NUR241 Health Alterations Supplementary Assessment – Australia.

Subject Code & Title : NUR241 Health Alterations Supplementary
Length: 1000 words
Estimated time to complete task: 15 hours
Individual/Group: The case study assignment is an Individual Assessment Item.
Formative/Summative : Summative
How will I be assessed: Limited grades rubric.You will be notified of your final grade: Supp Pass or Supp Fail
Submission details : Safe Assign in NUR241 Blackboard Supplementary Assessment Submission Portal
NUR241 Health Alterations Supplementary Assessment – Australia.

NUR241 Health Alterations Supplementary Assessment - Australia.

Presentation requirements:
This assessment task must:
1.Times New Roman Size 12 Justified 1.5 line spacing
2. Use APA7 referencing for citing academic literature
3. be submitted in electronic format as a word.doc document via Safe Assign.
4. Do not copy the actual questions into your assignment document
5. No Introduction or Conclusion is required as this is not an essay.

Task goal: The goal of this case study is for you to identify the role of the registered nurse in evidence-based assessment and care of individuals experiencing health alterations when access to healthcare is sub optimal or compromised. You also articulate the role of the nurse in encouraging access to, and participation in healthcare.

Task description: Present a response to a clinical scenario demonstrating appropriate assessment, management and discharge of an individual experiencing health alterations.

What you need to do :
In this task you will conduct a case study. There are three clinical scenarios, you will study only one. Please follow the steps below:

Step 1: Secondary assessment of the patient
D
etail the secondary assessment and investigations appropriate for this person

Step 2: Select the essential intervention
Select one (1) essential intervention from the following list:
1. administration of Frusemide,
2. administration of nitrolingual spray,
3. Falls risk management,
4. Thromboembolism prevention

Step 3: Implementation and evaluation
Describe and justify the nursing actions required to implement and evaluate the chosen essential intervention

Step 5. Plan the patient discharge
Select and describe nursing actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare

NUR241 Health Alterations Supplementary Assessment – Australia.

NUR241 Health Alterations Supplementary Assessment - Australia.

Additional notes
Select interventions that corrects the pathophysiological change within the patient. Patient monitoring actions (completing vital signs and fluid balance charts) is considered as assessment or evaluation, it is not an intervention.

Alternate Clinical Scenario
Situation :- Admitted to the medical ward for increased peripheral oedema and reduced mobility. The patient has been admitted with stable angina pectoris. The patient has been walking to the cafeteria, but called for help due to chest pain.

Background :-
Allergies: nil Medications: digoxin 250 micro grams OD, atorvastatin, metf or m in Pass medical history: congestive cardiac failure, cardiomegaly, type 2 diabetes mellitus, hyperlipidaemia,Last ate: lunch in ED

Events:
Decreased mobility, shortness of breath on minimal exertion (walking to the bathroom), chest pain on mobilising more than 1 minute, pitting oedema, alopecia on the lower legs, purple dis colouration to the lower legs

Lifestyle:
The patient is a taxi driver, he works 6 nights a week. The patient has a very poor diet, he snacks a lot from vending machines. He can perform all ADLs but it increasingly takes him a long time.

Social:
Peter had to move out of his house when he divorced his now ex-wife. Pam.Peter rents out a room from Blanche.
Peter is estranged from his family. Peter goes to the RSL every Friday to meet with other Vietnam Veterans.

Patterns of healthcare use:
Peter doesn’t have a GP as his last one left town 4 years ago. Peter doesn’t remember to take his medications regularly. Peter doesn’t like going to the ED, but often does, because he hasn’t found a GP in town that he likes.

Assessment :
The patients a flushed face, with jugular vein distension at the neck Vital signs:
RR = 24, SpO2 = 91% RA (crackles on lower and middle lobes on auscultation without a wheeze),
HR = 110, BP = 135/80 mmHg, S3 heard on auscultation
T = 37.0
GCS = 15, Alert
BGL =12 mmol/L (lower than normal for Peter)
Nil pain when resting, chest pain on continued mobilisation.

Investigations:
1. ECG shows sinus tachycardia
2. CXR shows enlarged heart, nil other abnormalities
3. BMI = 40

NUR241 Health Alterations Supplementary Assessment – Australia.

NUR241 Health Alterations Supplementary Assessment - Australia.

Blood tests:
1. LDL cholesterol = 7.5 mmol/L
2. triglycerides = 5 mmol/L
3. Troponin tests in ED this morning were negative

The patient has been admitted to the medical ward with a medication chart. On it are the patient’s regular medications and Nitrolingual spray 400 micro grams PRN, Frusemide 40mg BD, and clexane 40mg Subcut BD.

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