Clinical Nursing A: Case Based Written Assessment 2020

Length: 2,000 words
Mark loading: 50%
Essay to be submitted as a word document and submitted through Brightspace as directed.
The assessment applies to the following subject learning outcomes:
Demonstrate an understanding of the pathophysiology and risk factors associated with
problems of oxygenation, perfusion & urinary function.
Assignment instructions:
This case based assignment is related to a medical condition.
Key components of the assignment: Utilising the Clinical Reasoning Cycle:

1. Describe the patient situation.
2. Collect the cues/information: Identify the specific assessment data you would need to gather from a
   patient presenting with this condition. Focus on history, physical examination and investigations . Note
   the results that are not normal.
3. Process information: Discuss the underlying pathophysiology of Pulmonary Embolism and the
   relationship between the disease process & the patient’s signs & symptoms. Include any risk factors
   and/or precipitating causes. The pathophysiology MUST be referenced.
   Using a table (provided)
4. Identify 2 priority Nursing Problems. These must include the related factors & evidence of such.
5. Establish a short & long term goal that is SMART
6. Identify 5 priority nursing interventions supported by referenced evidence based rationales
   (et.al will be accepted in the table) for each intervention.
7. Formulate the expected outcome for your each of your nursing problems.
8. Reflection: Write your reflection on your learning during this assignment & how it enables you to
   enhance your critical thinking. This will not be marked.
9. Reference page: references are required to be no greater than 5 years old for acute care. At least
   10 references need to be cited. Referencing in text is according to APA 6th Ed
   Case Study:
   Banu is a 28-year-old female who presented to the Emergency Department
   with pain in her left calf after tripping over a tree root on her daily run yesterday.
   She did not hit her head. Banu is a fit healthy female. Her only medication is
   the contraceptive pill (Drospirenone & Ethinyl Estradiol 3/.02) which she takes
   daily. Banu lives with her family and has 3 siblings, one older brother, 30 and
   two younger sisters, 26 and 24. She rides to Holmesglen Institute most days
   where she is studying Allied Health. This equates to about 10 km/day. She has
   just returned from a trip to London this week where she visited her aunt and
   uncle. Her father has a history of Hypertension and GORD and her mother has
   a history on TIAs. Both are treated symptomatically. Banu enjoys reading
   books and partying with her friends. She claims she had not been drinking
   when she fell. Her siblings are all well. Banu’s mother is 54 and her father is
10. Both immigrated to Australia from Asia 36 years ago.
    At handover you are informed that Banu’s observations are: T37.3 P. 94 &
    regular BP.120/70 R.18 & O2 sats 98% RA. Pain Score 5/10.
    Banu’s left calf is swollen and painful. The right calf is normal.
    Her peripheral pulses and sensation are equal on both legs. A diagnosis of L)
    DVT is made. Banu is kept overnight for review by the medical team in the
    morning. She has been ordered Morphine 5mg IV for pain as required.
    When you go to the bedside to say good morning, Banu is very distressed.
    T.37.6, P.128 & regular, R.32, BP.140/90,O2 sats 92% RA and is holding her
    chest complaining of pain when she breathes 9/10. She is also a little vague
    as to where she is and is gasping when talking.
    A diagnosis of Pulmonary Embolism is made after a VQ scan. Heparin is
    commenced 5000 units IV stat & 30,000 units in Normal Saline at 42 ml/hour.
    An aPTT is ordered for 6 hours’ time.
    Protamine Sulphate is ordered if required.
    Using the Clinical Reasoning Cycle, formulate a plan of care for Banu.