CRICOS Provider No. 00103D NURBN3023 Context of Practice 5: Patient Deterioration and Management. Page 1 of 4
Assessment Task 2 Essay:
Application of clinical reasoning skills for clinical patient scenario
Essay: Application of clinical reasoning skills within a clinical patient scenario
Weighting: 30%
Due date: Friday 15th May 2020 12.00 midday (All Students).
Purpose: This assessment task is designed to develop the student’s ability to integrate theory into
practical clinical knowledge through the use of a patient case scenario.
Word count: should be no more than 2000 words in length +/- 10%
Format: The Essay will be presented as a formal academic paper and conform to the Federation
University, Faculty of Health, Student Academic Handbook (Higher Education).
Please note the following: The layout is a report – questions and answer style; an introduction or
conclusion is NOT necessary. However should include logically structured discussion sections;
Students are strongly encouraged to use headings; May use diagrams in their answers where
appropriate. Academic writing should be formatted according to the Federation University, General
Guide to Writing and Study Skills.
Referencing: Referencing should be included using APA 7th Edition guidelines. It is expected that
the students use primarily peer reviewed sources for referencing. For this assessment and to support
your findings, you are to use at least 15-20 peer-reviewed references in your paper.
Turnitin: Turnitin software will be used in this course for Assessment Task 2 to assist students with
their academic writing and to verify the originality of assessment tasks. It will be used to assess and
give feedback. FAILURE TO SUBMIT WORK THROUGH TURNITIN FOR THESE TASKS WILL
RESULT IN A ZERO GRADE. Please ensure you only use the link provided with the assessment
task. If you have any issues with your submissions through the Turnitin Link provided on Moodle, you
need to make contact with the Information Technology Service Desk (ph: 5327 9999) to resolve the
problem. If the problem cannot be resolved prior to the due date, you must email the Course
Coordinator immediately. Please note that you should always attempt to complete and submit your
assignment as early as possible to avoid any potential problems.
Marking:
University staff will mark this assessment task. Pre-marking moderation will apply to this assessment
task. A marking guide for this assessment task is included on page 4.
CRICOS Provider No. 00103D NURBN3023 Context of Practice 5: Patient Deterioration and Management. Page 2 of 4
Feedback:
Results and feedback for this assessment task will be available on Moodle on 12th June by 12.00
midday.
Description: This assessment task allows students to demonstrate theoretical knowledge around
pathophysiological changes in disease, pharmacological management of disease, planning nursing
care and evaluating care. Students are required to answer the case scenario questions provided.
Students should attempt all questions in the case study:
…You are just starting your shift as a graduate nurse and you are about to review your first patient,
William Tran is a 33 year old man who has been admitted to the surgical ward – high dependency
area post the formation of a temporary ileostomy. During admission, it is documented that William
has a past history of Crohn’s disease – ulcerative colitis and multiple hospitalisations for Crohns
related illnesses including malabsorption and weight loss (55kg).
He is prescribed Prednisolone, Metronidazole, Balsalazide. He is also on a narcotic analgesia
infusion (Morphine 60mg in 60 ml with Normal Saline 0.9%, equaling concentration of 1mg/ml) with a
continuous infusion rate of 3ml/hr and a patient controlled analgesia demand dose of 2mg. Prior to
transfer to the ward he was prescribed and administered a loading dose of intravenous morphine
(5mg). His social history reveals he has been partnered for 10 years. Extended family live in
Vietnam.
1.1 Describe the pathophysiology of acute pain. How does this differ from chronic pain? Include
in your answer the pathophysiological effects of narcotic analgesia as a treatment option for
acute pain. Demonstrate links to Tran’s case. (400 words)
When you arrive at Tran’s bedside, you notice that he is difficult to rouse and non-verbal. His eyes
are closed. You take an initial set of vital signs: Temp 35.8, Pulse irregular 110 bpm, BP 98/55, RR
6, SaO2 93% 6Lt oxygen via Hudson mask.
1.2 Discuss THREE types of nursing assessments in order of priority that would be appropriate
for Tran’s deterioration (excluding vital signs) and provide a description of each of these in
the context of Tran’s complaint with rationale as to why these would be your priority. (400
words)
1.3 Discuss THREE nursing interventions (may include one pharmacological) you would initiate
and provide rationale as to how these would improve physiological outcomes of Tran’s
problem. (400 words). Nursing interventions would include nursing activities or actions that
the nurse could initiate in response to nursing assessment findings.
CRICOS Provider No. 00103D NURBN3023 Context of Practice 5: Patient Deterioration and Management. Page 3 of 4
Note: please be aware of the difference between an assessment and an intervention.
1.4 Discuss the administration (including administration, benefits, risks and contraindications) of
Morphine for Tran’s pain. Include in your explanation what education you should provide to
Tran’s on commencement of the patient controlled analgesia (PCA). (400 words)
