RSG353 Congestive Cardiac Failure Assessment Case Study 1 Paper

Criterion Q1 Outline the disease, causes, incidence and risk factors. Discuss the impact of the selected disease on the

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patient and their family (450 words) 25% Q2** Discuss three (3) common signs and symptoms of the selected disease and explain the underlying pathophysiology of each. (350 words) 20% Q3 Discuss the pharmacodynamics & pharmacokinetics of one (1) common class of drug relevant to the chosen patient. (300 words) 15% High Distinction Distinction Credit Pass Fail All discussion linked to case study. Nearly all discussion linked to case study. Most discussion linked to case study. Some links to the case study. Minimal links to the case study. Provides comprehensive outline of the disease, causes, incidence and risk factors. Provides a detailed outline of the disease, causes, incidence and risk factors. Provides a mostly detailed outline of the disease, causes, incidence and risk factors. Provides an adequate outline of the disease, causes, incidence and risk factors. 7 (≥85%) Demonstrates comprehensive and thorough understanding of the disease impact on patient and family. (21.5-25) Provides a comprehensive discussion of the identified three (3) common signs and symptoms relevant to the chosen patient. Provides comprehensive links to pathophysiology. (17-20) Provides a comprehensive discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. All discussion is relevant and is linked to the patient. (12.75-15) 6 (75-84%) Demonstrates a solid understanding of the disease impact on patient and family. 5 (65-74%) Demonstrates a mostly solid understanding of the disease impact on patient and family. 4 (50-64%) Demonstrates an adequate understanding of the diseases impact on patient and family. (19-21) Provides a detailed discussion of identified three (3) common signs and symptoms relevant to the chosen patient. (16.5-18.5) Provides a mostly detailed discussion of the identified three (3) common signs and symptoms relevant to the chosen patient. (12.5-16) Provides an adequate discussion of the Identified three (3) common signs and symptoms relevant to the chosen patient. Provides clear links to pathophysiology. Provides mostly clear links to pathophysiology. Provides basic links to pathophysiology. (15-16.8) Provides a detailed discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. (13-14.8) Provides a mostly detailed discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. (10-12.8) Provides an adequate discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. All discussion is relevant and is mostly linked to the patient. (11.25-12.6) Most discussion is relevant and is mostly linked to the patient. Some discussion is relevant and some basic links to the patient provided. (9.75-11.1) (7.5-9.6) 3 2 1 (≤49%) Provides minimal and/or irrelevant outline of the disease, causes, incidence and risk factors. Demonstrates minimal understanding of the disease impact on the patient and family. (0.1-12) Provides minimal and/or inadequate discussion of the identified three (3) common signs and symptoms relevant to the chosen patient. Provides minimal links to appropriate pathophysiology. (0.1-9.8) Provides minimal and/or inadequate discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. Most discussion is irrelevant and minimal links to the patient provided. (0.1-7.3) No Attempt 0 No links to case study Does not define the disease, identify appropriate causes, incidences and risk factors. Does not demonstrate the impact on the patient and family. (0) Does not discuss three (3) common signs and symptoms relevant to the chosen patient. Does not link to appropriate pathophysiology. (0) No discussion of the pharmacodynamics and pharmacokinetics of one (1) common class of drug. Discussion is irrelevant and does not link to the patient. (0) Q4** In order of priority, develop a nursing care plan for your chosen patient who has just arrived on the ward from ED. Nursing care plan goals, interventions and rationales must relate to the first 8 hours post ward admission. (500 words) 30% Sources and Referencing All nursing care strategies are appropriately prioritised. All nursing care strategies are appropriately prioritised. Majority of nursing care strategies are appropriately prioritised. Some nursing care strategies are appropriately prioritised. Most nursing care strategies are not appropriately prioritised. All nursing care plan goals, interventions and rationales are logical, cohesive, convincing and relevant to the patient. Most nursing care plan goals, interventions and rationales are logical, cohesive and relevant to the patient. Most nursing care plan goals, interventions and rationales logical and relevant to the patient. Nursing care plan goals, interventions and rationales are descriptive but mostly relevant to the patient. There is little cohesion to nursing care plan. Discussion demonstrates a sound understanding of all the key areas. Discussion demonstrates a clear understanding of majority of the key areas. . Discussion demonstrates a basic understanding of some of the key areas. Discussion demonstrates comprehensive understanding of all the key areas. (25.5-30) Credible and relevant references are used. (22.5-25.2) Credible and relevant references are used. (19.5-22.2) Credible and relevant references are used. (15-19.2) Credible and relevant references are used. Accurate use of APA referencing style in all instances. A range of in-text citations has been used. Accurate use of APA referencing style on most occasions. A range of in-text citations has been used. Accurate use of APA referencing style on most occasions. There is limited use of a range of in-text citation formats. Accurate use of APA referencing style on most occasions. There is no variation of intext citation format. (4.25-5) (4) There are no errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible. (3.5) There are