NURS90155: Nursing of Acute Health Conditions \u2013 End of Semester 1 Take Home Examination 2023: Exam 1
\nDue Date: Monday 8th May 2023, 1000 hours
\nWeight: 20%
\nWord Count: 2000 words
\nSubmission: Online via Canvas, through the link in this subject.
\nAssessment Outline: This take-home exam consists of one case study, containing questions that you are
\nrequired to answer.
\nIntroductions and conclusions are NOT required; go directly into answering each question.
\nTake-home exam must be typed using double spacing and size 12 font and text left justified.
\nThe take-home exam must be presented in accordance with the American Psychological Association (7th ed APA) style.
\nAll pages must be numbered consecutively from the title page.
\nThe title page should include the Department, University, Course name, Student number, Subject name, and Subject code.
\nInsert your student number and subject code as a footer.
\nYou do not have to present your work in paragraph form (except where directed to do so). Dot points and\/or tabled format can be used where you are specifically directed to do so.
\nProvide citations in your responses wherever you have used ideas or information from other sources (texts, journal articles, websites). Reference your work carefully and include a reference List at the end. https:\/\/library.unimelb.edu.au\/recite\/apa
\nPenalties: You may lose up to five (5)% of the total marks for non-compliance with referencing requirements, including in-text citations and Reference List.
\nYou may lose up to five (5) % of the total marks allocated to the assessment component for errors or inaccuracy in spelling\/grammar and sentence construction.
\nWord Limit and penalties: Any piece of work which is over or is under the stipulated word limit by more than 10% will result in the deduction of five (5)% of the total marks allocated for the assessment for each 10% over the word limit. The maximum penalty that a student can receive is 50% of the mark for that piece of work.
\nFailure to submit an assignment by the required deadline will result in a penalty of the deduction of 10% of the total marks allocated to the assessment component for each day that the assignment is late.
\nAssessments submitted later than 5 working days after the due date will not be marked and will receive no marks.
\nThe Board of Examiners may offer supplementary assessment to a student in special circumstances.
\nStudents should refer to the assignment submission and return guidelines under the \u2018Policies, forms and resources\u2019 link for further information. www.nursing.unimelb.edu.au
\nI
\nKeith Griffiths| D.O.B. 12\/09\/1948| Male (he\/him) |NKA| Full Resuscitation
\nS
\nKeith was admitted to the hospital yesterday after visiting his general practitioner (GP) 2 days ago with increasing shortness of breath, reduced appetite and feeling hot. His GP diagnosed him with community acquired pneumonia and commenced him on oral antibiotics, but in the 2 days since, Keith has continued to deteriorate.
\nO
\nObservations at 0530 hrs
\nAlert & Orientated; Temp 38.4 OC, HR 104 irregular, RR 24; BP 120\/60 Sp02 91% on Room Air; BGL 10.6 mmol\/L
\nKeith had an IVC inserted into his L) hand (22g) yesterday, which is clean and patent with no signs of infection
\nB
\nWorked as a carpenter\/builder before retiring at 60 years after being diagnosed with asbestosis and moving to Melbourne to live with his daughter and her family. His daughter reports that he sleeps poorly, has few social contacts in Melbourne, and rarely leaves the house.
\nSmoker since aged 17 years. 30 cigarettes per day recently reducing to 5 per day.
\nPhx: Diagnosed with asbestosis and emphysema at 58-yrs old, Coronary Artery Bypass Grafts x2 at 55 yrs Hypertension; Type 2 Diabetes; asbestosis, emphysema, coronary artery disease
\nCurrent Medications: Aspirin; perindopril; metoprolol; atorvastatin; metformin; amoxicillin
\nA
\nAdmitted to Medical unit
\nInvestigations: ECG \u2013 12 Lead; Bloods: FBC; U&E\u2019s; Blood cultures; Chest X-Ray; Urinalysis Sputum specimen
\nFluid Balance Chart (FBC)
\nR Current nursing problems:
\nRisk of Delirium
\nAltered breathing pattern Risk of infection
\nQuestion 1
\nExcluding the three problems identified in the handover, identify one (1) actual and one (1) potential problem. For each problem, provide a rationale using data from the case study and relevant literature or practice guidelines.
