Posted: March 25th, 2021

Nursing 1 – NUR132 Assignment

College of Health & Medicine School of Nursing
Assignment

Clinical Reasoning Workbook

Foundations of Nursing 1 – NUR132

Bachelor of Nursing

Contents

Introduction. 3

Required Activities. 3

George Esposito Case Study. 4

Question 1. 6

Question 2. 7

Question 3. 9

Question 4. 11

Question 5. 12

Question 6. 13

Question 7. 14

Introduction
This assessment task has a weighting of 35% of your overall unit result.

In the assessment task you will be taking the knowledge and skills gained throughout module 1 and 2 to complete a range of activities.

Required Activities
These activities are:

1) Completion of the Hand hygiene module

2) Completion of the Infection Control module

3) Responses to the provided case study

Hand hygiene module

Your first task is completion of the Hand Hygiene module – this is a mandatory task with a pass/fail grade. A fail grade will result in an overall fail grade (0 NN) for this assessment task.

Infection control module

Your second task is completion of the Infection Control module – this is a mandatory task with a pass/fail grade. A fail grade will result in an overall fail grade (0 NN) for this assessment task.

Clinical Reasoning Case Study

This aspect of the assessment has one case study, shortly you will be introduced to Mr George Esposito. The questions ask you to engage with the clinical reasoning cycle – that is, you will be considering George’s situation, collecting cues and information, processing and identifying problems and reflecting on process and new learning.

Each question has a mark allocation, as indicated after each question.

George Esposito Case Study
George Esposito is a 79-year-old male admitted to a medical ward. George was taken to the emergency department by his daughter following a fall at home. George tells the staff it was “nothing but a bit of a dizzy spell”.

George lives alone and his daughter, Angela describes him as a very private man who prefers his own company. George owns his own small weatherboard home on a small farm. He has tank water only at the property. He has a vegetable garden, three chickens and his Jack Russel dog, Bella. George and Bella are inseparable.

George enjoys watching sport and news programs on television, loves a good strong cup of black tea with three teaspoons of sugar and chocolate biscuits. He likes to get up early and go to bed early. He does not like the recent hot weather.

Angela visits once a week and has been dropping off his meals, but she reports he says that he has not been eating them recently because he is not hungry, and things seem to get stuck in his throat. She notes her father has lost weight in recent months and there has been a significant decrease in his intake. She has been cleaning the bathroom and vacuuming the house when she visits, which her father has never let her do before but now seems happy to let her.

Angela tells you “Dad just seems to have really slowed down – he has always been such an active man, but he is just not himself”.

George has chronic pain from osteoarthritis and suffers from constipation. Hearing loss is also becoming a significant issue for George. He visits his GP once a year for his influenza vaccination, he takes no prescribed medication. His GP has spoken to George about analgesia and options to manage constipation, but he doesn’t want to ‘rattle with all those pills and potions’. He does take castor oil for his constipation and paracetamol and aspirin for his pain, which he buys from the local supermarket on his weekly trip to the shops. George has not visited the dentist for over 25 years.

George is a tall, thin gentleman (185cm and 53kg), he is pale, and his skin is dry, and you note poor skin turgor.

Question 1
Collect cues and information.

When you arrive in George’s hospital room he is sitting on the side of the bed, talking to the cleaner and telling her what has happened. The cleaner responds by stating “Oh, you poor thing, how awful”.

Question 1a. This statement is an example of empathy or sympathy – justify your response.

insert your answer here

(1 mark)

You are admitting George to the medical ward/unit.

Question 1b. How will you ensure George receives person-centred care? Using the cues from the case study, provide 6 (six) specific ways in which you will ensure your care in person-centred.

insert your answer here

(3 marks)

Question 2
Collect cues and information.

You will need to gather new information.

On admission to the ward, you undertake a urinalysis.

Question 2a. List the PPE you will need for this procedure and provide a rationale for your selection.

insert your answer here

(2 marks)

George’s urinalysis results:

Colour Amber and cloudy
Specific gravity 1.040
pH 6
Glucose Nil
Ketones Nil
Blood Trace
Protein Nil
Nitrates Trace
Leukocyte Positive
Bilirubin Negative
Question 2b.

Process information (interpret and predict).

Given the cues provided above, what deduction/s can you make at this point? Provide a justification for response (maximum 150 words).

insert your answer here

(3 marks)

Question 3
Collect cues/information (gather)

You need complete a Mini Nutritional Assessment (MNA) with George.

Question 3a.

After completing the MNA, do you consider George has a normal nutritional status, is at risk of malnutrition or is he malnourished? Provide a brief rationale for your response.

insert your answer here

(1 mark)

Question 3b.

This screening score provides you will one cue. List four (4) other cues you can collect from George’s case study to inform your nutrition assessment.

insert your answer here

(2 marks)

While undertaking the nutritional assessment with George you note he has halitosis. An inspection of his oral cavity reveals mucositis and xerostomia.

Question 3c. Given the cues provided in the case study, provide four (4) factors which may be contributing to George’s poor oral health. Ensure you include a rationale for each factor.

insert your answer here
Question 3a.

In the wake of finishing the MNA, do you consider George has an ordinary healthful status, is in danger of hunger or would he say he is malnourished? Give a short reasoning to your reaction.

embed your answer here

(1 imprint)

Question 3b.

This screening score gives you will one prompt. Rundown four (4) different signals you can gather from George’s contextual analysis to illuminate your nourishment evaluation.

embed your answer here

(2 imprints)

While undertaking the dietary evaluation with George you note he has halitosis. An investigation of his oral cavity uncovers mucositis and xerostomia.

Question 3c. Given the signals gave for the situation study, give four (4) factors which might be adding to George’s helpless oral wellbeing. Guarantee you incorporate a reasoning for each factor.

(2 marks)

Question 4
Process information (infer).

Question 4. George reports a long history of constipation. What factors place George at risk of constipation? Provide a justification for your response (maximum 200 words).

insert your answer here

(4 marks)

(4 marks)

Question 5
Collect cues/information.

As part of your admission assessment, you are required to undertake a pressure injury risk assessment.

Question 5a) Select one risk assessment tool to assess George’s risk. Identify this tool, the score and provide a justification for selecting this tool.

insert your answer here

(2 marks)

Question 5b) Describe the measures you would put in place to prevent George developing pressure injuries. Ensure you consider George’s situation and the context of his care in your response (Maximum 200 words).

insert your answer here

(5 marks)

Question 6
Reflect on process and new learning.

During your first intensive a skill overed was bed making, in addition during module 1 you will have watched Jessica (who you see first in the video) and Kimberly making George’s bed.

Question 6. You will need to provide Jessica and Kimberly with feedback on what they could do differently next time. You will need to identify three areas in which they did well and three areas for improvement.

insert your answer here

(3 marks)

Question 7
Identify problems /issues & take action.

On day two of his admission, George has a fall in the bathroom and sustains a large skin tear to his right forearm (STAR classification 2b.). The wound is 14cm in length.

Question 7a. Short answer

Can this skin tear be realigned? Yes or no, provide a brief rationale for your response.
The first priority in the management of this skin tear is to check for signs of infection True or false, provide a brief rationale for your response.
(1/5 mark per question)

Question 7b. How could George’s skin tear have been prevented? (maximum 200 words) Ensure you support your response with at least one scholarly source.

insert your answer here

(6 marks)