NUR132: Nursing Practice 1 Case Studies’ Assessment Help
Question
NUR132: In this assessment for the Murdoch University of Australia, the students are required to deploy their critical thinking skills and evaluate three lifespan foundation case studies for nursing students. Using the template provided in the task file, the assessment demands the nursing student to finish all the assessment activities based on the evaluation done for the respective case studies. For case studies one and two, the students will be required to fill two parts of the assessment which revolves around the application clinical reasoning cycle and ISOBAR clinical nursing handover. The third case scenario demands the student assess social determinants’ impact on a patient’s condition.
Solution
The solution for this assessment incorporates a detailed answer file based on performing all the assessment activities required by the nursing student.
Case Study One- Donald Jones
This case study revolves around an 80-year-old male who arrived at the hospital’s care facility after he fell and had a skin tear, following which the doctors administered a full body vitals checkup confirming that he depicted no signs of a fractured hip. The medical, social, and physical history of the patient is provided to us for review. Based on an in-depth analysis of this case study, the student is required to prepare a nursing care plan for the patient along with a handover document following the ISOBAR template.
Part A
In this section, our experts have analyzed the case scenario for Donald and have used the fifth step of the clinical reasoning cycle to develop two nursing care goals for the patient. We have provided a snippet of the complete solution below:
Goal one: Reduce Mr. Jones’ hip pain from 7/10 to less than 4/10 within 48 hours, ________________________________________________________ ______________________________________________________________
Nursing intervention one: Administer prescribed pain medications and place a pillow below the patient’s leg to position their hip in a semi-flexion and external rotation position _________________________________________________ ______________________________________________________________
Goal two: Optimize Mr. Jones’ respiratory status by increasing SpO2 levels from 93% to 95% and decreasing respiratory rate from 28bpm to 20bpm within ____________________________________________________________________________________________________________________________
Nursing intervention two: Position Mr. Jones in Semi-Fowler position in bed, with the head of the bed elevated to 45°, to help improve his breathing and oxygenation by maximizing lung expansion and reducing pressure on the diaphragm (Alan & Khorshid, 2019). __________________________________________________________________________________________________________________________________________________________________________________________
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Part B
This section provides a clinical handover which needs to be prepared and delivered to the nurse of the following shift, to brief them about the patient’s case history and treatment plan. Our experts have developed this handover using a structured ISOBAR template.
Introduction: Hi, I’m Komalpreet Kaur, and I’m here to give you an ISOBAR handover of my patient Donald Jones, _______________________________ ______________________________________________________________
Situation: Today at 12:30hrs, Donald had a fall resulting in a skin tear to the ______________________________________________________________
Observation: Post-fall, vital signs at 1300hrs were recorded as T – 36.1°C, Pulse – 95 bpm, Respirations – 28 bpm, SpO2 – 93% RA, and BP – 100/75mmHg. ____________________________________________________________________________________________________________________________
Background: Donald has a history of smoking but quit three years ago. His wife passed away five years ago, and he is currently using her old walking stick. He has two adult daughters, one living locally and the other in the Northern Territory. __________________________________________________________________________________________________________________________________________________________________________________________
Assessment: Donald’s fall resulted in a skin tear to the dorsum of his left hand and bruising to his left hip. __________________________________________________________________________________________________________________________________________________________________________________________
Recommendation: Nursing interventions include pain management, wound care for his skin tear, and mobilization with appropriate mobility aids. The next nurse should also monitor his respiratory rate, oxygen saturation, and blood pressure regularly. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Case Study Two- Donald Jones
In this case scenario, a middle-aged woman named Anne Purple comes into the healthcare facility with symptoms of breathlessness, dizziness, and fatigue. As a Registered Nurse, it has also been noted that she also exhibits symptoms of swollen feet. Based on this assessment, she has been admitted to be checked in later with the doctor.