\n(3 marks)
\nQuestion 2
\nFor each of the three problems identified in the handover:
\ni. Identify one independent nursing intervention and one collaborative intervention
\nii. For each intervention, provide a rationale using relevant literature or practice guidelines
\niii. For each, write a SMART goal and describe how you would evaluate the outcomes Present your responses in tables as shown below:
\nProblem 1: Risk of Delirium
\nNursing intervention: Rationale(s):
\nCollaborative Intervention: Rationale(s):
\nSMART goal:
\nProblem 2: Altered breathing pattern
\nNursing intervention: Rationale(s):
\nCollaborative Intervention: Rationale(s):
\nSMART goal:
\nProblem 3: Risk of infection
\nNursing intervention: Rationale(s):
\nCollaborative Intervention: Rationale(s):
\nSMART goal:
\n(8 marks)
\nQuestion 3
\nIt is now 0800 and Keith is due to be administered the following medications:
\n\u2022 Metoprolol 25 mg
\n\u2022 Metformin 750 mg
\n\u2022 Amoxicillin 1 gram
\nFor each medication:
\ni. explain why Keith requires the medication, with reference to his medical diagnoses and assessment data ii. describe the assessment(s) you would undertake prior to administering the medication (excluding checking the patients\u2019 name, number, and date of birth against the prescription)
\n(3 marks)
\nQuestion 4
\nKeith\u2019s medical team decides to commence him on a short-acting beta agonist (salbutamol) and long-acting betaagonist\/inhaled corticosteroid (salmeterol\/fluticasone), both via metered dose inhaler (MDI).
\nDescribe two (2) important points about taking these medications via MDI that you will need to provide Keith with education about prior to discharge. Support your response with relevant literature or practice guidelines.
\n(2 marks)
\nQuestion 5 (400 words)
\nOne of the aims of the Comprehensive Care Standard is to \u201c\u2026ensure that risks of harm for patients during health care are prevented and managed\u201d (p 44, ACSQHC, 2021), including actions for preventing harm related to delirium.
\nIn a short essay response, discuss why screening for delirium and implementing preventative care is important for preventing harm associated with healthcare. Support your response with reference to the standards, other relevant literature, and the case study,
\nPresent your ideas in your own words, in paragraph form with linked sentences to establish the flow of. There should be no single sentence paragraphs. Use double spacing between paragraphs. Reference your work carefully and include a Reference List at the end. https:\/\/library.unimelb.edu.au\/recite\/apa
\nReference
\nAustralian Commission on Safety and Quality in Health Care. (2021). National Safety and Quality Health Service Standards. 2nd ed. \u2013 version 2. Sydney: ACSQHC
\nRubric (Question 5)
\nCriterion 2 marks 1 mark 0 mark
\nApplies standards, relevant literature and policy to Keith\u2019s case in discussion of importance of delirium screening and prevention.
\nSupports responses with appropriate references
\nPresentation (spelling, language, grammar, referencing)
\n(4 marks)
\nEND OF EXAM<\/p>\n
_____________________________________________
\nQuestion 1<\/p>\n
Actual problem: Hypoxemia
\nRationale: Keith’s oxygen saturation (SpO2) is 91% on room air, which is below the normal range. This indicates a problem with the exchange of oxygen and carbon dioxide in his lungs, which may result in tissue hypoxia and organ dysfunction (Farrell & Dempsey, 2021).<\/p>\n
Potential problem: Impaired gas exchange
\nRationale: Keith’s respiratory rate (RR) is elevated, indicating that he is working harder to breathe. In addition, his chest x-ray and sputum specimen are being investigated, which may suggest an underlying respiratory infection, further affecting his oxygenation (Farrell & Dempsey, 2021).<\/p>\n
Reference:
\nFarrell, M., & Dempsey, J. (2021). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing. Lippincott Williams & Wilkins.<\/p>\n
Question 2<\/p>\n
Problem 1: Risk of Delirium<\/p>\n
Nursing intervention\tRationale(s)
\nAdminister medication for pain and discomfort as ordered\tUnmanaged pain and discomfort can lead to confusion and agitation, which can increase the risk of delirium. Administering medication for pain can help alleviate these symptoms and prevent delirium (Farrell & Dempsey, 2021).
