses to Maida Longbridge’s Nursing care plan
 Part C – Short answer knowledge-based questions relating to Maida Longbridge’s care
 Part D – Practical skills relating to caring for Maida Longbridge
During this assessment, you are required to demonstrate the following:
Part A – Short answer knowledge-based case study questions
You are required to read the case study background information on Maida Longbridge and use this
information to answer the twenty-five (25) questions relating to their care. The answers you
provide should be related to the patient information provided and all rationales of care should relate
to her specific needs.
You are to:
 Answer the questions from the perspective of a qualified Enrolled Nurse.
 Use correct anatomical and medical terminology in your answers.
 Reference your answers using the APA 6th Edition referencing standard.
Note: This part of the assessment must be completed before undertaking Part B.
Part B – Nursing Care Plan
You are required to read the case study background information on Maida Longbridge and use this
information to complete Maida’s Nursing Care Plan relating to risk prevention strategies. The answers
you provide should be related to the patient information provided and all rationales of care should relate
to Maida’s specific needs.
You are to:
 Answer the questions from the perspective of a qualified Enrolled Nurse.
 Use correct anatomical and medical terminology in your answers.
 Reference your answers using the APA 6th Edition referencing standard.
Note: This part of the assessment must be completed before undertaking Part C.
RTO 40049 | CRICOS Provider 03733E
35821/05 Implement, monitor and evaluate nursing care plans
Case Study v1.2 April 2020
Page 2
35821/05 Implement, monitor and evaluate nursing care plans
Case Study
Student Name: Student ID:
Part C – Short answer knowledge-based case study questions
You are required to read the case study background information on Maida Longbridge and use this
information to answer the five (5) questions relating to their care. The answers you provide should
be related to the patient information provided and all rationales of care should relate to Maida’s
specific needs.
You are to:
 Answer the questions from the perspective of a qualified Enrolled Nurse.
 Use correct anatomical and medical terminology in your answers.
 Reference your answers using the APA 6th Edition referencing standard.
Note: This part of the assessment must be completed prior to undertaking Part D.
Part D – Practical skills
You are required to read the case study background information on Maida Longbridge and use this
information to demonstrate knowledge and rationales as to why the following skills would be
important nursing interventions when caring for Maida.
The practical skills component of this assessment will take place in the clinical skills lab at a time
advised by your educator. You will be required to print this assessment before attending campus.
The three (3) skills to be demonstrated as part of this assessment are as follows:
1 Clinical Skill 19.4 Assessment of Venous Thromboembolism Assessment (page 40-41)
2 Clinical Skill 19.5 Assessment of Nutrition Assessment/ Weight, Height and BMI (page 45
-46)
3 Clinical Skill 25.3 Assessment of Incentive Spirometry (page 214-215)
The practical skills you will be assessed on will be conducted against the competency checklists
provided in the textbook (unless indicated otherwise):
Koutoukidis, G. and Stainton, K (2017). Essential enrolled nursing skills for person-centred
care. 7th Ed. Sydney: Elsevier Australia.
The skills will be simulated with a mannikin representing the patient. During your practical skills,
your educator will ask and discuss with you your rationales for your nursing actions and ask
clarifying questions as this will encourage you to think critically, problem-solve, and identify the
evidence that underpins your knowledge.
Deliverables for this assessment
To gain a satisfactory result for this assessment, you will need to upload all the following
documents into OpenSpace in one submission. Your OpenSpace assessment submission is to
include:
 You completed assessment coversheet
 Part A – Your completed responses to the short answer questions related to risk identification
and prevention strategies associated with Maida’s episode of care.
 Part B – Your completed responses to Maida Longbridge’s Nursing care plan
 Part C – Your completed responses to the short answer questions on Maida Longbridge
RTO 40049 | CRICOS Provider 03733E
35821/05 Implement, monitor and evaluate nursing care plans
Case Study v1.2 April 2020
Page 3
35821/05 Implement, monitor and evaluate nursing care plans
Case Study
Student Name: Student ID:
 Part D – Copies of your three (3) clinical skills checklists, (completed, assessed and signed)
which you were assessed on campus.
Once uploaded, your educator will assess your assessment submission and provide feedback to
you on the Assessment Evidence Checklist attached to this assessment. You will be given either
a Satisfactory or Not Yet Satisfactory result. If your result is Not Yet Satisfactory, you will be
given a due date for resubmission and feedback indicating what areas need addressing to gain a
satisfactory result.
Case study background information – Maida LONGBRIDGE
Maida is a 73-year-old lady who lives independently at home with her partner, Glenda. Maida was
standing on the ladder cleaning their front gutters and as she was coming down the ladder lost her
footing and fell on her left side from 40cm above the ground. Maida called out to Glenda who
Helped Maida to her feet. Glenda phoned the GP surgery who advised her to call for an
Ambulance to take Maida to Care Shore Hospital.
The Ambulance arrives and assesses Maida, IVA is established and NaCL 0.9% is commenced.
Maida has a 12 lead ECG recorded and she is transported to Care Shore Hospital. Currently, the
Ambulances are banked up and there is a one (1) hour wait. Maida remains in the Ambulance
whilst waiting to be transferred to the ED.
On presentation to the ED, Maida is alert and orientated. She looks pale and is cool to touch, her
L) Leg is externally rotated and shortened, and her pain score is 9/10 radiating down her L) Leg.
Maida is administered Intranasal Fentanyl as per the “fractured hip protocol.”
Past Medical History:
Depression and Anxiety (diagnosed 30 years ago as a result of childhood trauma)
Anorexia Nervosa
Spontaneous L) Calf DVT 2 years ago.
Medication
Nil medication is taken
RTO 40049 | CRICOS Provider 03733E
35821/05 Implement, monitor and evaluate nursing care plans
Case Study v1.2 April 2020
Page 4
35821/05 Implement, monitor and evaluate nursing care plans
Case Study
Student Name: Student ID:
1800 Maida’s vital signs a

______________________

Pain management: Maida is in a lot of pain, so it is important to provide her with effective pain management. This may include medication, heat therapy, or massage.
Range of motion exercises: Maida’s hip will need to be kept mobile to prevent stiffness and contractures. The nurse can teach Maida how to do range of motion exercises and can help her with them as needed.
Promotion of mobility: Maida will need help getting around until her hip heals. The nurse can help her with ambulation, or she can arrange for Maida to use a wheelchair or walker.
Skin care: Maida’s skin will be at risk for breakdown due to immobility. The nurse can inspect Maida’s skin regularly and can take steps to prevent breakdown, such as using pressure-reducing devices and keeping her skin clean and dry.
Nutritional support: Maida may have difficulty eating due to pain or immobility. The nurse can work with Maida to ensure that she is getting enough calories and nutrients.
Psychosocial support: Maida may be feeling anxious or depressed about her injury. The nurse can provide her with emotional support and can connect her with resources, such as a therapist or support group.
These are just a few of the nursing interventions that can be implemented for Maida Longbridge. The specific interventions that are needed will vary depending on Maida’s individual needs and circumstances.

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