Students are required to submit a critical discussion paper related to the nursing management of...

Question

Students are required to submit a critical discussion paper related to the nursing management of Mrs. Jane Smith case study below, with the support of literature.
Scenario:
Mrs. Jane Smith is an 80 year old woman who was admitted to ED at 1730 with the history of unwitnessed fall. She was found on the floor by her son. She was unable to stand up. In ED she was found to be in excruciating pain. Her right Leg appeared to be shortened and internally rotated. It was noted she had multiple
uising over her right arm and face and a 4 cm laceration to her right lower arm. She was administered intranasal Fentanyl 100 Mcg by the Ambulance crew.
Her Vital Signs: Bp – 147/77 mmHg, HR 112/mt - I
egular, RR - 24/min Spo2 – 99% RA, temp; 37.2
GCS - E3 V4M6 = 13/15.

    Regular Medication
    Medications Administered in Ed
    Rivaroxaban 15 mg
    Bupivacaine + fentanyl femoral block
    Thyroxine 50 mcg
    Panadol 1 g
    Amiodarone 100mg
    Neurofen 400 mg
    Metoprolol 25 mg
    Morphine 5 mg

Mrs. Jane Smith had blood taken. She a chest x-rays, which was NAD, and Right hip XRay which revealed # neck of femur.
She CT scan of her head has been ordered, which is yet to be done
A – Allergies – Penicillin
M – as mentioned above
P – Hypothyroidism, HTN, AF, IHD multiple falls
L – Last ate around noon
E – Events – Does not remember events leading to the fall

