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Posted: November 17th, 2023

Assessment name NUR2101 Assignment (assessment 2): Case Study

Assessment 2: Written Assignment – Case Study
Task overview
Assessment name NUR2101 Assignment (assessment 2): Case Study
Brief task description This assessment requires you to work individually and produce a poster aimed at understanding and managing an episode of care.

Rationale for assessment task A key role of nursing practice is to make prioritised clinical decisions based on critical thinking and the complex care needs of the individual and families. This assessment builds on the case study approach from your tutorials and lectures and incorporates critical thinking and clinical decision making to hone skills in prioritising care. Presenting the information in a poster format helps you develop skills, in succinct yet comprehensive articulation of concepts/ ideas for the care and education of patients, and the formulation of information requiring relevant graphics / text both of which are key skills for RN practice. This piece of assessment would be appropriate to include in your e-portfolio to demonstrate your capacity for future employability.
Due Date Date: 11.09.23
2355hrs (AEST)
Length Poster A3 presentation
• A3 size poster, font size 11- see below for details.
There is no word limit however, the poster must demonstrate a balance between information and graphics to explain your topics well.

Marks out of:
Weighting: 40 %
(marks out of 100)
Course Objectives measured Relevant course objectives for this assessment:
On successful completion of this assessment students should be able to:
1. Discuss diverse health concerns within the Australian context, including a selection of local (regional) and National Health Priorities across the lifespan.
2. Apply skills in critical thinking, clinical decision making, through assessing and prioritising care, and, applying evidence for individual care interventions including, ethico-legal and cultural safety considerations in various health care contexts.
4. Apply the underlying pathophysiology of health concerns and their pharmacological and non-pharmacological management to individual care episodes.
5. Clearly explain the impact of disease from a biopsychosocial perspective across the lifespan for individuals and families.
6. Examine the independent and collaborative roles of the nurse caring for individuals within the diverse inter-professional care conte

USQ Graduate attributes relevant to the assessment include 1,2,3,4,5,6
Writing Style – Correct Academic Writing conventions as per USQ guidelines
– APA 7th Edition Referencing (no less than 10 references) https://usq.pressbooks.pub/apa7/
– Contemporary literature must be sourced (no more than 7 years old), although seminal work is accepted. The reference list should be attached as a second page to the poster.
Formatting Style Poster– single spacing 11 font Calibri, New Times Roman or Verdana accepted.
o (in-text references can be 6 font, so they do not distract from the poster, intext referencing is required)
• Headings used in the poster are acceptable and preferred
Resources available to complete task USQ academic writing is provided in links on the course Resources Tab. https://www.usq.edu.au/library/study-support/assignments
Referencing
https://www.usq.edu.au/library/referencing

Please also see the accompanying recording on study desk in the assessment tab to guide you through this assessment.
Submission information
What you need to submit • You will need to submit your Poster via the assignment portal located in the assessment tab.

• The file name should have an identifier such as ‘poster final.’

• Referencing is imperative. You need to include a reference list on a separate A4 sheet, attached to the poster, however you need to cite correctly within the body of the poster. Refer to the USQ APA 7 referencing guides if you are unsure. Because of restriction of words within a poster a font size of 6 may be used.

For example: There are a range of management principles which are important to managing arterial wounds and it is agreed in the literature that debriding wounds is contraindicated (Nutter & Stanbury, 2018).

• Poster template is located on the study desk in the assessment tab under the case study details. Please do not use CANVA as CANVA posters will not go through the TURNITIN process appropriately, they are seen as an image only.

• Example of a poster is located on the study desk: Please note this is to give you the ‘look and feel’ of a poster demonstrating nursing research. Your poster is different and needs to answer the brief below.
• Headings/ subheadings are acceptable and advised.

Submission requirements
This assessment must be submitted in electronic format as a Microsoft Word document (not pdf) via Turnitin. The Turnitin process may take up to 24 hours to produce a report. Therefore, allow adequate time to do this and address any issues of plagiarism detected by Turnitin before final submission.
*Any percentage that relates to plagiarism detected by Turnitin is a concern and requires you to address this. A Turnitin % of greater than 15% of words within the text of the assignment will not be accepted.
File Name Conventions Save your document with the following naming conventions: name_topic_nur2101_A2final.docx
KennethQuirante_topic_nur2101_A2final

Moderation • All staff assessing your work meet with the Examiner to discuss and compare their judgements before marks or grades are finalised as part of the moderation process.
• Final release of grades will normally be at three weeks of submission date. This same timeframe applies for any approvals for an extension of time, commencing at the time of submission. We will not remark assignments unless there are grounds which meet the criteria outlined in ‘request for assessment mark re-check.’
Academic Integrity Statement Students should be familiar with, and abide by, USQ’s policy on Academic Integrity and the definition of Academic Misconduct . Penalties apply to student’s found to have breached these policies & procedures.

