Roger Taylor is a 76-year-old retired builder who lives in a two story building with wife, Mary, and 2 dogs. He takes the dogs for a walk most days, but the walks have become shorter and shorter as...

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Roger Taylor is a 76-year-old retired builder who lives in a two story building with wife, Mary, and 2 dogs. He takes the dogs for a walk most days, but the walks have become shorter and shorter as the left knee is becoming more painful. Roger and Mary have two adult sons who live locally and they have 4 grandchildren, two boys and two girls and most weekends he goes out fishing with his two grandsons. Roger is independent in ADL’s, has his driver’s licence and drives his car almost daily. He takes Mary shopping and every Friday they go out for a meal at the local bowling club. Roger wears glasses, hearing aids and a full set of dentures. He is 179 cm tall and weighs 96kg. He also drinks a couple of beers in the afternoon almost every day, but he has never been a smoker. Last Wednesday Roger was admitted for an elective left knee replacement. Roger’s medical history: Polio as a child Hypertension and Diabetes mellitus His medications are as follows: Lisinopril 5mg daily Cardura 4mg daily Metformin 500mg nocte On his admission his vital signs were BP 135 / 84 mmHg HR 78 bpm (regular) RR 18 bpm Temp 36.5°C Sats: 99% (RA) Pain 5-6 /10, left knee BGL 4.9 mmol/L Alert The operation went well and Roger returned to the ward in the evening. Post-operative Roger was prescribed: PCA Oxycotin 10mg bd Paracetamol qid Coloxyl with Senna 120mg nocte The following morning after breakfast Roger was out of bed with the support of two physiotherapists. Vital signs in the morning BP 128/82 mmHg HR 83 bpm (regular) RR 18 bpm Temp 36.8°C Sats: 97% (RA) Pain 2-3/10, left knee BGL 5.3 mmol/L Alert In the afternoon day one post operatively Roger started to become confused, restless and would not follow instructions. He was agitated and constantly trying to get out of bed. As Mary was visiting, she tried to get Roger to settle and have his evening meal with little success. The PCA was removed due to confusion. Vital signs in the afternoon BP 131/83 mmHg HR 95 bpm (regular) RR 21 bpm Temp 37.1°C Sats: 98% (RA) Pain not recorded BGL 5.8 mmol/L Alert but confused Roger was given 2mg Ativan at bedtime and he settled for a while before becoming more agitated and continued to try to get out of bed. He was frequently urinating in a urinal during the night, approximately 100ml each time. In the morning a bladder scan was performed and urinary retention of 600ml was reported. A Foley catheter was inserted and secured, however as Roger was confused, he began pulling on the Foley catheter and frank blood was found in the urine. You are the nurse that will take over care for Roger on the morning of the third day. As a nurse follow the clinical reasoning cycle and write your answers in the template provided. NRS387 Assessment Task 1: Clinical Reasoning Cycle Complex Scenario Instructions This template has developed for you to use to complete Assessment Task 1: Clinical Reasoning Cycle Complex Scenario. It includes the case scenario information and space for you to complete each part of the assessment task. The portions of the template that you must complete are highlighted in yellow. Please refer to the Subject Outline for details on the task, marking criteria and standards, presentation and referencing requirements. Make sure that you add a reference list to the end of this document and include in-text referencing to acknowledge your sources throughout the document in accordance with the referencing requirements in your Subject Outline. PLEASE DELETE ALL INSTRUCTIONS AND TEXT THAT ARE IN ITALIC (just leave the first column in the table ‘empty’ – if you do not delete the instructions and italic text, your word count will be approximately 500 words over the word count) Student Name: Enter your name Student Number: Enter your number Subject Code: NRS387 Subject Name: Clinical Reasoning in Nursing 5 Assessment item: 1 Assessment title: Clinical Reasoning Cycle Complex Scenario Due date: 29th March 2023 Word count (excluding reference list and tables): Assessment Task 1: Clinical Reasoning Cycle Complex Scenario (1800 words) Describe Provide an overview of the scenario (consider the person and context. Location – people – situation 150 words Describe Collect cues Collect relevant assessment data and identify additional assessment data that may be required. 