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ASSESSMENT

INFORMATION

















Assessment


Title















Written


assessment










































Purpose














The


purpose


of


this


written


task


is


to





engage


students


with


the


application


of


theory into practice and how this needs to be flexible to meet the needs of the person requiring health care assistance.












Weighting














40%














Length














1500


words


+/-


10% (includes


in-text


citations,


excludes


reference


list)












Assessment


Rubric












Refer


to


Extended


Unit


Outline


Appendix





2












LOs





Assessed












LO1,


LO3,





LO5

















































































































































































































































































Task











Students


will


assess,


prioritise


and


plan


the


care


of


the


guided


case


study


patient


using


a clinical reasoning framework in hospital and community setting. Introduction and conclusion not needed.







Case


study






Mr.


Johnson


is


a


75-year-old


man,


was


brought


to


the


emergency


department


(ED)


by


his daughter with concerns about his increasing levels of pain, intermittent periods of acute confusion and deteriorating overall general health.







Initial





Assessment






Mr. Johnson is alert but disorientated to time and place. He appears dishevelled and malnourished,


with


a


strong


odour


of


urine. He


was


brought


in


a


wheelchair


and


was guarding


his


L


knee.


Daughter


stated


Mr.


Johnson


took


two


(2)


Ibuprofen


(neurofen) tablets couple of hours ago with minimal effect.




BP


-


140/93




HR - 96 bpm and regular Peripheral


pulses


-


Present RR - 18 rpm




Temp


-


37.0C


(tympanic) Sa02 - 98% RA




BGL





9


mmol/L Height -170 cm




Weight


-


74


kg


(weighed


80


kgs


six


months


ago)




ECG


-





NAD



























































MMSE




23/30




L


Knee


Xray-





NAD




Urinalysis


-


dark


concentrated


yellow,


clear


urine,


SG


1.010,


pH


7,


Leukocytes


and nitrite- positive.







Medical





history






Mr. Johnson has a history of multiple chronic medical conditions, including osteoarthritis,


osteoporosis,


hypertension,


and


diabetes.


He


is


on


several


medications


and has regular visits with his primary care physician.










Medications







Ibuprofen

Panadol


osteo




Alendronate


(Fosamax)

Norvasc








Cholecalciferol


Calcium supplements




Metformin


Hydrochloride

Gliclazide Hydrochlorothiazide




Patient history





Mr. Johnson lives independently in his own home and usually cooks his own meals at home.


His


daughter


visits


him


couple


of


times


each


week.


Mr.


Johnson


walks


for


an


hour daily


and


catches


up


with


his


friends


at


the


nearby


park


once


a


week.


He enjoys


spending time with his grandchildren. He never smoked and drinks a bottle of beer after dinner while watching TV. He wears glasses for long distance and bilateral hearing aids.




Recently


the


daughter


noticed


Mr.


Johnson


increasingly


neglecting


his


personal


hygiene, nutrition, and household upkeep. Mr. Johnson has been socially isolated.


and had multiple falls at home recently.










Admitting


diagnosis:





Early


signs


of





dementia.







You


are


the


registered


nurse


looking


after


Mr.


Johnson,


and


you


are


required


to


plan


her care


guided


by


a


clinical


reasoning


framework


and


the


provided


case


study


information. Sections you need to respond to include:







1.








Patient


assessment


(500





words)









·





Provide


an


initial


impression


by





identifying


relevant


and


significant


features


from Mr. Johnson’s current ED presentation.












·





Discuss


the


possible


causes


for


Mr.


Johnson’s


intermittent


cognitive


impairment.











































































































































Do you agree or disagree with Mr. Johnson’s diagnosis of an early onset of dementia.


Justify


your


opinion


and


support


your


discussion


with


evidence


from the case study.







·





Evaluate


the


impact


a


misdiagnosis


may


have


on


the


care


provided


for


Mr.

Johnson.







Mr.


Johnson’s


intermittent


confusion


resolved


after


3


days.


He


was


assessed


by


the


Aged Care Assessment Team (ACAT) and was eligible for a community care package. Mr.




