HNN329 Chronic Illness & Supportive Care
\nAssessment Task 1: Care Plan
\nEquivalent 1500 words \u2013 15% weighting
\nPurpose of assessment task
\nThis assessment task will enable you to create a comprehensive plan of care for individuals experiencing chronic illness (ULO1) and explain the pathophysiology of selected chronic illnesses to inform quality evidence-based nursing care (ULO3).
\nDue date:
\nFriday 5 May 2023
\nTime:
\n8.00pm
\nLocation:
\nAssignment dropbox on HNN329 CloudDeakin unit site
\nFormat:
\nHNN329 Care Plan Template – PDF*
\n*PDF conversion software is available here on Deakin Software Catalogue
\n\u2022 Please check the document before submitting to the dropbox to ensure the formatting has not changed.
\n\u2022 You are responsible for ensuring that the correct version of your assessment task is properly uploaded into the correct assessment dropbox.
\nCase scenario:
\nIdentify: You are the Registered Nurse working in the Acute Medical Ward caring for Mrs. Edith Johnson.
\nSituation: Edith has been on the ward for 12 hours after being admitted via the Emergency Department (ED) following a three (3) day viral illness that was being managed at home by her local GP. During the viral illness, Edith reported a fever, productive cough, increased sputum production and shortness of breath. Edith has been unable to get any rest at home due to these symptoms.
\nBackground: Edith is a 68-year-old female who has a past medical history of Chronic Obstructive Pulmonary Disease (COPD), hypertension (HTN) and atrial fibrillation (AF). Edith was diagnosed with COPD 8 years ago and has a FEV1 of 55% predicted from 1 month ago. Edith\u2019s regular medications are: Symbicort (100mcg\/6mcg) 2 puffs BD, Ipratropium (2 puffs) QID, Metoprolol 50mg daily and Rivaroxaban 20mg daily. Edith comes from home alone following the death of her husband 3 years ago but has the support of her two daughters close by. Edith used to be a keen bingo player and a part of the local craft group. However, due to worsening COPD symptoms, she is not able to participate as much as she would like and now relies heavily on community services to help with her activities of daily living (ADLs).
\nAssessment: At the commencement of your shift, you undertake a comprehensive focused patient assessment on Edith and find the following:
\nBody System Assessment Assessment Data
\nNeurological (CNS) GCS 15 (E=4, V=5, M=6)
\nTemp 38.0\u00b0C
\nPain 4\/10 (Numerical)
\nCardiovascular (CVS) BP 138\/82mmHg
\nHR 92bpm (irregular)
\nRespiratory SpO2 92% on 2L via NP RR 28bpm
\nGenitourinary\/Renal IDC insitu
\nUrine Output 20mL\/hour
\nEndocrine\/Metabolic BGL 5.3mmol\/L
\nIntegument PIVC to L) cubital fossa
\nMusculoskeletal
\nPsychosocial\/other Lives at home alone
\nHelpance needed with ADL\u2019s
\n2 daughters close by
\nUnable to do social activities that Edith enjoys
\nRecommendation: Provide safe priority nursing care for Edith.
\nPatient Problems:
\nActual Patient Problems Potential Patient Problems
\nImpaired gas exchange Risk for ineffective coping
\nIneffective breathing pattern Risk for imbalanced nutrition
\nImpaired urinary elimination Risk for knowledge deficit
\nDecreased activity tolerance Risk of infection
\nIneffective airway clearance Risk of social isolation
\nTask Description:
\nBased on the case scenario and body system assessment data above, apply the nursing process to develop a comprehensive nursing care plan for this patient.
\n1.) Problem Identification:
\na) Identify four (4) priority patient problems from the above list. Include two (2) actual and two (2) potential patient problems. For each of these problems, identify at least two (2) findings from the case scenario to support your priority problem selection.
\nb) With reference to evidence-based literature, explain the relevant aetiology, pathophysiology and defining characteristics associated with each of the four (4) patient problems and provide a rationale as to why this is a priority problem for this patient.
\nc) Identify one (1) psychosocial problem and identify data findings from the case scenario to support your problem selection. Explain why this is an important psychosocial problem to consider in this patient, including explanation of how this problem may affect the patient\u2019s daily life.
\n2.) Planning
\na) Develop an appropriate goal of care with expected measurable parameters for the four (4) priority patient problems.
\nb) Develop an appropriate goal of care with expected patient outcomes for the identified psychosocial problem.
\n3.) Implementation
\na) Identify two (2) priority nursing interventions for each of the five (5) patient problems.
\nb) Provide a rationale for each of the identified nursing interventions, relating the identified nursing intervention to the underlying pathophysiology\/physiology of the specific patient problem.
\n4.) Assessment
\na) Describe the data you would analyse to evaluate the effectiveness of the identified nursing interventions.
