Medical Surgical Nursing

post has three assignments

Information on this document is to be read in conjunction with information on the NUR250 Learnline Assessments pages.
Before you start, a reminder to

NUR250 Assessment 1
Assessment 1 is to be prepared and submitted following the guidelines
below.
Marks are allocated for following presentation guidelines and attention to academic integrity and literacy
requirements. See the Assessment 1 marking criteria for full details.
Academic Literacy
Assessment 1 is to be submitted and presented:
? On the Assessment 1 template located in the Assessment 1 folder on NUR250
Learnline
? As a computer generated document in Word compatible format.
? Contents page, title page, introduction and conclusion are NOT required
? 1.5 line spaced in either Arial font size 11 or Times New Roman or Calibri font size 11
or 12
? In clear, coherent Australian English that demonstrates progression towards the
standard for written communication for professional nursing practice in Australia
? Using appropriate professional terminology
? With no acronyms, abbreviations and/or nursing jargon
? Unless otherwise indicated, in grammatically correct sentences and topic paragraphs
? Referencing is required when and where appropriate. (See academic integrity
information below)
? No more than 10% over or under the stated word count
o Note: Word count is assessed from the first word under Task 1 heading.
Headings, any task information copied in and in-text citations are included in
the word count
? Use of trade names is not acceptable. Only generic terms or names are to be used
when referring to specific medications or other prescribed treatments or resources
that may be used in nursing practice
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
3
Academic Integrity: Use of current, reliable evidence for practice
Marks are allocated for quality of sources, use of CDU APA format and your ability to paraphrase information
Although not always a requirement of CDU APA, where there is no DOI for the article, students are
requested to include an active URL in your reference list for this assignment and to ensure all URLs
are active. Do not remove the hyperlinks on URLs. Markers must be able to access ALL of you
sources
? Resources for NUR250 assignments should be from quality, reliable
and reputable nursing journals. This is where you will find information about the
nursing management of patient/health problems. Remember that you will have to apply
information from other countries to the Australian health and nursing context.
? In some items, it may be appropriate to use articles from other journals. If you locate what
you think is a relevant article from a non-nursing journal, carefully evaluate the article to
ensure it is relevant to nursing, and/or that the information is relevant to the role and scope
of practice of the RN in Australia and/or to humans.
? All resources must be dated between 2009 and 2016
? There must be at least 12 peer-reviewed journal articles cited in your
assignment. Articles reporting original research, formal literature and/or systematic
reviews are the preferred resources.
? Only one textbook can be cited as a reference in the assignment and it
must be a current edition. This includes any books from the CDU Library eBook collection. If
you must use a textbook, one of the set texts is the preferred reference.
? Relevant documents from reputable, reliable, professional websites may be used where it is
appropriate to do so.
? All resources cited in your assignment must have complete and correct details in the
reference list, including either a DOI or an active URL
Resources that are NOT appropriate
The following are NOT appropriate resources as they cannot be considered reliable
sources of information:
? Textbooks for lower level nursing courses. For example, any edition of Tabbner’s Nursing
Care (Funnell and/or Koutoukidis, et al) does not have the depth or breadth of information
required by a RN.
? Dictionaries
? Journal abstracts and journal articles that are not in English
? Journal articles that cannot be accessed via CDU databases or freely online
? Websites such as Wikipedia, myDr, RNCentral, Scribd, and other blog sites
? Information such as clinical guidelines from organisational intranet sites or other sites that
require registration or log in to access material. This is not publicly available information.
? Consumer websites such as the Better Health Channel or consumer information from
government departments or agencies
? Preview copies of books from online retailers
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
4
Assessment 1: Nursing care of a person requiring surgery
Source: Flickr
Meet Gill
You will be caring for her today
Shift handover:
Gill is a 63 year old female with osteoarthritis in both hips. She was admitted this morning
for an elective total hip replacement (total hip arthroplasty) of her left hip.
Gill has a past history of bilateral hip pain and severe pain in the groin, lateral hips and
buttocks. X-rays show bone spurring and severe joint space narrowing in both hips
consistent with advanced osteoarthritis. Conservative management has not helped her
symptoms and she currently ambulates with a single prong walking stick.
Gill is currently nil by mouth and has intravenous fluids running at maintenance. Her
current medications include regular paracetamol, diclofenalac, and prn oxycodone. Medical
staff have also prescribed glucosamine and chondroitin as Gill takes these regularly at home.
Prophylactic intravenous antibiotics commenced this morning and are to be continued for
24 hours post operatively. Subcutaneous enoxaparin is to be commenced 4 hours after
return to ward if observations and recovery from anaesthesia and surgery are satisfactory.
Gill has a long history of smoking but stopped recently on medical advice in preparation for
surgery. She has no other significant medical history and, until recently, has been actively
involved in part time work, walking, gardening, and community organizations.
Gill lives alone in a small unit that she owns. Her husband passed away several years ago
