Indicate the purpose of the paper  Describe the overall plan or structure of the paper BODY: (1400 words approx.) Please note that the table below is to guide you to structure the body of the essay.

  Mrs. Barbara Green is an 89-year-old woman who migrated to Australia from Germany 40 years ago. Barbara is a retired primary-school teacher and lives alone in a single-storey house. Barbara was married to Henry who was in the Royal Australian Navy; however he died of lung cancer two years ago. Barbara has a son Dominik from a previous marriage. He lives in Germany with his family and visits Barbara regularly. Henry‘s daughter from previous marriage, Tracy and his extended family live throughout Australia but keep in contact and visit regularly. Barbara retired twenty four years ago, at the same time Henry retired from the Navy. The couple spent their time together traveling around the world and volunteering at the local St Vincent de Paul shop. They participated actively in their local Catholic Church, organising fundraising activities. They were also very active members of the German Association. Barbara is fluent in both written and spoken English and German. She speaks with a strong German accent and sometimes people ask her to repeat herself. Barbara’s health has been slowly deteriorating over the last two years, forcing her to limit her level of activities. Last year, Dominik and his family visited Barbara. They wanted her to return to Germany with them so he and his family could be close to her, but Barbara decided not to leave her home. She was grateful to her son and family for the offer though. Henry’s daughter Tracy has kept in touch with Barbara since Henry died and visits every three months with daily phone calls. ? Barbara’s medical history is as follows: ? Dry macular degeneration ? Hypothyroidism ? Rheumatoid arthritis ? Osteoarthritis. Recently, Barbara has stopped driving due to her diagnosis of macular degeneration. She rarely leaves the house due to altered mobility and has lost physical contact with both friends and members of the German Association. Barbara’s house is unusually unkempt and the cupboards have minimal amounts of food consisting of some tins of soup and baked beans. Barbara feels very connected to her community and wants to stay in her own home. She realises that in order to do this, she may need help. Barbara feels she is already too much of a burden on Tracy and her family. Barbara’s local doctor is concerned that she is not eating properly, is losing weight and becoming too isolated. Barbara has been referred by her GP to the local community health centre for assessment and review. The referral letter from her GP states the following symptoms: ?? Joint stiffness. ? Swollen feet and enlarged joints. ? Painful joints particularly, her knee, hip, fingers and back. ? Limited joint movement. ? Constipation ? Occasional dizziness ? Vision deficit ?? Non-significant recent weight loss ? Patient states adherence to medications but it is suspected she may forget or skip doses when she is in pain Medications: ? Slow release Paracetamol 665 mg tab ii 3 times a day ? Ibuprofen 400 mg three times a day ? Thyroxine 150 mcg daily ? Hydroxychloroquine 200mg daily topic: You work at the local community health centre as a Registered Nurse and are assigned to manage Barbara’s assessment and care in her home.
Instruction:

please check all attached files before start work
APA reference list, use only (2012-2017) no use less than 2012
no plagiarism
no spelling mistake please
you must focus on nursing care plan
i attach 2 text book you must use those two text book for this case study please

