Posted: April 22nd, 2015

Congestive Cardiac Failure

Congestive Cardiac Failure

1
NRSG353 Assessment Task 2 –Case Study
Due Date: 1st May 2015 at 5pm via Turnitin
Weighting: 40%
Word count: 1600 words (every question has a specific word count, which must be adhered to)
Instructions:
• Students are to choose one (1) of the case studies below and answer the associated
questions. The assignment is to be presented in a question/answer format not as an
essay (i.e. no introduction or conclusion).
• Each answer has a word limit (1600 in total); each answer must be supported with
citations.
• A Reference List must be provided at the end of the assignment.
• Please refer to the marking guide available in the unit outline for further information.
** The following questions must be answered for your chosen case study **
The following questions relates to the patient within the first 24 hours:
1. Outline the causes, incidence and risk factors of the identified condition and how it can
impact on the patient and family (400 words)
2. List five (5) common signs and symptoms of the identified condition; for each provide a
link to the underlying pathophysiology (350 words)
a. This can be done in the form of a table – each point needs to be appropriately
referenced
3. Describe two (2) common classes of drugs used for patients with the identified condition
including physiological effect of each class on the body (350 words)
a. This does not mean specific drugs but rather the class that these drugs belong to.
4. Identify and explain, in order of priority the nursing care strategies you, as the registered
nurse, should use within the first 24 hours post admission for this patient (500 words).
Already(Choosen(and(given(on(page(2
Given(on(next(page
2
Case Study Question 1
Mrs Sharon McKenzie is a 77 year old female who has presented to the emergency department
with increasing shortness of breath, swollen ankles, mild nausea and dizziness. During your
assessment Mrs McKenzie reports the shortness of breath has been ongoing for the last 7 days,
and worsens when she does her gardening and goes for a walk with her husband.
On examination her blood pressure was 105/55 mmHg, HR 54 bpm, respiratory rate of 24 bpm
with inspiratory crackles at both lung bases, and Sp02 at 92% on RA. Her fingers are cool to
touch with a capillary refill of 1-2 seconds. Mrs McKenzie states that this is normal and she
always has to wear bed socks as Mr McKenzie complains about her cold feet.
Her current medications include: digoxin 250mcg daily, frusemide 40mg BD, enalapril 5mg daily,
warfarin 4mg daily.
The following blood tests were ordered: a full blood count (FBC), urea electrolytes and
creatinine (UEC), liver function tests (LFT), digoxin test, CK and Troponin. Her potassium level is
2.5mmol/L.
Mrs McKenzie also has an ECG which showed sinus bradycardia, and a chest x-ray showing
cardiac enlargement and lower-lobe infiltrates, suggesting the presence of acute exacerbation
of congestive cardiac failure.
Impression: Congestive cardiac failure with ?digoxin toxicity
NRSG353 Acute Care Nursing 2, Semester 1 2015Page 15 of 17
Assessment Task 2: Case Study – Marking Rubric (40%)
Criterion High Distinction Distinction Credit Pass Unsatisfactory
Q1
Outline the causes, incidence and risk
factors of the selected disease and how it
can impact on the patient and their family
(400 words – 20%)
Linked to case study
Provides comprehensive
identification of causes,
incidences and risk factors.
Provides comprehensive
understanding of the disease
impact on patient and family
Linked to case study
Provides a solid indication of
causes, incidences and risk
factors.
Provides a solid understanding of
the disease impact on patient and
family
Linked to case study
Provides an identification of
causes, incidences and risk
factors.
Provides an understanding of the
disease impact on patient and
family
Linked to case study
Provides minimal identification of
causes, incidences and risk factors
Provides minimal understanding
of the diseases impact on patient
and family
Not linked to case study
Does not identify appropriate
causes, incidences and risk
factors.
Does not identify the impact on
the patient and family
Q2
List five (5) common signs and symptoms
of the selected disease, and for each one
provide a link to the underlying
pathophysiology (350 words -15%)
Provides a comprehensive look at
the identified five (5) common
signs and symptoms
Provides a comprehensive link to
pathophysiology
Identifies five (5) signs and
symptoms that are less common
Provides a thorough link to
pathophysiology
Identifies five (5) signs and
symptoms
Provides a solid link to
pathophysiology
Identifies five (5) common signs
and symptoms
Provides basic links to
pathophysiology.
Does not identify five (5) signs and
symptoms
Does not link to appropriate
pathophysiology.
Q3
Describe two (2) common classes of drugs
used for patients with the selected disease
including physiological effect of each class
on the body (350 words – 15%))
Two (2) classes of drugs
appropriately identified.
A comprehensive understanding
and explanation of the
physiological effects on the body
Two (2) classes of drugs
appropriately identified.
A thorough understanding of the
physiological effects on the body
Two (2) classes of drugs
appropriately identified.
Some understanding of
physiological effects on the body
One (1) class identified in
appropriate
Minimal identification of
physiological effect on the body
Drugs identifies not appropriate
No identification of physiological
effect on the body
Q4
Identify and outline, in order of priority
the nursing care strategies you, as the
registered nurse, should use within the
first 24 hours post admission for this
patient (500 words – 40%))
40%
The care plan was articulate,
logical, balanced and convincing.
A diverse range of perspectives
offered. All important aspects are
covered demonstrating
comprehensive knowledge of the
key areas.
The care plan was cohesive and
logical. A sound attempt at
analysis and critique from a range
of perspectives was also made.
Most of the key areas are covered
demonstrating an advanced
understanding of the important
issues.
The care plan was cohesive and
logical. Some attempt at analysis
and critique was made. A number
of key areas are covered
demonstrating a clear
understanding of the important
issues.
A logical care plan was presented
but mostly descriptive. Some
structure to ideas with
satisfactory explanation of some
key areas provided. A basic
understanding was demonstrated.
There is little/no cohesion to the
flow of the case study. Broad
generalisations are made.
Irrelevant content and
unstructured points are made.
Key areas are not addressed.
Minimal understanding is
demonstrated.
NRSG353 Acute Care Nursing 2, Semester 1 2015Page 16 of 17
Referencing
5%
An extensive range of relevant
literature utilised with
sophisticated interpretation and
analysis.
Accurate referencing using APA
format.
An extensive range of relevant
literature utilised with
appropriate interpretation &
application.
Accurate referencing using APA
format.
Satisfactory use of literature with
appropriate interpretation &
application.
Mostly accurate referencing using
APA format.
Satisfactory use of literature.
Some attempt to interpret &
apply the literature is evident.
Mostly accurate referencing using
APA format.
Unsatisfactory use of literature.
No attempt to interpret & apply
the literature is evident.
Not accurate referencing using
APA format.
Presentation
5%
Within 10% of word limit
Flawless presentation
Within 10% of word limit
High standard of written
communication with few errors of
spelling, and grammar
Within 10% of word limit
Effective written communication
with few errors of spelling, and
grammar
Within 10% of word limit
Effective written communication
although a number or errors of
spelling and grammar
More than 10% over word limit
Multiple errors in spelling and
grammar
Structure does not flow
topics are not linked appropriately
Comments
Final Grade /100 Marker: