1.     Why is this medication being used to treat this patient? 2.     How does this medication work?

Rationales of morphine sulphate medications.

Rationales of morphine sulphate medications.

Assessment 1 – Case Study

Students will be required to complete a case study relating to the content presented in the unit. Students are to choose one of four case studies provided on LMS. Students are to utilise the same case study that they selected in NUR203. Students who are not enrolled in NUR203 may choose any of the four case studies.
Case studies will consist of a patient scenario including aspects of their medication management. Students must choose a medication that the patient is prescribed and provide a 1500 word rationale for the use of and nursing care of the patient in the case study.

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When writing their rationale students will consider the following questions:
(Please note: students must not use these questions as headings within their case study, they are for guidance only)

1.     Why is this medication being used to treat this patient?
2.     How does this medication work?
3.     What possible contra-indications or adverse effects need to be considered when taking this medication?
4.     What possible alternatives exist for this medication and when might they be utilised?
5.     What is the nursing care required for the patient whilst on this medication?
6.     How would we assess the effectiveness of the medication?
7.    What is the evidence base behind the use of this medication and the nursing care for the patient?

Case Study for Assessment No. 3 (Cholecystectomy)

Trent Black is a 65 year old retiree who is admitted to your ward from the emergency department. On arrival you note that he is trembling and nearly doubled over with severe abdominal pain.

Mr Black indicates he has severe pain in the right upper quadrant of his abdomen that radiate through to his mid back as a deep sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but ‘none as bad as this’.

He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. Mr Black experienced an acute onset of pain after eating fish and chips at a fast-food restaurant earlier today.

Admission vital signs are: BP 164/100, HR 132, RR 26, Temp 36, SaO2 96% on 2L of oxygen by nasal cannula.

Mr Blacks abdominal ultrasound demonstrates several retained stones in the common bile duct and a stone-filled gallbladder. He undergoes an ERCP and the stones and bile are released, but imaging reveals that a stone is still retained within the cystic duct, and multiple stones remain within the gallbladder as well. The surgeon decides that Me Black will require a laparoscopic cholecystectomy.

Mr Black is ordered morphine sulphate 2-4mg IV q1-2h.
Assessment 1 Marking guide Case study
Your introduction is to tell the reader what you will write about in the body of your work.     5%
Rationale – 1500 Words
This section is to include the following:
•    Medication use and rationale explained including aspects of pharmacology (15 marks)
•    Appropriate nursing care and nursing assessment discussed (15 marks)
•    Presentation of evidence to support pharmacology and nursing care. (15 marks)
•    Evidence presented represents recent and relevant research on the chosen medication and appropriate nursing care. (5 marks)
•    Student has addressed and given thought to the questions asked above as part of the assessment outline.  (20 marks)
•    Write in full paragraphs with topic sentences and explanation. (5 marks)
•    Appropriate use and citation of literature (references) to support the discussion you present. (5 marks)
•    Evidence of formulated structure and constructed discussion. (5 marks)

Your conclusion consists of two parts:
•    Summarise key findings from the body of your text
•    Write wrap up statements which suggest that you have derived a conclusion in your own mind about the significance of the treatment prescribed and the importance of appropriate nursing care.    5%
The following criteria must be addressed:
•    Table of contents and essay title
•    Headings within essay
•    A minimum of 10 research journal articles to be cited (students should consider articles written in the last 10 years).
•    Observe specified word limit. (+/- 10%)    5%
Total    100% converted to a mark out of 25


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