Late Submissions Penalty Please refer to the link on late submission of assessment items and penalties applied – Late Submissions of Assignments https://policy.usq.edu.au/documents/14749PL

MARKS LOST FOR LATE PENALTY for no extension (a penalty of 5% of the available Mark, per Calendar Day late). Assessment Items submitted more than 10 Calendar Days after the published due date without an approved extension, or more than 10 Calendar Days after the revised due date where an extension has been granted, will receive a Mark of zero.

Note on Late submission & extensions: Applications for an extension of time will only be considered if received in accordance with the USQ Assessment procedure and the Assessment of Compassionate and Compelling Circumstances Procedure. Refer to the links on StudyDesk for copies of these procedures.

Task information
Task detail Students will be required to complete the topic (a case scenario) outlined below.
You will be required to complete a poster, similar to ones that are presented at professional conferences. The poster needs to be high quality, creative, innovative, and engaging for the reader and based on informative evidenced-based information.

The marking rubric will provide guidance as to the expectations required for completion of this assignment task so, please ensure you read and understand this. Be guided by the mark breakdown for the focus of the assignment. The guidelines, marking rubrics and submission details are below.

Background information
1. Outline the context of the patient episode and give a brief description of the health issues for the person (this is determined mostly by the scenario you are developing and sets the context for the audience).
2. Describe succinctly and briefly the underlying pathophysiology and symptomatology (clinical signs and symptoms) the person may experience in the given context of the patient scenario.
3. Outline the ‘KEY’ or focused assessment criteria (data) you would include for the person i.e. what objective and subjective clinical data is necessary in order to develop a nursing plan of care for the person within the context outlined in the case scenario (be specific to the case scenario).
(a) Include in your discussion a brief outline of the relevant diagnostic and ongoing tests (e.g. including biochemistry, haematology, cytology, ultrasound, x-rays etc.) associated with the health problem for collaborative/ interprofessional care (this can be in point form on your poster). Ensure your response is focused and relevant to the context of the clinical scenario.
(b) Outline (briefly) the developmental considerations for the person in the case study. You will need to review developmental theory such as Erikson (example only) and support your response by referring to the developmental theorist you have chosen. This is available in ‘Fundamentals of Nursing’ texts. If in doubt, please seek further advice or ask on study desk.
Nursing management – this should be the focus of the case scenario.
1. Identify and explain the nursing management (from a biopsychosocial perspective i.e. physical, psychological and social perspective – focus on whatever is contextual) for the person’s health problem in the case scenario, this includes:
• Identifying and explaining at least three (3) key / priority nursing interventions. This should include any evidence-based approaches to care (e.g. you may review Joanna Briggs & Cochrane websites).
• Discussion of the rationale for your interventions (what is the reason for your chosen interventions / and explain why they are a priority)
• Discussion of any other nursing and collaborative management approaches and follow through care, including education / self-management strategies to assist the person managing their ongoing health care episode (relates to the point above). This may also include evidence-based approaches to care.
• Outlining the nurse’s role in the provision of collaborative care for optimal outcomes (be succinct here).

2. Discern two (2) potential problems (complications) associated with the current presenting condition and signs and symptoms (S&S) the nurse would assess and observe for, to detect a change in condition and prevent worsening of the person’s health status.

Case Study Topic
A 70 y.o. male Dan Ching with a suspected infected leg ulcer and Chronic heart failure.

