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NURS3046 Nursing Project

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NURBN 3030 Nursing Practice 6: Management of Deteriorating Patient

Question

Answered

Question:

Purpose: 

This assessment task is designed to develop the student’s ability to integrate theory into practical clinical knowledge using a patient case scenario. This task is intended to encourage students to practise writing and presenting researched material in a logical and concise manner that is academically rigorous. Therefore, each student is to demonstrate critical thinking, development of argument, discerning use of resources and the application of the principles of academic writing. Referencing, spelling and grammar, and overall presentation will also be assessed.

Case Study:

You are a Graduate Nurse commencing your afternoon shift on a surgical ward. You have arrived in recovery to collect your patient, Mr Yousef Kahil.

  • 72-year-old Male who has had a Hartmann’s procedure resulting in the formation of a colostomy.
  • Past Medical History: Newly diagnosed bowel cancer, hypertension, hypercholesterolemia, current smoker (20 pack per day), Chronic Obstructive Pulmonary Disease.
  • Nil Known Allergies.

1: Describe the Hartmann’s Procedure including definition, indications, and complications. Ensure you apply this discussion to Mr Kahil.

You are handed over that the procedure went well with no complications. Mr Kahil was stable throughout the recovery period. His observations pretransfer to the ward are:

  • Alert and coherent
  • Temperature: 35.9 and warm on palpation
  • Pulse: 72 bpm and regular
  • Blood Pressure: 110/72mmHg (MAP 65mmHg)
  • Respiration: 16 bpm
  • SpO2: 99% on 1lt intranasal delivery
  • Pain: 1/10 (localised to abdomen, dull in characteristics)

Mr Kahil is transported back to your ward for ongoing management. When you arrive on the ward you notice that Mr Kahil appears to be diaphoretic and cool to touch. You immediately complete a set of vital signs:

  • Drowsy
  • Temperature: 35.1 and cool on palpation
  • Pulse: 102 bpm and regular
  • Blood Pressure: 91/58mmHg (MAP 60mmHg)
  • Respiration: 14 bpm
  • SpO2: 92% on 1lt intranasal delivery
  • Pain: 1/10 (localised to abdomen, dull in characteristics)

2: Review the above vital signs of Mr Kahil. Using your knowledge of the common causes of clinical deterioration in the postoperative patient; state which likely reversible cause (one of the 4H’s & 4T’s) Mr Kahil is experiencing and describe its pathophysiological cause resulting in Mr Kahil’s deterioration. Ensure you include a discussion of the pathophysiology of the reversible cause and link to the above vital signs.

3: Discuss THREE specific nursing assessments that would be prioritised for Mr Kahil’s deterioration (excluding vital signs). For EACH nursing assessment, ensure your discussion includes a description of these assessments in the context of Mr Kahil’s condition AND clear rationale as to why these assessments would be priority.

4: Discuss THREE specific nursing interventions that YOU as a Registered Nurse could initiate to manage Mr Kahil’s deterioration. For EACH intervention, ensure your discussion includes link to evidence-based practice AND provides rationale as to how it would improve the physiological outcomes of Mr Kahil’s condition.

Nursing interventions would include nursing activities or actions that the nurse could initiate in response to nursing assessment findings. Note: please be aware of the difference between an assessment and an intervention.

5: Mr Kahil is prescribed a bolus of intravenous isotonic crystalloid fluids. Describe the indication for and physiological effect of administration of bolus fluids. Ensure you link to the pathophysiology occurring in Mr Kahil’s deterioration and how intravenous fluids may assist.

6: Describe THREE nursing evaluations that you would complete in response to the assessments and interventions you have completed. For EACH evaluation, provide a brief rationale as to how these evaluations will assist in preventing the further clinical deterioration of Mr Kahil.

NURBN 3030 Nursing Practice 6: Management of Deteriorating Patient

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Tellus molestie nunc non blandit massa enim nec dui. Tellus molestie nunc non blandit massa enim nec dui. Ac tortor vitae purus faucibus ornare suspendisse sed nisi. Pharetra et ultrices neque ornare aenean euismod. Pretium viverra suspendisse potenti nullam ac tortor vitae. Morbi quis commodo odio aenean sed. At consectetur lorem donec massa sapien faucibus et. Nisi quis eleifend quam adipiscing vitae proin sagittis nisl rhoncus. Duis at tellus at urna condimentum mattis pellentesque. Vivamus at augue eget arcu dictum varius duis at. Justo donec enim diam vulputate ut. Blandit libero volutpat sed cras ornare arcu. Ac felis donec et odio pellentesque diam volutpat commodo. Convallis a cras semper auctor neque. Tempus iaculis urna id volutpat lacus. Tortor consequat id porta nibh.

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Hac habitasse platea dictumst vestibulum rhoncus est pellentesque. Amet dictum sit amet justo donec enim diam vulputate ut. Neque convallis a cras semper auctor neque vitae. Elit at imperdiet dui accumsan. Nisl condimentum id venenatis a condimentum vitae sapien pellentesque. Imperdiet massa tincidunt nunc pulvinar sapien et ligula. Malesuada fames ac turpis egestas maecenas pharetra convallis posuere. Et ultrices neque ornare aenean euismod. Suscipit tellus mauris a diam maecenas sed enim. Potenti nullam ac tortor vitae purus faucibus ornare. Morbi tristique senectus et netus et malesuada. Morbi tristique senectus et netus et malesuada. Tellus pellentesque eu tincidunt tortor aliquam. Sit amet purus gravida quis blandit. Nec feugiat in fermentum posuere urna. Vel orci porta non pulvinar neque laoreet suspendisse interdum. Ultricies tristique nulla aliquet enim tortor at auctor urna. Orci sagittis eu volutpat odio facilisis mauris sit amet.

Tellus molestie nunc non blandit massa enim nec dui. Tellus molestie nunc non blandit massa enim nec dui. Ac tortor vitae purus faucibus ornare suspendisse sed nisi. Pharetra et ultrices neque ornare aenean euismod. Pretium viverra suspendisse potenti nullam ac tortor vitae. Morbi quis commodo odio aenean sed. At consectetur lorem donec massa sapien faucibus et. Nisi quis eleifend quam adipiscing vitae proin sagittis nisl rhoncus. Duis at tellus at urna condimentum mattis pellentesque. Vivamus at augue eget arcu dictum varius duis at. Justo donec enim diam vulputate ut. Blandit libero volutpat sed cras ornare arcu. Ac felis donec et odio pellentesque diam volutpat commodo. Convallis a cras semper auctor neque. Tempus iaculis urna id volutpat lacus. Tortor consequat id porta nibh.

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