$20 Bonus + 25% OFF
Securing Higher Grades Costing Your Pocket? Book Your Assignment at The Lowest Price Now!

NRSG370 Assignment Clinical Integration

tag 2 Downloads9 Pages 2,097 Words tag Add in library Click this icon and make it bookmark in your library to refer it later. GOT IT


Candace Evans is a 42 year woman admitted to the operating theatre at 38 weeks gestation for an elective lower uterine caesarean section (LUCS) under spinal anaesthesia. The patient has been diagnosed with Placenta Previa.

Pre-Operative Nursing Assessment:

  • Current History: Second pregnancy, 38 weeks gestation;
  • Past History: Gestational diabetes with her first pregnancy 5 years ago, which resolved following the birth with no recurrence in this pregnancy, depression, anxiety, post-natal depression.

You are working in the post anaesthetic recovery room (PACU) on a morning shift and will receive Candace following her LUCS. Candace arrives in the PACU, following the uneventful birth of a male infant via LUSC with APGARS of 8 at 1minute and 10 at 5 minutes following birth. Intraoperative blood loss was estimated at 150ml.

PACU Assessment:

  • Dermatome level T3;
  • Pain 0/10;
  • Lower uterine dressing dry and intact;
  • In-dwelling catheter with 100ml of rose coloured urine;
  • Intravenous therapy of Oxytocin in CSL running at 250mL/hour;
  • Vital Signs: HR 88, BP 104/76, SpO297% on RA, Temp 36.9° Celsius.



Nurses with active clinical reasoning have an affirmative influence on patient results; on the contrary, those with destitute clinical reasoning will frequently flop to discover imminent patient worsening.  Faults in decision making and judgment are recognised to version for more than half of unreceptive clinical actions (Schug, Palmer, Scott, Halliwell & Trinca, 2015).  Clinical reasoning is a learning skill requiring active engagement and determination in deliberate practice as well as reflection, specifically on activities designed to advance performance.  This essay will concentrate on the given case study on Candace Evans, a 42 years old woman with an elective lower uterine caesarean section under spinal anesthesia. The paper will then explore through three care priorities identified in Candace’s scenario: her in-dwelling catheter with 100ml of rose coloured urine, vaginal blood loss and the blood clot. The identified three prime priorities will be examined and justified using Levett-Jones clinical reasoning cycle through executed inventions and to assist nurses to attain those objectives which lead to the finest conceivable results of the patients.


Properly managed recovery steps can avert symptoms associated with the caesarian section (Neal et al., 2010). Candace is presented to the recovery room with vaginal blood loss and some clots as well as an in-dwelling catheter with 100ml of rose coloured urine.  The past history of the patient includes gestational diabetes with her first pregnancy five years down the line, which resolved following the birth with no recurrence in this pregnancy, anxiety, depression or post-natal depression. There is clear evidence that Candace suffered from complications as a result of operations. It is normal for women to lose lochia after birth until the wombs renew its lining.  Following Candace’s caesarean operation, she is given intravenous therapy of oxytocin in CSL running at 250m/L/hour. This will encourage the uterus to contract, assisting it to shrink back to its normal size and reduce blood loss (Baaqeel & Baaqeel, 2013). Blood normally flows quickly and uninterrupted through veins. But, sometimes, the clot can form that either reduce the blood flows or stops it completely. A deep vein thrombosis is a blood clot in vein usually pelvis or leg, and its common cause is immobility during surgery (Stephens & Bruessel, 2012).  Candace shows vaginal blood loss and the patients also display vaginal pad soaked with franks blood and some clots.  Therefore, perioperative and recovery nurses can use their critical reasoning capabilities in executing approaches in managing intricate care and take full advantage of the aids for patients by lessening risks elements connected with multifaceted health concerns.

Perioperative caregivers use evidence-based practice to advance the physical wellbeing and uphold the blood count for the Candace by affecting various tactics and setting desired goals (Pant, Fong & Scavone, 2014). For me to realize those goals, I must work closely with her and midwifery for the best promising results.   Patient life can be upgraded by using patient learning after an operation which will enable the patient and midwifery gain more knowledge and skills in her compelling conditions.  The anesthetic may make one feel sick. Thus, a drip going into her veins will make sure enough fluid when she is not able to drink.  While the patient is drinking enough fluid and no longer feels sick, then, the drip will be removed and I will tell her to start eating.  After two to three days, if the patient will have problems with bowel, I can give medicine to open her bowels. It will be helpful for the patient to drink a lot of fluid, eat a high fibre diet such as fruit, wholemeal or granary bread, cereals and vegetables (Torloni et al., 2011). To improve the blood circulation and prevent further blood clots from developing, I will encourage the patients to walk with the compression boots to improve the circulation. However, the first day, I will encourage sit out of bed in her chair, even if it is for short period. I will encourage resting, however, it is crucial to start exercise as soon as possible. As a result of vagina bleeding, I will advise the patient to use sanitary towels instead of tampons as this may increase the risk of infection.  I will discuss with patients and midwifery on the issues she should check after returning home. If the bleeding becomes heavy or once she notices a smelly discharge, she should see the GP for a check.  Therefore, health care providers can offer means related to diet and education on diet regulation and workout. Realistic goals can be established for vaginal bleeding.  Exercise chart and diet plan could be implemented for the recovery of patients.