A suggested structure of Assessment One CLINICAL SCENARIO – We use NRSG259 Tutorial scenario Giuseppe’s situation as an example to help you understand and structure of Assessment One. INTRODUCTION: (175 words approx.)  Introduce the topic and any important and relevant concepts to the reader.  Indicate the purpose of the paper  Describe the overall plan or structure of the paper BODY: (1400 words approx.) Please note that the table below is to guide you to structure the body of the essay. You will need to use paragraphs to present the discussion in your assignment. The body of the essay includes Part A and Part B: Part A – identifying three nursing care priorities Identify the three nursing care priorities using the first four steps of the Clinical Reasoning Cycle Consider Functional Consequences Theory – (embedded in discussion): 1. Consider the patient – describe facts and contents. This is the first stage of the clinical reasoning cycle, the nurse begins to gain an initial impression of the client’ situation. For example: This is an 87 old client – Giuseppe Guinta. He feels breathless on exertion, with wheezing and chest tightness. A 5 x 6x 0.2 cm ulcer is found at his right ankle, with a fair amount of exudate and an offensive smell. Giuseppe lives with his wife, Regina who experiences an intermittent memory loss, in a twostorey house…  Age-related changes (not modifiable) such as the decreased respiratory muscle tone and efficiency; decreased number of cilia cells; diminished chemoreceptor sensitivity to hypoxaemia; increased chest-wall compliance (Hunter, 2012, p. 434).  Risk factors (modifiable) such as smoking, occupational exposure to respiratory toxins, living in a 2- storey house, with COPD, etc. (Hunter, 2012, p. 434).  Negative Functional Consequences – difficulty 2. Collect cues/information – review the information, gather new information and recall knowledge; Giuseppe had a history of smoking for 20 years, COPD for 10 years, hypertension and cardiac failure for 6 years… Giuseppe feels tired easily and has difficulty climbing stairs and managing garden recently. His leg ulcer shows no sign of improvement. He also feels embarrassed about the smell and exudate from his leg ulcer… performing ADLs; a risk of being socially isolated and depression. 3. Process information – to interpret, discriminate, relate, infer, match the data and predict an outcome.  COPD – related to smoking  Shortness of breath – related to COPD and cardiac failure…  Leg ulcer – related to immobility, smoking, cardiac failure and COPD… (You should expand each point with support of the literature evidence.) 4. Identify problems/issues – synthesise all the information that has been collected and processed in order to identify the most significant patient problems or issues. You only need to identify three (3) issues for this assignment. You can conduct a literature search on your client’s issues and find relevant nursing diagnoses for each of the identified problems. Here is a useful link for some nursing diagnoses for COPD as an example. https://nurseslabs.com/chronicobstructive-pulmonary-disease-copdnursing-care-plans/ We have chosen the “Ineffective breathing pattern” as the top priority of care. Part B: Having identified all of the nursing care priorities, choose the top priority of care and then discuss using the remaining 4 steps in the Clinical Reasoning Cycle 5. Establish goals – setting up the goal with the patient (demonstrating dignity) for the particular nursing issue. The goal should be specific, measurable, achievable, realistic and timely (SMART). The goals for managing ineffective breathing pattern could be:  Giuseppe’s frequency and severity of the shortness of breath will be reduced to the level that John can tolerate within a week.  Giuseppe will be able to climb the stairs with decreased breathlessness in one month. You can write more goals according to the nursing issues identified. Considering Giuseppe’s age, his pathological conditions, psychological stressors, living environment, life style, and social network, etc. throughout the clinical reasoning cycle wherever it is applicable. 6. Take action – showing your nursing interventions/strategies with the relevant rationale(s) for each intervention. E.g.  deep breathing exercise to increase the lung expansion and prevent pneumonia  refer Giuseppe to GP for consideration of provision of home oxygen, bronchodilators and antibiotics;  ADLs assessment and organising a carer to assist Giuseppe with ADLs if needed.  Falls’ risk assessment (You should expand each point with support of the literature evidence. The rationale for each action should be included.) 7. Evaluate outcomes showing the expected outcomes and how you would evaluate them (objectively and subjectively). These should relate to your Goals. Think about using both objective and subjective data to evaluate the effectiveness of the nursing actions. E.g.  Giuseppe is able to wash and dress himself within minimal breathlessness.  Giuseppe is able to take the stairs with minimal breathlessness after using bronchodilators. (You should expand each point with support of the literature evidence.) 8. Reflection – what you have learned from this process and what you could have done differently. E.g. Next time, I would… I should have … If I had… I now understand… Here are a few examples:  I now understand the effects of COPD in limiting ability to carry out ADL.  If I had more knowledge of COPD I would understand the impact on the patient’s ability to undertake their ADL.  I now understand the effects of long term smoking on lungs. (You should expand each point with support of the literature evidence.) CONCLUSION: (175 words approx.)  In several sentences summarise what you have discussed. – THIS IS NOT A REPEAT of what you have written previously.  Then provide overarching statements that provide the reader with the most important take-home messages regarding the care plan for your client. Useful tips: The introduction and the conclusion need to be written AFTER the content has been written, not before. REFERENCES (12-15 references approx.) Two key references must be included: Hunter, S. (Ed). (2016). Miller’s nursing for wellness in older adults (2 nd Australia and New Zealand ed.) North Ryde, NSW: Lippincott, Williams and Wilkins. Levett-Jones, T. (Ed.). (2013). Clinical reasoning: Learning to think like a nurse. Frenchs Forest, NSW: Pearson.