minimal errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible. 5% (4) (3.5) There are no errors with grammar, spelling and punctuation that impact readability, and the meaning is easily discernible. (4.25-5) **Table format recommended for this question. Nursing care plan is irrelevant. No understanding of the key areas is demonstrated. Content is irrelevant and key areas are not addressed. Minimal understanding is demonstrated. (0.1-14.7) Not all references are credible and/or relevant. Many inaccuracies with the APA referencing style. (0) There are no references list or intext citation. (2.5-3) There are some errors with grammar, spelling and punctuation that impact readability. However, the meaning is discernible. (0.1-2.4) There are substantial errors with grammar, spelling and punctuation that impact readability. The errors detract significantly, but the meaning is discernible. (0) Grammar, spelling and punctuation are such that the reader cannot make sense of the content. (2.5-3) (0.1-2.4) (0) 5% Mechanics – Grammar, Spelling and Punctuation Broad generalisations are made. No nursing care strategies prioritised. NRSG353 Assessment Task 1 –Case Study Due Date: 29th March 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 disease, causes, incidence and risk factors. Discuss the impact of the selected disease on the patient and their family (450 words) 2. Discuss three (3) common signs and symptoms of the selected disease and explain the underlying pathophysiology of each (350 words) a. This can be done in the form of a table – each point needs to be appropriately referenced 3. Discuss the pharmacodynamics & pharmacokinetics of one (1) common class of drug relevant to the chosen patient (300 words) a. This does not mean specific drugs but rather the class that these drugs belong to. 4. In order of priority, develop a nursing care plan for your chosen patient who has just arrived on the ward from ED. Nursing care plan goals, interventions and rationales must relate to the first 8 hours post ward admission (500 words) a. This can be done in the form of a table – each point needs to be appropriately referenced 1 Case Study 1 Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency department with increasing shortness of breath, swollen ankles, mild nausea and dizziness. She has a past history of MI at age 65. During your assessment Mrs McKenzie reports the shortness of breath 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 current 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 bradycardia, 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 referred to the local hospital for further investigation. Maureen was diagnosed with rheumatoid arthritis (RA) when she was 15 years old, and has experienced multiple exacerbations of RA which have required the use of high dose corticosteroids. She is currently taking 50mg of prednisolone daily, and has been taking this dose since her last exacerbation 2 months ago. Maureen also has type 2 diabetes which is managed with metformin. She is currently 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 currently collecting urine for a 24-hour cortisol level measurement. Impression: Exogenous 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 married with 2 children. Mr James is a current 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 irritable. 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 breath. 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 he has some “unexplained” bruises 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 Cirrhosis Laboratory Findings: RBC WBC Platelets Serum Ammonia Total Bilirubin Sodium Potassium Haemoglobin Albumin Liver Enzymes BUN Creatinine Result 4.0 million/mm3 3500/mm3 75000/mm3 110 µm/dl 4.9 mcg/dl 150 mEq/L 3.4 mEq/L 85 g/L 24 g/L Slightly elevated 22 mg/dl 154 ml/min Normal Values 2.6 to 5.9 million/mm3 4300 to 10800/mm3 150000 to 350000/mm3 35 to 65 µm/dl 0.1 to 1.0 mcg/dl 135 to 145 mEq/L 3.7 to 5.5 mEq/L 120-170 g/L 35-50 g/L 7-18 mg/dl 88 to 137 ml/min 4 1 ASSIGNMENT Assessment Task 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 must be provided at the end of the assignment. Due date: 29th March 9 am Weighting: Asessment criteria: 40% Please include the word count of your assignment on the front page of your assignment or in a header. Please note that in-text citations are included in the word count whilst the reference list is not included in the word count. Words that are more than 10% over the word count will not be considered. Please see further information in the section below titled ‘Word Count’. 1600 words +/- 10% To assess learning outcomes as stipulated below. The Digital Poster page must be submitted via Turnitin Case study submissions will be returned to students online by the post-date stipulated within the Turnitin Case Study dropbox. Length and / or format purpose How to submit: Return of assignment Word Count Writing requires skill and being able to write within a specified word limit is an essential component of professional and academic work. Reading and writing critically are fundamental skills which demonstrate an understanding and an ability to make judgements and solve problems, hence why only 10% of a word count should be direct quotes. That is, if the word count is 1500 words only 150 of those words should be direct quotes. Word counts provide students with an indication of the amount of detail and work required for each assessment item. What is included in a word count? Essentially, all text within an assessment item from the introduction through to the conclusion is counted in the word count. This includes all in-text citations, direct quotes and headings. The word count does not include the following: 2 • Title page • Reference list • Appendices • Tables • Figures and legends REFERENCING This unit requires you to use the APA referencing system. See the ‘Academic referencing’ page from the Office of Student Success . (Academic referencing) for more details .