Health assignment

Purpose of assessment task
The purpose of this assessment task is to provide you with the opportunity to engage with key
knowledge and skills drawn from each of the five Unit Learning Outcomes (ULOs) paying particular
attention to ULO one, two and three. This will allow you to demonstrate your ability to use this
knowledge to organise and explain assessment findings, using principles of anatomy, physiology and
pathophysiology and health assessment frameworks. Completing this task will assist you to engage
with, and to demonstrate attainment of, key knowledge and skills.
Due date: 14th August 2020
Time: 8.00pm
Location: Assignment dropbox on HNN114 CloudDeakin unit site
Format: PDF*
*PDF conversion software is available here on Deakin Software Catalogue
• Please check the document before submitting to the dropbox to ensure the formatting has not
changed.
• You are responsible for ensuring that the correct version of your assessment task is properly
uploaded into the correct assessment dropbox.
Topic background:
Health assessment is a foundational skill for nurses in all contexts of care. Assessment informs
identification of patient problems in relation to risk, symptoms and patient function. Appropriate use of
assessment data will assist students to further develop clinical decision making skills foundational to
the provision of quality patient care.
In your role as a student nurse, you will be asked to undertake elements of health assessments in a
range of settings during your clinical placements.
Assignment Question / Task Description:
You are required to answer 5 questions that are presented as part of an ongoing case study. Each
question draws on one of the first 5 weeks of content in this unit.
2
Week One – Focus: Abdominal Assessment
Shift to shift Handover
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to a surgical ward 2 days ago for a right
knee replacement. She has mentioned that she feels bloated with slight
abdominal pain/discomfort and reports she has not had her bowels open
since admission.
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
blood pressure control. She uses a Seretide inhaler daily and salbutamol
PRN to manage her asthma. Appendectomy at 12 years of age.
Assessment Vital observations
Respiratory rate – 18 breaths per minute
Oxygen saturation – 99% on room air
Pulse – 90 bpm, thready and regular
Blood pressure – 100/60 mmHg
Temperature – 37.5°C
Dressing to right knee remains dry and intact.
Pain to right knee – 2/10 at rest increasing to 6/10 on
ambulation/movement
Recommendations Maintain comfort with positioning and medications as charted
Encourage oral hydration
Encourage exercise as tolerated
Consider nurse initiated laxatives and report symptoms to surgical team
Change diet to high-fibre
Maintain use of anti-embolism compression stockings
Maintain use of nonslip footwear when ambulating
Kaylene McCallum is a 64-year-old widow and a recently retired school teacher. She has a past history
of hypertension, osteoporosis and asthma, which is usually well controlled with medication. She is
normally active and enjoys swimming to keep fit and is looking forward to being able to take Sam on
longer walks following her knee replacement.
Today you are looking after Kaylene, who is two days post-surgery. She is reporting bloating,
generalised abdominal pain and mentions she has not used her bowels since the operation. Your
facilitator explains that Kaylene may be experiencing constipation.
ULO2
Relate principles of anatomy, physiology, and
pathophysiology to the collection and
interpretation of data collected during a nursing
health assessment.
Question One
You are asked to carry out an abdominal
assessment on Kaylene. Describe how you
would carry out this assessment, providing
rationales based on anatomy and physiology.
Outline the sequencing of assessment and
expected findings.
3
Week Two – Focus: Respiratory Assessment
Shift to shift Handover
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to the surgical Ward 4 days ago for a right
knee replacement. Discharge was delayed due to constipation which is now
resolved as a result of the laxatives administered – bowels well open this
morning.
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
blood pressure control. She uses a Seretide inhaler daily and salbutamol
PRN to manage her asthma. Appendectomy at 12 years of age.
Assessment Vital observations
Respiratory rate – 20 breaths per minute
Oxygen saturation – 95% on room air
Pulse – 105 bpm, thready and regular
Blood pressure – 105/60 mmHg
Temperature – 37.6°C
Pain – 1/10 at rest
Dressing to right knee remains dry and intact.
Recommendations Remove IVC ready for discharge.
Change dressing to right knee.
Contact her neighbour to arrange transport home once reviewed by
surgeon.
