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Apply appropriate assessment, problem solving, planning, prioritizing of interventions to care for the selected client scenario chosen

Apply appropriate assessment, problem solving, planning, prioritizing of interventions to care for the selected client scenario chosen.

Written Assignment – Nursing the Surgical

Task overview

Assessment name Nursing the Surgical Patient
Assignment Objectives 1.Demonstrate the use of research evidence for nursing practice applied to the care of a surgical patient.2.Augment skills in clinical decision making and reasoning through synthesizing and analyzing information required to care for a surgical patient.

3.Apply appropriate assessment, problem solving, planning, prioritizing of interventions to care for the selected client scenario chosen.

4.Demonstrate the nurse’s role in monitoring and implementing prioritized nursing interventions in response identified patient needs.

5.Demonstrate the ability to communicate specific patient care issues succinctly according to scholarly writing and referencing conventions.

Due Date
Length 2000 words +/-10% (including headings) (word length includes in-text referencing and excludes your reference list)
Marks out of:Weighting: A total of 80 marks = 40 %
Task description This assignment requires you to consider the case scenario of Frank Wright. Frank Wright has undergone a right total knee replacement.Applying your knowledge and understanding of the post-operative patient, you will write an academic essay applying the principles of surgery, consideration of patient co-morbidities and implementing nursing actions that identify, assess and prevent potential clinical issues.

Must be written in the format of an academic assignment and in third person.

You may use headings to differentiate the three parts.

The assignment has three parts –

Part A: Using the clinical reasoning cycle, devise a post-surgical plan of care for a patient who has undergone a total knee replacement

Parts B: Discuss the impact of co-morbidities and a general anaesthetic on post-operative recovery

Part C:  Discuss discharge planning for the patient following a total knee replacement

1. Provide an INTRODUCTION (approximately 150 words)

An introduction should provide clear scope about the direction of your assignment.

Part A  Utilising the case scenario and considering the pre and post- operative clinical data and academic literature devise a plan of care (approximately 600 words)

  1. This section will concentrate on the first 24 hours of post-surgical care.
  2. Analyze the case and formulate an appropriate prioritized plan of care for Frank within the defined 24 hour period.
  3. In the plan of care include:

I. Identify relevant assessment (e.g. vital signs, renal, respiratory, etc.)

I. Based on your assessment, propose three (3) potential patient clinical issues.

II. Based on your assessment and three (3) potential clinical issues, develop prioritized interventions (including monitoring). These interventions should include nurse initiated and collaborative interventions.

  1. The scope of your prioritized interventions may include both physical and psychosocial aspects of care.
  2. The care plan must involve justification of your prioritized interventions and supported with rationales derived from the literature.

Part B: Analyzing the case to identify potential clinical issues in relation to co-morbidities (400-500 words)

1.Discuss smoking, and the co-morbidity of hypertension, high cholesterol and obstructive sleep apnoea (OSA) in the context of having a general anaesthetic within the 24 hour postoperative period.

2.In your discussion, include the possible clinical issues related to the smoking and OSA that could arise in this 24 hour period and how Fred might deteriorate (You will need to reason explain the relevant pathophysiology).

3.Detail the nursing interventions the nurse would initiate to decrease risk of clinical deterioration and include your rationale for the nursing interventions. Justify your rationale with reference to the literature.

Part C: Discharge Plan (300 words)

1.Identify and briefly discuss discharge planning for Frank. Identify from the case the discharge planning that would need to be put in place for Frank. Keep this section brief.

Provide an conclusion (approximately 150 words)

Your conclusion succinctly summarizes the main points of your assignment but this section is not an opportunity to introduce new information.

 

 

Case Study Pre-operativeFrank Wright is a 76 year old man, retired architect, married with two grown children and has been admitted for a right total knee replacement. Frank’s wife suffers from dementia and Frank is her main carer.  Consider the pre-operative data in your discussion.

Utilizing clinical reasoning cycle and referring to the post-operative data you will devise appropriate nursing plan for Frank.  Your answer will be divided into three parts with an introduction and conclusion. Ensure you refer to pre and post-operative data to support your answer.

Objective Data Past Medical History Social History
·         Weight 92kgs·         Height 170 cm

·         BP 140/95

·         HR 86

·         RR 18

·         Temp 36/8

·         Urinalysis – normal

Current Medication

·         Simvastatin 40mg nocte

·         Atenolol 50mg daily

·         Ranitidine 150mg BD

·         Hypercholesterolemia·         Hypertension

·         Osteoporosis affecting both hips and knees

·         Obstructive sleep apnoea confirmed with sleep study March 2019

·  Married with 2 grown children·  Main carer for wife with who has early onset dementia

·  Retired

·  Smokes 10 cigarettes a day

·  Minimal alcohol use

Family history

·      Father RIP heart failure

·      Mother RIP pancreatic cancer

Postoperative

Frank has undergone a right total knee replacement and returned to the ward at 2100 hours. You are the nurse looking after him on the night shift.

Observations Medications Post-operative orders
·      BP 100/54, HR 106, Respiratory rate 12BPM, SaO2 95% FiO2 2 litres via nasal prongs, temperature 37.6°C Axilla,·      Sedation score = 1-2

·      Vacudrain in-situ 50  ml in bag

·      Estimated blood loss (EBL) in OT 200ml

 

 

·         Simvastatin 40mg nocte·         Regular paracetamol 1G QID

·         Captopril 50mg BD

·         Ranitidine 150mg BD

·         Aspirin 100 mg mane

·         Morphine PCA 1mg bolus: 5 minute lockout

·         Oxygen 2L via nasal prongs

·         Intravenous infusion: Sodium Chloride 0.9% (Normal Saline) (NaCl) 100mls/hour

·         Comfeel, crepe bandage to be de-bulked day one·         Apply cryotherapy as tolerated

·         Normal diet

·         DVT prophylaxis –TED stockings

·         Aspirin 100mg daily

·         Pain management

·         GP follow up 2/52

·         OPD appointment 6/52 with Dr McMeniman

 

 

 

Submission information

What you need to submit Suggestions:Microsoft Word document that contains the following items:

·       Coversheet including unit code, unit name, semester and year, assignment title, student name, student number, word count

·       Marking RUBRIC sheet on the last page of your assignment/ as a separate document

Submission requirements This assessment task must:1.Use APA6 is the appropriate form of referencing.

2.Word count includes in-text references and citations but not the reference page.

3.Achieving correct referencing formatting is just one aspect of referencing.  More important is how you use someone else’s published material and correctly synthesize it into your own work – and correctly acknowledge that it is either theirs – or ascribed to someone else within their work (a secondary citation).

4.Each section of the assignment should read smoothly within itself and bring the reader in (introduce the topic) and out (conclude).

5.Academic staff assistance is provided to answer questions but we are not in a position to review drafts – but we will help with clarifying the assignment instructions.

6. When submitting your assignment you must complete the student declaration statement declaring that the assignment is your own work.

Any breach of this is a breach of professional ethics and this will be penalized appropriately.  Turning in work that someone else has done for you and stating that it is your own is considered fraud.  It does not reflect well on a student who is soon to be a Registered Nurse in Australia.  It does not reflect well on the profession

Moderation All academic staff who are assessing your work meet to discuss and compare their judgements before marks or grades are finalized.
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