Johnson


was


discharged


home


with


regular


codeine


for


his


chronic





pain.
















2.











Physiological


changes


of


ageing


and


identify


patient


issues


(500





words)









·





Discuss how the normal physiological changes of ageing may increase Mr. Johnson’s


risk of falls. Identify three (3) evidence-based

nursing interventions

with


rationales


that


should


be


implemented


for


Mr.


Johnson


to


reduce


the


risk


of falls. (Do not include referrals in your answer).







·





Evaluate


how


Mr.


Johnson’s


chronic


pain


would


impact


on


his


capacity


to complete two of his activities of daily living (ADL’s) ensuring you have justified your choice of ADL’s.













3.











Pharmacological


management


and


nursing


considerations


(500





words)









·





Discuss


why


Mr.


Johnson,


as


an


older


adult,


is


more


vulnerable


to


adverse


drug effects. Ensure you


include factors related to the anatomical,


physiological and behavioural considerations associated with ageing.







·





Identify


with


rationale


two


(2)


nursing


interventions


you


would


consider





when




caring


for


Mr.


Johnson


who


takes


multiple


medications


(polypharmacy).


(Do


not include referrals in your answer.)










Submission











The


assessment


must


be


in


word


document


format


and


is


to


be


submitted


to


the


relevant campus Turnitin assessment drop box located on NRSG266 LEO Assessment Tile










FORMATTING














File





format












Please


submit as a


.doc


or


.docx


(not .pdf





files)












Margins














2.54cm,


all





sides












Font


and





size












Use


11-point Calibri,


Arial


or


Times


New





Roman





















Spacing























Double





spacing












Paragraph














Aligned


to


left


margin, indent


first


line of


each


paragraph

1.27cm






















































































































































































































Title





page/images












No


cover


pages, bullet


points, numbering,


tables,


or diagrams


are


to


be

used.





















Introduction/Conclusion























Introduction


or


concluding


paragraphs


are


not





required.





















Additional





Info












This is an academic piece and as such, third person writing is required. Headings


must


be


used,


such


as


Question


One


and


Question


Two


and


so


on.












Structure





























Direct





quotes












Always


require


a


page


number.


No


more


than


10%


of


the


word


count


should


be direct quotes.





















Footer














Name


_


Student Number_


Assessment


_ Unit _


Year


(9-point Calibri


or





Arial)












REFERENCING























Referencing





Style





















APA


7th

Edition.







































Minimum





References












There is no set number of references that must be used as a minimum for this task,


but


as


a


rough


guide


only,


if


you


have


utilized


less


than


12


unique


quality peer-reviewed sources then you have not read widely enough.









All


arguments


must


be


supported


using


a


variety


of


high-quality


primary evidence. Avoid using any one source repetitively.





















Age


of





References












Most


references


for


this


task


should


be


published


within


the


last


5


years,


however the appropriate use of older evidence sources (e.g. seminal theoretical ethical work) is acceptable.












List


Heading












“References”


is


centered,


bold, on


a


new


page


(14


point


Calibri


or





Arial).












