3000 words essay 100% weighing which relates to 1.) pharmacological processes 2.) medicines management 3.) nursing care 4.) safe practice two cases will be presented and can choose either case study 1 or 2. each has different guidelines i have also attached an example
September 2017: Case study 1: Essay Guidelines
Introduction (5-15%)
Provides structure to the essay
Provides the reader with an outline of the essay and what to expect
Present the topics logically and follow this sequence in main body of the essay
Third person only: no ‘I’ or ‘ME’
Outline the topics you are going to present in the essay (logically and sequentially)
Make it clear but short and succinct: 1 paragraph max.
Make reference to the case study: do not reproduce all the details
Introduce your topic with some relevant background information on the topic: make it short, snappy and interesting: grab the reader’s attention right at the beginning
This assignment will critically examine, explore, discuss, highlight or address………… Main Body (70-80%)
Use the information presented in the case study to illustrate and critically discuss the 4 required areas of the essay:
Case Study 2: September 2017
Critically discuss the case study in relation to Rosemary’s post-operative pain management. Your assignment should focus on: pharmacological processes, medicines management issues, nursing care and safe practice and the nurse’s role.
Rosemary Reynolds is 76 years old with a past medical history of rheumatoid arthritis. She has experienced increasingly severe pain, swelling and stiffness in her right knee for the past two years. Treatment with physiotherapy and exercises and regular steroid injections has not been effective and Rosemary has now decided to undergo a right total knee replacement. Rosemary’s symptoms affect her quality of life and prevent her from leading an active social life and disrupt her sleep pattern. Rosemary is otherwise fit and well and has no other relevant past medical history and lives alone in a ground floor flat with regular visits from her daughter.
Rosemary underwent a right total knee (arthroplasty) replacement 3 day ago and is now back on the orthopaedic ward. Her surgery was uneventful and there were no complications during the surgical procedure.
Rosemary is only managing very small amounts of food and fluids due to persistent nausea, frequent vomiting and mild dyspepsia. She has not had her bowels open since before the surgery (5 day post operatively) and is experiencing mild pruritus to her trunk and back. She has a small dressing on her knee wound, which is showing no signs of infection and is wearing anti embolism stockings (AES).
Rosemary has a morphine patient controlled analgesia pump (PCA) in progress and is managing to gently mobilise the short distance to the toilet and back with the assistance of a walking frame and one nurse. She is finding her physiotherapy exercises difficult to manage due to persistent nausea, pain and fatigue.
The nurse caring for Rosemary today has just completed a pain assessment using the numerical rating scale tool (NRS). Where 1-3 is calculated as mild pain and 7-10 as severe pain (Figure 1). Rosemary has stated that she is experiencing moderate to severe pain which she rates as 6-7 when mobilising and mild to moderate pain: 3-4 when resting in her chair. Her current sedation score according to the Alert, Confusion, Verbal, Pain and Unresponsive tool (ACVPU) (NEWS2 2017) is recorded as alert. All clinical observations are within normal parameters. She continues to experience persistent nausea and vomited once after breakfast this morning, her back and chest remain itchy with no visible rash present.
Figure 1: numerical rating scale tool.
Rosemary’s current medication regime: Drug Dose
Intravenous (IV) morphine PCA
50mg/50ml (concentration of 1mg/ml).
There is no continuous or background infusion 1mg (1ml) bolus with a lock out period of 5 minutes. Total dose: 12mg/hr
Paracetamol (acetaminophen)
1 gram every 6 hours: maximum daily amount 4 grams (PO)
Enoxaparin sodium
40mg once a day, subcutaneous (S/C)
Ondansetron
8mg twice a day (PO)
Diclofenac
50mg three times a day (PO), when required
Lactulose 15ml
Twice a day (PO)
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