Dan is a retired 70 y.o. widower who lives with his son aged 45 and his wife. Dan presented to the emergency department of his regional hospital with multiple issues. He has a suspected infection related to an unhealed ulceration (wound) on his R) lower anterior leg causing him pain and for the last few days has felt nauseated and is anorexic, has not eaten or drunk much for 3 days.
On examination, you as the registered nurse, notice he is short of breath on exertion and is hot to touch. His observations T38.9 P90 R28 BP 160/95 SpO2 93% weight 90kg. You note his peripheral perfusion is cool and pale, and his legs are swollen. He tells you he is normally on Frusemide (Furosemide) 40mg bd, Bisoprolol 5mg daily, Perindopril 5mgs daily, Aspirin 100mg daily, Span K 600mg bd with diuretics. However, he has felt too unwell to take ‘his pills’ the last 3 days and has remained in bed at home. On further examination you find there is pitting oedema in his legs, his ulcers are sloughy and painful. The surrounding skin is red, however laterally and close to the ankle the skin feels hot to touch while the other reddened surrounding tissue feels warm. The ulcers are more painful on exposure and particularly during the dressing procedure.
After the Medical Officer’s (MO) review, it is also noted Dan has bilateral crackles in the base of his lungs. Dan is admitted, an IVC is inserted, and N/Saline is ordered to run at 42 mLs per hour. Dan is to have 40mg of IV Lasix stat and is to commence on IV Amoxicillin / Clavulanic acid 1.2g 6-hourly (q6h). He can have Panadol 1000mg 4-hourly (q4h) prn for pain and Oxycodone 5mg prn prior to dressings. Dan also has a history of hypertension, retinopathy, and venous insufficiency and DVT, Atrial Fibrillation (AF) and Congestive Heart Failure (CHF).
See pic below:
1. Lateral aspect of leg
2. Medial aspect of leg
3. Distal aspect of leg (towards the foot)

Nursing Management of a 70-Year-Old Male with a Suspected Infected Leg Ulcer and Chronic Heart Failure

Background Information:

Context of the Patient Episode:

Dan Ching, a 70-year-old widower, presented to the emergency department with a suspected infected leg ulcer and symptoms of chronic heart failure.
Living with his son and daughter-in-law, Dan reports feeling nauseated and anorexic, with limited food and fluid intake for the past three days.
Key observations include shortness of breath on exertion, elevated temperature (T38.9), increased heart rate (P90), elevated respiratory rate (R28), elevated blood pressure (BP 160/95), and low oxygen saturation (SpO2 93%). Peripheral perfusion is cool, legs are swollen, and there’s pitting edema.
Underlying Pathophysiology and Symptomatology:

Suspected infected leg ulcer and chronic heart failure.
Leg ulcers are sloughy and painful, with surrounding redness and localized heat. Crackles in the base of the lungs indicate potential pulmonary edema.

Key Assessment Criteria:

Objective and subjective clinical data needed for nursing plan development:
Diagnostic tests: biochemistry, hematology, imaging (ultrasound, X-rays).
Developmental considerations: Considering Erikson’s theory for psychosocial development.
Nursing Management:

Key Nursing Interventions:

Administer IV Lasix stat, initiate IV Amoxicillin/Clavulanic acid, and manage pain with Panadol and Oxycodone.
Addressing sloughy leg ulcers: evidence-based wound care approaches.
Encourage adherence to prescribed medications, considering potential drug interactions.

Rationale for Interventions:

IV Lasix to manage fluid overload and alleviate symptoms of heart failure.
IV Antibiotics to address the suspected infection.
Pain management for enhanced comfort during wound care procedures.
Collaborative Management and Follow-Through Care:

Collaboration with medical professionals for ongoing assessment and adjustment of treatment.
Patient education on medication adherence, self-management strategies, and recognizing signs of worsening condition.
Monitoring for potential complications and timely intervention.

Nurse’s Role in Collaborative Care:

Facilitate communication between the healthcare team and the patient.
Advocacy for patient-centered care, addressing individual needs.
Continuous assessment of response to interventions and adjusting the care plan accordingly.

Potential Problems and Complications:

Worsening Heart Failure:

Signs and symptoms: increasing dyspnea, persistent tachycardia, and worsening edema.
Nursing actions: continuous monitoring, adjustment of diuretic therapy.
Sepsis from Infected Leg Ulcer:

Signs and symptoms: increased localized pain, spreading redness, systemic signs of infection.
Nursing actions: prompt administration of broad-spectrum antibiotics, close wound monitoring.
The nursing management of Dan Ching involves a comprehensive approach addressing both the suspected infected leg ulcer and chronic heart failure. Collaborative care, evidence-based interventions, and patient education are crucial for optimal outcomes. Regular assessment and prompt intervention for potential complications are integral components of this care plan.

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