Nursing caring and inquiry: foundationalOrder Description
This written assessment asks students to use the clinical reasoning process and refer to evidence based practice to formulate a nursing plan of care for a specific case study selected. After reflecting upon, analysing and researching the information provided in the case study, students will address each of the following tasks:
1. Critically analyse the patient assessment findings, taking into consideration the person’s situation and medical diagnosis. Discuss the data/information collected and process that information in terms of relevance to their nursing care using DRABC ( danger, response, airway, breathing, circulation) (10 marks)
2. Identify three (3) nursing diagnoses for this person;
One of which must address the client’s psycho-social needs.
The nursing diagnoses must be discussed in order of priority (e.g.: what nursing diagnosis should be addressed first and why).
You must also establish one patient centred goal for each nursing diagnosis. (5 marks)
3. For each nursing diagnosis,
discuss the specific nursing interventions (what you would do and why) that would be appropriate.
Each intervention must include detailed rationale (why you did what you did) and specific evaluation criteria (how will you know if the intervention was successful).
Your nursing interventions must be person or family centred and must be specific to this client (e.g., tailor the intervention to meet the needs of this specific patient based on evidence and professional recommendations).
All interventions must be referenced from professional literature. (20 marks)
The quality of your academic writing will be assessed throughout each of these three sections and will contribute to your overall mark for that section.
Please see 6h for specific guidelines for formatting an academic paper. Additional marks will be awarded for using correct APA format and referencing throughout your paper (5 marks).
You are a student nurse assigned to a morning shift on a general surgical ward of an acute care facility. You arrive early, before the shift starts, to review your patients’ notes in order to better plan your nursing care. Please select one person from the two listed to complete your written case analysis report using the information provided below.
Case Study 1
You are caring for Mr. Harry Flanagan who is Day 4 since his admission to hospital.
Mr. Harry Flanagan is a 24 year old man who was a passenger in a car involved in a head-on
collision with another car. Harry’s car was travelling at approximately 60 km/ hour. Harry
arrived at the Emergency Department about 35 minutes after the collision. He was not trapped
in the car, although the ambulance were required to extract him, because he couldn’t move his
left leg because of the pain and because of other potential injuries.
Harry has no significant medical history. He is normally fit and healthy. He has no allergies.
Social History: Harry is employed as a real estate agent; he has just bought an apartment and
has recently become engaged to his partner Janelle. They have an 18 month old daughter,
Sophie. Harry moved to Canberra from Alice Springs three years ago to play rugby.
Day 1, 3.30 pm: Arrival in ED :
BP: 153/ 74 mm hg
HR: 112 beats/ minute
RR: 22 breaths / minute
Temp: 35.9 OC
SpO2: 96% on room air.
Harry complained of pain in the right side of his chest that was 4 out of 10 in intensity. There
was considerable bruising in this area, consistent with the location of Harry’s seatbelt. An ECG
was performed which showed normal sinus rhythm.
The paramedics had placed a splint on Harry’s left leg. He had complained of pain of 8/ 10
intensity at the site in the left leg prior to the application of the splint. He was administered a
total of 20 mg of Morphine prior to his arrival in ED which reduced his pain to 5/ 10. He was
found to have a large laceration to his left thigh, approximately 20 cm long. The paramedics
reported that it had been actively bleeding when they arrived; it is now covered in a pressure
Two large bore cannulas were inserted and blood was taken to test for urea, electrolytes, full
blood count and his blood group. A normal saline IV infusion was commenced.
Harry had not reported any pain in his neck or back, although he was initially immobilised by
the paramedics on a spine board and with spinal precautions until his spine was cleared of
injury- because of the mechanism of injury. X-rays and a CT were performed which showed:
• Chest x-ray: No evident rib fractures, normal heart size, lung fields with good air entry
Acknowledgement: Scully & Wilson, (2014) 9049 Assessment 2, Case One, Page 2
• Pelvic x-ray: Pelvis intact, no bone displacement or evident fracture
• Limb x-rays: simple, closed fracture of left femur with swelling around the left thigh, no
other evidence of injuries
• Spinal x-ray and CT: no injuries evident.
