NURBN2012: NURSING PRACTICE 3 – PATHOPHYSIOLOGY AND PHARMACOLOGY APPLIED TO NURSING. Assessment Task 2 – Essay based on a Case Scenario Due date: Monday 10th April 1200 hrs The following video depicts Kevin at his most recent outpatient appointment. https://www.youtube.com/watch?v=cd89r54VzFA&feature=youtu.be Kevin who lives alone on his farm, was newly diagnosed with Atrial Fibrillation (AF) when he presented to hospital following a transient ischaemic attack (TIA). He has been discharged from hospital and is now being managed medically. Kevin needs education and support with understanding his new diagnosis and how it impacts upon his everyday lifestyle. He also needs assistance with managing his medications and modifying his everyday activities to decrease risk of morbidity associated with his illness. For this assessment task, you are required to write a 1500-word essay which addresses the main issues associated with providing nursing care for Kevin and assisting him to manage both the physical and psychological impacts of his new diagnosis. You will need to explore the pathophysiology, pharmacology and nursing management of the case and demonstrate your understanding in the answers you provide to the following questions. Your answers should be informed by your reading of current research and literature. Pathophysiology 1. Briefly describe the updated classifications for AF and outline the main objectives in the management of patients in AF; 2. Describe cardiac remodelling and discuss this with relation to Kevin’s AF and how this could impact on his risk for cardiac failure; 3. Describe why Kevin is at risk of thromboembolism, and where is thrombus most likely to manifest; 4. What is the pathophysiology associated with haemorrhagic and ischemic CVA and discuss the precipitating factors for each? Briefly discuss the risk of CVA in patients who have already experienced a TIA. Pharmacology 1. Identify the first line medications for rate control and rhythm management in AF, and describe the pharmacological actions of same; 2. Identify the first line medications for thromboembolic prophylaxis in AF, and describe how these medications act upon the coagulation cascade; 3. Compare the side-effects and lifestyle impact of taking vitamin K antagonists to that of the novel oral anticoagulants. Psychosocial issues 1. What measures would you take to ensure that Kevin remains compliant with medication and follow-up care? 2. How would you ensure that Kevin can recognise the signs of CVA? 3. Describe the nursing measures that you would take to educate Kevin about lifestyle modifications that he needs to make to decrease his risk of mortality and morbidity associated with his new diagnosis; 4. How will you assess Kevin’s understanding of the information that you have provided to him? Directions This assessment is to be presented in an essay format, which includes an introduction and conclusion. Do not rewrite the case study in your introduction. Please respond to the questions in a logical format. Dot points are not acceptable. It is acceptable to use headings at the start of new topics if this makes it easier for your essay organisation. However, avoid creating a question and answer document. It is important to produce academic writing that flows. https://www.temple.edu/writingctr/support-forwriters/documents/AchievingFlowinAcademicWriting.pdf Please use APA level headings throughout. Do not write in the first person. http://www.stlcc.edu/Student_Resources/Academic_Resources/Writing_Resources/Writing_Han douts/Point%20of%20View%20in%20Academic%20Writing%20.pdf Appropriately referenced and labelled tables, diagrams or images may be used in the body of the paper. Alternately, any tables, diagrams or images may be added as an appendix, as long as the information pertaining to same is integrated into the body of your paper References must be current, preferably from the past five years and no older than ten years, unless it is of historical significance, in which case a brief statement of the historical significance must be included when citing the source. Your writing should demonstrate wide reading from a variety of sources, such as, journals, texts and clinical practice guidelines. You are required to cite no less than 10 references. Consider the quality of the references you use. Wikipedia, Web MD, the Better Health Channel and blogging sites are not acceptable references. Any non-reliable sources in your reference list will not count toward the number of required references, and this will result in loss of marks. At this point in your BN you are expected to engage with best-practice literature. Marking of this assessment task will be undertaken by academic and teaching staff. Premarking moderation will be undertaken for this assessment task. Criteria for Grading: Marks will be allocated for each section of the essay. The Marking Rubric for the Case Study is below. Criterion NURBN 2012 Assessment Task 2 CASE STUDY - MARKING RUBRIC 5 marks 4 marks 3 marks 2 marks 1mark 0 marks Mark 1. Introduction of the topics. Clear and succinct introduction that provides background and direction. Identifies all topics specific to the case study. Clearly written introduction. Identifies most topics specific to the case study. One key element of introduction missing. Clearly written introduction. Identifies most topics specific to the case study, but lacking sufficient detail to smoothly lead into clinical questions. Introduction is clearly written but basic. Identifies some topics specific to the case study but several key elements missing. Introduction is very basic and difficult to follow. Identifies one or two topics specific to the case study but several key elements missing. No recognisable introduction. The topic is not introduced or is not specific to the case study. No direction offered /5 2(a). Answers to case study questions. Part A: Identification of underlying pathophysiological processes in case study. Constructs high level and strong connections, between the patient’s presenting problems and the associated pathophysiology from the micro level and uses this to correctly manage the patient’s illness. Demonstrates coherent knowledge and connects the pathophysiology to the information presented to correctly manage the patient and their illness. Broad demonstration of knowledge which mentions some associated pathophysiology but lacks the depth and understanding of the relationship between the pathophysiology and the illness. Minimal discussion of the relationship between the patient’s pathophysiology and the management of their illness. Attempted discussion, but inadequate understanding of the role