Scenarios for Adult nursing

This assignment has been designed to provide you with an opportunity to demonstrate your achievement of the following module learning outcomes:

LO 1

Utilise and apply knowledge of anatomy and physiology, pathophysiology and pharmacology to critically understand the nursing assessment and holistic management of adults.

LO 2

Demonstrate a critical understanding of a range of nursing skills to deliver safe and effective care to adults.

LO 3

Identify and analyse the best available evidence to care for adults in a range of care environments.

LO 5

Critically reflect on the use of effective communication skills with colleagues, people and their families

The selected two scenarios should be separately presented in an academic essay format, with a clear introduction, body, conclusion, and use an appropriate formal academic style. Do not include headings and sub-headings.

The structure of each answer to the care delivery should include the following:

· Introduction (Approximately, 150 words*). This will acknowledge which scenario you are addressing. Please do not just lift from the assignment brief/question, think of the fundamental care delivery as a whole. Briefly describe what the assignment will encapsulate. You may also consider:

How would you address the patient, confidentiality and dignity?

How would you seek consent?

How would you maintain infection control?

.

· Main body (Approximately, 900 words*). In this section, you should consider:

The definition of the condition

The pathophysiology of the condition

A-E assessment applying to the patient, their observations…

Medical interventions, including tests

Pharmacology (medications, including side effects)

Nursing care

· Evaluation of the care delivery (Approximately, 100 words*). In this section, you should consider

NEWS, SBAR and what you would do in case of improvement and

· Conclusion and possible recommendations (Approximately, 100 words*). In this section, you should consider:

Briefly describe what you’ve discussed, thinks of what next for the individual, being cared in the community.

· References

Answer two of the three questions

Question 1

Harry Ware is a 45-year-old gentleman who has recently visited his General Practitioner (GP) complaining of a ‘chest infection’. He was admitted immediately to your ward where he was diagnosed as suffering from acute bronchopneumonia. On admission, he had a productive cough and complained of general pain in his chest when breathing deeply, felt lethargic and tired.

Ward baseline Observations

· Oxygen saturations 85% on 2 litres (24%)

· Temp 390C

· Blood Pressure 110/60mm Hg

· Pulse 125 beats per minute

· Respiratory rate 32 breaths per minute

Medications as per drug chart;

· Oxygen 2 litres continual via nasal or mask

· Amoxicillin 500mg IV tds (three times a day)

· Paracetamol 1g qds (four times a day)

Six hours after admission, Harry’s condition deteriorated, and he became pyrexia and was sweating. His breathing was noisy and rapid, with a faint expiratory wheeze. His tachycardia was increasing, and his pulse felt weaker than it did earlier (and his respiration rate was increasing). Harry was also more lethargic than he was on admission.

Discuss Harry’s acute management and nursing care in the first 24 hours following the deterioration with reference to the relevant pathophysiology.

Question 2

Iqbal Kadaffi is a 62-year-old married Asian gentleman. He has over recent months complained of feeling unwell, with indigestion-like discomfort not relieved by antacids and shortness of breath. He has not been to see his doctor.

One night whilst lying on his bed he started having unbearable chest pain, which was radiating to the left side of his neck and pain between his shoulder blades. An ambulance was called, and he was taken to the hospital. Following further examination, in the A&E department, it was confirmed that he had a myocardial infarction (MI). He was transferred to your ward.

Medications as per drug chart

· Aspirin 75 mg OD (Once a day)

· Glyceryl trinitrate spray

· IV Diamorphine 2.5mg as required

· IV cyclizine 50mg as required

Ward baseline Observations

· Oxygen saturation 90% on room air

· Temperature 37.5°C

· Blood pressure 100/60mmHg

· Pulse 125 beats per minute

· Respiration rate 28 breaths per minute

Considering relevant pathophysiology, discuss Iqbal’s acute management and nursing care for the first 24hours of his admission.

Referencing

· Your work will be assessed using level 5 Marking Grid, which covers :

· Presentation /15 (see below),

· Please note: You need a front sheet on this submission:

Student number and cohort

SpLD sticker if applicable

Module code and name

The submission date

The module leader’s name

Word counts, one for each scenario

· Text should be Ariel Font 12, left hand justified only and an additional line space between paragraphs.

· The word count for this assignment is 1250 words for each scenario, excluding the reference list. Please note the University guidelines which stipulate that you may submit 10% over or under this word count.

· Two word counts are needed, they should be declared as “Scenario 1 ??? words, Scenario 2 ??? words)”. Word count excludes the reference list and word count itself.

· Write in an appropriately formal academic style, avoiding contractions (e.g., don’t, won’t, etc.) and informal or spoken forms of language. Avoid sub-titles, beyond Scenario 1 and Scenario 2, use the number actually attached to the Scenario below.

· Referencing /15 (how you use the references and how you record them, some items will need more than one reference)

· Separate reference lists-one list for both questions. References on the reference list to be presented in alphabetical order.

· Knowledge and understanding /25 (knowledge of the care delivery). The definition of the condition, the pathophysiology of the condition, A-E assessment applying to the patient, their observations…, medical interventions, including tests, pharmacology (medications, including side effects), nursing care

· Integrating academic learning with practice /20 (this section will consider how you have demonstrated the ability to integrate biological sciences and nursing theories to provide in-depth understanding/rationale for use of skills/interventions required when caring for the acutely ill patient).

· Analysis /20 (this section will consider of how you have demonstrated the ability to critique relevant theory & practice from a broad range of perspectives and has used these to reflect on own practice, demonstrates a sustained critically analytical approach).

· Synthesis and Evaluation /5 (This section will consider of how you demonstrated the ability to assemble and link ideas and evidence from a full range of relevant sources, evaluates data to build a reasoned and articulated argument; conclusion drawn demonstrates insight and creative thought).

· Be sure not to identify any individual or organisation directly or by implication in your work (NMC, 2018).

· Be aware, for unsafe practice, the academic regulations demand a penalty.