NSB021 Assessment 3

Comparative Essay Due Date: Monday 31st October 2016 Assessment Task – Comparative Essay Select one of the nursing care interventions listed (A to C below) for the patients in the clinical scenarios. For the nursing intervention you select, develop a discussion of the specific differences and similarities required in provision of nursing care for Mr. Stevens as compared to Jane. Particularly focus on discussing how nursing care will need to be modified for the intervention selected, based on the age and developmental considerations for each of the patients. Use a mix of contemporary text and research articles to support your discussion points. It is suggested that you use only a brief introduction and conclusion and employ the majority of the word length in addressing the focus of the assessment task. Submit via – Turn it in Weighting : 60% Length: 1000 words Check the Criteria Referenced Assessment (CRA) grid to review assessment expectations and the essay example on blackboard before you start. Clinical Scenarios Interventions planned for both Mr Stevens and Jane include the following: A. maintain adequate level of oxygenation B. maintain safety when mobilising out of bed C. maintain hydration and positive fluid balance Mr. Stevens is a frail looking 85 year old man admitted to hospital today with a 7 day history of a respiratory illness recently diagnosed as Influenza A with a secondary bacterial infection. He has experienced a severe productive cough, fever and malaise. He looks pale and says he feels really awful, faint and has a headache. His respirations are laboured and chest expansion is equal. In handover night staff said he was disorientated at times during the night and removed his oxygen mask so they changed him over to nasal prongs. Mr Stevens currently has oxygen 2 litres per minute delivered by nasal prongs. His most recent vital signs are BP 140/85 mmhg lying down, pulse 96 beats/minute and regular, respirations 28 breathes/ minute, temperature 37.8C and Sa02 95%. When the nurse inquires if he has pain Mr Stevens says he has a dull ache in his upper back that has got a bit better since another nurse got him a hot pack. He has an intravenous bung in his right forearm through which antibiotics are administered. Mr. Stevens usually lives independently with his wife of 60 years in their Brisbane home. He uses a walking stick when mobilising to aid his balance. Jane is a 4 year old girl accompanied by her mother and admitted today with a 72 hour history of a respiratory illness recently diagnosis as Influenza A, with a secondary bacterial infection. She has experienced high fever, frequent coughing and running nose at home. Mum, Anne says ‘I bought her in as she seemed so unwell and miserable, Jane is unusually quiet and wants to stay in bed or be sitting on my lap which is very abnormal for her’. Jane has an intravenous bung in her right forearm through which antibiotics are administered. Jane also has oxygen 1 litre per minute delivered by nasal prongs. Night staff said she removed the nasal prongs several times in her sleep and has been crying and angry when staff have cleaned mucus from her nostrils and replaced them. She told Anne ‘it hurts when I cough’. Her most recent vital signs are pulse 124 beats/minute and regular, respirations 30 breathes/ minute, temperature 37.8C, Sa02 95%. Peripheral capillary refill on the skin of her knee is a little slow at 2 seconds. Both Jane and Anne are accommodated in a single room with Anne staying as a ‘boarding parent’. Jane is the youngest of 2 siblings in this family. Anne is able to stay in hospital with Jane as her other child is being cared for by her grandmother.