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Aim of assessment
The purpose of the assessment is to enable students to demonstrate knowledge by accurately analysing information in a case study of complex critical care patient.
Read the case study attached and answer the following questions-
- Analyse the pathogenesis in relation to the clinical manifestations in the case study help (15 marks).
- Select ONE (1) appropriate nursing strategy, and explain the underpinning evidence base for this rational (5 marks)
- Critically Analyse the Arterial blood gas results, and relate them to the underlying pathogenesis (10 marks)
- Academic Writing (5 marks).
Case study Details: Mr. Kirkman a 75-year-old male, presented to ED complaining of burning sensation upon urination and lower abdominal pain radiating into the right flank.
Mr. Kirkman was admitted to the ward with a diagnosis of Urinary tract infection. He was placed on IV NaCl and IV Sulfamethoxazole-trimethoprim 1 0 mg/kg/day IV in 2 equally divided doses daily, and an Indwelling catheter was inserted.
Twenty-four hours later, his condition deteriorates HR 135, BP 80/42, RR 35, and TEMP 39 and looks generally unwell.
History from ED notes
- Wife died 12 months ago.
- Social drinker
- Heavy smoker 2 packs a day since commencing as a teenager.
- Chronic bronchitis on Vento in and Atrovent
- Previous UTI
- No cardiac history
Diagnosis 24 hours later
- UTI with severe sepsis
PRIMARY SURVEY O/E
- Patient speaking in single words
- RR 35bpm, accessory muscle use SPO2 82%, in obvious distress
- Sinus rhythm 135bpm, Blood pressure 80/42mmHg, Temperature 39°C
- E4, V4, MS
- Use of accessory muscles, lower abdominal pain 6/10, flushed face
- IVC in situ, IDC- Dark urine passed small amounts approximately 40mls in last 8 hours
Marking criteria and standards Assessment 2 Short Answer Questions