Before you begin NUR251 Assessment 1
It is strongly recommended that students revisit and ensure they understand the University and Unit policies and guidelines related to academic integrity, plagiarism, submission, extension, late submission and resubmission.
The Unit Coordinator cannot be held responsible for information about Assessment 1 that students’ access outside of the NUR251 Learnline site.
This includes information students may access from other students, whether enrolled in the unit or not, using social media tools such as Facebook and/or friends and/or colleagues they may discuss their assignment with.
The Unit Coordinator is the person to contact if you have any questions or queries about Assessment 1
NUR251 Assessment 1
Topic:
Nursing care of a patient with a medical condition
Due date:
Week 10 Monday 10th May, 2021, 09:30 (ACST)
Length: 2000 words ± 10% + 100 words to account for the headings in the template.
Markers will stop reading at the maximum allowable word count. This word count includes the text in the template provided to you.
Contribution to overall grade: 40%
Assessment purpose Learning objectives
Assessment 1 is the only written academic assignment in NUR251 for students to demonstrate they:
• Are developing the ability to locate, interpret, integrate, synthesize and apply nursing knowledge from NUR251 to a relevant nursing practice scenario in medical surgical settings
• Are developing appropriate critical thinking, clinical reasoning and sound clinical decision-making processes and strategies essential for safe, evidence-based and competent nursing practice in medical surgical settings
• Are able to focus their attention to the needs of the individual patient as the key concern of nursing practice in medical surgical settings
• Are able to explain and justify or defend their nursing care decisions
• Have a developing understanding of the role and scope of practice of the registered nurse in the Australian health care context
• Are progressing towards the level of professional written communication required for nursing practice in Australia
• Are demonstrating ethical and professional practice by adhering to the University’s academic integrity standards and plagiarism policy This assessment addresses the unit learning outcomes;
1, 2, 3, 4 and 5
Preparation
• Timely completion of study materials including modules 1, 2 and 3 with participation or review of online collaborate sessions, pre-recorded lectures or internal classes. Presentation Guidelines
• On the Assessment 1 template located in the Assessment 1 folder on NUR251 Learnline
• As a computer-generated document in Word format.
• 1.5 spaced using Arial or Calibri font in size 11 or 12
• In clear, coherent Australian English that demonstrates progression towards the standard for written communication for professional nursing practice in Australia
• Using appropriate professional terminology
• Contents page, title page, introduction and conclusion are NOT required
• Unless otherwise indicated, no acronyms, abbreviations and/or nursing jargon
• Unless otherwise indicated, grammatically correct sentences and topic paragraphs are required. Dot points only accepted in the nursing care plan.
• No more than 10% over or under the stated word count. Marking will cease at the 10% over mark.
• Note: Headings, any task information copied in and in-text citations are included in the word count. 100 words have been included in the word count to account for the headings within the nursing care plan template.
• Use of trade names is not acceptable. Only generic terms or names are to be used when referring to specific medications or other prescribed treatments or resources that may be used in nursing practice
Referencing
Students are reminded of their academic responsibilities and professional nursing practice requirements when using the work of others in assignments.
Reminder marks are allocated for academic integrity. See the marking criteria for Assessment 1 for full details. Breaches of academic integrity will be lodged on the University system and may have serious consequences for students.
• All information is to be interpreted and restated in your own original words demonstrating your ability to interpret, understand and paraphrase material from your sources
• CDU APA 7th referencing style is to be used for both in-text citations and end of assessment reference list.
• All resources for NUR251 assignments should be from quality, reliable and reputable journals relevant to nursing practice and the Australian healthcare industry. Please DO NOT use patient information leaflets or websites.
• All resources must be dated between 2011 and 2021
• There must be at least 10 peer-reviewed journal articles and/or evidence-based practice guidelines cited in your assignment.
• Do not use any health facility or local health service policies or procedures
• Only 1 current Australian medication textbook and 1 current Australian medical surgical nursing textbook to be referenced.
Please complete the assessment task on the next page.
Assessment 1: Case scenario one
Shift handover:
Identify: Mr William Blue, HRN: 123456, DOB: 26/01/1953
Situation: William (known as Bill) is a 68-year-old Indigenous man from a remote community in the NT. He has been admitted to the CDU medical ward with Acute Kidney Injury (AKI) secondary to dehydration. He has a 3/7 history of confusion, fatigue, decreased urine output, and decreased skin turgor. He has now been transferred to the CDU Medical ward for continuing care.
Background:
Bill lives with his wife, his 2 adult children and 6 grandchildren in a single storey home. His wife is supportive and the family help where possible. He is usually independent with his ADL’s.
