NURS1134 Aged Care Nursing And Healthcare Management

Case Study

In this written assessment, you will formulate a plan of care attributed to a patient scenario using the clinical reasoning cycle. This will allow you to demonstrate your understanding of associated pathophysiology, pharmacology, development of patient goals, assessment, interventions and evaluation of care.

This is an individual assessment task based on a patient clinical scenario where you are expected to apply clinical reasoning and critical thinking to develop a plan of care. You need to draw upon knowledge gained through workshops, clinical labs, simulations and your own self-directed learning through your pre/post learning resources during the initial three (3) weeks of the unit as well and from Contemporary Nursing A & B, and Contemporary Nursing A & B Mental Health as well as Research and Evidence Based Practice.

The purpose of this assessment task is to:

• Assist you in consolidating knowledge gained on the various focus topics relating to provision of evidence based care for patients with acute and chronic disorders.
• Apply knowledge obtained through participation in workshops, clinical labs, simulations and your self-directed learning through your pre & post activities in problem solving and decision making in authentic clinical scenarios.
• Reinforce theoretical underpinning of caring for patients with acute and chronic conditions prior to your professional experience placement (PEP).

The written assessment task is related to a case scenario below . The context of the scenario will be based on disorders that have been covered in the first three weeks of the block, and from Contemporary Nursing A & B, Contemporary Nursing A & B Mental Health.

The assessment piece should be developed with reference to the clinical reasoning cycle. Through application of critical thinking and clinical reasoning you are to explore the following points:

• patient’s history, presenting problems and the related pathophysiological processes to identify priority problems
• comprehensive assessment, i.e. specific observation, assessment tools and or tests
• holistic plan of care is developed by setting specific goals
• formulate nursing interventions and or treatments, with rationales and consider ways to evaluate the effectiveness of actions
• consider relevance of specific nursing standards, code of conduct, code of ethics and legalities and relevant legislation
• adherence to cultural awareness and diversity considerations
• Consider patient-centred care, recovery-oriented and trauma-informed practice, patient/consumer perspectives, and or lived experience research
• Consider current/future nursing practice and research implications

Scenario

Jessica Jones is an 18yo female who was previously diagnosed with Bulimia Nervosa. Jessica lives at home with mother, Marie.  Her parents are divorced and her father lives in Western Australia.  She has two older brothers both of whom live overseas, in the UK and USA respectively.   Jessica decided to defer going to university for a year and currently works for a logistics company as a receptionist.  Jessica was diagnosed with bulimia when she was 16years old.  She was treated with cognitive behavioural therapy and made a good recovery.

Over the last six months Marie, has noticed that Jessica has lost weight and there has been a change in Jessica’s behaviour including, being secretive around food, becoming more antisocial and withdrawn, eating alone and avoiding other people at meal times, and frequent trips to the bathroom after eating.

Jessica was reviewed by the GP who referred her to the local hospital with hypokalaemia, hypernatraemia and cardiac arrhythmias.  Vital signs: low blood pressure, irregular pulse, and feeling dizzy at times for unclear reasons. Jessica’s weight and height in ED: 170cm and 50kg.  Admitted to the cardiac unit for cardiac monitoring and treatment of hypokalaemia (2.9mmol/L) and hypernatraemia, on background of binge eating, purging and laxative abuse. Jessica voiced feelings of regret, guilt, low mood, and shame.  Jessica was reviewed by the Mental Health Team and SCOFF questionnaire performed.  A plan of care was arranged that included potassium supplements and continuous cardiac monitoring, fluid balance chart, food chart and supervision at all meal times, bed rest with supervised toilet privileges before meals and 1 hours after meals.  Jessica has voiced her anger at these rules and does not wish comply.

Case Study Question:

How would you as the Registered Nurse manage this situation?

In your answer you will need to consider the  Registered Nurse Standards for Practice (Nursing and Midwifery Board of Australia [NMBA], 2016), and relevant legislation.

Case study – Essay Structure

The clinical reasoning cycle & essay key points will also be interwoven into below structure).

Your case-study essay should be structured as follows:

• Start by setting the context and providing relevant background information.
• Include a statement that is a response to the case-study-essay question, and that summarises the main aim or points of the case-study essay.
• Outline the main ideas to be discussed in the case-study essay, in the order they appear in the body of the essay.

Body

• Each paragraph should cover a single idea expressed in a topic sentence, followed by supporting evidence and examples from contemporary academic literature, including peer-reviewed journal articles.

Conclusion: A summary of your appraisal.

• Restate your essay question, and sum up your main points

This is an academic assignment; therefore, academic standards inclusive of grammar, sentence structure, paraphrasing and APA 7th edition referencing for both in-text citations and referencing apply.

All written assessments must align to the following academic standards:

• use high-level quality contemporary evidence-based literature to inform the discussion and critical analysis, date of evidence within five years;
• use of the third person, unless specifically indicated otherwise;
• APA 7th edition for in-text citations and reference list;
• the following structure: an introduction, body and conclusion or as per directions in the assessment instructions;
• adherence to the word count; ten percent allowed either side of word count;
• a 12 size font in either Arial, Times New Roman or Calibri;

All assessments should have a title page that specifies:

• Unit Code & Unit Name
• Student Name
• Student Identification number
• Title of assignment
• An accurate word count that includes in-text citations, but excludes the reference section at the end of the essay