\nInstructions for this assessment task:
\n\u2022 Your nursing care plan must be presented on the HNN329 nursing care plan template located on the HNN329 CloudDeakin site.
\n\u2022 Writing in dot point\/s is accepted.
\n\u2022 You are required to present the information in your own words.
\n\u2022 This assessment task is an individual piece of work.
\n\u2022 Referencing is required for this assessment task in parts 1b and 3a above.
\nPresentation requirements:
\nThe School of Nursing and Midwifery follows the American Psychological Association (APA) 7th edition referencing style. Presentation requirements of this referencing style are outlined below. For further detail regarding APA 7 referencing style refer to Referencing | Students (deakin.edu.au).
\nTitle Page:
\nInclude the following information on separate lines; Title of Paper (bold font), Student Name\/s and student identification number, University Name, Unit Code and Name, Due Date.
\nFormatting of Title Page: Centred text alignment and double line spacing.
\nFont:
\nWriting is to be in an accessible font. Examples of these include; 12-point type size Times New Roman.
\n11-point type size Georgia.
\n11-point type size Calibri.
\n11-point type size Arial.
\nEnsure the same font is used consistently throughout the entire paper.
\nWord Count
\nThe HNN329 care plan assignment is 1500 words \u2018equivalent\u2019. Therefore, the no more or less than 10% of the indicated word count does not apply.
\nMarking criteria:
\nThis care plan assignment will be assessed according to the Marking Rubric, which is presented below. This Marking Rubric provides you with a breakdown of each criterion that will be assessed. It is essential to utilise this rubric to help you clearly identify detailed components that are important to your achieving success with this assessment task. Use the descriptors of each criterion to direct and develop your assessment task.
\nCriterion mode: Points Exceeds Expected
\nExpected Standard Minimum Standard Below Expected Standard
\nStandards
\nStarting % 80 Starting % 60 Starting % 50 Starting % 0
\nCriterion 1:
\nIdentification and planning of priority patient problems Correctly identifies two (2) findings from the case scenario to support selection of all priority patient problems.
\nAccurately and thoroughly describes the most appropriate goals of care for each patient problem.
\nPlanning for all patient problems includes relevant measurable parameters.
\nCorrectly identifies two (2) findings from the case scenario to support selection of most priority patient problems.
\nAccurately and clearly describes the most appropriate goals of care for each patient problem.
\nPlanning for most patient problems includes relevant measurable parameters. Correctly identifies one (1) finding from the case scenario to support selection of some priority patient problems.
\nClearly describes the most appropriate goals of care for each patient problem.
\nPlanning for at least two (2) patient problems includes measurable parameters. Incorrectly identifies findings from the case scenario to support selection of each priority patient problems.
\nBroad statements used to describe the most appropriate goals of care for each patient problem, or goals of care not provided.
\nPlanning for each patient problem does not include measurable parameters.
\nPoints 10
\nCriterion 2
\nEvidence-based explanation of underlying pathophysiology, defining characteristics and aetiology Referencing evidencebased literature, accurately and thoroughly explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
\nLevel of explanation provided demonstrates significant depth of understanding for each aspect.
\nReferencing evidencebased literature, accurately and clearly explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
\nHowever, further detail is
\nrequired to show significant depth of understanding for each aspect.
\nReferencing evidencebased literature, explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
\nHowever, significant further detail is required to show expected depth of understanding for each aspect.
\nNo referencing of evidencebased literature to explain the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
\nAll patient problems did not have appropriate explanation
\nof aetiology, defining characteristics and pathophysiology
\nPoints 24
\nCriterion 3
\nIdentification, explanation and planning of relevant psychosocial patient problem Accurately identifies one (1) psychosocial problem and associated data findings relevant to the case scenario.
\nAccurately and thoroughly explains the importance of the identified psychosocial problem for the case scenario.
\nConsideration within the explanation is given to how this psychosocial problem may affect the case scenario patient\u2019s life. Accurately identifies one (1) psychosocial problem and associated data findings relevant to the case scenario.
\nClearly explains the importance of the identified psychosocial problem for the case scenario.
\nSome consideration within the explanation is given to how this psychosocial problem may affect the case scenario patient\u2019s life. Accurately identifies one (1) psychosocial problem and some associated data findings relevant to the case scenario.
\nDescribes the importance of the identified psychosocial problem for the case scenario.
\nFurther consideration within the explanation is required to demonstrate how this psychosocial problem may affect the case scenario patient\u2019s life. Incorrect and\/or inappropriate psychosocial problem identified relevant to this case scenario.
\nInsufficient detail provided in explanation to demonstrate knowledge of importance of this patient problem and\/or how if may affect the patient\u2019s life.
\nDescribes the importance and impact of this patient problem in general, and not specific to the case scenario.
\nPoints 12
\nCriterion 4
\nImplementation of evidence-based nursing interventions including rationale Identifies a total of ten (10) correct evidencebased nursing interventions.
