NRSG370 Assessment Task 3: Case Study – Med Surg #2 Peritonitis ruptured appendix

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NRSG370 Assessment Task 3: Case Study – Med Surg #2
Mr Peter Ling: Post-operative inguinal hernia repair

Mr Peter Ling a 67-year-old man who is admitted to the Surgical ward, following an open mesh inguinal hernia repair. He had presented to ED with a 6-hour history of a R non-reducible tender, inguinal mass, post commencing a new gym/weight lifting regime.
Past Medical History: Mr Ling is retired, lives with his wife, ex-smoker and is obese, with a body mass index (BMI) of 30. Incidentally, he is an ex weight lifter. He is on medication for hypertension and hyperlipidaemia, which are both well controlled, and he also has mild congestive heart failure (CHF).
Mr. Ling was recovering well, but on Day 2 post op, he has become a little agitated and confused, complaining of significant left calf pain.
On your assessment:
• Vital signs: Temp: 39.3oC, RR: 25, HR:100 regular, SpO2 95% on room air (R/A), BP: 170/90, Pain score 7/10 (wound site and left calf), GCS 14/15
• Physical assessment: Mr. Ling is restless and confused to time and place. His chest is clear, skin is dry, post-op surgical wound dressing is oozing green purulent discharge and tender to touch. His left calf appears larger than the right and it is red, and warm to touch.
Investigations:
• Haemoglobin 16.5 gm/dl,
• WCC, neutrophils and CRP – all elevated
Nursing notes:
• Mr. Ling has an 18g Cannula in his Right arm
• He has tolerated diet and is voiding well
• Bowels opened yesterday
• Agitated and confused to time and place on assessment this am.
You are the registered nurse looking after Mr. Ling.

Assessment Task 3: Case Study
Students will complete a 1700 Word case study which discusses the provision of ethical, legal, evidence-based, holistic person-centred care including the establishment of realistic and relevant goals through the theoretical examination of a particular nursing specialty case study using the Clinical Reasoning Cycle (Levett-Jones, 2018).
Case Study Selection
Students must select and respond to the case study questions that reflects their allocated clinical placement specialty. If you have not been allocated a specialty placement by the end of week 4, please refer to your LEO campus announcements forum and the introductory lecture for instructions on how to proceed. If you are repeating the unit, or for any other reason unsure which case study to complete, please contact your campus LIC.
Please note – under no circumstances should you repeat the same case study twice.
There are a variety of case studies on LEO page under the case study tile:
• Choose the one that best reflects your specialty placement
• BNBP students – must do ‘High Dependency’ Case Study
Case study scenarios can be found on LEO via this link: https://leo.acu.edu.au/course/view.php?id=27543§ion=4
Students are expected to use the Clinical Reasoning Cycle (Levett-Jones, 2018) as a framework to plan and evaluate person-centred care. You are being asked to think through the case scenario and then discuss how data was collected and the type of data collected, identify problems and nursing issues, identify and state the objectives and discuss how care was provided in order to address the issues and evaluate the interventions carried out: (analyse and identify a nursing issues/problems/needs, set objectives, discuss the nursing interventions and evaluate the interventions of care carried out). Students are expected to apply the clinical reasoning cycle to address the case scenario using the following format:
• Provide an introduction
• Consider the person’s situation
• Collect, process and present related health information
• Identify and prioritise three (3) nursing problems/issues based on the health assessment data that you have identified for the person at the centre of care.
• Establish goals for priority of nursing care related to the nursing problem/issues identified
• Discuss the nursing care of the person; link it to assessment data and history.
• Evaluate your nursing care strategies to justify the nursing care provided
• Reflect on the person’s outcomes/your learning
• Provide a conclusion
Submission: Your Case Study should be clearly labelled Assessment 3 – Case Study and uploaded in the relevant drop box located in your campus tile on the LEO site (Assessment 3).

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