Ms Nancy Huang is a 29 year old university student undertaking her honour’s year in physics.  Nancy was diagnosed as a type 1 diabetic three years ago.  She normally manages her diabetes reasonably well. She made a number of lifestyle changes and uses regular insulin therapy.   Nancy has been very stressed, as she has not been able to finish her thesis on time due to having to recently return to China unexpectedly to attend a family funeral.  Since returning to Australia a few days ago, she has seen her GP, as she was unwell. She was diagnosed with a viral chest infection that was managed conservatively. She subsequently fell further behind in her studies.  Nancy decided to pull a few ‘all-nighters’ to get her thesis finished and consumed excessive amounts of coffee and soft drinks in order to stay awake to get finished.  The next day her husband noticed Nancy was particularly irritable and becoming emotional. She explained that she could not concentrate enough to finish her thesis.  Nancy was insisting on being driven to the university to speak to her lecturer.  On the drive in, they had to stop 4 times for Nancy to use the bathroom.  She became even more irritable and her husband decided to call an ambulance once they arrived at the university. After assessment by the paramedics, Nancy was transported to hospital.

You undertake additional assessments to gather new information, recording the following new data:  Vital signs:  BP: 90/50 Pulse: 120 bpm RR: 20, coarse air entry, moist productive cough Sp02: 94% Temp: 37.9 ° C Other data: BGL: 24 mmol/L GCS: 13 (confused) Poor skin turgor Frequent urination Urinalysis: glycosuria, specific gravity 1.000, no ketones present Abdomen soft, no rebound tenderness. Bowel sounds present. Patient irritable and agitated. Speaking in a confused mixture of English and Mandarin. Husband in attendance

Log book: Ms Huang’s husband gives you a logbook that Nancy has been provided with by her endocrinologist. It shows that Nancy has been diligently recording her blood glucose levels and insulin regime for several months. You note there are no entries for the last few days.

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CASE STUDY: Esther is a 78 year old female who suffers from osteoporosis. She Esther lives with her only daughter and son-in-law and her two teenage grandchildren. Not to mention, she also has a family dog. Esther is very fragile, weighing about 120 lbs and barely likes to eat. She enjoys her days watching the news, cooking, and watching over the Yorkie while everyone is at work and school.  Though recently she tripped while going down a step to the patio and fractured her ankle. The family found her crying on the steps. They called the ambulance and she was taken to the ER. A couple days later she is discharged home and a home care plan is issued. 

The project is to write a one page paper on patient teaching how to use a cane. The difference between 2 gait, 3 gait, and 4 gait canes. How Esther would use them, how to prevent any other fall. What side would the cane go on? (affected or non affected side) 

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Nursing case study

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“Nursing should not ‘borrow’ theories from other disciplines.” Refute this statement by providing specific examples from your current nursing practice. Describe the importance of increased nursing collaboration with other disciplines.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length. 

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I need you to find two clinical reasoning errors from my interventions in part B file and go with the instructions.

Introduction (300 words)

Provide a very brief overview of your clinical encounter that highlights where the error/challenge/missed opportunity occurred (300 words).

Body (700 words)

Upon reviewing the module content and your previous paper, identify TWO clinical reasoning errors that best aligned to, or potentially could have occurred during your encounter that contributed to why that encounter was challenging or perhaps did not go to plan.

Describe those TWO clinical reasoning errors chosen and discuss how these may have occurred and why. How were the errors eventually remedied? how could they have been mitigated? How could it have impacted on patient outcomes if the error was not identified? In this section you may have to recall elements/assessment data from your clinical encounter to contextualise your discussion.

Conclusion (500 words)

‘Reflect on and process new learning’

From your exploration, consider your future nursing practice. What did you learn? what would you do differently next time? What strategies will you use? How has this enhanced your clinical reasoning skills? This forms a reasonable portion of your paper and therefore you need to demonstrate deep reflection here. Saying ‘I would read more about…..’, etc is not sufficient. We really need to see the encounter as a whole. What have you learnt from this that has better enabled you to ‘think like a registered nurse’.

In addition to the information provided in the unit outline, a rubric is provided to guide your preparation of this assessment task. Word counts for each section are to be considered as a guideline.

 

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