\nAll nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and\/or physiology, which demonstrates understanding of how each intervention addresses the specific patient problem. Identifies a total of ten (10) correct evidencebased nursing interventions.
\nMajority of nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and\/or physiology.
\nFurther explanation required to demonstrate understanding of how each intervention addresses the specific patient problem. Some of the nursing interventions identified are evidence-based.
\nSome nursing interventions identified are nursing assessments. Some of the nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and\/or physiology.
\nFurther explanation is required to demonstrate understanding of how each intervention addresses the specific patient problem.
\nIdentified nursing interventions are incorrect, inaccurate and\/or are nursing assessments.
\nNursing interventions are not supported by a rationale, including an explanation of the underlying pathophysiology and\/or physiology.
\nUnable to demonstrate understanding of how each intervention addresses the specific patient problem.
\nPoints 25
\nCriterion 5
\nAssessment of nursing care provided Thoroughly and accurately describes correct measurable data to evaluate the effectiveness of each of the ten (10) identified nursing interventions. Majority of the data utilised to evaluate the effectiveness of the identified nursing interventions are appropriate.
\nDescription is lacking depth and requires further work. Some of the data utilised to evaluate the effectiveness of the identified nursing interventions are appropriate.
\nDescription is lacking significant depth and requires further work. Assessment method is incorrect, incomplete and\/or does not include correct measurable data.
\nPoints 10
\nExceeds Expected
\nStandard (80%+)
\nExpected Standard (50%+)
\nBelow Expected Standard
\n( 50%)
\nCriterion 6
\nPresentation, writing and referencing in accordance with assessment instructions
\nExceeds Expected
\nStandard (80%+)
\nAccurately follows presentation requirements, including the use of the care plan template.
\nContent is fluently written with minimal errors throughout.
\nUse of correct medical terminology.
\nReferencing is in accordance with APA 7 with minor errors only. Expected Standard (50%<\/p>\n
Majority of submission acc presentation requirements care plan template.
\nContent is fluently written throughout. Correct medic used.
\nReferencing in in accordan recurrent minor errors onl
\n+)
\nurately follows
\n, including the use of the
\nwith minor errors
\nal terminology mostly
\nce with APA 7 with
\ny. Below Expected Standard
\n( 50%)
\nPresentation requirements are not followed, or there are significant errors.
\nCare plan template is not used.
\nContent is not fluently written and at times is hard to follow.
\nAPA 7 referencing style not utilised and\/or references not provided to support writing.
\nPoints 9<\/p>\n
Introduction:<\/p>\n
Mrs Edith Johnson is a 68-year-old female admitted to the Acute Medical Ward after being managed for three days by her local GP for a viral illness that left her with a fever, productive cough, increased sputum production, and shortness of breath. She has a medical history of Chronic Obstructive Pulmonary Disease (COPD), hypertension, and atrial fibrillation. The purpose of this assessment task is to develop a comprehensive nursing care plan for Mrs Edith Johnson, taking into account her health history, current presentation, and associated patient problems.<\/p>\n
Problem Identification:<\/p>\n
Actual Patient Problems:<\/p>\n
Impaired gas exchange:
\na. Fever, productive cough, increased sputum production, and shortness of breath.
\nb. SpO2 of 92% on 2L via NP, RR 28 bpm.
\nIneffective airway clearance:
\na. Productive cough, increased sputum production, and shortness of breath.
\nb. SpO2 of 92% on 2L via NP, RR 28 bpm.
\nPotential Patient Problems:<\/p>\n
Risk for ineffective coping:
\na. Lives at home alone.
\nb. Unable to do social activities that Edith enjoys.
\nRisk for imbalanced nutrition:
\na. Decreased appetite.
\nb. Poor dietary intake.
\nWith reference to evidence-based literature, the relevant aetiology, pathophysiology, and defining characteristics associated with each of the four patient problems are explained below:<\/p>\n
Impaired gas exchange:
\nImpaired gas exchange is the inadequate delivery or uptake of oxygen and carbon dioxide (Doenges, Moorhouse & Murr, 2019). Mrs Edith Johnson’s viral illness has resulted in the production of sputum, increased cough, and shortness of breath, leading to the impaired exchange of gases. Impaired gas exchange in COPD patients is due to the decreased elasticity of the lungs, narrowing of airways, and destruction of lung tissue (Global Initiative for Chronic Obstructive Lung Disease, 2021).<\/p>\n
Ineffective airway clearance:
\nIneffective airway clearance occurs when secretions are not cleared from the airways, leading to increased cough, sputum production, and shortness of breath (Doenges et al., 2019). The viral illness and COPD in Mrs Edith Johnson have led to the accumulation of mucus, making it difficult to clear her airways.<\/p>\n","protected":false},"excerpt":{"rendered":"
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