and she has an adult daughter living overseas and a son and his family living interstate.
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
5
Assessment 1 Tasks:
Based on the handover you received at the beginning of your shift today, other information included
below and current reliable evidence for practice, address the following 5 tasks.
Do not make up or assume information in relation to or about Gill, the photo is not an
indication of her age or appearance. Only use what you know from the information you received
today.
Note:
Students are expected to demonstrate person-centred care and that they have read beyond the set
texts to prepare their responses and can apply and integrate knowledge to practice.
Reliance on text books alone is no guarantee that your information is current and reliable evidence
for practice. However, set texts are a good place to start to identify key points and to develop
search strategies to locate appropriate journal articles.
Task 1:
Patient teaching is a key nursing responsibility when preparing a person for surgery. You recognise
that two (2) important areas that you need to teach Gill about are post-operative breathing
exercises and movement restrictions.
In grammatically correct sentences and topic paragraphs,
? Identify the specific information you will need to tell Gill today about the two (2) areas
above before she goes to theatre
AND
? Explain
o Why these two (2) areas are an important aspects of Gill’s care
o How you will ensure that Gill knows and understand what she needs to do after her
surgery
(300 words, 5 marks)
Task 2:
While Gill is in theatre, you start to plan the care she will require on her return. You recognise that
two (2) priority nursing problems will be pain and restricted mobility.
In grammatically correct sentences and topic paragraphs,
? Explain
o Why these two (2) nursing problems are a priority in Gill’s care
AND
? Identify how you will position Gill in bed
? Explain why it is important that Gill is nursed in this position
(250 words, 5 marks)
Task 3
Two important aspects of medication management by registered nurses is for the nurse to
understand why a patient has been prescribed specific medications and how to monitor the patient
to ensure they are responding to prescribed medications as they should.
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
6
In grammatically correct sentences and topic paragraphs and using current, reliable evidence for
practice,
? Briefly explain why Gill has been prescribed:
o Diclofenalac orally
o Combination chondroitin /glucosamine orally
o Subcutaneous enoxaparin
AND
? Identify and explain
o The nursing responsibilities associated with administering the 3 medications above
o How you will monitor Gill to ensure she is responding appropriately to these 3
medications you will be administering
(400 words, 10 marks)
Task 4:
While you are waiting for Gill to return, you recognise that there are a number of nursing problems
that will be part of Gill’s post-operative care plan. You have already discussed several in Tasks 1 and
2.
Based solely on the handover you have received complete the nursing care plan template provided
for Task 4.
? Identify the nursing problems you will include in Gill’s post-operative care.
o Do not include any nursing problems mentioned or discussed in Tasks 1 and 2
o Nursing problems must reflect physical, psychosocial and functional aspects of care
For each nursing problem you add to Gill’s care plan, identify:
? What it is related to
? Goal of care
? Nursing interventions or actions
? Rationales for interventions
? Indicators your plan is working
(800 words, 30 marks)
Task 5:
An important legal requirement of nursing practice is to effectively and succinctly communicate
relevant information, actions and outcomes related to patient care and provide an accurate
reflection of the health status of the patient, their responses to care and the patient’s perspective.
It is now Day 5 post-operation and the Orthopaedic Team have decided that Gill is ready to be
transferred to a rehabilitation facility for ongoing treatment and therapy to assist her to reach
optimum function and mobility.
Using the ISBAR format, the handover you initially received and the additional information below:
? Write a handover for the rehabilitation service that clearly and succinctly outlines the
important information other health professionals, including other nurses, need to know
about Gill
Additional information you need to know for Task 5 is on next page
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
7
During the past 5 days
? Gill recovered well from surgery with no complications
? With physiotherapy assistance Gill has been mobilising since post-operative Day 2
? Gill is not yet weight bearing on left leg
? Observations stable and within normal parameters
? Wound healing well, dressed daily with a non-adherent dressing and sutures to remain until
day 14 post-operation
? Medications continue as prescribed
? Indwelling catheter removed Day 3 post operation
During your shift today the following has occurred:
? Gill has declined the prescribed subcutaneous enoxaprin due to extensive bruising on
her abdomen
? You have assisted her to transfer onto a commode chair to shower and to sit out of bed
? Gill has been reviewed by the physiotherapist and assisted to mobilise with a forearm
support frame.
? Gill regularly complains of pain but is declining oxycodone. She states it is making her
drowsy and nauseated
? Towards the end of your shift Gill reports moderate pain and some swelling in her left
lower leg
? Gill’s heart rate and blood pressure are elevated above her normal values
Your handover must:
? Demonstrate person-centred care
? Address the physical, functional and psychosocial aspects of care and reflect any changes
you have made to Gill’s care plan
? Adhere to the legal and professional standards for documentation
? Be in appropriate professional language
? NO abbreviations or nursing jargon
(250 words, 5 marks)
Before you submit
? Check you have followed the presentation guidelines for Assessment 1
? Ensure the academic integrity of your work