Alphabetical





Order












References


are


arranged


alphabetically


by


author


family





name












Hanging

Indent












Second


and subsequent


lines


of a


reference


have


a hanging

indent





















DOI


or

URL





















Presented


as


functional


hyperlink












Spacing














Double


spacing


the


entire


reference


list,


both


within


and


between





entries





































































































































































NRSG266: Principles of Nursing: Contexts of Ageing ASSESSMENT INFORMATION Assessment Title Written assessment Purpose The purpose of this written task is to engage students with the application of theory into practice and how this needs to be flexible to meet the needs of the person requiring health care assistance. Weighting 40% Length 1500 words +/- 10% (includes in-text citations, excludes reference list) Assessment Rubric Refer to Extended Unit Outline Appendix 2 LOs Assessed LO1, LO3, LO5 Task Students will assess, prioritise and plan the care of the guided case study patient using a clinical reasoning framework in hospital and community setting. Introduction and conclusion not needed. Case study Mr. Johnson is a 75-year-old man, was brought to the emergency department (ED) by his daughter with concerns about his increasing levels of pain, intermittent periods of acute confusion and deteriorating overall general health. Initial Assessment Mr. Johnson is alert but disorientated to time and place. He appears dishevelled and malnourished, with a strong odour of urine. He was brought in a wheelchair and was guarding his L knee. Daughter stated Mr. Johnson took two (2) Ibuprofen (neurofen) tablets couple of hours ago with minimal effect. BP - 140/93 HR - 96 bpm and regular Peripheral pulses - Present RR - 18 rpm Temp - 37.0C (tympanic) Sa02 - 98% RA BGL – 9 mmol/L Height -170 cm Weight - 74 kg (weighed 80 kgs six months ago) ECG - NAD NRSG266: Principles of Nursing: Contexts of Ageing NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 2 of 5 MMSE – 23/30 L Knee Xray- NAD Urinalysis - dark concentrated yellow, clear urine, SG 1.010, pH 7, Leukocytes and nitrite- positive. Medical history Mr. Johnson has a history of multiple chronic medical conditions, including osteoarthritis, osteoporosis, hypertension, and diabetes. He is on several medications and has regular visits with his primary care physician. Medications Ibuprofen Panadol osteo Alendronate (Fosamax) Norvasc Cholecalciferol Calcium supplements Metformin Hydrochloride Gliclazide Hydrochlorothiazide Patient history Mr. Johnson lives independently in his own home and usually cooks his own meals at home. His daughter visits him couple of times each week. Mr. Johnson walks for an hour daily and catches up with his friends at the nearby park once a week. He enjoys spending time with his grandchildren. He never smoked and drinks a bottle of beer after dinner while watching TV. He wears glasses for long distance and bilateral hearing aids. Recently the daughter noticed Mr. Johnson increasingly neglecting his personal hygiene, nutrition, and household upkeep. Mr. Johnson has been socially isolated. and had multiple falls at home recently. Admitting diagnosis: Early signs of dementia. You are the registered nurse looking after Mr. Johnson, and you are required to plan her care guided by a clinical reasoning framework and the provided case study information. Sections you need to respond to include: 1. Patient assessment (500 words) · Provide an initial impression by identifying relevant and significant features from Mr. Johnson’s current ED presentation. · Discuss the possible causes for Mr. Johnson’s intermittent cognitive impairment. Do you agree or disagree with Mr. Johnson’s diagnosis of an early onset of dementia. Justify your opinion and support your discussion with evidence from the case study. · Evaluate the impact a misdiagnosis may have on the care provided for Mr. Johnson. Mr. Johnson’s intermittent confusion resolved after 3 days. He was assessed by the Aged Care Assessment Team (ACAT) and was eligible for a community care package. Mr. Johnson was discharged home with regular codeine for his chronic pain. 2. Physiological changes of ageing and identify patient issues (500 words) · Discuss how the normal physiological changes of ageing may increase Mr. Johnson’s risk of falls. Identify three (3) evidence-based nursing interventions with rationales that should be implemented for Mr. Johnson to reduce the risk of falls. (Do not include referrals in your answer). · Evaluate how Mr. Johnson’s chronic pain would impact on his capacity to complete two of his activities of daily living (ADL’s) ensuring you have justified your choice of ADL’s. 3. Pharmacological management and nursing considerations (500 words) · Discuss why Mr. Johnson, as an older adult, is more vulnerable to adverse drug effects. Ensure you include factors related to the anatomical, physiological and behavioural considerations associated with ageing. · Identify with rationale two (2) nursing interventions you would consider