You have arrived for your shift and are looking after Kaylene as part of your patient allocation. A few
hours into your shift you notice she has become short of breath (dyspnoeic), tachypnoeic (RR24) and
has an audible respiratory wheeze.
ULO2
Relate principles of anatomy, physiology, and
pathophysiology to the collection and
interpretation of data collected during a nursing
health assessment.
Question Two
Your facilitator explains that Kaylene’s
symptoms indicate an asthma attack. They
explain that primary assessment findings that
support this include:
• tachypnoea
• tachycardia
• use of accessory muscles & tracheal
tugging
• dyspnoea & unable to speak in
sentences
• oxygen saturation is below 95%
Choose one of the above assessment findings
and explain the pathophysiological changes that
have resulted in this abnormal assessment
finding.
ULO3
Differentiate normal from abnormal assessment
findings.
4
Week Three – Focus: Cardiac Assessment
Shift to shift Handover
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to surgical Ward 5 days ago for a right
knee replacement. Discharge has been delayed due to constipation and an
asthma attack that are now controlled.
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
blood pressure control. She uses a Seretide inhaler daily and salbutamol PRN
to manage her asthma. Appendectomy at 12 years of age.
Assessment Vital Observations
Respiratory rate – 16 breaths per minute
Oxygen saturation – 96% on room air
Pulse – 89 bpm, thready and regular
Blood pressure – 105/65 mmHg
Temperature – 37.5°C
Dressing to right knee remains dry and intact.
Pain to right knee – 2/10 at rest increasing to 5/10 on
ambulation/movement
Recommendations Prepare for discharge tomorrow assuming Kaylene remains stable.
You are halfway through your busy AM shift when you undertake a set of vital observations on
Kaylene. You discover her blood pressure is 92/55 mmHg and she tells you that she feels a little
lightheaded.
ULO3
Differentiate normal from abnormal assessment
findings.
Question three
Using a symptom assessment framework, state
5 (five) questions you would ask to assess the
hypotensive episode. Other than blood
pressure, describe 3 (three) specific
assessments you would undertake and using
anatomy and physiology explain why these
assessments are relevant.
UOL5
Perform and document a comprehensive and
focused assessment of an individual.
5
Week Four – Focus: Central Nervous System (CNS)
Shift to shift Handover
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to surgical Ward 6 days ago for a right
knee replacement. Discharge has been delayed due to constipation and an
asthma attack that are now controlled. Kaylene also had an episode of chest
pain yesterday. Kaylene was diagnosed with angina and was treated
successfully with glyceryl trinitrate (GTN). She has had recent episodes of
hypotension. Yesterday afternoon Kaylene experienced a transient
ischaemic attack (TIA) with slurred speech and left arm deficit/weakness.
Symptoms are now resolved.
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
her blood pressure. She uses a Seretide inhaler daily and salbutamol PRN to
manage her asthma. Appendectomy at 12 years of age.
Assessment Vital Observations
Respiratory rate – 16 breaths per minute
Oxygen saturation – 98% on room air
Pulse – 86 bpm, weak and regular
Blood pressure – 115/70 mmHg
Temperature – 37.4°C
Dressing to right knee remains dry and intact.
Pain to right knee – 2/10 at rest increasing to 4/10 on
ambulation/movement
Recommendations Continue to monitor 1/24 vital observations including neurological
observations.
You arrived at clinical placement for an AM shift and Kaylene has been allocated as one of your
patients. Your facilitator asks you to assess Kaylene to assist in the planning of her care.
UOL1
Explain and use frameworks to assist the
systematic collection of data required for
comprehensive and focused health assessment.
Question four
Formulate an assessment for Kaylene using
primary/secondary survey approach and explain
why this approach may be considered
appropriate.
6
Week Five – Focus: Musculoskeletal
Introduction Kaylene McCallum is a 64-year-old female admitted under Dr. Tracy Taylor
Situation Kaylene presented as an inpatient to surgical Ward 7 days ago for a right
knee replacement. Discharge has been delayed due to multiple
complications. Kaylene was diagnosed with angina and was treated
successfully with glyceryl trinitrate (GTN).
Background Kaylene has a history of hypertension, asthma and osteoporosis. She lives
alone with her dog Sam. Nil Known allergies. Kaylene receives an annual
zoledronic acid infusion for her osteoporosis and she takes irbesartan for
her blood pressure. She uses a Seretide inhaler daily and salbutamol PRN to
manage her asthma. Appendectomy at 12 years of age.