The critical discussion paper should address the following issues:
1. What data deviate from normal findings, suggesting the needs for further investigation?
2. What additional information should the nurse ask or question for?
3. Describe the patient’s presenting problem focusing on the pathophysiological issues.
4. Identify 2 nursing diagnosis that needs immediate interventions and discuss the nursing management appropriate for the patient and evaluations of the nursing management plans presented in the literature.
5. Explain the pharmacokinetics of the prescribed medications in ED and their indications.
6. Discuss nursing management of the prescribed medication in ED, the adverse effects of the medications, contraindication, and side effects, with the age of the patient in mind, using evidence-based literature.
7. Describe in detail the information you would share with the patient and how you will educate the patient about the interactions and long-term effects of the regular medications of Mrs. Jane Smith.
Ru
ic
NK2 Assignment 1
    NK2 Assignment 1
    Criteria
    Ratings
    Pts
    This criterion is linked to a Learning OutcomeDemonstrated an understanding of the topic and addressing the topic
1. Nursing Management
a. A presentation of abnormal data suggesting the need for further investigation, additional information should the nurse ask or question for and the pathophysiology of the presenting problem with
supporting literature
. Identify 2 nursing diagnosis that needs immediate interventions, discuss the nursing management appropriate for the patient and evaluations of the nursing management plans presented in the literature (peer review/evidence-based practice sources)
2. Application of pharmacology
to practice
a. Explain the pharmacokinetics of the prescribed medications in the ED and their indications with supporting literature.
. Discuss nursing management of the prescribed medication in ED, the adverse effects of the medications, contraindication, and side effects, with the age of the patient in mind, using evidence-based peer-reviewed literature.
c. Describe in detail the information you would share with the patient and how you will educate the patient about the interactions and long-term effects of the regular medications (with supporting peer-reviewed literature) of Mrs. Jane Smith
        20.0 to >17.0 pts
Higher Distinction
An excellent level of analysis of the patient's condition(s) addressing all elements.
    17.0 to >13.0 pts
Distinction
A very good analysis of the patient's condition(s) addressing all elements.
    13.0 to >11.0 pts
Credit
A good analysis of the patient's condition(s) addressing most of the elements.
    11.0 to >10.0 pts
Pass
A
ief and reasonable analysis of the patient's condition(s) addressing a few of the elements.
    10.0 to >5.0 pts
High fail
A poor analysis of the patient's condition(s) addressing a few of the elements.
    5.0 to >0 pts
Fail
Very poor analysis of the patient’s condition(s) addressing very few/no elements.
    20.0 pts
    This criterion is linked to a Learning OutcomeCritical analysis and synthesis supported by relevant and credible literature
1. Critical analysis of the issues
2. Evidence of original ideas
3. Relevant and credible literature were integrated into the arguments.
        10.0 to >9.0 pts
High Distinction
The assignment incorporated an excellent critical analysis in reference to 10 or more literature, with evidence of original ideas.
    9.0 to >7.0 pts
Distinction
The assignment incorporated a very good critical analysis in reference to 10 or more literature, with evidence of original ideas.
    7.0 to >6.0 pts
Credit
The assignment incorporated some evidence of critical analysis including some logical and coherent approaches in reference to 10 or more literature, with evidence of original ideas.
    6.0 to >5.0 pts
Pass
The assignment incorporated limited evidence of critical analysis including little logical and coherent approach in reference to 10/less than 10 literature, with little evidence of original ideas. Many ideas were expressed at a descriptive level.
    5.0 to >2.0 pts
High Fail
The assignment incorporated very little evidence of critical analysis without a logical and coherent approach in reference to 10/less than 10 literature, with very limited evidence of original ideas. Most of the ideas were expressed at a descriptive level.
    2.0 to >0 pts
Fail
The assignment incorporated no evidence of critical analysis without a logical and coherent approach in reference to 10/less than 10 literature, with no evidence of original ideas. All ideas were expressed at a descriptive level.
    10.0 pts
    This criterion is linked to a Learning OutcomeSequencing and Structure
1. A logical flow of ideas
2. Co
ect grammar, spelling and punctuation
3. An appropriate essay structure
        5.0 to >4.0 pts
High Distinction
A high level of skill was demonstrated in developing the assignment topic in an integrated, logical and coherent presentation with no/ minimal grammar and spelling and punctuation e
ors; the assignment structure included an introduction, body and conclusion.
    4.0 to >3.0 pts
Distinction
A very good level of skill was demonstrated in developing the assignment topic in a logical and coherent presentation with a few e
ors in grammar, spelling and punctuation; the assignment structure included an introduction, body and conclusion.
    3.0 pts
Credit
A good level of skill was demonstrated in developing the assignment topic in a logical and coherent presentation with some grammar, spelling and punctuation e
ors; the assignment structure included an introduction, body and conclusion
    3.0 to >2.5 pts
Pass
A reasonable level of skill was demonstrated in developing the assignment topic with multiple grammar, spelling and punctuation e
ors but the meaning is discernible; the assignment structure included an introduction, body and conclusion.
    2.5 to >1.0 pts
High Fail
A limited skill was demonstrated in developing the assignment topic with substantial grammar, spelling and punctuation e
ors and the meaning is not discernible; the assignment structure has a poor structure.
    1.0 to >0 pts
Fail
A very limited or no skill was demonstrated in developing the assignment topic with substantial grammar, spelling and punctuation e
ors and the meaning is not discernible; the assignment has a very poor structure.
    5.0 pts
    This criterion is linked to a Learning OutcomeSource and Referencing
1. Accurate APA referencing style
2. Relevant and updated literature
        5.0 to >4.0 pts
High Distinction
Proper and extensive referencing. Accurate use of APA referencing style in all instances. Most important and most recent resources were used.
    4.0 to >3.0 pts
Distinction
Referencing done in a proper manner. APA referencing adheres to acceptable conventions with minimal e
ors. Important and recent resources were used
    3.0 to >2.5 pts
Credit
APA referencing largely in-line with acceptable conventions with some e
ors. Relevant resources were used.
    2.5 to >2.0 pts
Pass
APA referencing done in a poor manner and did not always adhere to acceptable conventions with few i
elevant and outdated resources.
    2.0 to >1.0 pts
High Fail
Referencing done in a poor manner and did not adhere to acceptable conventions with some i
elevant and outdated resources.
    1.0 to >0 pts
Fail
A very poor concept in APA referencing. Substantial e
ors in APA citation methods. Most of the resources included were i
elevant and outdated.
    5.0 pts
    Total Points: 40.0

