Subject Code & Title :- 35813/02 Implement and monitor care for a person with acute health problems
Assessment Type :- Assignment Case Study
This assessment comprises of two (2) parts.
1. Part A – Short answer knowledge-based questions relating to the attached case study.
2. Part B – Practical skills relating to caring for the patient in the case study.
During this assessment, you will be assessed on your ability to analyse the information you have been provided on your patient and use it to plan care and perform nursing interventions specific tothe care of the person with acute health problems.
35813/02 Nursing Assignment
Part A – Short answer knowledge-based case study questions
You are required to read the case study background information on Lia Akintola and use this information to answer the ten (10) questions relating to her 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:
1. Answer the questions from the perspective of a qualified Enrolled Nurse.
2. Use correct anatomical and medical terminology in your answers.
3. Reference your answers using the APA 6 th Edition referencing standard.
Note: This part of the assessment must be completed prior to undertaking Part B – Practical skills.
35813/02 Implement and monitor care for a person with acute health problems Assignment
Part B – Practical skills
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 prior to attending campus.
The three (3) skills to be demonstrated as part of this assessment are as follows:
a. Clinical Skill 43.1 Assessment of Pre and postoperative exercises. Pages 369 – 373
b. Clinical Skill 30.3 Enteral Feeding. Pages 293 – 294
c. Clinical Skill 26.1 Assessment of Fluid Balancing Charting (You must document Lia’s fluid input and output as outlined below). Pages 240 – 241.
The clinical 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. 7 th Ed. Sydney: Elsevier Australia.
The skills will be simulated with a mannequin representing the patient.
During your practical skills your educator will ask and discuss 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 Open Space assessment submission is to include:
a. This assessment including your completed assessment cover sheet.
b.Part A – Your completed responses to the short answer questions on Lia Akintola.
c. Part B – Copies of your three (3) clinical skills checklists of which you were assessed on campus.
Once the following documents have been uploaded into Open Space 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 – Lia Akintola
Lia Akintola is 24-year- old female (who’s birthday is on April 17 th ) who has presented to the emergency department, at 1200, after 6 hours of increasing persistent abdominal discomfort.
Lia states the pain has moved from the middle of her abdomen to the right lower quadrant. She has rebound tenderness and is finding it increasingly difficult to find a comfortable position. Lia has stopped her gastrostomy feed yesterday at 2200.
A urinalysis, midstream urine specimen and urine hCG is requested by the ED medical officer and CBE and hCG bloods are sent to pathology.
Lia was diagnosed with cerebral palsy at 6 weeks of age and has a permanent gastrostomy tube. She has had a recent upper respiratory tract infection over the past 2 weeks.
35813/02 Nursing Assignment
On presentation to the ED, 1200, her vital signs are as follows:
1. Temperature: 39.2oC
2. BP: 135/70 mmHg
3. Pulse: 96 beats per minute
4. Respirations: 26 breaths per minute
5. SpO2: 94% on air
6. Pain Score: 9/10, R) Lower abdominal quadrant
1330
Lia is diagnosed with Acute Appendicitis and is required to be prepared for emergency theatre. As part of the pre-operative surgical orders, Lia is to be measured for anti embolic stockings.
1400
Once in surgery, the surgeon discovers that Lia’s appendix has perforated and as a result, she will require IV antibiotic therapy postoperatively.
Part A – Short answer knowledge-based case study questions
1800 Lia returns to the ward
Lia returns to the ward at 1800 she is drowsy however opens her eyes to your voice.
Lia’s post-op medical orders are
PICC line inserted in the operating theatre
IV fluid
IV antibiotics
PCA
Incision line- dressing to remain intact
Post-operative observations as per clinical pathway
Nil by mouth until review in am
Estimated Discharge Date: 4 days
Lia had a litre of 4% Dextrose and 1/5 normal saline from 1400-1530. She currently has, IV normal saline, 1000mls over 8 hours, running which commenced at 1530. She has vomited 100 mls at 1600 and at 1700. Lia last voided 300mls at 1300. Her gastrostomy feed is to be recommended in the am after finishing at 0200 this morning (200mls). (This must be documented on the fluid balance chart you are required to complete as part of Clinical Skill 26.1 Assessment of Fluid Balancing Charting)
35813/02 Nursing Assignment
1815
Lia states her pain is 5/10 and that she is feeling increasingly nauseous and tells you she would like to “have something to take away the nausea as she has had it for some time now….
You tell Lia you will go and discuss this with the RN and will be right back. As you re-enter Lia’s room you find her trying to get out of bed as she really needs to go to the toilet… As you approach Lia, she appears to lose consciousness and falls back onto the bed.
2000 – The MET Dr diagnoses Lia with having had a vasovagal syncope and remains in the ward post the MET call.
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