It is important to assess the efficacy of the approaches used and to ascertain whether the probable result is realised or not.  For this purposes, will use diverse tools and resources to appraise patient’s improvement.  In Candace’s case, the nurse can use diet controlling plan and discuss it with midwifery and patient herself to see how changing the lifestyle will affect her recovery position. Body mass index is important gears in measuring the body weight before and after recovery to assess the effectiveness of the exercise and diet plan.  Therefore, the above evaluation will back Candace to preserve the dynamic lifestyle and support her to use the idea in further managing of operation in future.

As earlier discussed, Candace was also diagnosed with the vaginal bleeding as a result of the operation.  Literature suggests that it is normal to lose lochia. However following the caesarian one will be given a drug which is a synthetic version of the naturally occurring oxytocin (Butwick, Coleman, Cohen, Riley & Carvalho, 2010). Therefore, lowering the blood bleeding is a prime priority which ultimately improves the health of patient for quick recovery.   Reduced blood bleeding will assist the patient to do a light workout and allow her to execute daily doings with a positive influence on her self-esteem and avert her historical postnatal depression and anxiety symptoms.

For the reduction in vaginal bleeding, nurses should implement an invention based on evidence-based practice.  Nurses can use pharmacological and non-pharmacological invention after putting into deliberation the patient needs and maximization of benefit.  Non-pharmacology treatment involves using the sanitary towels.  Also, management of hemorrhage should be a multi-disciplinary effort. Major obstetric hemorrhage can become fatal very quickly and experienced clinician should be involved as soon as possible (Lie & Mok, 2017).  To prevent the primary major of PPH, involving supportive therapy with airway control and supplemental oxygen is important. Non-pharmacological may include mechanical maneuvers to raise the bimanual compression, uterine tone and artery ligation. Pharmacological means predominantly uterotonic drugs and correction of coagulation-deficient (Rosales-Ortiz et al., 2014).

The assessment of the used invention is important to recognize the effectiveness of the applied approaches in the controlling of the complex state.  The nurses can use a pulse oximeter to measure the oxygen saturation in the Candace body.  The data will enable the nurses to identify the effectiveness of the breathing exercise (Mushambi et al., 2015).

Another priority is the rose colour urine in the patient, likely as a cause of the presence of the haemoglobin in the urine. A simple examination can show if the rose colour is from hematuria, the medical word for the blood in urine.  “Urine can also turn rose if it contains myoglobin, an oxygen-binding protein in muscle cells that is similar to the hemoglobin found in the red blood cells” (Torloni et al., 2011).  Due to the interference with the urinary system, it can allow blood get into the urine.  Therefore, one will be encouraged to drink plenty of fluids which will dilute out the blood so that it does not clot off the catheter and which will encourage the cessation of bleeding (Toth, 2014).


Personal reflection

The life experience in the recovery room is crucial to my future career, as I was able to acknowledge that potentials according to the nurses, comprises of recognising the relatives as a resource in the practical nutritional care offered. Perceiving health education as prime from nutritional problems and physical inactivity viewpoint was identified as a potential for the healthcare to offer good nutrition and physical activity.  I now understand that relatives or midwifery are always the ones who influence the patients much as they spend quite long with them; so it is important to involve them in any decision making.  I also came to realise that my work is also influenced by the style and manner of communication with other healthcare providers. It is affected if the patient would not cooperate and where there were difficulties in understanding each other.  I now understand recovery is a time-consuming process, which can leave patients feeling tired, emotionally tearful or low. This frequently happens during the early days and is a normal reaction. Patient’s body needs time and energy to build new cells and repair itself. I think I did a recommendable job but next time I should be prepared for the big task as the complex scenario can happen in future.



Vaginal bleeding, clotting and rose coloured urine are three priorities to sustain   Candace’s multifaceted care help.  Evidence-based practice permits the nurses to reason critically by pinpointing the concerns and use of intervention according to the best possible outcomes for the patient. Critically analysing the patient situation, an involvement of patient and midwifery in setting up the goals and objective is of the essence for the victory of the implemented strategies. Observing ethical in the service provider is also vital. Both verbal and written information was given about the voluntary participation. The patient was also guaranteed confidentiality (Broaddus & Chandrasekhar, 2011). For instance, I was able to pull the curtains to inspect for the vaginal blood loss.  The above illustrates ensuring the self-esteem of a patient is upheld as well as considering the privacy of the patient is intact. Finally, evaluation and personal reflection are essential to decide the success of the intervention and let the healthcare provider use various treatment options for the best outcomes. Thus, by using the critical responsibilities leant, health caregivers can give the best care to Candice.