2: Cellulitis

Presentation must include:

1) Three learning objectives that must be clearly written and presented
2) A complete SOAP on the approved template
3) An extended SOAP note
4) At least five test questions (such as multiple choice and/or matching) designed to asses mastery of the learning
objectives
5) A minimum of five scholarly resources

Assignment Grading Criteria:
Identified a minimum of three learning objectives and five test questions. Learning objectives are written in a clear and
concise manner. 5

Identified a diagnosis that has been covered in course materials up to this week and created a completed extended SOAP
note and evaluation following template. Presented pathophysiology of the disease process contributing to this patient’s
diagnoses. 15

Proposed and discussed a treatment plan, education plan, and follow-up plan based on clinical guidelines and current
literature. Identified and described research material to support the diagnosis and plan. Described best practices for
optimal outcomes. 10

Provided a critical reflection of interaction and investigation. Evaluated the patient encounter and finished with
concluding remarks that highlighted the learning objectives. 5
Included a minimum of five scholarly resources with maximum of one course text—no secondary sources. Included clinical
guidelines and literature that provided the evidence for the diagnosis, therapeutic plan and education. References followed
APA guidelines. 5
Facilitated a discussion relevant to the presentation topic. 10
Total: 50

3:Gastrointestinal disorders

•Assessment, diagnostic testing, and management of diarrhea and vomiting in a pediatric patient.
•Assessment and evaluation of abdominal pain in pediatric patients.
•Assessment and evaluation of dysuria, hematuria, and proteinuria in the pediatric population.

Respond to the following questions:
•Which essential questions will you ask a pediatric patient or their caregiver when the presenting complaint is bloody
diarrhea? Will these questions vary depending upon the child’s age? Why or why not?
•How do the common causes of vomiting differ in infants, children, and adolescents? What clinical or historical findings
will indicate the need for diagnostic studies and why? Which diagnostic studies will you initially order and why?
•What are the various ways in which UTIs manifest in pediatric patients? How are UTIs managed differently, depending on
the age of the patients? Which diagnostic studies would you recommend considering the age of a patient and why? When
would you recommend prophylactic antibiotics to pediatric patients and why?

Cellulitis