nursing-knowlege-iqjefamn.docx

Sunabh · Accepted Answer

Running Head: HEALTHCARE		1
HEALTHCARE		11
HEALTHCARE
NK2 ASSIGNMENT 1
Table of Contents
Introduction	3
1. Deviation from Normal Findings and Need for Further Investigation	3
2. Additional Information to be Collected by Nurse	4
3. Patient’s Presenting Problem and Pathophysiological Issues	5
4. Nursing Diagnosis Requiring Immediate Interventions	6
5. Pharmacokinetics of the Prescribed Medications in ED	6
6. Nursing Management of the Prescribed Medication in ED	8
7. Discussion of Medication with the Patient	8
Conclusion	9
References	10
Introduction
Evaluation of medical data concerning nursing management is not easy. Moreover, it requires collaborative efforts of leadership functions and governance, along with decision-making of the required nursing interventions. This paper would discuss Mrs. Jane Smith’s case study who was admitted in the Emergency Department (ED) conclusive of unwitnessed fall.
Further, efforts would be made to present a critical discussion taking help from the presented data concerning the present and past medical health of Mrs. Jane Smith. Likewise, this paper would tend to inculcate support from available literature in order to justify potential discussion and explanation. Nevertheless, this paper would end with the explanation, which would be given to the patient concerning the administration of medication. 
1. Deviation from Normal Findings and Need for Further Investigation
As evident from the presented data, Mrs. Smith experienced an unwitnessed fall and was unable to stand up. Physical examination resulted into shortened and internally rotated right leg. Further, was also reported to have multiple bruising over her right arm, face along with a laceration (approximately 4 cm) on her right lower arm. Vital sign analysis of the patient reflected presence of abnormally high heart rate 112 and respiratory rate – 24 per minute. Moreover, Mrs. Smith was also reported to have higher systolic and low diastolic blood pressure.
Likewise, as evident from the presented Glasgow Coma Scale (GCS) was reported to be 13/15. Jain, Teasdale and Iverson (2019) proposed that 13 out of 15 score correspond to a mild closed head injury. Thus, this also reflects that Mrs. Smith received a mild brain injury due to fall. Moreover, the fracture at neck of femur is also resultant from the fall; however, 4 cm laceration to her right lower arm is something abnormal because it reflects that she hit and then fell.
Similarly, the author’s deviation from the normal findings is the fact that the patient does not even remember the incident or the events leading to fall. Mrs. Smith was reported to suffer from numerous medical issues; however, none of them reflected that she also has memory loss issue; therefore, it is expected that the patient should have remembered something or certain event leading to the fall. 
2. Additional Information to be Collected by Nurse
It would be essential to understand that immediate evaluation accompanied with the elderly fall could include a review of patient’s system and description of injuries. Since, description of injuries have already been provided and the patient does not remember anything concerning the events of fall. Therefore, it would be necessary for the nurse to collect some additional information on the subject.
Firstly, the nurse can investigate fall circumstances in order to understand the risk factors, which facilitated the fall. As evident from the data presented by King, Pecanac, Krupp, Liebzeit and Mahoney (2018), direct care staff or the nurses can use their knowledge and experience in order to develop educated guesses based upon the presented evidence. Moreover, the nurse would also be required to access patient’s situation at home.
This is majorly because Mrs. Smith’s past medical history reflects cases of multiple falls; therefore, there should have been certain precautions at her house concerning minimal damage in case of future falls. Accordingly, the nurse would also have to join the dots in order to come up with the explanation of fall, which could be due to her past cardiovascular issues, blood pressure, avoidance of medication or something new. 
3. Patient’s Presenting Problem and Pathophysiological Issues
One of the major medical complications, Mrs. Smith has been reported to suffer from, is ‘hypothyroidism’ or underactive thyroid. Hypothyroidism refers to a medical condition where thyroid gland does not secrete or fail to produce enough thyroid hormone. Lack of thyroid hormone could lead to numerous other health issues such as joint pain,

Students are required to submit a critical discussion paper related to the nursing management of Mrs. Jane Smith case study below, with the support of literature. Scenario: Mrs. Jane Smith is an 80...

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