HNN114 Health Case Study Assignment 2
1500 words
Unit weight 40%
Purpose of assessment task :
The purpose of this assessment task is to provide you with the opportunity to engage with key knowledge and skills drawn from each of the five Unit Learning Outcomes (ULOs) paying particular attention to ULO one, two and three. This will allow you to demonstrate your ability to use this knowledge to organise and explain assessment findings, using principles of anatomy, physiology and pathophysiology and health assessment frameworks. Completing this task will assist you to engage with, and to demonstrate attainment of, key knowledge and skills.
HNN114 Health Case Study Assignment 2
Topic background:
Health assessment is a foundational skill for nurses in all contexts of care. Assessment informs identification of patient problems in relation to risk, symptoms and patient function. Appropriate use of assessment data will assist students to further develop clinical decision making skills foundational to the provision of quality patient care. In your role as a student nurse, you will be asked to undertake elements of health assessments in a range of settings during your clinical placements
HNN114 Health Case Study Assignment 2
Assignment Question / Task Description:
You are required to answer 5 questions that are presented as part of an ongoing case study. Each question draws on one of the first 5 weeks of content in this unit.
Week One – Focus: Abdominal Assessment
Shift to shift Handover
Introduction – Kaylene is a 64-year-old female admitted under Dr. XXX
Situation – Kaylene presented as an inpatient to a surgical ward 2 days ago for a right knee replacement. She has mentioned that she feels bloated with slight abdominal pain/discomfort and reports she has not had her bowels open since admission
Background – Kaylene has a history of hypertension, asthma and osteoporosis. She lives alone with her dog Sam. Nil known allergies. Kaylene receives an annual zoledronic acid infusion for her osteoporosis and she takes irbesartan for blood pressure control. She uses a Seretide inhaler daily and salbutamol PRN to manage her asthma. Appendectomy at 12 years of age.
Assessment –
Vital observations
Respiratory rate – 18 breaths per minute Oxygen saturation – 99% on room air Pulse – 90 bpm, thready and regular Blood pressure – 100/60 mmHg Temperature – 37.5°C Dressing to right knee remains dry and intact. Pain to right knee – 2/10 at rest increasing to 6/10 on ambulation/movement
Recommendations – Maintain comfort with positioning and medications as charted Encourage oral hydration Encourage exercise as tolerated Consider nurse initiated laxatives and report symptoms to surgical team Change diet to high-fibre Maintain use of anti-embolism compression stockings Maintain use of nonslip footwear when ambulating
Kaylene is a 64-year-old widow and a recently retired school teacher. She has a past history of hypertension, osteoporosis and asthma, which is usually well controlled with medication. She is normally active and enjoys swimming to keep fit and is looking forward to being able to take Sam on longer walks following her knee replacement.
Today you are looking after Kaylene, who is two days post-surgery. She is reporting bloating, generalised abdominal pain and mentions she has not used her bowels since the operation. Your facilitator explains that Kaylene may be experiencing constipation.
| ULO2 Relate principles of anatomy, physiology, and pathophysiology to the collection and interpretation of data collected during a nursing health assessment. | Question One You are asked to carry out an abdominal assessment on Kaylene. Describe how you would carry out this assessment, providing rationales based on anatomy and physiology. Outline the sequencing of assessment and expected findings. |
Week Two – Focus: Respiratory Assessment
Shift to shift Handover
| Introduction | Kaylene is a 64-year-old female admitted under Dr. Tracy Taylor |
| Situation | Kaylene presented as an inpatient to the surgical Ward 4 days ago for a right knee replacement. Discharge was delayed due to constipation which is now resolved as a result of the laxatives administered – bowels well open this morning. |
| Background | Kaylene has a history of hypertension, asthma and osteoporosis. She lives alone with her dog Sam. Nil known allergies. Kaylene receives an annual zoledronic acid infusion for her osteoporosis and she takes irbesartan for blood pressure control. She uses a Seretide inhaler daily and salbutamol PRN to manage her asthma. Appendectomy at 12 years of age |
| Assessment | Vital observations Respiratory rate – 20 breaths per minute Oxygen saturation – 95% on room air Pulse – 105 bpm, thready and regular Blood pressure – 105/60 mmHg Temperature – 37.6°C Pain – 1/10 at rest Dressing to right knee remains dry and intact |
| Recommendations | Remove IVC ready for discharge. Change dressing to right knee. Contact her neighbour to arrange transport home once reviewed by surgeon. |
You have arrived for your shift and are looking after Kaylene as part of your patient allocation. A few hours into your shift you notice she has become short of breath (dysphonic), tachypnoeic (RR24) and has an audible respiratory wheeze.
