Submission Details:
1250 words handed in through Turnitin
Aim of assessment
The purpose of the assessment is to enable students to demonstrate knowledge by accurately analysing information in a case study of complex critical care patient.
Read the case study attached and answer the following questions-
i. analyse the pathogenesis in relation to the clinical manifestations in the case study (15 marks).
2. Select ONE (1) appropriate nursing strategy, and explain the underpinning evidence base for this rational (5 marks)
3. Critically analyse the Arterial blood gas results, and relate them to the underlying pathogenesis (10 marks)
4. Academic Writing (5 marks).
Resources
Examples may be available on the vUWS site.
ii. There are a number of textbooks and resources available through the Western Sydney University Library that may assist you. Please refer to the unit's vUWS site for specific unit resources
2
Case Study Details: Mr Kirkman a 75-year-old male, presented to ED complaining of burning sensation upon urination and lower abdominal pain radiating into the right flank. Mr Kirkman was admitted to the ward with a diagnosis of Urinary tract infection. He was placed on IV NaC1 and IV Sulfamethoxazole-trimethoprim 10 mg/kg/day IV in 2 equally divided doses daily and an Indwelling catheter was inserted.
Twenty-four hours later, his condition deteriorates HR135, BP 80/42, RR 35, TEMP 39 and looks generally unwell.
History from ED notes
• Wife died 12 months ago
• Social drinker
• Heavy smoker 2 packs a day since commencing as a teenager.
• Chronic bronchitis on Ventolin and Atrovent.
• Previous UTI
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History from ED notes
• Wife died 12 months ago
• Social drinker
• Heavy smoker 2 packs a day since commencing as a teenager.
• Chronic bronchitis on Ventolin and Atrovent.
• Previous UTI
• No cardiac history
Diagnosis 24 hours later
• UTI with severe sepsis
PRIMARY SURVEY 0/E
A — Patient speaking in single words
B RR 35bpm, accessory muscle use. SP02
82%, in obvious distress.
C — Sinus rhythm 135bpm, Blood pressure
80/42mmHg, Temperature 39°C
D — E4, V4, M5
E- Use of accessory muscles, lower abdominal pain 6/10,
flushed face
F- IVC insitu, IDC- Dark urine passed small amounts
approximately 40mls in last 8 hours
G- 8.4mmol/L
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Diagnostics
Urinalysis
Positive — nitrite, leukocytes & blood. Arterial blood gases (ABGs)
ABGs Result Normal range
pH 7.25 7.35-7.45
Pa02 75 mmHg .80-100 mmHg
PaCO3 32 mmHg 35-45 mmHg
HCO, 15 mmollL 22-32 mmol/L
BE -6 mmol/L -2 - +2mmol/L
Lactate 3.2 mmol/L 0.3-0.8 mmol/L
Full blood count (FBC)
FBC
Haemoglobin (Hb)
Red cell count (RCC)
Packed cell volume (PCV)
Total white cell count (WCC)
Platelets Result
140g/L
5.0 x 10'/L
0.42
15.2 x 109/L
290 x 109/L Normal range
130-180 g/L 4.5-6.5 1012/L 0.40-0.54 4.0-10.0 x 109/L 150-400 x 109/L
Coagulation (`Coags')
Coags Result Normal range
APTT 30 25-35
PT 15 11-15
INR 2.2 2.0-3.0
Electrolytes, urea & creatinine (EUC)
EUC Result ,Normal range
Na' 148 mmol/L 135-145mmon
IC' 5.2 mmol/L 3.8-4.9 mmol/L. 95-110 mmol/L
Cl- 111 mmol/L
Mg`' 0.82 mmollL 0.8-1.0 mmol/L
Urea 15 mmol/L 3.0-8.0 mmol/L
Creatinine 130 µmon 60-120 umol/L
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Marking criteria and standards: Assessment
2: Short Answer Questions
High
Mark
Distinction
Criteria
Distinction
Credit
Pass
Fail

Criteria 1 — Using Provides an
the case study accurate, clear
analyse the and
pathogenesis in comprehensive
relation to the analysis of the
clinical pathogenesis in
manifestations, relation to the
clinical
manifestations.
115
Provides an accurate analysis of the pathogenesis in relation to the clinical manifestations.
Provides an accurate analysis of the pathogenesis in relation to the clinical manifestations. However, the information may be incomplete or lack clarity.
Provides a basic analysis of the pathogenesis in relation to the clinical manifestations.
There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow, Superficial analysis of the pathogenesis in relation to the clinical manifestations.
There are major inaccuracies, omissions or repetition of information, lack of clarity or logical flow,
Select ONE (1) appropriate nursing strategy, including the rationale.
13-15
Provides an appropriate. accurate, clear and comprehensive nursing strategy and rationale.
/5
4.5-5 11.5-12.5
Provides an appropriate and accurate nursing strategy and rationale.
4
10-11
Provides an appropriate and accurate nursing strategy and rationale. However, the information may be incomplete or lack clarity.
3.5
7.5-9.5
Provides an appropriate but basic nursing strategy and rationale. There may be minor inaccuracies, omissions and lack of clarity.
2.5-3 Incorrect prioritisation.
Does not accurately identify the nursing strategy OR identifies the strategy but does not accurately explain the rationale.
g2
/5
Criteria 2 —Critically analyse diagnostic result Arterial blood gas, and relate to the underlying pathogenesis
Academic Writing Style.
Critically analyses ABG diagnostic result, and comprehensively and accurately relates to the underlying pathogenesis.
Critically analyses ABG diagnostic result, and accurately relates to the underlying pathogenesis.
Ideas are clearly documented
Use of written word enables effective flow of ideas.
Minor errors in spelling, grammar, referencing punctuation or sentence structure that do not impede the logical flow of ideas and meaning.
Writes in a reasonably clear, but limited use of language sometimes hinders the effective flow of ideas and meaning.
Minor, frequent errors in spelling, referencing grammar, punctuation or sentence structure sometimes impede meaning and the flow of ideas.
refers to ABG diagnostic result with inaccuracies in relating to the underlying pathogenesis
Inaccurately discusses ABG diagnostic results with little/no relating to the underlying pathogenesis.
54.5
Writes in an elementary style with basic use of language and poor articulation of ideas.
Organisation of material and main points are unclear. confused or disorganised
Multiple errors in spelling, referencing grammar, punctuation and sentence structure.
Analyses ABG Discusses ABG diagnostic result, diagnostic result
and accurately with little
relate to the analysis. Some
underlying inaccuracies in
pathogenesis relating to the
However, underlying
response may pathogenesis.
lack some
relevant
information or
clarity in relating
to pathogenesis.
5-6
6.5-7.0
/10
8.5-10 7.5-8
Writes in an Writes clearly
advanced style and succinctly
exhibiting highly with a coherent, coherent and logical logical flow of
flow of ideas. ideas exhibiting
No errors in advanced clarity. referencing, spelling, No errors in
grammar, spelling,
punctuation or referencing
sentence structure, grammar, punctuation or sentence structure.
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