Assignment 2 INC3: Case study

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Assignment 2 INC3: Case study
Addresses learning outcome(s):
1. Communicate effectively with interprofessional colleagues and healthcare
teams, and advocate, with support, for people and families to ensure safe care.
2. Integrate culturally appropriate psychosocial and emotional wellbeing
assessments into the holistic care of people and their families.
3. Describe the interconnectedness of mental and physical health and integrate
evidence-informed strategies, policies, and guidelines to promote well-being.
4. Model safety in the simulated environment, including documentation, clinical
handover, risk assessment and prevention, parenteral medication
administration, and nursing care for a person undergoing surgery.
5. Assess deterioration in health status and initiate care escalation, accurately
communicate nursing assessment and actions verbally and in writing.
This assignment challenges you to critically analyze the clinical data and use the
nursing process to develop care priorities for a post-operative patient. You are required
to identify priorities of care, identify and describe appropriate assessments and
synthesize these into a holistic person-centered care approach to nursing care.
This assignment requires a scholarly approach to academic writing using evidence to
inform your decisions and formatting and presentation of a standard expected at tertiary
level study.

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Due: 21 April 2023 (Semester 1 Week 12)
Time: 1000hrs
Weighting: 50%
Case Study
Mrs. Kimberly Carey, a 42 year-old-female, was admitted this morning to the surgical
ward where you are working as a Registered Nurse (RN). Her admission notes outline

that she was admitted to the ward to manage acute cholecystitis while waiting
for her scheduled laparoscopic cholecystectomy.
Kimberly is a mother to two primary school-aged children and works part-time as a
librarian at the National Library of Australia. Kimberly has a supportive husband, Bob, who
works in the Australian Public Service with the Australian Taxation Office. Kimberly is a
practicing Jehovah’s Witness.
Kimberly has a medical history of diagnosed asthma, anxiety and obesity (current BMI is
30 kg/m2). Kimberly was noted to have been feeling anxious about her surgery pre-
operatively, specifically outlining concerns regarding difficulty performing usual caring
role, work commitments and changes to body image due to scaring.
The laparoscopic cholecystectomy has concluded and, following a four (4)-hour operation,
she has returned to the Surgical Ward. The Post-Anaesthetic Care Unit (PACU) RN is
currently providing you with a clinical handover and informs you that Kimberly required
an open cholecystectomy for a gangrenous gallbladder. You review the surgical site with
the PACU RN and you note a surgical wound to her right sub-costal region that is closed
with staples and covered by a clear Comfeel® dressing. You note that the dressing is
intact with a small amount of blood along the incisional wound. There is also an
Exudrain®, on suction, from the surgical site.
Kimberly currently has a Fentanyl PCA insitu and is receiving intravenous fluid therapy.
The PACU RN informs you that Kimberly received a total of 80mcg of fentanyl in PACU
before the PCA was commenced.
Kimberly is also receiving supplemental oxygen therapy via nasal prongs at 2 litres/min.
She is drowsy but rouses to your voice and describes pain at her surgical site as 8 out of
10. Kimberly’s husband (Bob) expresses concern about her drowsy condition and is asking
you whether it is normal to have so much fluid collecting in the drain.

Vital sign observations on return to ward.
HR:         105 bpm

NIBP:     90/60 mmHg
RR:         20 breaths/min
SPO2:    97% @ 2lpm via NP
T:            37.3 ⁰C

Medications charted on NIMC.
Flixotide 100mcg inhale BD.
Ventolin 5mg inhale PRN/QID.
Fentanyl PCA 10mcg/mL IV, bolus dose 20mcg with lockout time 5min.
Enoxaparin 40mg S/C Nocte To commence DAY 2 post-operatively.
Cephazolin 1g IV TDS.

This assignment has three (3) parts (Part A, B and C).
Your response to the assessment will be submitted via the file upload tab in Canvas: Part
A as a .mp4 or .mov video file and Part B and Part C as a word document.
Part A: Provide a verbal and visual nursing handover using the ISBAR format, as though
you are giving this ISBAR handover to a Registered Nurse colleague of the case study
patient. Your ISBAR handover must clearly address key safety concerns related to the
case study provided. Your ISBAR handover must not exceed four (4) minutes in duration
and include only information that is stated in the case study. It is important that the ISBAR
format is evident within handover and is clear and easily understood with video on. The
students face must be visible. Use .mp4 or .mov video file to submit the assessment.
Part B: You are required to submit a 1500-word response to the case study that
demonstrates critical analysis of the given clinical data, use of the nursing process to
prioritise your approach to nursing care, and synthesis of these points into a holistic

person-centred care approach that is relevant to the post operative phase of a
perioperative patient.
Your response must:
1. Identify one (1) nursing priority for each of the following areas of (i) pain, (ii)
wound, (iii) elimination, and (iv) patient education, in relation to the case
study.
2. Identify and describe comprehensive nursing assessments you would
undertake to develop a nursing plan of care that addresses the four (4)
nursing priorities identified.
3. Outline a rationale for undertaking each of the nursing assessments
identified, including reference to any additional assessment findings you
would seek to identify or questions you would ask. Students are encouraged
to take into consideration the person’s demographics, history and pre-
operative health issues when discussing their approach to assessment.
4. Discuss recommendations for ongoing care including interventions and
collaboration within the interdisciplinary team to address the nursing
priorities identified.

Please present your responses to the questions using structured paragraphs. It is
recommended that you paraphrase the question in your opening topic sentence.
 Headings can be used to support the student in addressing the requirements of
the assessment.
 If headings are included this will count towards the overall word count of the
assessment.
 In text citations must be used throughout your responses, following APA 7th
edition requirements.
 A reference list should be placed at the end of the document encompassing all
sources cited in your responses and following APA 7th edition requirements.
 You must include a list of references at the end of your submission. You will be
assessed on the use of evidence-based practice guidelines and contemporary
peer reviewed academic literature.

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Word Limit
1500 word (+/- 10%) including intext citations.

Part C: You are to include, as an attachment to the case study, a one (1) page concept map
identifying relationships between Kimberlys' psychosocial and mental health concerns.
Include nursing interventions to address these concerns in brief dot points.
Using the exemplar below, create a concept map where Kimberly is within the center. Your
concept map will branch off into the following sections (i) Nursing education (ii) Mental
health concerns post operatively (iii) Recovery and rehabilitation (iv) Family and other
psychosocial concerns. In each section you will briefly identify how you will manage and
anticipate complications within these areas within short sentences or dot points. Concept
map should not exceed one (1) page.
Students are required to submit their response to the assessment task via the unit
canvas site.
The submission must include the following:
1. Part (A) ISBAR format handover to a Registered Nurse colleague using Video
file (.mp4 or .mov). Video must clearly show the students face and audio must
be clear. Must not exceed four (4) minutes in duration.

Submission Instructions
You are required to submit Part A .mp4 or .mov video file first. Part B and Part C are to be
submitted together as a Word document with a cover page and APA reference list.
Students' names are not to be included on any assessment tasks/submissions.  Student ID
numbers should be included (per the Assessment Policy and Procedures).
All work must be appropriately referenced as per current APA 7 th  Ed. Guidel

An example concept map to be considered.

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