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NSG3RDP Semester One 2022



SCHOOL OF NURSING & MIDWIFERY

NSG3RDP– Recognising and Responding to the Deteriorating Patient
Assessment activity XXXXXXXXXXwords (35% of overall subject mark)
Due date: May 10th 2022


Subject Intended Learning Outcomes (SILOS)

1. Explain common pathophysiology, as it relates to assessment data and pharmacology, that can
esult in deterioration of an individual's condition in order to develop appropriate interventions.
2. Apply the clinical reasoning cycle to provide person-centred care for individuals experiencing a
deterioration in health in order to provide safe nursing care.
3. Develop an awareness of and contribute to the risk management strategies of a healthcare
agency, in order to implement incident reporting procedures and apply risk management
procedures.

Context


Serious adverse events, such as unexpected death, intensive care admission and cardiac a
est, are
often preceded by observable physiological, clinical abnormalities and deterioration. Other serious
events, such as suicide and aggression, are also often preceded by observed or reported changes in a
person’s behaviour or mood that can indicate deterioration in their mental state.
Early identification of deterioration may improve outcomes and decrease interventions required to
stabilise patients whose condition deteriorates in a health service organisation.
The warning signs of clinical deterioration are not always identified or responded to appropriately.
The organisational and workforce factors that contribute to a failure to recognise and respond to a
deteriorating patient are complex and overlapping (Australian Commission on Quality and Safety in
Health Care, 2017)
NSG3RDP Semester One 2022

Task

In this assessment you are required to further explore the trauma case study introduced in topic two
of your LMS and workshop materials for NSG3RDP/RDM.
You will be provided with an ISBAR handover and a National Observation Chart (NOC) for Joanna
Cleese. (These documents will be attached at the end of this instruction sheet)

Using the provided information and cu
ent academic literature please provide a response to the
following three questions
Instructions
Please answer the following questions as instructed

• Question XXXXXXXXXXwords)
The condition of your patient Joanna Cleese described in the ISBAR handover, appears to be
changing. (Please refer to the attached documentation)
Using the information that you have identified from the NOC and the ISBAR case study
handover:
1. Discuss the possible causes of Joanna’s changing condition, supporting your
esponse with contemporary literature and the associated significant cues, signs
and symptoms listed in the case study.
2. Explain what possible further deterioration could occur for this patient, with a
detailed evidenced -based response.
(Please support your justification and rationales with quality peer-reviewed literature).

• Question XXXXXXXXXXwords)
There are many tools that can be utilised when assessing a patient. When assessing a
deteriorating patient accurate assessment is essential. Compare and contrast the following
methods of patient assessment and their appropriate applications for the deteriorating
patient.
1. Primary (ABCDE)
2. Head to toe assessment
(Please support your discussion with evidenced based literature).

• Question XXXXXXXXXXwords)
A change in a patient’s heart rate, blood pressure, temperature and respiratory rate can all
e an indication of clinical deterioration. It has been suggested that a changing respiratory
ate is the earliest indication of clinical deterioration and yet it is often not measured
co
ectly, or not measured at all. Using evidence-based literature to support your
arguments:
1. Discuss why a changing respiratory rate is an important indicator of clinical
deterioration.
2. Explain how the respiratory rate can be measured reliably and accurately.
NSG3RDP Semester One 2022



**Discussions are to be supported with relevant and contemporary literature.

**References: Reference list and appendices are excluded from the word count.

**References to be no older than ten years

**10% word limit allowed.

Resources

Australian Commission on Quality and Safety in Health Care XXXXXXXXXXNational Quality and Safety
Health Care Standards Edition Two. Retrieved from
https:
www.safetyandquality.gov.au/wp-content/uploads/2017/11/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf



GENERAL ASSESSMENT REQUIREMENTS
SUBMITTING WRITTEN WORK WITH TURNITIN
Turnitin is a web-based text-matching software system used at La Trobe University to assist you in
writing your assignments and checking for similarity with existing published work. Please remember to
allow adequate time to submit your assignment to Turnitin. It is your responsibility to have your
assignment submitted by the assessment due date. Not receiving an originality report is not an
acceptable reason for requesting an assignment extension unless it is a required part of the assessment.

