Subject Code & Title : NSB236 The Deteriorating Patient Case Study
Length: 1200 words +/-10% (word length includes in-text referencing and excludes your references).
Weighting: Pass/Fail
Task : The assessment tasks requires you to write an academic essay that
addresses the following tasks:
1.From the chosen case study identify and discuss two (2) signs or symptoms of clinical deterioration reported in the case study, making connections between the related pathophysiology and the patient’s reported admission diagnosis.
2.Identify one (1) priority problem associated with the patient’s clinical presentation and signs or symptoms of clinical deterioration (identified in point 1). Justify why the selected problem is a clinical priority within the case. Use contemporary research to support your justification.
3.Discuss evidence based clinical interventions to address the priority problem and how to evaluate the efficacy of the intervention.
NSB236 The Deteriorating Patient Case Study Assessment – QUT Australia.

What you need to do:
In order to undertake this essay, you will need to research the case using current and relevant peer reviewed literature, in conjunction with reviewing:

• The lecture, tutorial and support materials associated with the relevant topic located on blackboard.
• Review the Quality Commission on Safety and Quality in Health Care; Standard: Recognising and Responding to Acute Deterioration
• Your knowledge and understanding related to:

1.The physiology and pathophysiology of the primary diagnosis and associated clinical data identified within the chosen case study;
2.The physiological assessments relevant to the features within the case study.

This assessment task is an individual assessment item and should be reflective of your own independent work.

Additional information:
• The intervention can be either independent or collaborative and must be clinically appropriate to the case and context, and supported by contemporary evidence.
• The intervention should identify and consider the nursing role within the provision of the intervention.

NSB236 The Deteriorating Patient Case Study Assessment – QUT Australia.

Presentation requirements:
This assessment task must:

• Be a formal written academic essay containing an introduction, body and conclusion, addressing the task, specified requirements and adhering to the prescribed word limit.
• Use QUT Cite Write APA referencing for citing academic literature
• Assessment cover page should include, student name, ID number, tutorial day and time, tutorial leaders name, case study title, and word count (actual).
• Be submitted in electronic form via Turnitin as a word document only. Submission made in any other form will not be accepted and a zero grade will be awarded.
• Integrate contemporary literature in the form of published articles
within journals, no older than 7 years.
• Include a footer on each page with your name, student number,
unit code and page number.
• 3 cm margins on all sides, double-spaced text
• Use font, such as Times New Roman, Arial or Calibri; font size 12
• Cite Write APA 7 th Edition style referencing with the page number included

Please note:
• If using web pages they must be current and evidence based.Sponsored sites and review sites such as Stat Pearls should be avoided. Your textbooks can be used but should not make up the majority of supporting evidence.
• The submitted essay should NOT contain tables, figures or appendices.
• The use of dot points is NOT permitted.
• Heading and/or subheadings are NOT permitted in this essay

Learning outcomes assessed:
1.Consolidate knowledge of key NMBA Registered Nurse Standards for Practice, National Safety and Quality Health Services Standards, and National Health Priorities to enable effective decision planning and action in a range of complex clinical situations across the lifespan.
2.Apply knowledge of anatomy, physiology and pathophysiology to
support evidence-based decision making associated with planning and action.
3.Demonstrate structured decision making and clinical reasoning to
review a range of health situations, synthesise evidence and data, determine priorities and formulate plans of care and interventions in line with time frames and agreed goals

What you need to submit:
One (1) word document that contains the following items:
1.A cover page with the items outlined in the presentation requirements provided.

NSB236 The Deteriorating Patient Case Study Assessment – QUT Australia.

All assessments must be submitted in electronic form via Turnitin by the due date. Emailed submissions will not be accepted.

Resources needed to complete task:
• Case study – contained within this document
• NSB236 unit content accessible on blackboard
• Ability to utilise research databases
• Access to the prescribed texts for this unit as outlined in the unit details

Case study:

Patient profile
Rebecca Bath child is a 59 year old women who has been admitted to the gastrointestinal ward with increasing abdominal pain, nausea and vomiting, and anorexia over the past 4 days. Her brother has reported that her alcohol use had been substantial (he had counted 30 bottles of wine
in the bin) over the past week.

She has a known medical history of pancreatitis, alcohol induced liver disease and ethanol misuse.An abdominal CT scan was performed yesterday and confirmed a suspected diagnosis of necrotising pancreatitis.

The nursing notes from the night shift report the following:

22/10/2021 at 06:10 hours – Patient slept well overnight. Diazepam 5 mg administered at 23:30 hours for an alcohol withdrawal scale (AWS) of 10, and subcutaneous morphine at 03:00 hours for increased abdominal pain 7/10. Reviewed overnight by the night registrar at 05:00 due to the patient experiencing malena, full blood count taken, with Hb reported at 05:30 hours of 88g/L (reduced from 101g/L 21/10/21 at 07:00 hours). Vital signs as documented. Night registrar to follow-up with treating team regarding malena, advised to monitor for further instances, and report if patient heart rate exceeds 100 beats/minute and if blood pressure decreases below 110 mm Hg systolic.

Subjective data:
At 08:05 hours Rebecca has pressed the nurse buzzer. She has vomited a large amount (estimated to be 200 ml) of dark brown coffee ground like fluid. She appears distressed and is reporting increased abdominal pain.

Physical assessment
Neurological – orientated to person, place and time. Appears anxious, mildly diaphoretic

Cardiovascular – pale, cool clammy skin to touch, blue tinge noted to fingernails, CRT approximately 3 seconds, pulse rapid and weak , HR 118 beats/minute and regular, Blood pressure 104/78 mm Hg, temperature 36.4 degrees Celsius. IV cannula insitu left cubital fossa –patent.

NSB236 The Deteriorating Patient Case Study Assessment – QUT Australia.

Respiratory – siting up in bed, increased work of breathing, respiratory rate 26 breaths/min, Sp O 2 89% on 2 L via NP.

Gastrointestinal – sharp abdominal pain 7/10, decreased bowel sounds, BGL 4.1 mmol, no further malena.

Renal – last voided 04:00 hours and pass urine in the toilet.

You have notified the team leader of your assessment findings and she/he is calling the treating to team to review.