Reference no: EM133927650

Assessment

Health Variations - Acute Exacerbations of Chronic Conditions

Instructions:

Aim of the assessment- The purpose of this assessment is to enable you to:
Demonstrate knowledge of a comprehensive assessment for a patient with an embolic stroke, using the A to E (Airway, Breathing, Circulation, Disability, Exposure)

Identify and discuss relevant diagnostic results to inform clinical decision-making and implementing high-priority interventions to optimise patient outcomes.

Identify and discuss key evidence based high priority nursing interventions for managing a patient with an embolic stroke

Demonstrate effective management to optimise the care of a patient with an embolic stroke by administering prescribed therapies and medications

Students are to use evidence-based literature to support answers for the following questions.

CASE STUDY - ORAL PRESENTATION - Mrs Teresita Manalo

Review the ISBAR, identify AND analyse important information
I -Identify Mrs Teresita Manalo has an embolic stroke
S- Situation During night shift ward round Mrs Manalo was found with decreased level of consciousness, slurred speech and left sided weakness
B- Background Admitted to hospital 2 days ago with dizziness, palpitations, generally feeling unwell. 12-lead ECG diagnosed Atrial Fibrillation (AF). Transferred to Coronary Care unit for cardiac telemetry. Reviewed by cardiologist who prescribed heparin infusion. Was due for discharge the next day

Assessment
Airway: Patent. Oxygen administered via Hudson mask @ 6L
Breathing: RR 26bpm, shallow RR, SpO2 95% , Air entry: R=L, decreased in bases
Circulation: HR 132bpm. BP 170/95mmHg, peripherally cool, capillary refill <3sec, pitting oedema in feet
Disability: GCS 12/15 (E 4, V 3, M5), slurred speech, signs of left-sided weakness (hemiparesis) with facial droop noted, following commands with the unaffected right side. Able to squeeze with the right hand and move the right leg, pupils round, equal and reacting briskly to light
Exposure: No wounds or bleeding noted. Afebrile. IVC left cubital fossa
Fluids: Compound Sodium Lactate (Hartmann's) via left cubital fossa IVC at 20mL/hr TKVO
Glucose: Blood Glucose Level (BGL) 5.5mmol/L
Height 145cm and weight 65kg
Stroke Assessment
F: Face Left sided facial droop
A: Arms Left sided weakness
S: Speech Aphasic
T: Time of onset approximately 0100 hrs
R: Recommendation
Call Clinical Review for drop in alertness level of consciousness-eyes opened to voice only (V on AVPU scale)
Position patient semi- to High Fowlers, support head if cannot sit upright unaided, support LEFT side of body with pillows
Monitor airway for obstruction or increased loss of consciousness. Call MET/Rapid Response for a drop in GCS by 2 or more points from the patient's baseline or if airway becomes compromised
Maintain SpO2 > or equal to 95%
Baseline bloods (UEC/CMP, FBC, Coagulation Tests (PT, INR, aPTT), Troponin)
Stroke team notified. Stroke nurse in attendance
Q1. Discuss the A to E (Airway, Breathing, Circulation, Disability, Exposure) assessment approach for Mrs Teresita Manalo, who is experiencing an Embolic Stroke with decreased level of consciousness, slurred speech and left sided weakness. In your discussion, integrate relevant vital signs and explain how they inform your clinical decision-making.
Q2. List four high priority nursing interventions for managing Mrs Manalo's embolic stroke and briefly discuss your rationales for each.
Q3. Select any 3 of the following medications and discuss each of the nursing considerations (i.e., Assessment, Administration and Side Effects) when administering the following therapies and medications to Mrs Manalo.
IV Alteplase
Heparin IV infusion
Metoprolol 50mg BD
Pantoprazole 40 mg Daily
Oral Presentation Details:
You are to record and submit your oral presentation based on the case study for Mrs Teresita Manalo who has an embolic stroke

References: You must include references. These should be listed at the end of your presentation using APA 7 referencing style

Instructions to assist with the Assessment 2: Video and template

Step 1: Preparation
Ensure your presentation is developed in alignment with the Assessment 2 guidelines and marking rubric (below). These outline the required content, structure, and criteria by which your work will be assessed. Review them carefully before you begin.

Step 2: Presentation Format
You may use any method of video presentation, as long as the following requirements are met:
Your presentation slides must be clearly visible throughout the recording. Get online assignment help-AI & plagiarism-free-now!
The student must appear on camera during the entire presentation (i.e., the students' view must be visible on screen, not just voiceover).
Introduction including your full name and show student ID
Address and answers for each question -all relating to the case study provided
Summary of the significant points

Step 3: Record and upload presentation to vUWS
Plan the presentation by researching the evidence-based literature together
Develop your presentation transcript by completing the Presentation Transcript Template provided under 'Assessment 2' in the vUWS Assessment Zone. labelled "NURS2016 Presentation Transcript Template.doc"

Rehearse and practice your presentation-Your presentation should be no longer than 10 minutes long.
Record your oral presentation.
Ensure that you upload your recording to YouTube and select Unlisted
Check that you have included in your Presentation Transcript Template:
Students full name
Student ID
The URL for your recording of your oral presentation
Your complete presentation transcript
Reference list (using APA 7 referencing style)
Copy and paste any PowerPoint slides into the document if used.

Step 4: View the following resources on how to upload your video:

Step 5: View the following resources on how to create an unlisted YouTube:

Step 6: Check that the YouTube link works! Before submitting