Reference no: EM134007200 , Length: Word Count:1200

Assessment: Part A Individual Written Assignment

Case Study:

Mr. Smith is a 63-year-old Aboriginal male who was admitted to the hospital due to persistent chest pain that had been ongoing for several weeks, exacerbated by recent episode of flu one week prior. He described the chest pain as sharp, centrally located in the mid-sternal area, radiating to the left side of his back, neck and shoulder, and accompanied with mild dyspnea. The pain worsened when lying supine and improved when sitting up and leaning forward.

His past medical history includes hypertension, hyperlipidemia, type 2 diabetes mellitus (T2DM), smoker and obesity, with a Body Mass Index (BMI) of 32. Laboratory tests revealed elevated troponin levels and increased inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count). A physical examination noted pedal edema, jugular vein distension, and signs of shortness of breath. Subsequent diagnostic tests, including ECG and echocardiography, confirmed a diagnosis of pericarditis with suspected cardiac tamponade and a moderately large pericardial effusion. Concepts related to physiology and anatomy biology are relevant to understanding the patient’s deteriorating cardiovascular condition.

• At 0700hrs Mr Smith’s BP was 105/60 mmHg (the last reading was 120/60)

• His heart rate was 84 bpm (an increase from previous 74 bpm)

• Temperature: 37.5C (previously 36.8)

• His respiratory rate has increased to 24 breaths per minute (an earlier reading of 18 breaths per minute).

Due to being occupied with two other patients, you did not get a chance to check up on Mr. Smith. At 0900hrs, a medical emergency team (MET Call) was announced for his room. Upon entering, he was found to be confused, cyanotic, and lethargic. His BP was 100/50, and his heart rate was irregular and tachycardic with muffled heart sounds. As the MET arrived, Mr Smith became unconscious, necessitating the initiation of cardiopulmonary resuscitation (CPR) and you commenced cardiac compressions.

Assessment 2: Part A Individual Written Assignment

Refer to the NSQHS third edition for Essential Elements for Recognising and Responding to Acute Physiological Deterioration (National Consensus Statement) and identify and explain four contributing factors for Mr. Smith’s deteriorating condition. (250 words)

Using the NSQHS standards and other evidence-based resources, identify and discuss four evidence-based nursing priority care interventions/assessments that can be implemented for Mr. Smith during his hospital stay to prevent the onset of further complications. (600 words) Knowledge of homoeostasis and patient monitoring principles may support the discussion of physiological deterioration and nursing interventions.

(Nursing interventions should focus on post-BLS care, not what will be provided during BLS. These interventions may also include nursing assessments. Additionally, it is important to note that cultural care aspects will be addressed in Part B and therefore should not be the focus of this discussion)

Identify two different validated risk assessment tools utilised by nursing staff that recognise patient deterioration with clear escalation processes embedded. Discuss and critique their effectiveness with supporting evidence. (350 words)

Assessment Details

• References must be within ten years, and use as many resources as necessary to support your argument.

• An introduction or conclusion is not required.

• Do not use dot points.

• 1.5 line spacing.

• Font style: Arial, font size 12.

• Academic writing standards are required, including grammar, sentence structure, paraphrasing, and APA 7th edition referencing.

Assessment Overview

Part A is an individual assessment task based on a patient clinical scenario where students are expected to use clinical reasoning and critical thinking to apply evidence-based nursing practice to identify contributing factors to patient deterioration and interventions to prevent further complications. Topics associated with immunology may also assist in understanding inflammatory responses linked to pericarditis and infection-related complications.

Length: 1200 words