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NRSG353 Assessment Task 2 –Case Study Due Date: 3rd April at 5pm via Turnitin Weighting: 40% Word count: 1600 words (every question has a specific word count, which must be adhered to) Instructions: •...

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NRSG353 Assessment Task 2 –Case Study
Due Date: 3rd April at 5pm via Turnitin
Weighting: 40%
Word count: 1600 words (every question has a specific word count, which must be adhered to)
Instructions:
• Students are to choose one (1) of the case studies below and answer the associated
questions. The assignment is to be presented in a question/answer format not as an
essay (i.e. no introduction or conclusion).
• Each answer has a word limit (1600 in total); each answer must be supported with
citations.
• A Reference List must be provided at the end of the assignment.
• Please refer to the marking guide available in the unit outline for further information.
** The following questions must be answered for your chosen case study **
The following questions relates to the patient within the first 24 hours:
1. Outline the causes, incidence and risk factors of the identified condition and how it can
impact on the patient and family (400 words)
2. List five (5) common signs and symptoms of the identified condition; for each provide a
link to the underlying pathophysiology (350 words)
a. This can be done in the form of a table – each point needs to be appropriately
eferenced
3. Describe two (2) common classes of drugs used for patients with the identified condition
including physiological effect of each class on the body (350 words)
a. This does not mean specific drugs but rather the class that these drugs belong to.
4. Identify and explain, in order of priority the nursing care strategies you, as the registered
nurse, should use within the first 24 hours post admission for this patient (500 words).
1
Case Study 1
Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency
department with increasing shortness of
eath, swollen ankles, mild nausea and
dizziness. She has a past history of MI at age 65. During your assessment Mrs McKenzie
eports the shortness of
eath has been ongoing for the last 7 days, and worsens when
she does her gardening and goes for a walk with her husband.
On examination her blood pressure was 170/110 mmHg, HR 54 bpm, respiratory rate of
30 bpm with inspiratory crackles at both lung bases, and Sp02 at 92% on RA. Her fingers
are cool to touch with a capillary refill of 1-2 seconds. Mrs McKenzie states that this is
normal and she always has to wear bed socks as Mr McKenzie complains about her cold
feet.
Her cu
ent medications include: digoxin 250mcg daily, frusemide 40mg BD, enalapril 5mg
daily, warfarin 4mg daily but she sometimes forgets to take all of her medications.
The following blood tests were ordered: a full blood count (FBC), urea electrolytes and
creatinine (UEC), liver function tests (LFT), digoxin test, CK and Troponin. Her potassium
level is 2.5mmol/L.
Mrs McKenzie also has an ECG which showed sinus
adycardia, and a chest x-ray
showing cardiac enlargement and lower-lobe infiltrates.
Impression: Congestive cardiac failure
2
Case Study 2
Ms Maureen Smith is a 24 year old female who presented to her GP for ongoing
gastrointestinal bleeding, abdominal pain and fatigue which has been worsening, and was
efe
ed to the local hospital for further investigation.
Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has
experienced multiple exace
ations of RA which have required the use of high dose
corticosteroids. She is cu
ently taking 50mg of prednisolone daily, and has been taking this
dose since her last exace
ation 2 months ago.
Maureen also has type 2 diabetes which is managed with metformin. She is cu
ently
studying nursing at university and works part-time at the local pizza restaurant.
On assessment, Maureen’s vital signs are: PR 88 bpm; RR 18 bpm; BP 154/106 mmHg; Temp
36.9ºC: SpO2 99% on room air. She has a body mass index (BMI) of 28kg/m2 and the fat is
mainly distributed around her abdominal area, as well as a hump between her shoulders.
Maureen’s husband notes that her face has become more round over the past few weeks.
Her fasting BGL is 14.0mmol/L. Blood test results show low cortisol and ACTH levels, and
high levels of low density lipoprotein cholesterol. She is awaiting a bone mineral density test
this afternoon, and is cu
ently collecting urine for a 24-hour cortisol level measurement.
Impression: Cushing’s syndrome
3
Case study 3
Mr Nathan James is a 48 year old male who was admitted to the high dependency unit for
investigation of jaundice and ascites. He is an interstate truck driver and is ma
ied with 2
children. Mr James is a cu
ent smoker and known to consume 2 glasses of beer per day.
He has a previous (15 years ago) history of recreational drug use and was diagnosed with
Hepatitis C 10 years ago.
On assessment:
Mr James is lethargic but orientated to time, place and person and slightly i
itable. He is
slightly tachypnoeic with moderate use of accessory muscles. His wife reported that Mr
James has been spitting blood stained sputum for the last few weeks with no associated
cough or shortness of
eath. Mr James reports that he has lost 9 kilos in weight which he
attributed simply to a lack of appetite. No changes were reported with his urine output. On
examination his sclera is mildly jaundiced and has some “unexplained”
uises on his arms
and legs. His abdomen is tight and distended and pitting oedema noted on his ankles.
Observations: BP: 115/60mmHg, HR: 110 bpm, RR: 24 bpm, SpO2: 88% on RA, 95% on 6L via
Hudson Mask, Temp: 37.8C
Impression: Liver Ci
hosis
Laboratory Findings:
Result Normal Values
RBC 4.0 million/mm3 2.6 to 5.9 million/mm3
WBC 3500/mm3 4300 to 10800/mm3
Platelets 75000/mm XXXXXXXXXXto 350000/mm3
Serum Ammonia 110 µm/dl 35 to 65 µm/dl
Total Bilirubin 4.9 mcg/dl 0.1 to 1.0 mcg/dl
Sodium 150 mEq/L 135 to 145 mEq/L
Potassium 3.4 mEq/L 3.7 to 5.5 mEq/L
Haemoglobin 85 g/L XXXXXXXXXXg/L
Albumin 24 g/L 35-50 g/L
Liver Enzymes Slightly elevated
BUN 22 mg/dl 7-18 mg/dl
Creatinine 154 ml/min 88 to 137 ml/min
4