1.5 Report the major side effects of intravenous morphine apply your findings to Tran’s case.
Explain why this finding would need to be reported immediately to the Doctor. (200 words)
CRICOS Provider No. 00103D NURBN3023 Context of Practice 5: Patient Deterioration and Management. Page 4 of 4
| NURBN 3023 Assignment 2018 Report Marking Rubric | ||||||
| Area | Not demonstrated |
Limited demonstration |
Minimally demonstrated |
Moderately demonstrated |
Highly demonstrated | Comprehensive demonstration |
| Part 1.1 20% |
No discussion of acute pain. No differentiation between acute and chronic pain No link to Tran’s case (0 marks) |
Incorrect or unclear description of acute pain provided. Limited understanding of differences between acute and chronic pain. Limited or no link to Tran’s case (4 marks ) |
Basic description of acute pain demonstrated. Limited understanding of differences between acute and chronic pain. Minimal link to Tran’s case (8 marks) |
Provides a basic description of acute pain Some description of differences between acute and chronic pain though limited linking to Tran’s case. (12 marks) |
Good description understanding of acute pain demonstrated. Some description of understanding of differences between acute and chronic pain. Some link to Tran’s case. (16 Marks) |
Excellent description of pathophysiology with thorough understanding demonstrated of differences between acute and chronic pain and all linked well to Tran’s case. (20 marks) |
| Part 1.2 20% |
No appropriate nursing assessments identified related to patient presentation. No rationale for priority applied. (0 marks) |
Unclear identification of 1-2 appropriate nursing assessments of patient presentation. No clear rationale for priority. (4 marks ) |
Unclear identification of 2 appropriate nursing assessments of patient presentation. Poor or incorrect rationale for priority. (8 marks) |
Clear identification of 2 appropriate nursing assessments of patient presentation. Some rationale for priority. (12 marks) |
Good identification of 3 mostly appropriate nursing assessments of patient presentation. Reasonably clear rationale for priority. (16 Marks) |
Excellent and thoughtful identification of 3 appropriate nursing assessments of patient presentation. Clearly and correctly explained with rationale for priority. (20 marks) |
| Part 1.3 20% |
No appropriate nursing interventions identified related to patient presentation. No rationale for priority applied (0 marks) |
Unclear identification of 1-2 appropriate nursing interventions for patient presentation. No clear rationale for priority. .(4 marks ) |
Unclear identification of 2 appropriate nursing interventions for Patient presentation. Poor or incorrect rationale for priority. (8 marks) |
Clear identification of 2 appropriate nursing interventions for patient presentation. Some rationale for priority. (12 marks) |
Good identification of 3 mostly appropriate nursing interventions for patient presentation. Reasonably clear rationale for priority. (16 Marks) |
Excellent and thoughtful identification of 3 appropriate nursing interventions for patient presentation. Clear and correctly explained rationale for priority. (20 marks) |
| Part 1.4 20% |
No discussion. No benefits or risks. No links to Tran’s education of PCA (0 marks) |
Poor discussion of the use of medication linked to Tran. Few benefits, risks and contraindications were discussed at length and lacked application to Tran’s education of PCA. (4 marks ) |
Poor discussion the use of medication linked to Tran. Some benefits, risks and contraindications were discussed at length and tenuous application to Tran’s education. (8 marks) |
Discussed the use of medication linked to Tran. Most benefits, risks and contraindications were discussed at length and demonstrated relevant application to Tran’s education. (12 marks) |
Good discussion the use of medication linked to Tran. Most benefits, risks and contraindications were discussed at length and demonstrated relevant application of appropriate education for Tran’s PCA. (16 Marks) |
Excellent discussion the use of medication linked to Tran. All benefits, risks and contraindications were discussed at length and demonstrated an excellent level of application education for Tran. (20 marks) |
| Part 1.5 10% |
No or incorrect side effects reported. No application to Tran’s case. No or incorrect reasons why it would need to be reported immediately to the Doctor. (0 marks) |
Few side effects reported. Poor application to Tran’s case. Few reasons why it would need to be reported immediately to the Doctor. (2 marks) |
Some side effects reported. Some application to Tran’s case. Some reasons for reporting. Poorly articulated or not prioritised (4 marks) |
Some or most side effects reported with some attempt to link to Tran’s case. Some reasons for reporting and some prioritization. (6 marks) |
Most side effects reported with good links to Tran’s case. Good reasons for reporting and good attempt to prioritise (8 marks) |
Excellent reporting of side effects of Morphine and strong links to Tran’s case. Excellent, prioritized reasons for reporting. (10 marks) |
| Referencing 5% | No in text referencing AND/OR reference list in APA style provided. (0 marks) |
APA style not correctly applied with major mistakes with referencing AND < 5 recent (5- 7 years old) or relevant sources (1 marks) |
APA style not correctly applied with minor mistakes with referencing AND/OR < 7 recent (5-7 years old) or relevant sources (2 marks) |
APA style correctly used. Recent (5-7 years old) and relevant sources used that demonstrate reasonable depth of reading though minimum of 7 peer reviewed sources. (3 marks) |
APA style correctly used. Recent (5-7 years old) and relevant sources used that demonstrate good depth of reading. Minimum of 9 peer reviewed sources. (4 marks) |
APA style correctly used, no errors. Excellent recent (5-7 years old) and relevant sources used that demonstrated excellent depth of reading. Minimum of 10 peer reviewed sources. (5 marks) |
| Presentation/ Writing 5% |
Writing cannot be followed. Poor or absent use of spelling and grammar checks (0 marks) |
Unclear layout. Writing is not concise or thorough. Many major spelling or grammatical errors. (1 marks) |
Somewhat clear layout. Writing is not concise or thorough though can be followed Several spelling or grammatical errors. (2 marks) |
Clear layout. Writing may be concise but not thorough. Few minor spelling or grammatical errors. (3 marks) |
Good layout. Writing is concise and thorough. No spelling or grammatical errors. (4 marks) |
Excellent layout. Writing is concise, thorough and demonstrates excellent understanding of the topic. No spelling or grammatical errors. (5 marks) |
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