He has an extensive past medical history including:
T2DM (on insulin), HTN, Hyperlipidaemia, chronic kidney disease stage 3 (Baseline eGFR 40 ml/min/1.73m2), previous toe amputations due to diabetes and has a history of falls. No known drug allergies (NKDA).
He is obese (BMI 30) he drinks 3 bottles of beer every night.
Assessment:
Airway: Own, patent
Breathing: RR 23, O2 Sats 93% on RA.
Circulation: HR 62bpm, BP 95/65 mmHg.
Disability: GCS 14/15, he is drowsy and ‘wants to be left alone to sleep’.
Exposure: Temp 37.8 oC, BGL 3.9mmol/L
Bill looks unwell. He is restless and confused. His urine is dark in colour and offensive smelling. He has passed approximately 30 ml of urine in 6 hours. He had 2 x IVC’s inserted to both ACF’s and is not tolerating any food due to nausea. He last opened his bowels this morning and says it was ‘like liquid’.
Recommendations/Read back:
Medical orders
• Routine ward assessments and observations
• Strict fluid monitoring
• Administer Intravenous fluids as prescribed
• MSU for MC & S
• Diabetic diet and fluids as tolerated
• TED stockings and DVT prophylaxis
IV Fluid orders
• Intravenous compound sodium lactate (CSL) 500mls over 2 hours followed by:
• Intravenous sodium chloride 1000mls/8 hourly.
Medication orders
• Furosemide 10mg BD (IV)
• Ramipril OD (PO)
• Insulin Glargine 30 Units OD (s/c)
Nursing orders
• Devise a plan of care for your patient
Assessment 1: Case scenario two
Shift handover:
Identify: Miss Grace Orange, HRN: 123567, DOB: 07/05/2005
Situation: Grace is a 16-year-old caucasian female from Darwin. She has been admitted to the CDU medical ward due to Diabetic
Ketoacidosis. She has a 2/7 history of feeling unwell, fatigue, and a fever. Her Mum was worried as Grace has been complaining of increased thirst and passing large amounts of urine frequently. Her Mum brought her to the emergency department (ED). She was treated for DKA in ED. She has been reviewed by the
Endocrinology team and has been diagnosed with Type 1 Diabetes Mellitus (T1DM) and subsequently developed DKA. She has been transferred to the CDU Medical ward for continuing care.
Background:
Grace lives with her parents and younger brother Tommy. She is independent with her cares and plays Netball at state level 3 times a week after school.
She has never been admitted to hospital before.
Her past medical history:
Previously ankle sprain in 2020 – resolved.
Tonsilitis.
She is allergic to Penicillin.
Assessment:
Airway: Own, patent
Breathing: RR 26, Sats 98% on RA.
Circulation: HR 115 bpm, BP 90/55 mmHg.
Disability: GCS 15/15
Exposure: Temp 37.8 oC
Grace feels tired and anxious.
Grace has 2 x IVC’s inserted to both ACF’s.
She is refusing to eat, feels sad and tells you ‘Leave me alone, my life is ruined, I’ll never play sport again'
Venous Blood Gas attended shows Potassium 3mmol/L
BGL 25mmol/L
Ketones – 1mmol/L
Recommendations/Read back:
Medical orders
• Routine ward assessments and observations
• Strict fluid monitoring
• Administer Intravenous fluids as prescribed
• Commence Insulin sliding scale
• MSU for MC & S
• Diabetic diet and fluids as tolerated
• TED stockings and DVT prophylaxis
IV Fluid orders
• Intravenous compound sodium lactate (CSL) 500mls over 2 hours followed by:
• Intravenous Potassium Chloride 40mmols/1000mls over 8 hours
Medication orders
• Actrapid insulin (sliding scale) S/C
• Insulin Glargine 10 Units S/C OD
• Tazocin 4.5g IV TDS
Nursing orders
• Devise a plan of care for your patient
Assessment 1 Tasks:
Using the template provided in the Assessment 1 folder and, based on the handover you received at the beginning of your shift today, other information included below and current reliable evidence for practice, address the following tasks.
Do not make up or assume information in relation to or about your chosen patient. Only use what you know from the information you received today.
Task 1: Assessment
Based on your chosen case scenario and in grammatically correct sentences identify:
• Three (3) priority nursing assessments you would conduct at the commencement of your shift
AND
For each assessment you have identified explain:
• Why it is necessary for the patient’s condition and nursing care?
• What consequences can occur if this assessment is not completed accurately?