100 words Process Information compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference needed. (The number of boxes is not an indication of the number of assessment findings required) 250 words Collect cues Process information Normal/ Abnormal The finding indicates ….. Additional assessments required Synthesise identify the main clinical issues for the patient. 75 Main clinical issue Outline the pathophysiology of the presenting health challenge. Reference needed 175 Pathophysiology Establish (SMART) goals Identify three person-centred desired outcomes for this patient that are relevant to the scenario 200 Goal 1 Goal 2 Goal 3 Select a course of action Outline 3 nursing interventions that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. Reference needed in the rationale 150+250 Evaluate outcomes Explain the process for evaluating the desired outcomes in this scenario. 150 Select a course of action (intervention) Intervention 1 for goal 1 Intervention 2 for goal 2 Intervention 3 for goal 3 Rationale 1 Rationale 2 Rationale 3 Evaluate outcomes Outcome 1 Outcome 2 Outcome 3 Reflect Consider what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it) 300 Reflection References (start on a new page) Student Name: (enter your name) Student Number: (enter your number) NRS387 Assessment Item 1 Assessment item 1 - Clinical Reasoning Cycle Complex Scenario Value: 50% Due Date: 29th March 2023 Return Date: 21st April 2023 Length: 1800 words Group Assessment: No Submission method options: Turnitin Assignment Portal TASK This assessment task requires you to utilise the case study provided on the NRS387 subject Interact2 site and use the template provided under assessment 1 to address each of the following points: Describe – provide an overview of the scenario (consider the person and context. Location – people – situation (approx. 150 words) Collect Cues – Collect relevant assessment cues and identify additional assessment data that may be required (approx. 100 words) Process Information – compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference/s needed (approx. 250 words) Synthesise – Identify the main clinical issues for the patient. Identify and provide an overview of the pathophysiology of the main health challenge evident in the case study. Reference/s needed (approx. 250 words) Establish goals -identify three (3) person-centered desired outcomes for this patient that are relevant to the scenario (approx. 200 words) Select a course of action – outline three (3) nursing interventions, one (1) for each goal, that will assist the patient to meet the desired outcomes and provide basic evidence-based rationales for each. These interventions should be prioritised according to clinical urgency. Reference/s needed. (approx. 150 words/intervention, 250 words/rationale) Evaluate outcomes – Explain the process for evaluating the desired outcomes in this scenario (approx. 150 words) Reflect – reflect on what you have learned from completing this task and how it will contribute to your future practice. (You should use an established model of reflection and reference it) (approx. 300 words) You are to support your work with academic sources, use in-text references and provide a reference list. All sources must be correctly referenced in-text and in the reference list in accordance with APA 7th Edition referencing style. SUBJECT LEARNING OUTCOMES This assessment task will assess the following learning outcome/s: · be able to identify and apply assessment frameworks and techniques to the care of infants, children, adolescents, adults and older people in a simulated environment. · be able to identify and demonstrate selected evidence-based nursing interventions to promote safety, healing and caring in practice for infants, children, adolescents, adults and older people in a simulated environment. · be able to apply the Clinical Reasoning Cycle to interpret assessment findings, plan, justify and evaluate care in the context of complex clinical scenarios in a simulated environment. GRADUATE LEARNING OUTCOMES This task also contributes to the assessment of the following Charles Sturt Graduate Learning Outcome/s: · Academic Literacy and Numeracy (Skill) - Charles Sturt Graduates demonstrate the literacy and numeracy skills necessary to understand and interpret information and communicate effectively according to the context. · Professional Practice (Knowledge) - Charles Sturt Graduates possess the knowledge and understanding of the discipline and the nature of professionalism required for the given profession or discipline in contemporary societies. PRESENTATION All items of assessment must be word processed and not handwritten. In addition: · Leave 2 cm margins and double