Baaqeel, H., & Baaqeel, R. (2013). Timing of administration of prophylactic antibiotics for caesarean section: a systematic review and meta?analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 120(6), 661-669.

Broaddus, B. M., & Chandrasekhar, S. (2011). Informed consent in obstetric anesthesia. Anesthesia & Analgesia, 112(4), 912-915.

Butwick, A. J., Coleman, L., Cohen, S. E., Riley, E. T., & Carvalho, B. (2010). Minimum effective bolus dose of oxytocin during elective Caesarean delivery. British journal of anaesthesia, 104(3), 338-343.

Lie, S. A., & Mok, M. U. S. (2017). Peri-operative management of caesarean section for the occasional obstetric anaesthetist–an aide memoire. Proceedings of Singapore Healthcare, 26(3), 180-188.

Mushambi, M. C., Kinsella, S. M., Popat, M., Swales, H., Ramaswamy, K. K., Winton, A. L., & Quinn, A. C. (2015). Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia, 70(11), 1286-1306.

Neal, J. M., Bernards, C. M., Butterworth IV, J. F., Di Gregorio, G., Drasner, K., Hejtmanek, M. R., ... & Weinberg, G. L. (2010). ASRA practice advisory on local anesthetic systemic toxicity. Regional anesthesia and pain medicine, 35(2), 152-161.

Pant, M., Fong, R., & Scavone, B. (2014). Prevention of peri-induction hypertension in preeclamptic patients: a focused review. Anesthesia & Analgesia, 119(6), 1350-1356.

Rosales-Ortiz, S., Aguado, R. P., Hernandez, R. S., Castorena, M., Cristobal, F. L., González, M. C., ... & Coomarasamy, A. (2014). Carbetocin versus oxytocin for prevention of postpartum haemorrhage: a randomised controlled trial. The Lancet, 383, S51.

Schug, S. A., Palmer, G. M., Scott, D. A., Halliwell, R., & Trinca, J. (2015). Acute pain management: scientific evidence. Acute Pain Management: Scientific Evidence, lxiv.pp. 647.

Stephens, L. C., & Bruessel, T. (2012). Systematic review of oxytocin dosing at caesarean section. Anaesthesia and intensive care, 40(2), 247-252

Torloni, M. R., Betran, A. P., Souza, J. P., Widmer, M., Allen, T., Gulmezoglu, M., & Merialdi, M. (2011). Classifications for cesarean section: a systematic review. PloS one, 6(1), e14566.

Toth, C. (2014). Pregabalin: latest safety evidence and clinical implications for the management of neuropathic pain. Therapeutic Advances in Drug Safety, 5(1), 38-56. doi:10.1177/2042098613505614


Cite This Work

To export a reference to this article please select a referencing stye below:

My Assignment Help. (2020). Assignment Clinical Integration. Retrieved from

"Assignment Clinical Integration." My Assignment Help, 2020,

My Assignment Help (2020) Assignment Clinical Integration [Online]. Available from:
[Accessed 21 February 2020].

My Assignment Help. 'Assignment Clinical Integration' (My Assignment Help, 2020) <> accessed 21 February 2020.

My Assignment Help. Assignment Clinical Integration [Internet]. My Assignment Help. 2020 [cited 21 February 2020]. Available from:

Get a list of interesting, informative speech topics from Here, we have 5000+ high-qualified experts, who will provide you with a list of intriguing topics for your next assignment. If you are willing to write your essay in the proper essay format, you can again rely on our team of an experienced writer. We never back down when someone asks us to “Write an essay for me.”

Latest Nursing Samples

CNA576 Self Management In Renal Nursing 4

Download : 0 | Pages : 6

Answer: Introduction: Every healthcare professional have the duty to encourage self-management to every patients suffering from chronic disorders. Self-management in the present generations should go beyond the traditional knowledge-based patient education for including processes that help in developing the patient problem solving skills as well as to improve self-efficacy. It should also help in supporting of aplication of knowledge in the r...

Read More arrow

NUR844 Clinical Care And Treatment Issues In HIV

Download : 0 | Pages : 11
  • Course Code: NUR 844
  • University: Duke University
  • Country: United Kingdom

Answer: Human immune-deficiency virus can be defined as the transmissible organism that participates in infecting the different human bodies through the support from the T-helper cell. The infection is mainly seen to lead a progressive decline in the immune function and subsequently leads to the situation of a state of immune compromise (Boyer et al., 2017). Mainly because of the compromised immune system, individuals who are infected with the...