Assessment Vital Observations
Respiratory rate – 14 breaths per minute
Oxygen saturation – 99% on room air
Pulse – 78 bpm, weak and regular
Blood pressure – 110/75 mmHg
Temperature – 37.7°C
Dressing to right knee remains dry and intact.
Pain to right knee – 1/10 at rest increasing to 2/10 on
ambulation/movement
Recommendations Arrange for outpatient cardiology review
You arrived at clinical placement for an AM shift and Kaylene has been allocated as one of your
patients. You have been assisting Kaylene with bed exercises as she recovers from her post-operative
complications. Today you are required to assess her mobility status and her readiness to ambulate.
UOL1
Explain and use frameworks to assist the
systematic collection of data
required for comprehensive and focused health
assessment.
Question five
Identify the indications for a mobility
assessment and the specific mobility
assessment tool you would utilise.
Explain how you would undertake a mobility
ULO2 assessment on Kaylene, prior to ambulation.
Relate principles of anatomy, physiology, and
pathophysiology to the collection and
interpretation of data collected during a nursing
health assessment.
ULO3
Differentiate normal from abnormal assessment
findings.
ULO4
Apply clinical decision making skills to
synthesise data and identify patient problems.
UOL5
Perform and document a comprehensive and
focused assessment of an individual.
7
Instructions for this assessment task:
• Assignment is to be presented with the full text of each of the five questions as subheadings
• High-quality references (unit text, other relevant texts, peer-reviewed journal articles) are to
be used in supporting your responses with a focus of quality over quantity
• You should aim to include references that are up-to-date and relevant to the details in the case
study and questions.
• A cover page including:
o Student Name
o Student Number
o Assignment title
o Unit: HNN114
o Unit chair name
o Word count: (your word count – not the word limit)
• Writing should be in the third person
• APA 6 referencing required
• Do not include an introduction or conclusion
Presentation requirements:
Font:
12-point type size.
Times or Times New Roman.
Spacing:
Double-line spacing (Do not insert extra lines between paragraphs or the references list
entries.)
Page numbers
Page numbers to be provided on all pages except front/cover page. Place page number in the
top right-hand corner
Margins
2.54 cm at the top, bottom, left-hand, and right-hand sides of the page.
Paragraph indents
Indent the first line of each paragraph (using the tab key or paragraph tool).
Exceptions: titles and headings
Justification of text
All text needs to be aligned to the left, not justified
Word Count
1500 words (+ or – 10%). Assignments must be no more than 10% of the indicated word
count, not including title page, in-text citations, headings and reference lists.
8
9
Criterion mode: Weight High Distinction Distinction Credit Pass Fail
Starting % 80 Starting % 70 Starting % 60 Starting % 50 Starting % 0
Criterion 1
The student demonstrates the
ability to describe the assessment
in the context of the case study
using knowledge of anatomy,
physiology and pathophysiology.
(ULO2)
The student has:
Accurately (clearly
and concisely)
described the
assessment and
provided rationales
based upon
principles of
anatomy, physiology
and pathophysiology
to justify planned
assessments.
The student has:
Clearly, but not
concisely described
the assessment and
provided rationales
based upon
principles of
anatomy, physiology
and pathophysiology
to justify planned
assessments.
The student has:
Described the
assessment and
provided rationales
that are correct, and
refer to concepts of
anatomy, physiology
and pathophysiology,
but lack clarity.
The student has:
Described the
assessment and
provided rationales
that are correct, but
are inadequately
supported by
principles of
anatomy, physiology
and pathophysiology.
The student has:
Not correctly
described the
assessment and/or
provided rationales
that are incorrect, or
absent.
Points 15
Criterion 2
The student demonstrates an
understanding of ONE
pathophysiological change
related to the case study
(asthma) and the associated
assessment findings. (ULO 2 & 3)
The student has:
Accurately (clearly
and concisely)
explained the
expected assessment
finding using
principles of
anatomy, physiology
and pathophysiology.
The student has:
Clearly, but not
concisely explained
the expected
assessment finding
using principles of
anatomy, physiology
and pathophysiology.