line space your work · Font must be 12pt, unless otherwise indicated. · All pages must be numbered. · Student name and number must be included in the header or footer of every page of every assignment. · A title page must accompany your written assessment task and include the subject name and code, title of the assessment task, due date, lecturer’s name, student name and student number. · Assessment must be uploaded as a MS WORD document. Below are further written information to guide you in the assessment task. Each marking criteria will be explored. Criteria High Distinction (85 - 100%) Distinction (75-84.5%) Credit (65-74.5%) Pass (50-64.5%) Fail (0 - 49.5%) Marks Describe –provide an overview of the scenario You have used a holistic approach to analyse the patient situation, and derived components of the patient's context that will impact care. (7.1 - 8 marks) You have used a holistic approach to examine the patient situation. A description of the facts and the patient's context has been included. (6.1 – 7 marks) You have used a holistic approach to describe the patient situation. The facts and the patient's context have been included. (5.1 – 6 marks) You have described the patient situation, including some aspects of the patient’s social circumstances. (4 - 5 marks) You have not described the patient situation or you have paraphrased the content of the case study to describe some of the facts. (0 – 3.9 marks) /8 Describe – provide an overview of the scenario (consider the person and context. Location – people – situation (approx. 150 words) In this section I want you to be able to describe who Roger is, why is he in hospital, what are the factors that influence how Roger is feeling now when you are taking over care. Using a holistic approach, how has Roger’s persona and lifestyle influenced how he is now and is that what you expect from what you can read about him? Criteria High Distinction (85 - 100%) Distinction (75-84.5%) Credit (65-74.5%) Pass (50-64.5%) Fail (0 - 49.5%) Marks Collect cues Collect relevant assessment cues and identify additional assessment tools that may be required. Relevant assessment cues have been identified, following an analysis of the case study. Identified cues have been presented systematically. Additional relevant assessment tools have been identified to address subtle cues. A rationale for additional assessment tools is included. (9.1 - 10 marks) Relevant assessment cues have been identified, following an analysis of the case study. Identified cues has been prioritised systematically. Additional relevant assessment tools have been identified to address subtle cues. (7.6 – 9 marks) Relevant assessment cues have been identified. Some subtle cues have been overlooked. Identified cues have been Presented systematically. Additional relevant assessment tools have been identified. (6.6 – 7.5 marks) Relevant assessment cues have been identified. Some cues have been missed but will not impact immediate care. Additional relevant assessment tools have been identified. (5 - 6.5 marks) Relevant assessment and important cues have been missed. Additional relevant assessment tools have not been identified or additional assessment tools of questionable relevance to the case study. (0 – 4.9 marks) /10 Processing Compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance Recognises subtle deviations from expected patterns in identified cues and assess why the findings are of importance. Supported by high quality references. (9.1 - 10 marks) Recognises patterns and deviations in the identified cues and describe why these findings are of importance. Supported by quality references. (7.6 – 9 marks) Recognises obvious patterns and deviations in the identified cues. Deviations from expectations have been identified and supported by references. (6.6 – 7.5 marks) Obvious patterns and deviations in the identified cues have been identified. A description of the importance of these findings are included with limited referencing. (5 - 6.5 marks) Patterns and deviations from expectations are not clearly identified. Or there is no description of the importance of these findings. No references. (0 – 4.9 marks) /10 Collect Cues – Collect relevant assessment cues and identify additional assessment data that may be required (approx. 100 words) What are the cues you need to collect in order to provide appropriate care for Roger? Remember that normal vital signs are also cues Explore both signs and symptoms Process Information – compare any abnormal assessment findings with normal or expected findings and
Answered 11 days AfterMar 09, 2023Charles Sturt University

