FLI307: Case Study and Post Reflection Assignment Help
Question
FLI307: The present assessment is a case study and post reflection based assignment to evaluate the student’s understanding related to the nursing care provided to the patients who require emergency services in isolated settings. Students are required to complete two parts in order to complete the assignment. First part requires the students to answer some questions related to a case study of a patient Michael who needs emergency care in an isolated community setting through careful case analysis. Secondly, students need to critically reflect on their learning in comparison to their real experience in the clinical settings during work-integrated learning.
Solution
The solution of this assessment comprises of detailed answers through a thorough analysis of Michael’s case study.
Our experts have undertaken significant care in answering the questions which depict careful application of learning and skills in provision of emergency care in isolated situations. Please read half of the solution to understand how our experts can assist you in providing high quality assignments.
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a) Description of the signs and symptoms of Michael’s deteriorating condition.
Answer 1) Several signs and symptoms in Michael’s presentation indicate clinical deterioration. Firstly, Michael presents with progressively aggravating tachycardia. The release of large amounts of cytokines and inflammatory markers in the circulatory systems leads to endothelial injury and consequently increased leak of fluid into interstitial spaces (Evans, 2018). Consequently, the vaso-regulatory mechanism of the blood vessels is disrupted, which leads to increased systemic vascular resistance (SVR) (Trammel & Sapra, 2022). Consequently, increased SVR will lead to decreased cardiac output (CO), which will be compensated by the heart to maintain systemic circulation through tachycardia, as seen in Michael’s case. Moreover, both SVR and heart rate are directly proportional to blood pressure (Reule & Drawz, 2012). As such, elevated SVR and tachycardia directly lead to elevated blood pressure in septicemia, as seen in Michael’s case (Reule & Drawz, 2012).
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b) Understanding the root of Michael’s deteriorating condition by providing a pathophysiology of the condition of septicaemia.
The multidimensional pathophysiology of septicaemia in Michael’s case results in an array of signs and symptoms, which collectively contribute to the deterioration of his health. Pathogenic invasion of the wound is detected by the immune system through the detection of pathogen-derived molecules (endotoxins and exotoxins) or endogenous molecular signals internally produced by the immune system (Schortgen., 2012). Consequently, the anti-inflammatory immune response is intensified through increased release of immune cells, whereas the pro-inflammatory response is intensified through release of inflammatory markers (Schortgen., 2012). Additionally, pathogen-derived molecules also activate toll-like receptors to produce intrinsic pyrogenic cytokines, which also trigger the release of prostaglandins (Schortgen., 2012). These cytokines and prostaglandins inform the thermoregulatory systems in the anterior hypothalamus as well as other parts of the central nervous system to increase core body temperature (Schortgen., 2012). Consequently, Michael experiences fever. Moreover, fever can also be life-threatening in Michael’s case because the increased basal metabolic rate (BMR) can lead to further clinical decline (Schortgen., 2012).
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c) Highlighting the urgent responsibilities that accompany a registered nursing professional with appropriate rationale for this action plan.
Three immediate nursing responsibilities are relevant in Michael’s case. Firstly, the nurse should position Michael in the semi-fowler’s position to ease breathing and improve SaO2. Endothelial damage leads to fluid accumulation in the pulmonary interstitium, leading to the development of pulmonary oedema (Mezidi & Guérin., 2018). Since visceral contents impose pressure against the diaphragm in supine lying, this position limits thoracic excursion and increases the work of breathing, which makes it harder for the patient to breathe effectively (Mezidi & Guérin., 2018). As such, the nurse should position Michael in semi-fowler’s position with the head side of his bed elevated by 30° or more, and place pillows to support his knees and elbows (Mezidi & Guérin., 2018). This position will enable Michael’s thorax to expand optimally, while also reducing the work of breathing, which will help improve his SaO2. Subsequently, the nurse should closely monitor Michael’s respiratory rate and SaO2 to determine the effectiveness of the intervention.
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d) Elaborating on the communication-related strategies which will need to be implemented to better coordinate with the patient, their family members, medical officer, retrieval team assigned on the case, and the entire community. Students need to assume themselves as the only registered nursing professional who is deployed to the community at this time.
When communicating with Michael, the nurse should practise effective communication through active listening. By demonstrating cultural awareness and collaborating with the Indigenous health worker (IHW), the nurse can resolve any language and cultural barriers with Michael and better understand him. Secondly, when communicating with Michael’s family, the nurse should practise empathetic communication, wherein the nurse is aware and considerate of the emotions of the family (Babaii et al., 2021). Consequently, the nurses practise empathetic listening to establish a trusting relationship with the patient’s family that can provide necessary emotional and psychological support to them (Babaii et al., 2021).
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e) Explore the challenges that might accompany the student’s provision of care to the patient due to the employment of Michael’s wife at the same centre, while also communicating with her regularly.
The nurse’s familiarity with Michael’s wife makes it challenging for her to care for him in various ways. Firstly, this friendship with his wife makes it challenging for the nurse to remain impartial and unaffected when provisioning treatment to him (Ledoux, 2015). Being worried and emotionally overwhelmed about her friends (Michael and his wife) limits the ability of the nurse to provide effective care to them (Ledoux, 2015).
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f) Elaborate the strategies that need to be implemented by the student in the present scenario whilst the emergency as well as post it in order to ensure safety at both personal and professional levels.
The nurse can undertake an array of steps to maintain professional and personal safety during an emergency. Firstly, the nurse should practise hand hygiene and other techniques of sterilisation to prevent cross-contamination from her to Michael (Martos-Cabrera et al., 2019). Maintaining patient safety through this strategy ensures that the nurse conserves professional safety in this case.
Secondly, the nurse should undertake extreme care and caution when carrying out the orders of the ED doctor in Michael’s case, to prevent the occurrence of a medication error. Nurses in emergency clinical settings face significant psychological and physical stress to ensure optimal health outcomes for the patient.
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The second part of this assignment is a critical reflection post the clinical experience of the student.
Our experts have provided a detailed reflection through a comparison of the knowledge gathered by the student and their real-life clinical experience. The experts have reflected on the prior research done about the community by the student, and a comparison to city-based care option available for Michael. Additionally, the experts provide an evaluation of emergency care services in an isolated community by reflecting on the experience assuming the role of a registered nurse. Please read the response below:
Yes, I researched my community of placement to learn about the socioeconomic conditions, prevalent lifestyle, and culture of the population living there.
While Michael had access to only basic primary care at the PHC, someone in the capital city would have access to specialised, tertiary-level healthcare services.
Yes, gaining first-hand experience working in an isolated practice significantly changed my presumptions about it. I previously believed that working in an isolated practice meant less workload, less experience, and more enjoyment.
Emergency care in an isolated area is poorly managed due to a lack of both material and human resources (Vaughan & Edwards, 2020).
Yes, I was accepted as a valued member of the team at my placement. Effective communication enabled such a large number of healthcare professionals to coordinate and adequately care for patients.
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