Assessment 1 description and marking rubric Page 1 of 4 Assessment Task 1 – Written Assignment – Care Planning: Individual Discussion Description: This assessment is designed to measure your ability to identify and prioritise the most important nursing care issues for a client. Two theoretical frameworks underpin your assignment: Miller’s Functional Consequences Theory to identify the influences impacting on the older person and their level of function and Levett-Jones’ Clinical Reasoning Cycle as the tool to drive the process of identifying and assessing, implementing and evaluating care. In addition students need to demonstrate how the dignity of the older person is maintained and how the cultural background of the older person is considered, throughout the process of assessment and care provision Students are required to deconstruct a provided scenario and identify and describe three nursing care priorities with rationale. Then select the top priority (one) to be discussed in further detail .The 50% of the assignment body is to be dedicated to the indepth discussion of the identified care priority. Due date: Week 6 Weighting: 40% Length and/or format: 1750 words Purpose: The purpose of this assessment is to promote both problem solving and nursing care provision, related to a selected clinical scenario. Learning outcomes assessed: 2, 3, 7, 8 How to submit: Submission of assessments is by the Turnitin Assessment Dropbox in the unit LEO site only. Assessments may not be submitted by email. Please be aware of the 24 hour lockout period for Turnitin and ensure you allow enough time for reporting and resubmission. Please also be aware if students all try to submit in the final 15 minutes before due time, the system may not Assessment 1 description and marking rubric Page 2 of 4 accept your assignment on time and you may receive a late penalty. Issues with submission in the final hour before due time will not be considered as extenuating circumstances. Return of assignment: Marks for the assessment will be published on LEO. Marked assessments will be available online via drop box. ASSESSMENT CRITERIA: Please see criterion reference rubric on the next page and consult assessment block in LEO for further information. Assessment 1 description and marking rubric Page 3 of 4 ASSESSMENT TASK ONE – Written Assignment (1750 words) CARE PLANNING: INDIVIDUAL DISCUSSION Name: Student Number: Criteria High Distinction 12.75-15 Distinction 11.25-12.6 Credit 9.75-11.1 Pass 7.5-9.6 Unsatisfactory <7.5 Score 1. Evidence of use of relevant concepts of Miller’s Functional Consequences Theory of healthy ageing. Sophisticated and insightful use of the Functional Consequences Theory of Healthy Ageing in developing a nursing care plan for an older adult in the community. Systematic and accurate use of the Functional Consequences Theory of Healthy Ageing in developing a nursing care plan for an older adult in the community. Accurate use of the Functional Consequences Theory of Healthy Ageing in developing a nursing care plan for an older adult in the community. Adequate use of the Functional Consequences Theory of Healthy Ageing in developing a nursing care plan for an older adult in the community. Limited or insufficient use of the Functional Consequences Theory of Healthy Ageing in developing a nursing care plan for an older adult in the community. /15 12.75-15 11.25-12.6 9.75-11.1 7.5-9.6 <7.5 2. Demonstration of understanding and utilising a clinical decision making framework. Sophisticated and insightful use of the eight phases of the Levett- Jones Clinic al Reasoning Framework. Clear and accurate us e of the eight phases of the Levett- Jones Clinic al Reasoning Framework. Well-developed use of the Levett-Jones Clinical Reasoning Framework, Adequate but limited use of the Levett-Jones Clinical Reasoning Framework. There is an attempt to use the LevettJones Clinical Reasoning Framework; however, the eight steps are used inaccurately or inappropriately. Little or no demonstration of using the Levett-Jones Clinical Reasoning Framework. Inappropriate nursing care is identified for the chosen care priorities. /15 –42.5-50 37.5-42 32.5-37 25-32 < 25 3. Demonstrates the ability to problemsolve care issues and provide a comprehensive plan for person-centred nursing taking into account the client’s choice, dignity, and cultural considerations if necessary. Sophisticated and insightful discussion of the most relevant and effective person-centred care planning, with strong and consistent evidence of a systematic approach to the development of the chosen nursing care priority. Exceptional demonstration of ethical consideration for patient’s dignity, choice and culture. Thorough and accurate discussion of the most relevant and effective personcentred care planning, with strong evidence of a systematic approach to the development of the chosen nursing care priority. Sound demonstration of ethical consideration for patient’s dignity, choice and culture. Accurate discussion of some relevant and effective person-centred care planning, with clear evidence of a systematic approach to the development of the chosen nursing care priority. Mostly sound demonstration of ethical consideration for patient’s dignity, choice and culture. Adequate discussion of some relevant personcentred care planning, evidence of a systematic approach to the development of the chosen nursing care priority. Adequate demonstration of ethical consideration for patient’s dignity, choice and culture. Inadequate or inaccurate discussion of nursing care provision. Limited demonstration of personcentre care, with little or no evidence of a systematic approach to the development of the chosen nursing care priority. . Limited/little or no demonstration of ethical consideration for patient’s dignity, choice and culture. /50 Assessment 1 description and marking rubric Page 4 of 4 8.5-10 7.5-8.4 6.5-7.4 5.0-6.4 <5 4. Presentation, Structure and Written Communication Clear informative introduction, followed by body of essay, with a clear, rational conclusion. All paragraphs are organised in a logical manner so that content flows from one paragraph to the next. Exceptional skills in use of academic language, flawless spelling and grammar. Correct word count +/- 10%. Clear informative introduction, followed by body of essay, with a clear, rational conclusion. Most paragraphs are organised in a logical manner so that content flows from one paragraph to the next. Highly accomplished skills in use of academic language, with minimal spelling or grammatical errors evident. Correct word count +/- 10%. Mostly clear introduction with some information missing, followed by the body of essay, with a rational conclusion, but content within the body and within paragraphs is occasionally illogically sequenced. Competent skills in use of academic language, with few spelling and grammatical errors evident. Correct word count +/- 10%. Introduction provided but some information missing, followed by the body of the essay, with an attempt at a conclusion, but content within the body and within paragraphs is frequently illogically sequenced. Adequate use of academic language, some spelling and grammatical errors evident but meaning is discernible. Correct word count +/- 10%. There is no clear introduction, body and conclusion (i.e. no evidence of introduction or conclusion paragraph). There is limited sequencing (i.e. limited or no distinct paragraphs). No conclusion or conclusion introduces new content Limited or insufficient skills in written communication. Poor use of academic language, poor spelling, grammar, and punctuation. Meaning difficult to discern. Word count is either over or under the word limit of +/- 10%. /10 8.5-10 7.5-8.4 6.5-7.4 5.0-6.4 <5 5. Literature Sources and Referencing Evidence of extensive reading, and use of the most current, relevant and creditable evidence-based research. Exceptional and correct use of APA style for all citations and references. Evidence of wide range of reading, and use of good current, relevant and creditable evidence-based research. Correct use of APA style for most citations and references. Evidence of range of reading, and use of some current, relevant and credible evidence-based research. Use of largely correct APA style for some citations and references. Evidence of adequate reading, but use of few acceptable current, relevant and credible sources of evidence-based research. Adequate use of APA style with some inaccuracies of style. Evidence of a narrow range of reading, and use of limited current, relevant and credible evidence-based literature (i.e. commercial websites). Significant errors of APA style or insufficient use of academic referencing to adequately identify sources. /10 COMMENTS: TOTAL: /100 ASSESSOR NAME: DATE:

NRSG 259 Semester One 2017 Scenario for Assessment One Mrs Barbara Green Mrs. Barbara Green is an 89-year-old woman who migrated to Australia from Germany 40 years ago. Barbara is a retired primary-school teacher and lives alone in a single-storey house. Barbara was married to Henry who was in the Royal Australian Navy; however he died of lung cancer two years ago. Barbara has a son Dominik from a previous marriage. He lives in Germany with his family and visits Barbara regularly. Henry‘s daughter from previous marriage, Tracy and his extended family live throughout Australia but keep in contact and visit regularly. Barbara retired twenty four years ago, at the same time Henry retired from the Navy. The couple spent their time together traveling around the world and volunteering at the local St Vincent de Paul shop. They participated actively in their local Catholic Church, organising fundraising activities. They were also very active members of the German Association. Barbara is fluent in both written and spoken English and German. She speaks with a strong German accent and sometimes people ask her to repeat herself. Barbara’s health has been slowly deteriorating over the last two years, forcing her to limit her level of activities. Last year, Dominik and his family visited Barbara. They wanted her to return to Germany with them so he and his family could be close to her, but Barbara decided not to leave her home. She was grateful to her son and family for the offer though. Henry’s daughter Tracy has kept in touch with Barbara since Henry died and visits every three months with daily phone calls. Barbara’s medical history is as follows:  Dry macular degeneration  Hypothyroidism  Rheumatoid arthritis  Osteoarthritis. Recently, Barbara has stopped driving due to her diagnosis of macular degeneration. She rarely leaves the house due to altered mobility and has lost physical contact with both friends and members of the German Association. Barbara’s house is unusually unkempt and the cupboards have minimal amounts of food consisting of some tins of soup and baked beans. Barbara feels very connected to her community and wants to stay in her own home. She realises that in order to do this, she may need help. Barbara feels she is already too much of a burden on Tracy and her family. Barbara’s local doctor is concerned that she is not eating properly, is losing weight and becoming too isolated. Barbara has been referred by her GP to the local community health centre for assessment and review. The referral letter from her GP states the following symptoms:  Joint stiffness.  Swollen feet and enlarged joints.  Painful joints particularly, her knee, hip, fingers and back.  Limited joint movement.  Constipation  Occasional dizziness  Vision deficit  Non-significant recent weight loss  Patient states adherence to medications but it is suspected she may forget or skip doses when she is in pain Medications:  Slow release Paracetamol 665 mg tab ii 3 times a day  Ibuprofen 400 mg three times a day  Thyroxine 150 mcg daily  Hydroxychloroquine 200mg daily You work at the local community health centre as a Registered Nurse and are assigned to manage Barbara’s assessment and care in her home.


 

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