Assessment 1
Students are to choose one (1) of the case studies available (see LEO) and answer the associated questions. The assignment is to be presented in a question/answer format not as an essay (i.e. no Introduction or conclusion). Each answer has a word limit (1600 in total); each answer must be supported with citations. A Reference List more than 15 must be provided at the end of the assignment.
Due Date: 1st April
Please strictly be mindful on plagiarism follow the marking ru
ic provided and aim for the distinction.
Reference: APA
Name of subject is NRSG353
Purpose: To assess learning outcomes as stipulated below.
· Apply clinical decision making skills to identify and prioritise health problems for individuals experiencing acute medical health alterations
Explain the impact of acute medical health alterations for the individual and their family/carers
· Minimise the psychosocial effects of acute alterations in health for individuals and their families/carers
Identify the links between the pathophysiology and manifestations of acute medical health alterations (GA 4)
· Plan evidence-based, holistic, person-centered care for individuals experiencing acute medical health alterations, including education and discharge planning (GA 5) Determine appropriate nursing therapies and describe medical and allied health interventions for selected acute medical health alterations
· Evaluate the effectiveness of nursing therapies and interventions
Apply evidence, standards and guidelines to analyse selected acute critical incidents and their management

Assessment Task 1: Case Study Marking Ru
ic (40%)

Criterion

High Distinction
7 (≥85%)
Distinction
XXXXXXXXXX%)
Credit
XXXXXXXXXX%)
Pass
XXXXXXXXXX%)
Fail
XXXXXXXXXX (≤49%)
Q1
Outline the causes,
incidence and risk factors
of the selected disease
and how it can impact on
the patient and their family
(400 words)
20%
Linked to case study.
Provides
comprehensive
identification of
causes, incidences
and risk factors.
Provides
comprehensive
understanding of the
disease impact on
patient and family.
(17-20)
Linked to case study.
Provides a solid
indication of causes,
incidences and risk
factors.
Provides a solid
understanding of the
disease impact on
patient and family.


XXXXXXXXXX)
Linked to case study
Provides an
identification of
causes, incidences
and risk factors.
Provides an
understanding of the
disease impact on
patient and family.


XXXXXXXXXX)
Linked to case study
Provides minimal
identification of
causes, incidences
and risk factors.
Provides minimal
understanding of the
diseases impact on
patient and family.


XXXXXXXXXX)
Not linked to case
study
Does not identify
appropriate causes,
incidences and risk
factors.
Does not identify the
impact on the patient
and family.


(0-9.9)
Q2
List five (5) common signs
and symptoms of the
selected disease, and for
each one provide a link to
the underlying
pathophysiology (350
words)
15%
Provides a
comprehensive look at
the identified five (5)
common signs and
symptoms.
Provides a
comprehensive link to
pathophysiology.
XXXXXXXXXX)
Identifies five (5)
common signs and
symptoms.
Provides a thorough
link to
pathophysiology.


XXXXXXXXXX)
Identifies five (5)
common signs and
symptoms.
Provides a solid link to
pathophysiology.



