2.4.2 Short Answer Exam based on one case study Of acute life-threatening and/or traumatic complex health condition
Weight: 35%
Type Of Collaboration: Individual
Due: Week 10, Monday 3rd May 2021, 23:59 hrs
Submission: Refer to section 2.5 of the Learning Guide - General Submission Requirements
Format: Short answer.
Length: 1250 words
Curriculum Mode:
Word Count
There is a word limit of 1250 words. Use your computer to total the number of words used in your assignment. Ho.vever, do not include the reference list at the end of your assignment in the word count. In-text citations will be included in the additional 10% word count. If you exceed the word count by 10% (1375 words) the marker will stop marking.
Aim of assessment
The aim of this assessment is to enable students to:
1. Demonstrate knowledge by analysing the information provided in the case study.
2. Apply the clinical information provided in the case study and describe this clinical information within a pathophysological and patient focused framework.
3. Discuss nursing strategies and evidence based rationales to manage a patient with an acute episode of asthma.
4. Discuss the pharmacological interventions related to the management of a patient with an acute episode of a patient episode of asthma.
Details
You are to ansvær all questions related to the case study provided. Your answers must be directly related to the clinical manifestations that your patient presents with. You must submit your work with a minimum of six references from the past 5 years including journal articles, textbook material or other appropriate evidence based resÖurces.
Case study
Peter is a 10 year old male, weight 45Kg.
He presented to ED with worsening respiratory symptoms over the past few hours. His parents state he is unable to talk in full sentences or undertake a peak flow. In ED Peter has been given 3 x 20 minutely nebulised Salbutamol with 6LPM of 02, IVF commenced, Stat dose of Prednisone administered, Chest X-ray shows hyperinflation of both lung fields. He was admitted to ICU due to his deteriorating respiratory function with a diagnosis of acute exacerbation of asthma.
EXCERPT OF RELEVANT ICU NOTES
Past History
Diagnosed with asthma age 3 (infrequent intermittent asthma).
Current medications: - Ventolin PRN. IUTD (immunisations up to date)
Nursing Assessment
A. Clear. speaking in single words
B.RR 43bpm, Sp02 87% RA, 92% on 6LPM 02 + nebuliser, auscultation decreased AE bibasally, inspiratory and expiratory wheeze
C. HR 162bpm, ST, peripherally warm
D. GCS 14/15 (E4. V4, M6)
E. Accessory muscle use, shoulder shrugging on inspiration, tracheal tug
F. IVF Naa 54 ml/hr
G.
a. Mg- low 0.60mmol/L (0.70-1,10mmoI/L) all other pat'hology is normal,
b. BGL 9.0mmol/L
c. Beta-agonist- Salbutamol
d. Anticholinergic Atrovent
e. IV Hydrocortisone
f. ABG shows respiratory acidosis, (PH 7.32, PaC02 49, Pa02 70, 'HC03 27, BE -2.1,
Lactate 1.4)
Plan
- Keep sp02
— Beta- antagonist Salbutamol continuous via nebuliser
Anticholinergic Ipratropium bromide (Atrovent) 500ug 4/24 Hydrocortisone 100mg 6/24
— MgS04 4mmol/20 minutes
IVF 53ml/hr — Repeat ABGs in lhour — Monitor BGI Peak flow /spirometry
Question I
Explain the pathogenesis causing the clinical manifestations with which Peter presents.
Question 2

1. Sit Peter in a High Fowlers position
— How does positioning a patient with acute asthma in a High Fowlers position assist to alleviate respiratory distress?
1. Apply and titrate oxygen
— What oxygen delivery device will you use?
Why did you choose this device?
— How does providing supplemental oxygen work and, how will it assist Peter?
Question 3
For each medication below explain
— The mechanism of action
Why your patient is receiving this medication in relation to her symptoms and diagnosis?
— What are the nursing considerations for this medication?

— What clinical response you expect?
— What continuing clinical observations will you need to undertake?
Salbutamol via nebuliser
Hydrocortisone IV
Ipratropium Bromide via nebuliser
Submission
Refer to Section 2.5 of the Learning Guide- General Submission Requirements
Submit your assessment through Turnitin
Format
All assignments are to be typed
Typing must be according to the following format:
3 cm left and right margins, double spaced.
Font: Arial or Times New Roman
Font size: 12pt
See further submission requirements below
Submission Requirements
I. Electronic copy only. Students are to 'submit an electronic copy of the assessment. Students are not required to submit the originat hard copy of their assessment on campus
2. Submit your assessment electronically through the Turnitin link on the unit vUWS site.
3, Students are to upload the assessment with the following title; Surname_Firstname_assessment title 4, Your assessment must be submitted in ,doc, docx format.
5. This assessment is marked online; no paper copy will be accepted. Marks. comments and the marking criteria will be released online. If you do not receive your marked assessment when all others have been returned, it is your responsibility to contact the Unit Coordinator for assistances
Resources:
i. Examples may be available on the vUWS site.
ii. There are a number of textbooks and resources available through the Western Sydney University Library that may assist you. Please refer to the unit's vUWS site for specific unit resources.
iii. Assessments listed as individual assessments must be completed independently Students are advised to refer back to their notes, textbooks or appropriate academic, peer-review•cd resources utilised during unit delivery
Marking Criteria:
High Distinction Unsatisfactory
Criteria I -Explain the pathogenesis causing the clinical manifestations with which Poppy presents.
/50 Analyses information from a discerning selection Of sources and provides an accurate and comprehensive explanation of the pathogenesis causing the clinical manifestation of the patient in the case study.
The explanation is developed in a logical sequence and incorporates all manifestations presented in the case study. The discussion is clearly and accurately supported by appropriate sources.
42.5-50 Analyses information from a discerning selection Of sources and accurately explains the pathogenesis causing the clinical manifestations of the patient in the case study,
Mostly synthesises the information effectively in own words and in a logical sequence including all manifestations presented by the patient,
The discussion is clearly and accurately supported by appropriate sources.
37.5-42 Analyses information from relevant sources and generally provides an accurate explanation Of the pathogenesis causing 'the clinical manifestations of the patient in the case Study.
The explanation is mostly developed in a logical sequence but there may be one or omissions Of significant information or all manifestations are accurately explained but there is little logical development in the discussion,
The discussion is Clearly and accuratcly supported by appropriate sources.
32.5-37 Using information from relevant references provides a basic description of the pathogenesis in relation to the case study with some links to the clinical manifestations presented by the patient in the case study,
There may be minor inaccuracies, omissions or repetition Of information, lack Of clarity or logical flow of the process of the pathogenesis of acute exacerbation Of asthma.
The discussion is mostly supported by appropriate sources.
25-32 A superficial description Of the pathögenesis in relation to the case study is provided with a number of significant inaccuracies, repetition or lack Of Clarity, Has not accurately related the clinical manifestations to the pathogenesis. The sources Of information are not accurate and clearly evident.
0-24.5

