Case Study – Assignment 2 NUR20006

Case Study – Assignment 2 NUR20006

2000 words +/- (10%) words included.   Over 2200 words will not be marked.

Assignment Instructions:

  • This assignment must be completed individually.
  • Please consider the suggested word count when responding to each part of the question. Please ensure you include a word count at the end of your assignment.
  • The word count includes quotes and headings. The word count does not include appendices, contents page or reference lists.
  • An introduction and conclusion should be incorporated into your assignment with suggested word count for each only up to 150 words.
  • Please ensure you pay close attention to the mark allocations in the marking rubric for Assignment 2.
  • You will be expected to use evidence-based literature to support your writing including in-text referencing and a complete reference list.
  • Provide justification for all of your discussions using current literature (from the 7 years) from appropriate sources.
  • A minimum of 10 references should be used. If you undertake an appropriate literature search, you will be able to find many more than this.
  • Please utilise the APA (7th) referencing guide for both in-text citations and reference list formatting. 

Submission Instructions:

  • You are required to submit your assignment electronically via Canvas.
  • Please submit only Word Doc format, as Canvas does not accept other document writing platforms.
  • Use 2.5cm margins on each side of the page with double spacing between lines. Font used should be 11 or 12 points Arial or Times New Roman style.
  • Please ensure you include an assignment Download Coversheet.pdf with your submission.
  • An electronic copy of your assignment must be retained by you, and this copy must be available on request if resubmission is required.
  • For assistance with academic writing, referencing, submission, extensions or special consideration please review Part C of your unit guide.
  • The marking rubric can be downloaded here. 

CASE STUDY

Identify

Kasun Perera is a 61-year-old Sri Lankan man who has been living in Australia for 30 years; DOB – 3/1/1962

Situation

Kasun has been admitted to the Surgical ward today with pain in both legs, which increases when walking and a non-healing ulcer on his Left foot. 

Background

Kasun has a long medical history of:

  • AMI, CVA with no residual deficits, HT, and Type 2 Diabetes Mellitus
  • Cigarette smoker for 40 years and requiring oral hypoglycaemic agents for 30 years.

Socially Kasun lives at home with his wife Asheni, who is also a cigarette smoker.  Kasun and Asheni have 3 adult children who do not live at home with their parents.

Assessment

  • CNS – Alert, orientated to time, place and person. PEARL – 2+. Complaining of 7/10 pain in Left foot/leg, that worsens with ambulation.
  • CVS- BP 148/95mmHg; irregular HR 90bpm; Peripheral pulses difficult to palpate – Left leg – femoral and popliteal pulses present, dorsalis pedis absent; right leg pulses all present but weak. Capillary refill> 4 secs to both legs. Left foot – cool, pale and mottled in colour and has reduced sensation. Right foot – cool but warmer than left foot, pale and has reduced sensation.
  • RESP- RR-20b/min; SpO2 95% on Room Air. Auscultation – some scattered expiratory wheezes
  • GIT- BO yesterday; patient denies constipation or diarrhoea.
  • METAB – Temp 36.6oC; BSL – 10.8mmol/L
  • RENAL – Voiding in a bottle; awaiting E &U results
  • INTEG– Left foot -ulcer present 2cms x 2cms with dark eschar covering the wound. Both legs have thin, shiny skin with no hair evident. Nil other wounds/pressure areas evident.
  • MSK- Ambulant with supervision; currently very painful to walk and has intermittent ‘pins and needles’ in feet.
  • Social – wife aware of admission today; will return this evening to visit again.

Recommendations

Kasun is planned to have investigations into the peripheral circulation of both legs by the Vascular surgery team.

Kasun requires referrals to multiple members of the allied health team including the Dietician, Diabetic educator, Physio and OT.

Your assignment will need to include the following information:

  1. An introduction to what you are going to cover in your discussion about Kasun and his care (up to 150 words).
  2. Kasun has just been admitted to the Surgical ward that you are working on, and you have been allocated to care for Kasun on your morning shift. The ISBAR handover given to you by the ED nurse shows some abnormal findings. Please highlight the abnormal findings that you need to investigate when completing your own nursing assessment of Kasun this morning.  Include in your explanation, which two (2) body systems require a focused nursing assessment. Ensure you use appropriate literature to support your assessment priorities (200 – 300 words).
  3. Outline the pathophysiology of why Kasun has been admitted to the hospital related to his recent medical history (300 – 450 words).
  4. Identify and discuss three (3) specific nursing care interventions you will need to undertake for Kasun this morning. Provide rationales for each of your three (3) interventions and how you will evaluate the effectiveness of each intervention (400-550 words).
  5. Identify and discuss one (1) medical intervention that Kasun is likely to undergo to investigate the peripheral circulation in his legs. Provide a rationale for this intervention and potential risks for Kasun undergoing this procedure. (150-200 words)
  6. There is an interprofessional team that works together to care for Kasun that includes physiotherapists, pharmacists, occupational therapists, social workers, diabetic educators, and dieticians. Pick one member of the interprofessional team and discuss their role in helping to optimize Kasun’s care whilst in hospital and preparing for discharge (150 – 200 words).
  7. conclusion summarizing the main points of your assignment (up to 150 words). 
Case Study – Assignment 2 NUR20006

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