\nCollaborate with the healthcare team to implement a delirium prevention protocol\tA delirium prevention protocol includes strategies to optimize the patient’s environment, minimize the use of restraints, promote sleep, and encourage family involvement in the patient’s care, which can reduce the risk of delirium (Inouye et al., 2014).
\nSMART goal: Keith will maintain an alert and oriented mental status throughout his hospital stay as evidenced by a score of 0-1 on the Confusion Assessment Method (CAM) tool.<\/p>\n
Problem 2: Altered breathing pattern<\/p>\n
Nursing intervention\tRationale(s)
\nAssist Keith to assume a position of comfort and optimize oxygen delivery\tA comfortable position, such as elevating the head of the bed, can help reduce the work of breathing and improve oxygenation. Supplemental oxygen may be required to maintain adequate oxygen saturation levels (Farrell & Dempsey, 2021).
\nCollaborate with the healthcare team to implement a plan of care for Keith’s respiratory management\tCollaborating with the healthcare team can help ensure that Keith receives appropriate respiratory therapies, such as nebulized bronchodilators, chest physiotherapy, or non-invasive ventilation, to improve his respiratory function (McEvoy et al., 2015).
\nSMART goal: Keith will maintain an oxygen saturation level of at least 94% on room air within 24 hours of admission, as evidenced by pulse oximetry readings.<\/p>\n
Problem 3: Risk of infection<\/p>\n
Nursing intervention\tRationale(s)
\nPerform hand hygiene and ensure appropriate infection prevention and control measures are in place\tHand hygiene is the most effective way to prevent the spread of infection. Ensuring appropriate infection prevention and control measures, such as isolation precautions, can help prevent the transmission of infectious agents to other patients and healthcare workers (Centers for Disease Control and Prevention, 2019).
\nCollaborate with the healthcare team to implement an appropriate antibiotic therapy\tCollaborating with the healthcare team to implement an appropriate antibiotic therapy can help treat the underlying infection and prevent its progression (Farrell & Dempsey, 2021).
\nSMART goal: Keith’s temperature will remain within the normal range and his white blood cell count will decrease to within the normal range within<\/p>\n","protected":false},"excerpt":{"rendered":"
NURS90155: Nursing of Acute Health Conditions \u2013 End of Semester 1 Take Home Examination 2023: Exam 1 Due Date: Monday 8th May 2023, 1000 hours Weight: 20% Word Count: 2000 words Submission: Online via Canvas, through the link in this subject. Assessment Outline: This take-home exam consists of one case study, containing questions that you […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[210,215,212,220,219,209,222,213,211,214,45,218,216,221,208,217],"tags":[232,229,230,224,228,236,233,235,226,234,225,227,223,231],"class_list":["post-631","post","type-post","status-publish","format-standard","hentry","category-1-assignment-help-online-service-for-students-in-the-usa","category-ai-plagiarism-free-essay-writing-tool","category-australian-best-tutors","category-best-trans-tutors","category-buy-essay-uk","category-can-someone-write-my-assignment-for-me","category-cheap-dissertation-writer","category-do-my-essay-assignment","category-help-me-write-my-dissertation","category-help-with-writing-an-essay","category-homework-for-you","category-help-write-my-paper-ai-free","category-online-essay-writers","category-phd-essays","category-write-my-assignment-help-for-college-students","category-write-my-essay-for-me","tag-apa-citation-format-assignment","tag-assignment-help-by-uks-no-1-writing-service","tag-assignment-writers-australia-college-student","tag-assignment-writers-canada-university-cost","tag-assignment-writers-china-english-free-ai","tag-buy-essay-usa","tag-help-write-a-page-assignment","tag-i-need-someone-to-do-my-assignment-within-hours","tag-in-page-paper-write-an-essay","tag-need-to-write-an-essay","tag-professional-assignment-writers-usa","tag-uae-1-cheap-assignment-writing-service","tag-write-a-word-essay","tag-write-pages"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/631","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/comments?post=631"}],"version-history":[{"count":0,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/631\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/media?parent=631"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/categories?post=631"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/tags?post=631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}