XXXXXXXXXX)
Identifies five (5)
common signs and
symptoms.
Provides basic links to
pathophysiology.



XXXXXXXXXX)
Does not identify five
(5) signs and
symptoms.
Does not link to
appropriate
pathophysiology.


(7.3-0)
Q3
Describe two (2) common
classes of drugs used for
patients with the selected
disease including
physiological effect of
each class on the body
(350 words)
15%
Two (2) classes of
drugs appropriately
identified.
A comprehensive
understanding and
explanation
Answered Same Day Mar 20, 2020 NRSG353

Solution

Soumi answered on Mar 26 2020
139 Votes
Running Head: NRSG353 ASSESSMENT 2        1
NRSG353 ASSESSMENT 2        9
NRSG353 ASSESSMENT 2 –CASE STUDY
(SELECTED CASE STUDY = 1)
Table of Contents
1. Causes, risk factors and incidence of Congestive cardiac failure and its impact on Mrs McKenzie as well as her family    3
2. 5 signs and symptoms of Congestive cardiac failure; linking them to the underlying pathophysiology    4
3. 2 common classes of drugs used for patients with Congestive cardiac failure with their physiological effect on body    5
4. Nursing care strategies to be used within first 24 hours of admission for Mrs McKenzie    6
References    8
1. Causes, risk factors and incidence of Congestive cardiac failure and its impact on Mrs McKenzie as well as her family
    Congestive cardiac failure is the condition of the human body, when the heart does not function properly and fails to pump enough blood through the cardiac cycle. As mentioned by Colombo et al. (2015), the key causes of congestive cardiac failure could be coronary artery disease, hypertension and blocked valves. In case of Mrs Sharon McKenzie, she had had an issue of myocardial infarction, which might have been due to the blockage of valves inside her heart that could cause congestive cardiac failure in her, cu
ently. Besides, she had been on a prescription of a daily consumption of warfarin 4mg, which is a medicine to prevent blood clots in the heart. Hence, this relates to her having acquired congestive cardiac failure. Not only these, she also has high pressure that is 170/110, which can also cause her cu
ent medical condition because hypertension is also a cause of this disease.
    The risk factors of this medical condition are hypertension, obesity, diabetes and sometimes abnormal levels of thyroid in the body. Mrs McKenzie is an elderly woman aged 77 years old. Although she has not exhibited to have been an obese or diabetic; however, she does have high levels of blood pressure, thus making her vulnerable to developing this disease. As mentioned by Reddy, Melenovsky, Redfield, Nishimura and Borlaug (2016), the occu
ence of coronary artery disease could also be attributed as a risk factor for this. In case of Mrs McKenzie, since she has been suffered from myocardial infarction at the age of 65 years, she might have been prone to congestive cardiac failure since then.
    The incidence of congestive cardiac failure can take place in two ways that are diastolic and systolic heart failure. As stated by Mahmood, Levy, Vasan and Wang (2014), the systolic heart failure takes place when the contraction at the left ventricle is inappropriate, leading to insufficient flow of blood into the double circulation cycle of the human body. On the other hand, diastolic failure takes place when the dilations of the left ventricle are not proper, leading to less volume of blood being filled into this chamber. In case of Mrs McKenzie, she must have been suffering from the systolic heart failure because her systolic pressure is higher than normal than that of the diastolic pressure.
    This condition could lay emotional impact on the family and adverse physical impact on Mrs McKenzie, because she is not being able go for walks with her husband and do garnering, which shows her capabilities to do things she enjoys have been curtailed due to this medical condition.
2. 5 signs and symptoms of Congestive cardiac failure; linking them to the underlying pathophysiology
    The issues of congestive cardiac failure are illustrated on the body of the patient, with the help of the following signs and symptoms, which are indeed the consequences of their individual pathophysiology:
    Signs and Symptoms
    Pathophysiology
    Shortness of
eath
    Also known as dyspnoea, shortness of
eath is a common symptom of the patient suffering from congestive cardiac failure. The patient is shown to have exhibited rapid
eathing or inability to
eath, which indicates through their
eathing pattern. It is so because according to Munzel, Gori, Keaney Jr, Maack and Daiber (2015), the heart in a condition of congestive cardiac failure fails to pump in and out sufficient volume of blood, which is why an obvious effect is that the heart receives insufficient amount of oxygen. As a result, the patient feels uneasiness in
eathing.
    Swelling of legs and feet
    Due to the lack of blood supply to the other parts of the body, there occurs an accumulation of the deoxygenated blood at different body parts. As supported by Kasper et al. (2015), the oxygenated blood is not...
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