| ULO2 Relate principles of anatomy, physiology, and pathophysiology to the collection and interpretation of data collected during a nursing Health assessment. ULO3 Differentiate normal from abnormal assessment findings. | Question Two Your facilitator explains that Kaylene’s symptoms indicate an asthma attack. They explain that primary assessment findings that support this include: · tachypnoea · tachycardia · use of accessory muscles & tracheal tugging · dyspnoea & unable to speak in sentences · oxygen saturation is below95% Choose one of the above assessment findings and explain the pathophysiological changes that have resulted in this abnormal assessment finding |
HNN114 Health Case Study Assignment 2
Week Three – Focus: Cardiac Assessment
Shift to shift Handover
| Introduction | Kaylene is a 64-year-old female admitted under Dr. Tracy Taylor |
| Situation | Kaylene presented as an inpatient to surgical Ward 5 days ago for a right knee replacement. Discharge has been delayed due to constipation and an asthma attack that are now controlled. |
| Background | Kaylene has a history of hypertension, asthma and osteoporosis. She lives alone with her dog Sam. Nil known allergies. Kaylene receives an annual zoledronic acid infusion for her osteoporosis and she takes irbesartan for blood pressure control. She uses a Seretide inhaler daily and salbutamol PRN to manage her asthma. Appendectomy at 12 years of age. |
| Assessment | Vital Observations Respiratory rate – 16 breaths per minute Oxygen saturation – 96% on room air Pulse – 89 bpm, thready and regular Blood pressure – 105/65 mmHg Temperature – 37.5°C Dressing to right knee remains dry and intact. Pain to right knee – 2/10 at rest increasing to 5/10 on ambulation/movement |
| Recommendations | Prepare for discharge tomorrow assuming Kaylene remains stable. |
You are halfway through your busy AM shift when you undertake a set of vital observations on Kaylene. You discover her blood pressure is 92/55 mmHg and she tells you that she feels a little lightheaded.
| ULO3 Differentiate normal from abnormal assessment findings. UOL5 Perform and document a comprehensive and focused assessment of an individual | Question three Using a symptom assessment framework, state 5 (five) questions you would ask to assess the hypotensive episode. Other than blood pressure, describe 3 (three) specific assessments you would undertake and using anatomy and physiology explain why these assessments are relevant. |
Week Four – Focus: Central Nervous System (CNS)
Shift to shift Handover
| Introduction | Kaylene is a 64-year-old female admitted under Dr. Tracy Taylor |
| Situation | Kaylene presented as an inpatient to surgical Ward 6 days ago for a right knee replacement. Discharge has been delayed due to constipation and an asthma attack that are now controlled. Kaylene also had an episode of chest pain yesterday. Kaylene was diagnosed with angina and was treated successfully with glyceryl trinitrate (GTN). She has had recent episodes of hypotension. Yesterday afternoon Kaylene experienced a transient ischaemic attack (TIA) with slurred speech and left arm deficit/weakness. Symptoms are now resolved. |
| Background | Kaylene has a history of hypertension, asthma and osteoporosis. She lives alone with her dog Sam. Nil known allergies. Kaylene receives an annual zoledronic acid infusion for her osteoporosis and she takes irbesartan for her blood pressure. She uses a Seretide inhaler daily and salbutamol PRN to manage her asthma. Appendectomy at 12 years of age. |
| Assessment | Vital Observations Respiratory rate – 16 breaths per minute Oxygen saturation – 98% on room air Pulse – 86 bpm, weak and regular Blood pressure – 115/70 mmHg Temperature – 37.4°C Dressing to right knee remains dry and intact. Pain to right knee – 2/10 at rest increasing to 4/10 on ambulation/movement |
| Recommendations | Continue to monitor 1/24 vital observations including neurological observations. |
You arrived at clinical placement for an AM shift and Kaylene has been allocated as one of your patients. Your facilitator asks you to assess Kaylene to assist in the planning of her care.