Read More arrow Tags: Australia Footscray Management information management and control University of Sydney 

NURS3002 Supplementary Assessment System

Download : 0 | Pages : 12

Answer: Part A Information processing theory The information processing theory reflects that the human mind acts like an information processor in comparison to the notions of behaviourists to the people merely respond to the stimuli. The information processing model focuses on the information that is expanded through various ways (Butler, Guiso and Jappelli 2014). This in turn is involved in affecting the ability of the individuals to a...

Read More arrow

NURS3016: Professional Practice Experience

Download : 0 | Pages : 15
  • Course Code: NURS3016
  • University: Sydney University
  • Country: Australia

Answer: Introduction: Medical-surgical ward has emerged out as one of the most important ward in the healthcare units in the present generation. The main scope for the nursing service in this ward is to provide total care for both the medical as well as the surgical adult patients (Arnold & Boggs, 2015). The daily comprehensive interdisciplinary healthcare team mainly provides the service in this setting. This team remains dedicated exten...

Read More arrow

HNB3209-Prevalence Of Annual Influenza Vaccination

Download : 0 | Pages : 12
  • Course Code: HNB3209
  • University: Victoria University
  • Country: Australia

Answer: Annual Influenza Vaccination Annual influenza vaccination in Australia has been a recommended practice since 1999 specifically for the old aged individuals of sixty-five years and above. Statistics reveal that the Commonwealth government has offered to give a free vaccine to the mentioned group which is not funded publicly (Demicheli, 2018). However, an exemption has always been made to individuals who are vulnerable to severe influen...

Read More arrow Tags: Australia Arlington Management University of New South Wales 

Save Time & improve Grades

Just share your requirements and get customized solutions on time.

We will use e-mail only for:

arrow Communication regarding your orders

arrow To send you invoices, and other billing info

arrow To provide you with information of offers and other benefits




Overall Rating



Our Amazing Features


On Time Delivery

Our writers make sure that all orders are submitted, prior to the deadline.


Plagiarism Free Work

Using reliable plagiarism detection software, only provide customized 100 percent original papers.


24 X 7 Live Help

Feel free to contact our assignment writing services any time via phone, email or live chat.


Services For All Subjects

Our writers can provide you professional writing assistance on any subject at any level.


Best Price Guarantee

Our best price guarantee ensures that the features we offer cannot be matched by any of the competitors.

Our Experts

Assignment writing guide
student rating student rating student rating student rating student rating 5/5

416 Order Completed

95% Response Time

Tyler Moore

MBA in Accounting

Washington, United States

Hire Me
Assignment writing guide
student rating student rating student rating student rating student rating 5/5

755 Order Completed

95% Response Time

Douglas Cowley

Masters in Finance with Specialization in Audit

Wellington, New Zealand

Hire Me
Assignment writing guide
student rating student rating student rating student rating student rating 5/5

134 Order Completed

95% Response Time

Thomas Nelson

MS in Information Systems Technology with Specialization in Database Administration

New Jersey, United States

Hire Me
Assignment writing guide
student rating student rating student rating student rating student rating 5/5

230 Order Completed

97% Response Time

Liya Han

Master Of Science in Geotechnical Engineering (MSc Geotec)

Singapore, Singapore

Hire Me

FREE Tools


Plagiarism Checker

Get all your documents checked for plagiarism or duplicacy with us.


Essay Typer

Get different kinds of essays typed in minutes with clicks.


GPA Calculator

Calculate your semester grades and cumulative GPa with our GPA Calculator.


Chemical Equation Balancer

Balance any chemical equation in minutes just by entering the formula.


Word Counter & Page Calculator

Calculate the number of words and number of pages of all your academic documents.

Refer Just 5 Friends to Earn More than $2000

Check your estimated earning as per your ability




Your Approx Earning

Live Review

Our Mission Client Satisfaction

A large proportion of this assignment has been copied from other sources, 34% Turnitin score. Although you use quotation marks to identify this in places you are not referencing correctly. You should only quote direct from the source if you are using...


User Id: 361245 - 20 Feb 2020


student rating student rating student rating student rating student rating

Thank you for your support. Work is well written all learning outcomes achieved.


User Id: 368401 - 20 Feb 2020


student rating student rating student rating student rating student rating

Because its not done properly so i am working on it byself. Some of part not explained verg well


User Id: 367680 - 20 Feb 2020


student rating student rating student rating student rating student rating

very very good outline, helped me to have a clear idea of what i need to do on my first essay ever.


User Id: 373468 - 20 Feb 2020


student rating student rating student rating student rating student rating
callback request mobile
Have any Query?