Part A
Step five of the clinical reasoning cycle has been presented for the patient based on an extensive study of the patient’s presenting issues as well as medical and social history. Our experts have ensured that both the goals proposed here are person-centered and follow the SMART acronym of goal setting.
Goal one: Maintain Anne’s BP at or below 140/90 mmHg within the next 24 hours, and _____________________________________________________
Nursing intervention one: Administer the prescribed anti-hypertensive medication to Anne at the correct dose, time, and route, and document the administration appropriately (Hamdidouche et al., 2017). ____________________________________________________________________________________________________________________________
Goal two: Reduce Anne Purple’s peripheral edema by 20% from her initial assessment within 24 hours, ______________________________________________________________
Nursing intervention two: Encourage Anne to elevate her legs above the level of her heart for at least 30 minutes three times a day during her hospital stay. This can help improve venous return and reduce swelling in the lower limbs (Orhurhu et al., 2021). ____________________________________________ ____________________________________________________________________________________________________________________________
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Part B
Based on the assessment of this lifespan foundations case study for nursing students, our experts have developed a clinical handover that will help the Doctor review the patient’s case in detail. You can read half of the complete handover below:
Introduction: I, Komalpreet Kaur, am handing over care for Anne Purple, a 45-year-old indigenous woman ______________________________________________________________
Situation: Anne’s vital signs on admission were T – 37.0°C, radial pulse – 92 bpm, Respirations – 20 bpm, SpO2 – 95% RA, and BP – unable to be obtained with automatic machine – just reads as HIGH. __________________________________________________________________________________________________________________________________________________________________________________________
Observation: Anne presents with swelling in both feet and has ______________________________________________________________
Background: Anne is married with four children and seven grandchildren. She is a respected local artist who teaches at TAFE. __________________________________________________________________________________________________________________________________________________________________________________________
Assessment: The two goals of care for Anne are to maintain her blood pressure at or below 140/90 mmHg within the next 24 hours and to educate her about heart failure signs and __________________________________________________________________________________________________________________________________________________________________________________________
Recommendation: To achieve the goals of care, the next nurse should administer the prescribed anti-hypertensive medication to Anne at the correct dose, time, and route, and document the administration appropriately. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Case Study Three- Matilda Tan
This is a case study of a five-year-old girl named Matilda Tan who was presented to the child healthcare facility by her mother after she complained of chest tightness and exhibited extreme coughing and wheezing symptoms. The assigned Nurse assessed Matilda’s vitals and advised to be taken her to the emergency department. Her social and medical history has been recorded in detail. Based on a thorough assessment of this case study, the student is required to determine three social determinants that are bound to harm the patient’s condition. Our experts have provided a well-evidenced justification for each of the respective social determinants. You can read a part of the complete solution below:
Social determinants of health include social, economic, and environmental factors that can shape an individual’s health and wellbeing (Crisp et al., 2021). These factors can significantly impact healthy childhood development in various ways. Firstly, low family income and lack of social protection can lead to inadequate nutrition, poor living conditions, and limited access to healthcare, all of which negatively impacts children’s health and development (Siddiqui et al., 2020). Secondly, parents who experience job loss or insecurity may struggle to provide basic necessities to their children, leading to food insecurity, inadequate healthcare, and psychological stress, which adversely affects children’s mental health and development (Weaver & Swank, 2021). Consequently, lack of access to nutritious food can result in malnutrition and poor health outcomes, while poor living conditions, such as overcrowding and exposure to environmental toxins, can also harm children’s health and well-being (Royce, 2021). Moreover, social discrimination and exclusion can also negatively impact children’s mental health and development, leading to poor social and academic outcomes (Cave et al., 2020). Finally, limited access to healthcare can result in untreated illnesses and delayed diagnoses, leading to poor health outcomes for children (Ezzat, 2023). Matilda’s case study illustrates the impact that social determinants of health can have on childhood development. The three social determinants that are having a negative impact on Matilda’s health include poverty, housing, and access to healthcare. Poverty is a significant social determinant of health that is affecting Matilda’s health.
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