when caring for Mr. Johnson who takes multiple medications (polypharmacy). (Do not include referrals in your answer.) Submission The assessment must be in word document format and is to be submitted to the relevant campus Turnitin assessment drop box located on NRSG266 LEO Assessment Tile FORMATTING File format Please submit as a .doc or .docx (not .pdf files) Margins 2.54cm, all sides Font and size Use 11-point Calibri, Arial or Times New Roman Spacing Double spacing Paragraph Aligned to left margin, indent first line of each paragraph 1.27cm Title page/images No cover pages, bullet points, numbering, tables, or diagrams are to be used. Introduction/Conclusion Introduction or concluding paragraphs are not required. Additional Info This is an academic piece and as such, third person writing is required. Headings must be used, such as Question One and Question Two and so on. Structure Direct quotes Always require a page number. No more than 10% of the word count should be direct quotes. Footer Name _ Student Number_ Assessment _ Unit _ Year (9-point Calibri or Arial) REFERENCING Referencing Style APA 7th Edition. Minimum References There is no set number of references that must be used as a minimum for this task, but as a rough guide only, if you have utilized less than 12 unique quality peer-reviewed sources then you have not read widely enough. All arguments must be supported using a variety of high-quality primary evidence. Avoid using any one source repetitively. Age of References Most references for this task should be published within the last 5 years, however the appropriate use of older evidence sources (e.g. seminal theoretical ethical work) is acceptable. List Heading “References” is centered, bold, on a new page (14 point Calibri or Arial). Alphabetical Order References are arranged alphabetically by author family name Hanging Indent Second and subsequent lines of a reference have a hanging indent DOI or URL Presented as functional hyperlink Spacing Double spacing the entire reference list, both within and between entries NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 5 of 5 NRSG266: Principles of Nursing: Contexts of Ageing NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 1 of 2 ASSESSMENT INFORMATION Assessment Title Written assessment Purpose The purpose of this written task is to engage students with the application of theory into practice and how this needs to be flexible to meet the needs of the person requiring health care assistance. Weighting 40% Length 1500 words +/ - 10% (includes in - text citations, excludes reference list) Assessment Rubric Refer to Extended Unit Outline Appendix 2 LOs Assessed LO1, LO3, LO5 Task Students will assess, prioritise and plan the care of the guided case study patient using a clinical reasoning framework in hospital and community setting. Introduction and conclusion not needed. Case study Mr. Johnson is a 75 - year - old man, was brought to the emergency department (ED) by his daughter with concerns about his increasing levels of pain, intermittent periods of acute confusion and deteriorating overall general health. Initial Assessment Mr. Johnson is alert but disorientated to time and place. He appears dishevelled and malnourished, with a strong odour of urine. He was brought in a wheelchair and was guarding his L knee. Daughter stated Mr. Johnson took two (2) Ibuprofen (neurofen) tablets couple of hours ago with minimal effect. BP - 140/93 HR - 96 bpm and regular Peripheral pulses - Present RR - 18 rpm Temp - 37.0C (ty mpanic) Sa02 - 98% RA BGL – 9 mmol/L Height - 170 cm Weight - 74 kg (weighed 80 kgs six months ago) ECG - NAD NRSG266: Principles of Nursing: Contexts of Ageing NRSG266 _ Assessment 2: Written Assessment _ © Australian Catholic University 2023 _ Page 1 of 2 ASSESSMENT INFORMATION Assessment Title Written assessment Purpose The purpose of this written task is to engage students with the application of theory into practice and how this needs to be flexible to meet the needs of the person requiring health care assistance. Weighting 40% Length 1500 words +/- 10% (includes in-text citations, excludes reference list) Assessment Rubric Refer to Extended Unit Outline Appendix 2 LOs Assessed LO1, LO3, LO5 Task Students will assess, prioritise and plan the care of the guided case study patient using a clinical reasoning framework in hospital and community setting. Introduction and conclusion not needed. Case study Mr. Johnson is a 75-year-old man, was brought to the emergency department (ED) by his daughter with concerns about his increasing levels of pain, intermittent periods of acute confusion and deteriorating overall general health. Initial Assessment Mr. Johnson is alert but disorientated to time and place. He appears dishevelled and malnourished, with a strong odour of urine. He was brought in a wheelchair and was guarding his L knee. Daughter stated Mr. Johnson took two (2) Ibuprofen (neurofen) tablets couple of hours ago with minimal effect. BP - 140/93 HR - 96 bpm and regular Peripheral pulses - Present RR - 18 rpm Temp - 37.0C (tympanic) Sa02 - 98% RA BGL – 9 mmol/L Height -170 cm Weight - 74 kg (weighed 80 kgs six months ago) ECG - NAD
Answered 1 days AfterSep 28, 2023