of the patient’s pathophysiology in relation to the management of their illness. No attempt to answer case study questions. /5 2(b). Answers to case study questions. Part B: Identification of pharmacological issues relevant to case study. All relevant pharmacological concepts and mechanisms of action are included and correct. All drug names, sites of action and uses are correct All relevant pharmacological concepts and mechanisms of action are included and correct. Most drug names, sites of action and uses are correct Most relevant pharmacological concepts and mechanisms of action are included and correct. Most drug names, sites of action and uses are correct Few relevant pharmacological concepts and mechanisms of action are included or correct. Some drug names, sites of action and uses are correct Attempted discussion, but inadequate understanding of medications, pharmacological concepts and mechanisms of action. No attempt to answer case study questions. /5 2(c). Answers to case study questions. Part C: Identification of patient issues/needs in case study. Provides a meticulous and holistic representation of the care issues and needs identified in the patient case study. Provides a thorough representation of the care issues and needs identified in the patient case study. Provides an adequate representation of the care issues and needs identified in the patient case study, with some omissions. Provides a basic representation of the care issues and needs identified in the patient case study. Focuses mostly on physical needs. Provides an inadequate and muddled representation of care issues and needs. Significant omissions. No attempt to answer case study questions. /5 3. Evidence of best practice Clearly and accurately affirms best practice, citing only the most recent and reliable scholarly sources. Clearly affirms best practice. Majority of information cited from recent and reliable primary sources. Demonstrates some affirmations of best practice. Information sourced from a mix of primary and secondary sources. One or two outdated sources. Attempted affirmations of best practice, but majority of information is from secondary sources. Few primary sources. More than 3 sources are greater than 7 years old. Weak and superficial. Relies on information copied from texts. Outdated information with little evidence that best practice was sought to answer case study questions. No evidence that best practice has been sought to answer case study questions. No sources provided. /5 4. Conclusion Succinct and precise conclusion of the essay, with clear and scholarly analysis of all issues. A creative transitional phrase is used to start the conclusion. The main points are uniquely restated, and the conclusion is strongly connected to the information presented in the introduction. Provides a recommendation and includes an ending comment that inspires the reader to further investigate the topic. No new topics introduced. Succinct and precise conclusion of the essay, with clear and scholarly analysis of all issues. A creative transitional phrase is used to start the conclusion. The main points are uniquely restated, and the conclusion is strongly connected to the information presented in the introduction. No recommendation provided. No new topics introduced. Clear conclusion that outlines the main points and brings the assignment to a close. A clear but not creative transitional phrase is used to start the conclusion. The main points are repeated in the same way as discussed previously. The ideas are loosely connected to the information presented in the Introduction. No new topics introduced. Some conclusions are supported. However, others are not. There is no transitional phrase to start the conclusion. There are some attempts to connect ideas in the conclusion back to the information presented in the introduction, but links are unclear. New topic/s introduced in the conclusion Some conclusions are supported. However, others are not. There is no transitional phrase to start the conclusion. There is no attempt to connect any ideas in the conclusion back to the information presented in the introduction. New topic/s introduced in the conclusion. No conclusion attempted. The essay just ends. /5 5. Academic writing, Sentence Structure, grammar, and Spelling All sentences are well constructed and have varied structure and length. No errors in grammar or spelling. Meets the word limit within 10% Most sentences are well constructed and have varied structure and length. Minor errors in grammar or spelling that do not interfere with understanding. Meets the word limit within 10% Most sentences are well constructed and have varied structure and length. A few errors in grammar, and/or spelling that do not interfere with understanding. Requires a more formal tone. Meets the word limit within 10%. Most sentences are well constructed, but have similar structure and/or length, and require a more formal tone. Several errors in grammar, and/or spelling that occasionally interfere with understanding. Meets the word limit within 10%. Sentences sound awkward, are distractingly repetitive, informal or are difficult to understand. Many errors in grammar and/or spelling that significantly interfere with understanding. Word limit over or under 10%. Sentences are poorly constructed with numerous errors in grammar and/or spelling that severely interfere with understanding. Severely under the word length. /5 6. APA 6th ed. formatting and referencing Reference list provided. In-text citations included. No APA formatting or referencing errors. 10 or more references. All references from reliable or scholarly sources. Correctly formatted title page provided. Reference list provided. In-text citations included. Minor APA formatting or referencing errors. 10 or more references provided. All references from reliable or scholarly sources. Title page provided but not in APA format. Reference list provided. In-text citations included. Minor APA formatting and referencing errors. 10 or more references provided. Most references from reliable or scholarly sources. Title page provided but not in APA format. Reference list provided. In-text citations included. Major APA formatting and referencing errors. Less than 10 references provided. Most references from reliable or scholarly sources. Title page provided but not in APA format and some information missing. Reference list is provided but no in-text citations. No adherence to APA style. Less than 10 references provided. References not from reliable or scholarly sources. No title page provided. Reference list not provided, no intext citations. No title page provided. /5 Total mark out of 40