POLICIES, PROCEDURES AND GUIDELINES
The University has a comprehensive policy framework to which both staff and students must adhere.
You should familiarise yourself with those policies, procedures and guidelines likely to affect you
especially the following:

• Academic Integrity
• Academic Progress Review
• Assessment Policy
• Adjustments to Assessment, including extensions to submission dates and Special Consideration
• Validation and Moderation, including applications for review and re-mark
ADJUSTMENTS FOR ASSESSMENT
You may be affected by a range of adverse circumstances while you are preparing for or undertaking an
assessment task. There are avenues for adjustments to your assessment depending on the
circumstances you face. For more detailed information refer to the Assessment Procedure –
Adjustments.

REQUEST AN EXTENSION OF TIME TO SUBMIT AN ASSIGNMENT TASK
Where you know in advance that you will not be able to submit an assessment task by the due date due
to adverse circumstances that have affected you during the preparation of the task, you will need to
equest an extension of time to submit. This must be done at least three days prior to the due date.
http:
www.safetyandquality.gov.au/wp-content/uploads/2017/11/National-Safety-and-
https:
policies.latrobe.edu.au/document/view.php?id=221
https:
policies.latrobe.edu.au/document/view.php?id=220
https:
policies.latrobe.edu.au/document/view.php?id=216
https:
policies.latrobe.edu.au/document/view.php?id=216
https:
policies.latrobe.edu.au/document/view.php?id=380
https:
policies.latrobe.edu.au/document/view.php?id=140
https:
policies.latrobe.edu.au/document/view.php?id=380
https:
policies.latrobe.edu.au/document/view.php?id=380
https:
www.latrobe.edu.au/students/admin/forms
equest-an-extension
https:
www.latrobe.edu.au/students/admin/forms
equest-an-extension
NSG3RDP Semester One 2022

Penalties normally apply if you submit an assessment after the due date. Poor time management is not
an acceptable reason for an extension.
To apply, go to https:
www.latrobe.edu.au/students/admin/forms
equest-an-extension
equest

SPECIAL CONSIDERATION
If you have experienced serious short term, adverse and unforeseen circumstances that substantially
affect your ability to complete an assessment task to the best of your potential, you may be eligible to
apply for Special Consideration. To do this or find more information, go to
http:
www.latrobe.edu.au/special-consideration
https:
www.latrobe.edu.au/students/admin/forms
equest-an-extension
equest
http:
www.latrobe.edu.au/special-consideration
NSG3RDP Semester One 2022



Late submission
There are policies and procedures to guarantee fair, consistent and transparent treatment of late
submission of assessment tasks provide equity around extensions to submission dates and penalties
associated with not submitting assessment by the due date and time.

https:
intranet.latrobe.edu.au/teaching-and-learning/teaching-support-and-tools/assessment-policy
NSG3RDP Semester One 2021




School of Nursing & Midwifery: NSG3RDP/NSG3RDM Assessment One
CRITERIA Excellent (> 80 %) Very good (70% - 79%) Good (60% - 69%) Fair (50% - 59%) Poor (<50%) MARK
Question One
Discusses the possible
causes of Joanna’s
changing condition
Explains what possible
further deterioration
could occur


USE OF LITERATURE TO
SUPPORT DISCUSSION

(35% of total mark)
28 + marks
Clearly and consistently
discuss possible causes of
the Joanna’s changing
condition
Clearly and consistently
explains what possible
further deterioration
could occur
Demonstrated an
excellent understanding
of links between the
necessary concepts.
Demonstrated clear and
consistent evidence of
critical appraisal of
eference material
Evidence of synthesis of
information and logical
development of
arguments

