1
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: Time: Location: Format: |
Friday 5 May 2023 8.00pm Assignment dropbox on HNN329 CloudDeakin unit site 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
2
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
3
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.
4
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.
5
Criterion mode: Points | Exceeds Expected Standards |
Expected Standard | Minimum Standard | Below Expected Standard | |||
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 evidence based 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 evidence based 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 evidence based 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 evidence based 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 |
6
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 |
7
Criterion 4 Implementation of evidence-based nursing interventions including rationale |
Identifies a total of ten (10) correct evidence based 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 evidence based 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 (<50%) |
8
Criterion 6 Presentation, writing and referencing in accordance with assessment instructions |
Exceeds Expected Standard (80%+) Accurately follows presentation requirements, including the use of the care plan template. Content is fluently written with minimal errors throughout. Use of correct medical terminology. Referencing is in accordance with APA 7 with minor errors only. |
Expected Standard (50%+) Majority of submission accurately follows presentation requirements, including the use of the care plan template. Content is fluently written with minor errors throughout. Correct medical terminology mostly used. Referencing in in accordance with APA 7 with recurrent minor errors only. |
Below Expected Standard (<50%) Presentation requirements are not followed, or there are significant errors. Care plan template is not used. Content is not fluently written and at times is hard to follow. APA 7 referencing style not utilised and/or references not provided to support writing. |
Points | 9 | ||
Total Points | 90 |