Answer To: ASSESSMENTINFORMATIONAssessmentTitle...

Dipali answered on Sep 29 2023
36 Votes
WRITTEN ASSIGNMENT        2
WRITTEN ASSIGNMENT
Table of contents
Patient Assessment    3
Physiological Changes of Aging and Patient Issues    5
Increased Risk of Falls    5
Impact on Activities of Daily Living (ADLs)    6
Pharmacological Management and Nursing Considerations    7
Vulnerability to Adverse Drug Effects    7
Nursing Interventions for Mr. Johnson's Polypharmacy    8
Medication Reconciliation    8
Rationale    8
Implementa
tion    8
Medication Adherence Support    9
Rationale    9
Implementation    9
References    10
Patient Assessment
Mr. Johnson, a 75-year-old man, arrived at the emergency room (ED) with a number of alarming symptoms that necessitate a thorough evaluation to direct his care. This initial evaluation tries to pinpoint pertinent and important elements from Mr. Johnson's presentation, talk about plausible reasons for his sporadic cognitive impairment, and examine the precision of his early onset dementia diagnosis. First off, Mr. Johnson's daughter took him to the ED because of his poor general health, rising discomfort, and periodic severe disorientation. During the evaluation, some important conclusions were made:
· Mental Status: Mr. Johnson appeared awake but out of place and time. Concerns regarding cognitive damage arise because of this disorientation.
· Physical Appearance: He smelled strongly of urine and looked dishevelled and undernourished. These data imply that diet and personal cleanliness have been neglected.
· Pain and Mobility: Mr. Johnson showed signs of localised discomfort by protecting his left knee. He had taken Ibuprofen, but it had had little impact, indicating insufficient pain management.
· Vital Signs: The patient's blood pressure was high (140/93 mmHg), heart rate was within acceptable limits, breathing rate was 18 breaths per minute, and oxygen saturation in the air was 98%. These vital indicators outline his physiological state.
· Temperature: The tympanic temperature of Mr. Johnson was 37.0 °C.
· Blood Glucose Level (BGL): His BGL was high at 9 mmol/L, which meant he needed to control his diabetes (Schwerzmann et al., 2020).
· Cognitive Function: His Mini-Mental State Examination (MMSE) score was 23/30, which may or may not be early dementia and implies cognitive decline.
· Knee X-ray: His left knee's X-ray revealed no obvious abnormalities.
· Urinalysis: Potential urinary tract infection was indicated by the presence of nitrite and dark concentrated yellow urine with positive leukocytes.
In light of these results, it is necessary to investigate a number of probable reasons for Mr. Johnson's sporadic cognitive impairment. Early onset dementia is a serious concern, but more aspects need to be looked into:
· Urinary Tract Infection (UTI): The likelihood of a UTI increases with the presence of leukocytes and nitrite in the urine analysis. UTIs can make people feel disoriented, especially elderly people (Hodkinson et al., 2022).
· Medications: Mr. Johnson is taking a number of medications, and these side effects or combinations might be causing him disorientation.
· Dehydration and Malnutrition: His untidy appearance, undernutrition, and black concentrated urine point to dehydration and poor nutrition, which might impair cognitive performance.
· Chronic Pain: Guarding his left knee, a sign of untreated or improperly controlled pain, can cause bewilderment and anguish.
· Hypertension: Increased blood pressure may cause cerebral hypoperfusion, which may impair cognition (Enskär et al., 2020).
Before validating Mr. Johnson's diagnosis of early onset dementia, it is important to proceed with care and take into account any potentially treatable conditions, such as the UTI, adverse effects from medications, and dehydration. To make a firm diagnosis, a more thorough cognitive evaluation that includes neuroimaging and neuropsychological testing should be conducted.
Misdiagnosis of dementia can have serious repercussions, including delaying treatment for treatable illnesses and causing the patient unneeded mental suffering. Therefore, in order to give Mr. Johnson the best treatment possible, a thorough and evidence-based assessment is crucial.
In conclusion, Mr....
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