XXXXXXXXXXmarks
Clearly and mostly
consistently discuss possible
causes of the Joanna’s
changing condition
Clearly and mostly
consistently explains what
possible further deterioration
could occur
Demonstrated a very good
understanding of links
etween the necessary
concepts.
Demonstrated some
evidence of critical appraisal
of reference material
Some evidence of synthesis
of information and logical
development of arguments
Literature predominantly
used effectively to support
key ideas
XXXXXXXXXXmarks
Good but inconsistent
attempt to consistently
discuss possible causes of the
Joanna’s changing condition
Good but inconsistent
attempt to consistently
explain what possible further
deterioration could occur
Demonstrated good
understanding of links
etween the necessary
concepts.
Demonstrated inconsistent
evidence of critical appraisal
of reference material
Inconsistent evidence of
synthesis of information and
logical development of
arguments
Literature inconsistently used
to support key ideas
XXXXXXXXXXmarks
Fragmented and
inconsistent attempt to
discuss possible causes of
the Joanna’s changing
condition
Fragmented and
inconsistent attempt to
explain what possible
further deterioration could
occur
Demonstrated limited
understanding of links
etween the necessary
concepts.
Demonstrated limited
evidence of critical
appraisal of reference
material
Limited evidence of
synthesis of information
and logical development of
arguments
Literature poorly used to
support key ideas
17 marks
Demonstrated lack of
understanding of possible
causes of the Joanna’s
changing condition
Demonstrated lack of
understanding of what
possible further
deterioration could occur
Demonstrated lack of
understanding of links
etween the necessary
concepts.
No evidence of critical
appraisal of reference
material
No evidence of synthesis
of information and logical
development of
arguments
Ove
eliance on direct
quotes Key ideas not
supported by the
literature














35
NSG3RDP Semester One 2021
Question Two
Compares and
contrasts
1. Primary (ABCDE)
2. Head to toe
assessment


USE OF LITERATURE TO
SUPPORT DISCUSSION

(35% of total mark)
28 + marks
Clearly and consistently
compared the two
methods of assessment
Demonstrated an
excellent understanding
of links between the
necessary concepts.
Demonstrated clear and
consistent evidence of
critical appraisal of
Answered 1 days After May 15, 2022

Solution

P answered on May 16 2022
99 Votes
Person-centered care to analyze Thoracic trauma
1. Explain the common pathophysiology, as it relates to assessment data and pharmacology, that can result in deterioration of an individual’s condition in order to develop appropriate interventions.
The trauma in United states is one of the leading causes for increased number of deaths (25 % of the deaths) (Jones, 1980). The most common trauma reported was the blunt or thoracic trauma that is associated with the bone injuries especially chest injuries. Thoracic trauma is one of the reasons for causing the chest injuries that left un treated results in the death of the patient (Reid et.al., 2013). The etiology of the thoracic trauma is associated with the hemothorax, failed chest, pneumothorax and in some of the patients will have simultaneous hemothorax and the pneumothorax and the reason are the bone injuries (Pearson et.al., 2017). The bone injuries are mostly associated with either the ribs damage or the clavicle damage and in some cases the intra-abdominal injuries were observed. The symptoms observed in these patients are pain,
eathing difficulties, hypoxemia, pneumonia etc (Wu et.al., 2015). The Diagnosis of the thoracic traumas due to bone injuries can be diagnosed by using the X-ray and other radiographic imaging like CT scan, aortic imaging and physical clinical observation of the patients.
Pathophysiology:
The pathophysiology of the thoracic trauma may result in the mo
idity or mortality of the chest trauma that is because of direct damage to the lungs or because of altered respiration mechanism of
eathing (Dogrul et.al., 2020). The bone injuries may cause the pulmonary contusion or tracheo
onchial leading to the hemothorax, pneumothorax or failed chest. The circulation process will get impaired because of the internal bleeding, decreased venomous and direct cardiac a
est because of damages of the myocardium. The imagining studies will help to analyze the internal damages with the significant chest trauma, ultrasonography to analyze the heart, CT scan to check the damages of the Aortic injury etc (Whizar-Lugo et.al., 2015) The blunt thoracic trauma results in the damages to the chest (ribs fracture), pulmonary damages etc. sometime myocardial injuries were also reported and the effect of the damage may depend on how the injuries has happed i.e. by accident of falls from the heights etc. This is one of the emergency conditions which requires a in detailed examination to analyze the internal injuries of the patients as in some cases these are not noticeable.
Case-study analysis:
In the cu
ent case study, the Joanna Cleese a 55-year got admitted to the emergency department with a sudden fall from the 2-meter height. The injuries reported for her after the admission into the hospital after preforming the initial assessments of the X-ray analysis of the chest, abdomen, pelvis, left arm that fractures were reported in the ribs, femur, ulna. From the CT scan of the Head laceration was diagnosed. Bruising of the chest, temporal area, thigh and left arm were noted. As soon as the patient got admitted the Intravenous fluids were administered to make hydrate the patient. Meanwhile the patient previous medical history was examined indicating that the patient is diagnosed with the Hypertension, Type 2 Diabetes, and Obesity...
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