Topic: Nursing

Order Description
Assignment 2: Written assignment Physical Assessment Step 1: Select a case study from the two options below
Alice Palmer 54 yrs. Ischaemic stroke
Mrs. Alice Palmer is a 54 year old woman who has been admitted to your unit. She had an ischaemic stroke 18 hours ago and has been transferred to the acute stroke unit to receive ongoing assessment and rehabilitation. The previous nurse hands over to you: HR 89, BP 155/90, left hemiparesis and bilateral visual fields deficit. Glasgow Coma Scale score 15. Mrs. Palmer was also noted to have some difficulty with remembering recent information but can recall with some prompting. You introduce yourself to Mrs. Palmer and her husband. Mrs. Palmer says that she has had hypertension ‘for years’ but that she didn’t really like to take medication. You will need to complete the admission assessment(s) for Mrs. Palmer
Len Thompson 49 yrs. Acute abdomen
Mr. Len Thompson is a 49 year old man who has had Crohn’s disease for 12 years. He presents following two days of abdominal pain with frequent bouts of watery diarrhoea. The previous nurse hands over to you: HR 120, BP 100/45, Temperature 36.9, severe abdominal pain with the last episode of diarrhoea being around 2 hours ago. The nurse also states that he is pale with dry mucous membranes, and that he is requesting a drink of water. Len’s 12 year daughter is with him. You are to complete the admission assessment for Mr. Thompson.
NRSG125Assignment 2
Step 2: Utilising elements of Levett-Jones (2013) Clinical Reasoning Cycle below, write a 1500 word essay, incorporating the following the information.
I. Consider the person’s situation
Identify and discuss the key elements of the demographic data recorded in your chosen scenario
II. Collect cues and information:
Review current and handover information.
Describe what additional information you may need
III. Process information:
Interpret what you currently know about presenting problem – what are the expected assessment parameters for this person’s situation?
IV. Identify problems/issues
Describe what focused health assessment/s you think you would need to use and why
Describe how your chosen person’s findings differ from normal expectations
V. Detail the assessment
Detail how you are going to undertake the health assessment – ensuring you describe the technique and person considerations.
Academic Skills Unit. (2013). ACU study guide: Skills for success (3rd ed.). Fitzroy: Australian Catholic University. Levett-Jones, T. & Hoffman, K. (2013). Clinical reasoning: What it is and why it matters. In: T. Levett-Jones (Ed.). Clinical Reasoning: Learning to think like a nurse. French’s Forest: Pearson.
NRSG125Assignment 2
Frequently asked questions
Can I use the clinical reasoning cycle elements as headings in my paper?
You may use the elements provided during your draft to organise your thoughts and writing. You need to submit an essay without sub-headings, and ensure paragraphs are linked and ideas flow in a logical sequence.
How many references do I need?
You need to use at minimum 8-10 references. You should aim for quality sources – peer reviewed articles and textbooks. All ideas that are not your own need to be referenced. Consumer or hospital websites are NOT authoritative resources, and should not be used. Please refer to LEO for further information on the use of consumer websites.
Do references get included in the word count?
In-text citations are included in your word count, but not the reference list.
What if I go over the word count?
There is a 10% allowance under or over 1500 words. After this amount, the marker will not mark content beyond 1650 words.
How should I present my paper?
Please refer to the NRSG125 style guide post in LEO under ‘My Assessments.’
You essay should also include an introduction and conclusion, please see the ACU study guide for further clarification of essay structure.
Where can I get help with APA style and referencing?
ACU study guide
ACU student website: https://students.acu.edu.au/office_of_student_success/academic_skills_un it_asu
APA blog https://blog.apastyle.org/

Nursing

QUESTION 1:Georgina Graves is a 42-year-old female who presents to the provider’s office with fatigue.

Subjective Data
•PMH: none, (except gynecological issues)
•Significant family history of heart disease
•Fatigue started about 2 months ago, getting worse
•Relieved with rest, exacerbated with activity
•Denies chest pain
•C/O shortness of breath on exertion
•Smoker 1 PPD

Objective Data
•Vital signs: T 37 P 100 R 18 BP 110/54
•Lungs: clear
•O2 Sat = 94%
•Skin = cool to touch
•CV = heart rate regular, positive peripheral pulses, ECG = intermittent complete left bundle branch block (New Finding)
•Edema

Medications: Premarin 0.3 mg po/day
1.What other questions should the nurse ask about the fatigue?
2.What other assessments would be necessary for this patient?
3.What are some causes of fatigue?
4.What should be included in the plan of care?
5.Based on the readings, what is the most likely cause of fatigue for this patient?
QUESTION 2:
Nelson Carson is a 62-year-old man who presents to his private practitioner’s office with a hacking, raspy cough.

Subjective Data
•PMH: HTN, CAD
•Cough is productive, bringing up green, thick phlegm
•Runny nose, sore throat
•No history of smoking or seasonal allergies
•Complains of fatigue

Objective Data
•Vital signs: T 37 P 72 R 14 BP 134/64
•Lungs: + Rhonchi bilateral upper lobes, wheezes
•O2 Sat = 98%

Medications: Metoprolol 25 mg per day, ASA 325 mg/daily
1.What other questions should the nurse ask about the cough?
2.What nursing diagnoses can be derived from the data?
3.What should be included in the plan of care?
4.What risk factors are associated with this age group?
5.Based on the readings, what is the most likely cause of cough for this patient?

Nursing

QUESTION 1:Georgina Graves is a 42-year-old female who presents to the provider’s office with fatigue.

Subjective Data
•PMH: none, (except gynecological issues)
•Significant family history of heart disease
•Fatigue started about 2 months ago, getting worse
•Relieved with rest, exacerbated with activity
•Denies chest pain
•C/O shortness of breath on exertion
•Smoker 1 PPD

Objective Data
•Vital signs: T 37 P 100 R 18 BP 110/54
•Lungs: clear
•O2 Sat = 94%
•Skin = cool to touch
•CV = heart rate regular, positive peripheral pulses, ECG = intermittent complete left bundle branch block (New Finding)
•Edema

Medications: Premarin 0.3 mg po/day
1.What other questions should the nurse ask about the fatigue?
2.What other assessments would be necessary for this patient?
3.What are some causes of fatigue?
4.What should be included in the plan of care?
5.Based on the readings, what is the most likely cause of fatigue for this patient?
QUESTION 2:
Nelson Carson is a 62-year-old man who presents to his private practitioner’s office with a hacking, raspy cough.

Subjective Data
•PMH: HTN, CAD
•Cough is productive, bringing up green, thick phlegm
•Runny nose, sore throat
•No history of smoking or seasonal allergies
•Complains of fatigue

Objective Data
•Vital signs: T 37 P 72 R 14 BP 134/64
•Lungs: + Rhonchi bilateral upper lobes, wheezes
•O2 Sat = 98%

Medications: Metoprolol 25 mg per day, ASA 325 mg/daily
1.What other questions should the nurse ask about the cough?
2.What nursing diagnoses can be derived from the data?
3.What should be included in the plan of care?
4.What risk factors are associated with this age group?
5.Based on the readings, what is the most likely cause of cough for this patient?