Answer To: Roger Taylor is a 76-year-old retired builder who lives in a two story building with wife, Mary, and...

Dipali answered on Mar 14 2023
37 Votes
NRS387 Assessment Task 1: Clinical Reasoning Cycle Complex Scenario
Instructions
This template has developed for you to use to complete Assessment Task 1: Clinical Reasoning Cycle Complex Scenario.
It includes the case scenario information and space for you to complete each part of the assessment task. The portions of the template that you must complete are highlighted in yellow.
Please refer to the Subject Outline for details on the task, marking criteria and standards, presenta
tion and referencing requirements.
Make sure that you add a reference list to the end of this document and include in-text referencing to acknowledge your sources throughout the document in accordance with the referencing requirements in your Subject Outline.
PLEASE DELETE ALL INSTRUCTIONS AND TEXT THAT ARE IN ITALIC (just leave the first column in the table ‘empty’ – if you do not delete the instructions and italic text, your word count will be approximately 500 words over the word count)
Student Name:Enter your name
Student Number: Enter your number
Subject Code: NRS387
Subject Name: Clinical Reasoning in Nursing 5
Assessment item: 1
Assessment title: Clinical Reasoning Cycle Complex Scenario
Due date: 29thMarch 2023
Word count (excluding reference list and tables):
Assessment Task 1: Clinical Reasoning Cycle Complex Scenario (1800 words)
    Describe
Provide an overview of the scenario (consider the person and context. Location – people – situation150 words
    Describe
The scenario involves Roger Taylor, a 76-year-old retired builder who has been admitted for an elective left knee replacement. He lives with his wife, Mary, in a two-story building and is accompanied by two dogs. Roger has a history of polio as a child, hypertension, and diabetes mellitus. He takes Lisinopril, Cardura, and Metformin as his regular medications. Roger is independent in his activities of daily living, drives his car almost daily, and goes out fishing with his grandsons most weekends. Post-operatively, Roger has become confused, agitated, and restless, which has led to the removal of his PCA. On the third day, the nurse is expected to take over care of Roger and provide further nursing interventions to improve his clinical condition. The context of the scenario is the post-operative care of a patient who has undergone an elective left knee replacement. The location is a hospital, where Roger is being cared for by healthcare professionals. The people involved in the scenario include Roger, his wife Mary, the healthcare professionals caring for him, and his grandsons who he goes fishing with. The situation is that Roger has become confused, agitated, and restless, which has led to the removal of his PCA, and nursing interventions are required to improve his clinical condition.
    Collect cues
Collect relevant assessment data and identify additional assessment data that may be required.
100 words
Process Information
compare any abnormal assessment findings with normal or expected findings and describe why the findings are of importance. Reference needed.
(The number of boxes is not an indication of the number of assessment findings required)
250 words
    Collect cues
    Process information
    
    Normal/ Abnormal
    The finding indicates …..
    
    Blood pressure 135/84 mmHg Abnormal.
    Hypertension - Slightly elevated BP (135/84 mmHg).
    
    
Heart rate on admission.
Normal
    Regular heart rate (78 bpm)
    
    
Respiratory rate 20 breaths/min Normal
    Respiratory rate within normal limits (18 bpm)
    
    
Temperature 99.2°F Normal
    Normal body temperature (36.5°C)
    
    Sats on admission. Normal.
    Normal oxygen saturation levels (99% on room air)
    
    Pain on admission. Abnormal.
    Moderate to severe pain in the left knee (5-6/10)
    
    BGL on admission. Normal.
    Normal blood glucose levels (4.9 mmol/L)
    
    Sats post-op. Abnormal.
    Slightly decreased oxygen saturation levels (97% on room air)
    
    Pain post-op. Abnormal.
    
    Mild to moderate pain in the left knee (2-3/10)
    
    BGL post-op. Normal.
    Normal blood glucose levels (5.3 mmol/L)
    
    Alert and oriented to person, place, and time Normal
    N/A
    
    No focal neurological deficits noted Normal
    N/A
    
    Additional assessments required
· Neurological assessment: Given the patient's confusion and altered level of consciousness, a neurological assessment should be performed to assess cognitive function, motor function, sensory function, reflexes, and cranial nerve function.
· Laboratory tests: Further laboratory tests may be needed to investigate the underlying cause of the abnormal findings. This may include a complete blood count (CBC), electrolyte panel, liver function tests, renal function tests, and blood glucose level.
Imaging studies: Imaging studies such as a CT scan or MRI may be needed to assess the brain and rule out any structural abnormalities (Ludwig &...
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