The blood pathology results were reported as all being within normal range and his blood
group is A+.
Medical assessment determines that although Harry’s spinal x-ray and CT were clear, spinal
precautions should be taken until the Morphine had worn off because it may have masked pain
on his physical spinal assessment. It was determined that he needed surgery to stabilise his
fracture once the thigh swelling had diminished.
Harry’s vital signs were then:
HR: 102 beats/ minute
Resp rate: 20;
Temp: 35.7 OC;
SpO2: 97% with oxygen at 6 l/min via a simple face mask.
Harry is transferred to the ward after a full secondary survey assessment was conducted by
the nurse and a care plan was developed so the nurse could individualise strategies to ensure
the patient had a successful admission. After 24 hours Harry’s spine was cleared of requiring
Day 2 following his admission to hospital Harry went to the operating theatre and had an open
reduction and internal fixation (ORIF) of his left femur. He had an uneventful stay in the postanaesthesia
unit where he was cared for, for 4 hours before being discharged to the ward with
post op orders for standard post –op care, including fluids, observations, analgesia and
enoxaparin. The surgical treating team directed that calf compressors should not be used.
Day 4: Morning Handover:
Harry’s progress has been uneventful since then and the night nurse hands over to you. He
specifically mentions that Harry has been having difficulty complying with the
physiotherapists’ direction to do deep breathing and coughing exercises several times every
hour because of the pain and bruising of his chest. He also reports that Harry hasn’t been
complying with the direction to do leg exercises every 2 hours.
You introduce yourself to Harry and take his vital signs that are scheduled 4th hourly:
HR: 92 beats/ minute
Resp rate: 18 breaths/ minute
Temp: 35.6 OC;
SpO2: 97% on room air.
Harry complains to you of pain and swelling in his right calf and you note it is swollen and red.
formulate a plan of care for Harry following the Assessment 2 Guidelines and marking
We value our customers, and so ensure that our papers are 100 percent original. Our Team of professionals does not miss the mark; they ensure that step by step each paper is written uniquely. We never duplicate or work as we compare papers rest assured. We deliver our work a day before time to ensure that you don’t miss your deadlines. It is not only doing the work but delivering it at the right time. We capture the consequences of late remittances. .
We value customer satisfaction here at popularessaywriters.com and make sure that you get the best value for your Money. It happens that sometimes you can pay twice for your order or may want to cancel it, or you feel that it doesn’t meet your requirements; our money back guarantee will give you the opportunity to get back your money. We will also refund 100% of money paid double. In case your paper does not satisfy your requirements , we request that you notify us via writing within 2 days otherwise on the third day we will assume that you have been satisfied. Do all your correspondences through our email address email@example.com.Read more
At popularessaywriters.com, our professional writers know the consequence plagiarism does for our clients. We have updated software’s such as article checker and copyscape to check for originality of the custom papers before submission of the final paper to the you. Our guarantee to the customer is that we will write 100% original papers for them that are quality, timely and of low cost. We have experienced professional and competent PhD writers who will write quality custom papers for you..Read more
. At popularessaywriters.com, we are proud to provide top-quality Essay writing service to our esteemed customers. We are ready to take up that challenging academic assignment that is giving you sleepless nights and simplify it for you according to your desired requirements. We are willing to revise your paper if it does not meet your requirements. At popularessaywriters.com, we do not compromise with quality; thus, we offer unlimited free revisions until the customer is satisfied with their custom paper. Our unlimited free revision services are provided under the following terms:.. .Read more
Popularessawriters.com knows that client’s information is an essential tool for our company. It means that whatever the client requests from our service is kept strictly confidential. It means that whoever writes for this company understands the terms and conditions hence you should not be worried because you will never see your work somewhere else...Read more
Rest assured that we will always be attentive to your needs and requirements. We belief in the phrase treat your neighbour as you would want them to treat you. We leave nothing to chance and always look forward to a good interaction with each other.. .Read more