HNN329 Chronic Illness & Supportive Care
Assessment Task 1: Care Plan
Equivalent 1500 words – 15% weighting
Purpose of assessment task
This assessment task will enable you to create a comprehensive plan of care for individuals experiencing chronic illness (ULO1) and explain the pathophysiology of selected chronic illnesses to inform quality evidence-based nursing care (ULO3).
Due date:
Friday 5 May 2023
Time:
8.00pm
Location:
Assignment dropbox on HNN329 CloudDeakin unit site
Format:
HNN329 Care Plan Template – 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.
Case scenario:
Identify: You are the Registered Nurse working in the Acute Medical Ward caring for Mrs. Edith Johnson.
Situation: Edith has been on the ward for 12 hours after being admitted via the Emergency Department (ED) following a three (3) day viral illness that was being managed at home by her local GP. During the viral illness, Edith reported a fever, productive cough, increased sputum production and shortness of breath. Edith has been unable to get any rest at home due to these symptoms.
Background: Edith is a 68-year-old female who has a past medical history of Chronic Obstructive Pulmonary Disease (COPD), hypertension (HTN) and atrial fibrillation (AF). Edith was diagnosed with COPD 8 years ago and has a FEV1 of 55% predicted from 1 month ago. Edith’s regular medications are: Symbicort (100mcg/6mcg) 2 puffs BD, Ipratropium (2 puffs) QID, Metoprolol 50mg daily and Rivaroxaban 20mg daily. Edith comes from home alone following the death of her husband 3 years ago but has the support of her two daughters close by. Edith used to be a keen bingo player and a part of the local craft group. However, due to worsening COPD symptoms, she is not able to participate as much as she would like and now relies heavily on community services to help with her activities of daily living (ADLs).
Assessment: At the commencement of your shift, you undertake a comprehensive focused patient assessment on Edith and find the following:
Body System Assessment Assessment Data
Neurological (CNS) GCS 15 (E=4, V=5, M=6)
Temp 38.0°C
Pain 4/10 (Numerical)
Cardiovascular (CVS) BP 138/82mmHg
HR 92bpm (irregular)
Respiratory SpO2 92% on 2L via NP RR 28bpm
Genitourinary/Renal IDC insitu
Urine Output 20mL/hour
Endocrine/Metabolic BGL 5.3mmol/L
Integument PIVC to L) cubital fossa
Musculoskeletal
Psychosocial/other Lives at home alone
Assistance needed with ADL’s
2 daughters close by
Unable to do social activities that Edith enjoys
Recommendation: Provide safe priority nursing care for Edith.
Patient Problems:
Actual Patient Problems Potential Patient Problems
Impaired gas exchange Risk for ineffective coping
Ineffective breathing pattern Risk for imbalanced nutrition
Impaired urinary elimination Risk for knowledge deficit
Decreased activity tolerance Risk of infection
Ineffective airway clearance Risk of social isolation
Task Description:
Based on the case scenario and body system assessment data above, apply the nursing process to develop a comprehensive nursing care plan for this patient.
1.) Problem Identification:
a) Identify four (4) priority patient problems from the above list. Include two (2) actual and two (2) potential patient problems. For each of these problems, identify at least two (2) findings from the case scenario to support your priority problem selection.
b) With reference to evidence-based literature, explain the relevant aetiology, pathophysiology and defining characteristics associated with each of the four (4) patient problems and provide a rationale as to why this is a priority problem for this patient.
c) Identify one (1) psychosocial problem and identify data findings from the case scenario to support your problem selection. Explain why this is an important psychosocial problem to consider in this patient, including explanation of how this problem may affect the patient’s daily life.
2.) Planning
a) Develop an appropriate goal of care with expected measurable parameters for the four (4) priority patient problems.
b) Develop an appropriate goal of care with expected patient outcomes for the identified psychosocial problem.
3.) Implementation
a) Identify two (2) priority nursing interventions for each of the five (5) patient problems.
b) Provide a rationale for each of the identified nursing interventions, relating the identified nursing intervention to the underlying pathophysiology/physiology of the specific patient problem.
4.) Evaluation
a) Describe the data you would analyse to evaluate the effectiveness of the identified nursing interventions.
Instructions for this assessment task:
• Your nursing care plan must be presented on the HNN329 nursing care plan template located on the HNN329 CloudDeakin site.
• Writing in dot point/s is accepted.
• You are required to present the information in your own words.
• This assessment task is an individual piece of work.
• Referencing is required for this assessment task in parts 1b and 3a above.
Presentation requirements:
The School of Nursing and Midwifery follows the American Psychological Association (APA) 7th edition referencing style. Presentation requirements of this referencing style are outlined below. For further detail regarding APA 7 referencing style refer to Referencing | Students (deakin.edu.au).
Title Page:
Include the following information on separate lines; Title of Paper (bold font), Student Name/s and student identification number, University Name, Unit Code and Name, Due Date.
Formatting of Title Page: Centred text alignment and double line spacing.
Font:
Writing is to be in an accessible font. Examples of these include; 12-point type size Times New Roman.
11-point type size Georgia.
