2803NRS Written Assignment – Trimester One, 2020.
1500 words: Weighting 30%
The aim of this assignment is for students to demonstrate their ability to apply the principles of evidenced-based and person-centred care to plan effective care for a client with an acute medical or surgical condition, as part of the role of the Registered Nurse.
This assignment addresses all the learning outcomes of this course. Task Description:
For this task you are required to write a 1500-word essay in which you:
Discuss the risk factors, pathophysiology and assessment of the post-operative client presented in the following clinical scenario.
Identify two (2) priorities of post-operative nursing care. Discuss ONE of the following potential complications: pulmonary embolism OR
post-operative wound infection.
Develop a plan of care to reduce the risk of the potential complication. Reflect on the process of creating the plan of care.
You MUST include the following information in your essay:
Introduction (approximately 100 words)
Your introduction should contextualise and identify the aim of the essay.
Body (approximately 1300 words)
1. Discuss the risk factors and pathophysiology that have led to the presenting patient
condition. (100 words) 2803NRS_Acute_Nursing_Practice_Essay_T1_2020_FINAL
2. Discuss TWO (2) comprehensive post-operative assessments that an RN would undertake for the patient. With reference to current evidence-based literature, justify why each assessment is necessary for the presenting condition. (300 words) (Please note your assessments need to be specific to the post-operative patient)
3. Discuss ONE (1) potential complication (either pulmonary embolism OR post-operative wound infection), including the development and risk factors of the complication itself and ONE (1) nursing assessment used to identify the complication. (400 words)
4. Develop a plan of care to reduce the risk of the chosen potential complication (either pulmonary embolism OR post-operative wound infection). Use current evidence-based literature to justify why your plan is appropriate for this patient. (400 words)
5. Apply Gibbs’ Reflective Cycle to develop the plan of care and on what you have learnt from designing the plan. This section can be written in first person. (100 words)
Conclusion (approximately 100 words)
Your conclusion should give a brief summary of the main points of the essay (100 words)
? You must support all sections of your essay with scholarly literature that has been published within the past 5 years, i.e., from 2015 (inclusive) onwards.
John Grant, a 63-year-old man has been diagnosed with bilateral knee osteoarthritis. The pain had been well controlled with paracetamol 1gm four times daily for the past 8 months. His general practitioner (GP) added oxycodone 5 mg prn due to increasing pain, mostly in his right knee. John was referred for a right total knee replacement. A plan is in place to have the left knee replaced once he has completely recovered from the first operation. John has a history of angina, hypertension (HTN), hyperlipidaemia, type 2 diabetes (T2DM), and depression. He also has mild gastro- oesophageal reflux disease (GORD) and self-manages his symptoms with antacids prn and moderating his alcohol intake.
John is a widower and owns a café, along with his eldest daughter. He previously worked 6 days a week, however due to his painful knees he reduced his work to light duties and office work 2 days a week and now worries about his daughter’s workload. John lives in his own home, which has six steps at the front, and is usually able to undertake all his own activities of daily living (ADLs), and housework independently. His family visits regularly, and recently his son and daughter-in-law have been helping with the housework and cooking.
John has returned to the surgical ward post total knee replacement (TKR) surgery. He has IV Normal Saline 0.9% running. He is drowsy but rousable and is complaining of pain (rating 7/10). His vital signs on arrival to the ward are: BP 145/70, HR 105bpm, temp 35.9 degrees, SpO2 99% on 8 litres of oxygen via a Hudson mask. He has an indwelling urinary catheter in situ with 60mL of urine output. He has a dressing on his right knee that is intact, but there is a small amount of blood oozing onto the dressing. He has a Redi-vac drain in situ that contains 30 mls of frank blood. He also has patient- controlled analgesia (PCA) in situ. You have been allocated to care for John.