Nursing Assignment: Systematic Assessment Framework and Nursing Considerations in Medication Administration

Running head: NURSING ASSIGNMENT
Nursing assignment
Name of the Student
Name of the University
Author note

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NURSING ASSIGNMENT
Clinical case studies are important and act as instructive examples that describes the
background of a patient, determine diagnosis and indicate plan of treatment. It provides a broader
understanding of the patient’s condition and possible outcomes. Health assessment is an
important component in nursing practice that is intended to provide patient-centred care.
According to Nursing and Midwifery Board of Australia (NMBA), nursing assessment is a
competency standard for the registered nurses (Ross, Barr & Stevens, 2013). They need to
perform systematic and comprehensive nursing assessments and plan of care through
interdisciplinary approach to respond effectively to rapidly changing or unexpected situations.
Patient-centred approach forms the basis for health assessment that is helpful in developing an
integrated or coordinated plan along with follow-up for maximizing positive health outcomes
(Kitson et al., 2013). This is witnessed in the clinical case study of Mr. Walter Williams, an 83-
year-old man who had fracture in his left neck of femur (NOF) and underwent total jip
replacement (THR). Later, he recovered in Post-Anesthetic Care Unit (PACU) and currently
placed in Orthopedic Surgical Inpatient Unit (PACU). During the clinical handover, the patient
was found to have complained about pain; however, PACU staff did not give him analgesia due
to hypotension and assumed that he was not in too much pain. This poses ethical and legal
considerations involved in the case study. Therefore, in this assignment, systematic assessment
framework would be conducted relevant to Walter William’s medical condition, nursing
considerations in medicine administration and legal, ethical and professional issues that is related
to the case scenario.
As illustrated in the case study, comprehensive and systematic geriatric health
assessment is important, as it is an interdisciplinary, multi-dimensional and collaborative
approach in nursing (Tavassoli et al., 2014). It is considered a framework for diagnostic process

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NURSING ASSIGNMENT
for determining the medical, function al and psychological capabilities of elderly people in order
to develop integrated plan of care with possible outcomes. In addition, geriatric assessment help
clinicians to implement care plan that is patient-centered so that there is reduction of functional
decline while supporting independence and improving the overall quality of life.
ABCDEFGHI framework for systemic health assessment is used for the systemic assessment of
trauma patients. The tool is useful in emergency cases. The main purpose of the assessment is to
preserve the life of the patient through proper actions. There are two parts of the assessment;
primary and secondary. ABC is included in the primary survey and DEFGHI is the part of
secondary survey. Once the patient reach life threatening condition, the health professionals must
begin the secondary survey (Peacock, 2004). In the given case study, during the clinical
handover, systematic health assessment is required to understand Walter’s condition and
document for further use.
(A) Airway is the first step of assessment. In this process head tilt chin lift technique is used in
order to open airway. The process could help in the case of Walter to identify any blocked
airway that could lead to cardiac or respiratory attack (Donovan-Kicken et al., 2013).
(B) Breathing: After the airway is opened, next it is important to check breathing by using the
look, listen and feel techniques. In case of Walter, it is important to look at the chest in order to
observe rising and falling of his normal respiration, listen to the air movement and feel the air
coming out of the nose or mouth. If breathing problem is detected then it is important to initiate
CPR (Peabody, 2015).

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NURSING ASSIGNMENT
(C) Circulation: Without breathing oxygen in the blood cannot be circulated. Thus, it is
important to check blood circulation to detect whether the oxygenated blood circulated
throughout the body in an effective manner (Peacock, 2004).
(D) Disability: It is important to check disability in case of Walter as he had a fall in his
workplace. X-ray report has confirmed the fracture in the left neck of femur. Thus, further
neurological status needs to be observed in order to recognize any disabilities or deformities
within the patient (Liu et al., 2012).
(E) Expose and examine: Detail examination of patient’s body is important to identify any
critical sign. In this regards it is important to remove the clothe and assess properly the patient,
however the patient must be kept warm (Peacock, 2004).
(F) Full set of vital sign is important to document changes in the pulse rate, blood pressure,
pupil breathing, skin color, body temperature, any rashes, and level of consciousness in order to
understand the current situation of the patient and use the report in further treatment (Donovan-
Kicken et al., 2013).
(G) Give comfort measure: As the patient has undergone major operation it is important to give
comfort measure. Continue rest is needed to provide to the patient in order to ensure fast
recovery and prevent further injury (Liu et al., 2012).
(H) History and head-to-toe assessment: A total head-to-toe assessment needs to be done in
order to gather information regarding the health condition of the patient and identify further
treatment if needed. To collect patient history SAMPLE framework could be follow which
includes assessment of symptoms, allergies, medications, past medical history, last oral intake
and events. In case of Walter it has been found that he has morphine allergy, thus, such