11-point type size Calibri.
11-point type size Arial.
Ensure the same font is used consistently throughout the entire paper.
Word Count
The HNN329 care plan assignment is 1500 words ‘equivalent’. Therefore, the no more or less than 10% of the indicated word count does not apply.
Marking criteria:
This care plan assignment will be assessed according to the Marking Rubric, which is presented below. This Marking Rubric provides you with a breakdown of each criterion that will be assessed. It is essential to utilise this rubric to help you clearly identify detailed components that are important to your achieving success with this assessment task. Use the descriptors of each criterion to direct and develop your assessment task.
Criterion mode: Points Exceeds Expected
Expected Standard Minimum Standard Below Expected Standard
Standards
Starting % 80 Starting % 60 Starting % 50 Starting % 0
Criterion 1:
Identification and planning of priority patient problems Correctly identifies two (2) findings from the case scenario to support selection of all priority patient problems.
Accurately and thoroughly describes the most appropriate goals of care for each patient problem.
Planning for all patient problems includes relevant measurable parameters.
Correctly identifies two (2) findings from the case scenario to support selection of most priority patient problems.
Accurately and clearly describes the most appropriate goals of care for each patient problem.
Planning for most patient problems includes relevant measurable parameters. Correctly identifies one (1) finding from the case scenario to support selection of some priority patient problems.
Clearly describes the most appropriate goals of care for each patient problem.
Planning for at least two (2) patient problems includes measurable parameters. Incorrectly identifies findings from the case scenario to support selection of each priority patient problems.
Broad statements used to describe the most appropriate goals of care for each patient problem, or goals of care not provided.
Planning for each patient problem does not include measurable parameters.
Points 10
Criterion 2
Evidence-based explanation of underlying pathophysiology, defining characteristics and aetiology Referencing evidencebased literature, accurately and thoroughly explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
Level of explanation provided demonstrates significant depth of understanding for each aspect.
Referencing evidencebased literature, accurately and clearly explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
However, further detail is
required to show significant depth of understanding for each aspect.
Referencing evidencebased literature, explains the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
However, significant further detail is required to show expected depth of understanding for each aspect.
No referencing of evidencebased literature to explain the relevant aetiology, defining characteristics and pathophysiology associated with each of the four (4) identified patient problems.
All patient problems did not have appropriate explanation
of aetiology, defining characteristics and pathophysiology
Points 24
Criterion 3
Identification, explanation and planning of relevant psychosocial patient problem Accurately identifies one (1) psychosocial problem and associated data findings relevant to the case scenario.
Accurately and thoroughly explains the importance of the identified psychosocial problem for the case scenario.
Consideration within the explanation is given to how this psychosocial problem may affect the case scenario patient’s life. Accurately identifies one (1) psychosocial problem and associated data findings relevant to the case scenario.
Clearly explains the importance of the identified psychosocial problem for the case scenario.
Some consideration within the explanation is given to how this psychosocial problem may affect the case scenario patient’s life. Accurately identifies one (1) psychosocial problem and some associated data findings relevant to the case scenario.
Describes the importance of the identified psychosocial problem for the case scenario.
Further consideration within the explanation is required to demonstrate how this psychosocial problem may affect the case scenario patient’s life. Incorrect and/or inappropriate psychosocial problem identified relevant to this case scenario.
Insufficient detail provided in explanation to demonstrate knowledge of importance of this patient problem and/or how if may affect the patient’s life.
Describes the importance and impact of this patient problem in general, and not specific to the case scenario.
Points 12
Criterion 4
Implementation of evidence-based nursing interventions including rationale Identifies a total of ten (10) correct evidencebased nursing interventions.
All nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and/or physiology, which demonstrates understanding of how each intervention addresses the specific patient problem. Identifies a total of ten (10) correct evidencebased nursing interventions.
Majority of nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and/or physiology.
Further explanation required to demonstrate understanding of how each intervention addresses the specific patient problem. Some of the nursing interventions identified are evidence-based.
Some nursing interventions identified are nursing assessments. Some of the nursing interventions are supported by a rationale, including an explanation of the underlying pathophysiology and/or physiology.
Further explanation is required to demonstrate understanding of how each intervention addresses the specific patient problem.
Identified nursing interventions are incorrect, inaccurate and/or are nursing assessments.
Nursing interventions are not supported by a rationale, including an explanation of the underlying pathophysiology and/or physiology.
Unable to demonstrate understanding of how each intervention addresses the specific patient problem.
Points 25
Criterion 5
Evaluation of nursing care provided Thoroughly and accurately describes correct measurable data to evaluate the effectiveness of each of the ten (10) identified nursing interventions. Majority of the data utilised to evaluate the effectiveness of the identified nursing interventions are appropriate.
Description is lacking depth and requires further work. Some of the data utilised to evaluate the effectiveness of the identified nursing interventions are appropriate.
Description is lacking significant depth and requires further work. Evaluation method is incorrect, incomplete and/or does not include correct measurable data.
Points 10
Exceeds Expected
Standard (80%+)
Expected Standard (50%+)
Below Expected Standard