| UOL1 Explain and use frameworks to assist the systematic collection of data required for comprehensive and focused health assessment. | Question four Formulate an assessment for Kaylene using primary/secondary survey approach and explain why this approach may be considered appropriate. |
HNN114 Health Case Study Assignment 2
Week Five – Focus: Musculoskeletal
| Introduction | Kaylene is a 64-year-old female admitted under Dr. Tracy Taylor |
| Situation | Kaylene presented as an inpatient to surgical Ward 7 days ago for a right knee replacement. Discharge has been delayed due to multiple complications. Kaylene was diagnosed with angina and was treated successfully with glyceryl trinitrate (GTN). |
| Background | Kaylene has a history of hypertension, asthma and osteoporosis. She lives alone with her dog Sam. Nil Known allergies. Kaylene receives an annual zoledronic acid infusion for her osteoporosis and she takes irbesartan for her blood pressure. She uses a Seretide inhaler daily and salbutamol PRN to manage her asthma. Appendectomy at 12 years of age. |
| Assessment | Vital Observations Respiratory rate – 14 breaths per minute Oxygen saturation – 99% on room air Pulse – 78 bpm, weak and regular Blood pressure – 110/75 mmHg Temperature – 37.7°C Dressing to right knee remains dry and intact. Pain to right knee – 1/10 at rest increasing to 2/10 on ambulation/movement |
| Recommendations | Arrange for outpatient cardiology review |
You arrived at clinical placement for an AM shift and Kaylene has been allocated as one of your patients. You have been assisting Kaylene with bed exercises as she recovers from her post-operative complications. Today you are required to assess her mobility status and her readiness to ambulate
| UOL1 Explain and use frameworks to assist the systematic collection of data required for comprehensive and focused health assessment. ULO2 Relate principles of anatomy, physiology, and pathophysiology to the collection and interpretation of data collected during a nursing health assessment. ULO3 Differentiate normal from abnormal assessment findings. ULO4 Apply clinical decision making skills to synthesise data and identify patient problems. UOL5 Perform and document a comprehensive and focused assessment of an individual. | Question five Identify the indications for a mobility assessment and the specific mobility assessment tool you would utilise. Explain how you would undertake a mobility assessment on Kaylene, prior to ambulation. |
HNN114 Health Case Study Assignment 2
Instructions for this assessment task:
- Assignment is to be presented with the full text of each of the five questions assubheadings
- High-quality references (unit text, other relevant texts, peer-reviewed journal articles) are to be used in supporting your responses with a focus of quality overquantity
- You should aim to include references that are up-to-date and relevant to the details in the case study andquestions.
- A cover page including:
- Student Name
- Student Number
- Assignment title
- Unit:HNN114
- Unit chair name
- Word count: (your word count – not the wordlimit)
- Writing should be in the thirdperson
- APA 6 referencingrequired
- Do not include an introduction or conclusion
Presentation requirements:
Font:
12-point type size.
Times or Times New Roman.
Spacing:
Double-line spacing (Do not insert extra lines between paragraphs or the references list entries.)
Page numbers
Page numbers to be provided on all pages except front/cover page. Place page number in the top right-hand corner
Margins
2.54 cm at the top, bottom, left-hand, and right-hand sides of the page. Paragraph indents
Indent the first line of each paragraph (using the tab key or paragraph tool). Exceptions: titles and headings
Justification of text
All text needs to be aligned to the left, not justified
Word Count
1500 words (+ or – 10%). Assignments must be no more than 10% of the indicated word count, not including title page, in-text citations, headings and reference lists
HNN114 Health Case Study Assignment 2