• What chart or document could you use to assist with/record your assessments?
(Approximately 500 words)
Task 2:
Based solely on the handover you have received and using the template provided, complete a nursing care plan for your patient. Your plan must address the physical, functional and psychosocial aspects of care.
Three (3) nursing problems have been provided for you. For each nursing problem on your care plan you need to identify;
• What it is related to?
• Goal of care
• Interventions
• Rationales for interventions
• Evaluation
Notes for Task 2 only
• Dot points may be used in the care plan template
• Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
• Rationales must be appropriately referenced (Only rationales need referencing in the care plan)
(Approximately 500 words)
Task 3: Patient education
Discharge planning
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or prevention of reinfection or deterioration on discharge.
Patient education and discharge planning starts on admission and you need to provide your patient with education during your shift in preparation for discharge home.
• Explain two (2) important points/topics you will need to include in your patient’s preparation for discharge to aid healing and prevent further illness. For each education point identified provide:
• One (1) strategy to assist your patient to implement the education into their daily routine.
(Approximately 500 words)
Task 4: Medication
• Calculate the hourly rate of the compound sodium lactate and the sodium chloride infusions. List the formula that you used.
• Choose two (2) medications that your patient has been prescribed (one (1) from their IV fluid order and one (1) from their medication order) and include the following in your discussion:
• Describe the pharmacokinetics of the fluid/medication?
• Why has your patient been prescribed this fluid/medication?
• Discuss any side effects that could affect the patient.
(Approximately 500 words)
Your assignment must include a reference list after the completion of the tasks and a key if you have used abbreviations in task 2.
NUR251 Assessment 1 Marking Rubric S1 2020
5-7.5
Excellent 3-5
Satisfactory 0-3
Needs Development
Criterion:
Task 1:
Assessment
Demonstrates excellent
safe practice knowledge for assessment. Explains clearly, succinctly and specifically how to conduct the relevant assessments and explains their relevance to the patient.
Demonstrates satisfactory knowledge of patient assessment. Rationales demonstrate satisfactory ability to conduct the relevant assessments and explain their relevance to the patient. Demonstrates a limited knowledge of assessment. Does not demonstrate safe practice, knowledge of the relevant assessments and/or explain their relevance to the patient.
Criterion:
Task 2: Care planning Develops individualised, comprehensive nursing care plan relevant to the case study using the clinical reasoning cycle. All rationale is referenced.
Demonstrates strong critical thinking skills.
Develops individualised, comprehensive nursing care plan relevant to the case study using the clinical reasoning cycle. Most rationale is referenced.
Demonstrates emerging critical thinking skills. Care plan has been completed using the clinical reasoning cycle, but it is not individualised or comprehensive. There is a discourse between the sections of the care plan. No critical thinking skills displayed.
Criterion:
Task 3: Discharge planning Demonstrates a highlevel ability to provide relevant and comprehensive patient education. Provides specific patient education discussing two topics with an implementation strategy.
Demonstrates a
satisfactory ability to provide relevant and comprehensive patient education; discussing two topics with an implementation strategy. Discussion lacks detail and/or is not person centred Poor interpretation of task or
Education is provided but it is not specific to the
patient. No implementation strategy is identified.
Criterion:
Task 4:
Medication
Provides excellent, relevant and specific discussion about medications. Side effects are discussed. Demonstrates strong critical thinking skills. IV fluid calculations and formula are correct.
Provides a satisfactory discussion about medications. Discussion is not specific. Side effects are discussed.
Demonstrates emerging critical thinking skills. IV fluid calculations are correct and/or some minor errors in formula.
Provides a limited discussion about medications. Side effects are not discussed and/or Discussion is not specific to the case study. No critical thinking skills displayed. IV fluid calculations are missing or incorrect.
Referencing 4-5
All ideas supported with in-text citations
and there is a complete and accurate reference
list.
No errors detected in CDU APA 7th format.
Referencing guidelines met. 2-3
Some ideas supported with in-text citations and there is a complete reference list.
A few errors detected in CDU APA 7th format.
Referencing guidelines met with errors. 0-1
Many references are
missing and there are
many errors in CDU APA
7TH format. Referencing guidelines not met.
Presentation 4-5
No errors with grammar, syntax, sentence and
paragraph structure.
Presentation guidelines met. 2-3
A large number of errors with grammar, syntax,
sentence and paragraph structure.
Presentation guidelines met with errors. 0-1 Many errors with grammar, syntax, sentence and paragraph structure.
Writing lacks cohesion.
Presentation guidelines not met.