Criteria 2-
Accurately discusses and explains the rationales and justifies the nursing strategies
Discussion is sell supp«ted by a p propriate evidence. Comprehensively and accurately discusses each nursing strategy used to manage a patient with an acute exacerbation of asthma. The nursing strategies are well supported by discussion that clearly explains the rationales.
The discussion is clearly and accurately supported by appropriate sources.
17-20 Accurately discusses each nursing Strategy used to manage a patient with an acute exacerbation Of asthma
The discussion is clearly and accurately supported by appropriate sources,
15-16.5 Provides accurate rationales for the management Of a patient with acute exacerbation of asthma but not clearly evidence basedThe discussion is Clearly and accurately supported by appropriate sources.
13-14.5 Provides basic rationales for the strategies identified but they are not evidence-based. The discussion is mostly supported by appropriate sources-
10-12.5 Provides little or inaccurate explanation Of rationales. Information predominantly copied or quoted from inappropriate sources.
The sources Of information are not accurate and clearly evident.
0-9.5
High Distinction Unsatisfactory
Criteria 3Demonstrates Of the mechanism of action of medications, and demonstrates application to the pathogenesis of asthma,
/20 Comprehensively and accurately discusses each medication and relates the medication to the underlying pathogenesis and clinical manifestations Of an acute exacerbation Of asthma. Each question is answered in clear and accurate detail and relates to the case study. The discussion is clearly and accurately supported by appropriate sources.
17-20 Accurately discusses each medication and relates the medication to the underlying pathogenesis and clinical manifestations Of an acute exacerbation of asthma. Each question is answered in Clear and accurate detail and relates to the case Study, The discussion is clearly and accurately supported by appropriate sources.
15.5-16.5 Explains each medication and relates the medication to the underlying pathogenesis and clinical manifestations of an acute exacerbation Of asthma. Each question is answered in clear and accurate detail and relates to the case Study. The discussion is clearly and accurately supported by appropriate sources.
13-14.5 Provides a basic explanation Of the medications and their relationship to acute exacerbation of asthma The answer may not be clearly related to the pathogenesis Of an acute exacerbation of asthma or contain some inaccuracies or lack Clarity. The discussion is mostly supported by appropriate sources.
10-12.5 The medications' relationship to an acute exacerbation Of asthma is incomplete or inaccurate with little or no relationship to the underlying pathogenesis of an acute exacerbation of asthma, Information Bredominantly taken from inappropriate sources.
The sources of information are not accurate and clearly evident.
0-9,5

Criteria 4-
Academic writingWrites in a clear succinct academic Style using correct grammar. spelling and punctuation. A minimum of six references from the past 5 years including journal articles. textbooks or other relevant evidence based resources. All source Of information are Clearly and accurately acknowdedged applying conventions of APA style referencing. Writes in an advanced style exhibiting highly coherent and logical flow of ideas. No errors in spelling or grammas Referencing technique is flawless and follows APA convention both in-text and in the reference list, Uses at least 6 appropriate

8.5-10 Writes clearly and succinctly with a coherent, logical flc»v Of ideas exhibiting advanced clarity. NO errors in spelling, or grammar, Referencing technique follows APA convention but contains infrequent minor errors.
Uses at least 6 appropriate references.
7.5-8 Writes clearly and uses language that enables effective flow of ideas. Minor, infrequent errors in spelling or grammar that do not impede floe,' of ideas, Referencing technique follows APA convention but contains infrequent errors. Uses at least 6 appropriate references.
6.5-7 Writing is reasonably clear, but at times the effective floe.' of ideas and meaning is hindered. Minor. frequent errors in spelling or grammar sometimes impedes the flo•.•' Of ideas. There may be frequent minor errors in APA referencing convention in in-text referencing and/or the reference list. Uses at least 6 appropriate references. Use of Cited Sources not always Clearly evident.
5-6 Writes in an elementary style with very basic use Of language and poor articulation Of ideas. Writing may be verbose, convoluted or difficult to read. Organisation Of material and main points is unclear. The errors in spelling, punctuation, grammar and Sen tence construction impede There may be absent or incorrect use of APA referencing technique. Does not use the minimum number of required references, or uses predominantly inappropriate or non-authoritative sources, Sources of information not correctly acknowledged.
0-4.5