The student has:
Correctly but not
clearly explained the
expected assessment
finding using
principles of
anatomy, physiology
and pathophysiology.
The student has:
Provided some
rationales for the
assessment finding
that are correct, but
are inadequately
supported by
principles of
anatomy, physiology
and pathophysiology.
The student has:
Provided rationales
that are incorrect, or
absent.
Points
15
Criterion 3
The student demonstrates the
use of a symptom assessment
framework and how current
assessment findings can be used
to plan further assessments
within the registered nurses’
scope of practice. (ULO 3 & 5)
The student has:
Accurately used a
symptom assessment
framework and
planned further
assessments, and
The student has:
Clearly but not
concisely used a
symptom assessment
framework and
planned further
assessments, and
The student has:
Correctly used a
symptom assessment
framework and
identified some
relevant further
assessments. The
The student has:
Correctly used a
symptom assessment
framework and
identified some
relevant further
assessments, but has
The student has:
Described
assessments
(subjective and
objective) that are
not relevant, entirely
outside of the
10
Points 15
identified the
purpose
identified the
purpose
stated purpose for
each assessment is
correct but lacks
clarity.
included assessments
that are outside of a
nurses’ scope of
practice (eg imaging,
diagnostics). The
stated purpose of
each assessment is
incorrect or absent.
registered nurses
scope of practice, or,
has not provided
further assessments.
Criterion 4
The student demonstrates the
use of primary and secondary
survey to plan and prioritise
further assessments in relation to
the case study. (ULO 1)
The student has:
Accurately used the
primary/secondary
survey to plan and
prioritise further
assessments
The student has:
Clearly but not
concisely used the
primary/secondary
survey to plan and
prioritise further
assessments
The student has:
Correctly used the
primary/secondary
survey to plan further
assessments, but may
not have identified
the correct
assessment priorities
The student has:
Correctly used the
primary/secondary
survey to plan some
further assessments,
with minimal
evidence of
prioritisation
The student has:
Not correctly used
the
primary/secondary
survey or has not
identified any
Points 15 priority assessments
Criterion 5
The student demonstrates an
understanding of the indications
and use of a mobility assessment
tool and describes how to
perform the assessment. (ULO 1,
2, 3, 4 & 5)
The student has:
Accurately (clearly
and concisely)
described the
indications and use of
the tool and how to
perform the
assessment.
The student has:
Clearly, but not
concisely described
the indications and
use of the tool and
how to perform the
assessment.
The student has:
Described the
indications and use of
the tool and how to
perform the
assessment, but the
descriptions lack
clarity.
The student has:
Described parts of
the indications, use of
the tool and how to
perform the
assessment, but the
descriptions are
incomplete
The student has:
Not correctly
described the
indications and use of
the tool and how to
perform the
assessment, but the
descriptions lack
clarity
Points 15
Criterion 6
The student demonstrates the
ability to use APA referencing
standards.
The student’s work
is:
Consistent with APA
referencing
standards
The student’s work
contains:
Several minor errors
in referencing
The student’s work
contains:
Consistent
referencing errors
The student’s work
contains:
Referencing errors
that detract from
readability at times
The student’s work
contains:
No references or
citations
Points 5
11
Criterion 7
The student demonstrates the
ability to present and structure
the assignment according to the
provided instructions.
The student has:
Presented their work
completely
according to the
provided
instructions
The student has:
Presented their
work according to
the provided
instructions, with
the exception of one
or two minor
discrepancies
The student has:
Presented their
work according to
the provided
instructions, with
the exception of
several minor
discrepancies
The student has:
Presented their work
according to some of
the instructions
The student has:
Not presented their
work according to
instructions
Points
5
Criterion 8
The student demonstrates the
ability to write in accordance
with standard language
conventions and academic
writing
The student has:
Written at a high
level of clarity and
fluency, and the
work is virtually
error-free
The student has:
Written fluently but
has several minor
errors eg. spelling,
long sentences
The student has:
Writing that
contains regularly
occurring
grammatical,
structural errors
affecting fluency
The student has:
Writing that has
errors (grammar,
punctuation,
sentence/paragraph
structure that detract
from readability at
times
The student has:
Writing that contains
multiple errors in
spelling/grammar
and/or punctuation
that significantly
detracts from
readability
throughout