Nursing Care of a Patient with Acute on Chronic Renal Failure 2000 Words

Topic: Nursing care of a patient with acute on chronic renal failure (2000 words (+ 100 words for headings in the template) +/- 10% 1.5gm spaced using Arial or Calibri font in size 11 or 12 Contents page, title page, introduction and conclusion are NOT required Unless otherwise indicated, no acronyms, abbreviations and/or nursing jargon Unless otherwise indicated, grammatically correct sentences and topic paragraphs are required. 100 words have been excluded from the word count to account for the headings within the nursing care plan

Topic: Nursing care of a patient with acute on chronic renal failure
2000 words (+ 100 words for headings in the template) +/- 10%
1.5 spaced using Arial or Calibri font in size 11 or 12
Contents page, title page, introduction and conclusion are NOT required
Unless otherwise indicated, no acronyms, abbreviations and/or nursing jargon
Unless otherwise indicated, grammatically correct sentences and topic paragraphs are required. Dot points only accepted in the nursing care plan.
Note: Headings, any task information copied in and in-text citations are included in the word count. 100 words have been excluded from the word
count to account for the headings within the nursing care plan template
Use of trade names is not acceptable. Only generic terms or names are to be used when referring to specific medications or other prescribed
treatments or resources that may be used in nursing practice
APA 6th referencing style is to be used for both in-text citations and end of assessment reference list.
All resources must be dated between 2010 and 2019
There must be at least 10 peer-reviewed journal articles and/or evidence based practice guidelines cited in your assignment.
• Do not use any health facility or local health service policies or procedures
• Only 1 current Australian medication textbook and 1 current Australian medical surgical nursing textbook to be referenced.

Assessment 1: Case scenario This is David Smith
You will be caring for him today.
Identify: Mr David Smith, HRN: 123456, DOB:
26/03/1948
Situation: David is a 72 year old caucasian man from
Darwin. He has been admitted to the CDU
medical ward with Acute Kidney Injury (AKI)
secondary to Pyelonephritis. He has a 1/52
history of fever, fatigue, decreased urine
output, increased urgency and R) flank pain.
He has now been transferred to the CDU
Medical ward for continuing care.
Background: David is a widower and lives in Darwin. He
lives alone in a single story home but his
daughter lives close by and helps out when
needed. He is independent with his cares.
He has an extensive past medical history
including:
T2DM, Ex-smoker (quit 5 years ago), HTN,
Hyperlipidaemia, chronic kidney disease
stage 3 (Baseline eGFR 40 ml/min/1.73m2),
chronic venous leg ulcer to L) leg, anxiety. No
known declared allergies (NKDA).

He is obese (BMI 30) and drinks 1 bottle of
wine every night.
Assessment: Airway: Own, patent
Breathing: RR 22, Sats 94% on RA.
Circulation: HR 96 bpm, BP 160/95 mmHg,
Bilateral pitting oedema to his calves.
Disability: GCS 15/15, 2/10 pain to R) flank,
feels tired and a bit worried.
Exposure: Temp 38.4 oC
David looks unwell. He is restless and has a
flushed appearance. His urine is dark in
colour and offensive smelling. He has
urinated 100 ml into a urine bottle since
admission to hospital 4 hours ago. David had
2 x IVC’s inserted to both ACF’s and is
tolerating a diabetic diet. He last opened his
bowels this morning.
Pathology (on
admission)
WBC
15.0 x 109/L (4.0-
11.0)
urea 14 mmol/L (3.0-8.0)
serum creatinine 213 μmol/L (60-
100)

eGFR 25 mL/min/1.73
m2 (90-120)
Recommendations/Read back: Medical orders
• Routine ward assessment and observations
• Strict fluid monitoring
• MSU for MC & S
• Diabetic diet and fluids as tolerated
• Pain management
• TED stockings and DVT prophylaxis
Medication orders
• Intravenous sodium chloride 1000mls over
8 hours
• Intravenous frusemide 80mg STAT
• Oral paracetamol 1g QID, S/C morphine
2.5mg, 4 hourly PRN
• Usual medications: Metformin XR 1gm BD,
Ramipril 10mg OD, Simvastatin 20mg OD
Nursing orders
• Devise a plan of care for your patient
Assessment 1 Tasks:
Using the template provided in the Assessment 1 folder and, based on the handover you received at the beginning of your shift today, other
information included below and current reliable evidence for practice, address the following tasks.
Do not make up or assume information in relation to or about David. Only use what you know from the information you received today.

Task 1: Assessment
Based on the case scenario and in grammatically correct sentences identify:
• Three (3) priority nursing assessments you would conduct at the commencement of your shift
AND
For each assessment you have identified explain:
• Why it is necessary for David’s condition and nursing care?
• What consequences can occur if this assessment is not completed accurately?
• What chart or document could you use to assist with/record your assessments?
(Approximately 350 words)
Task 2:
Based solely on the handover you have received and using the template provided, complete a nursing care plan for David. Your plan must address
the physical, functional and psychosocial aspects of care.
Five (5) nursing problems have been provided for you. For each nursing problem on your care plan you need to identify;
• What it is related to?
• Goal of care
• Interventions
• Rationales for interventions
• Evaluation
Notes for Task 2 only
• Dot points may be used in the care plan template
• Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full
terminology must be provided after
the assignment references – key will be excluded from word count tally
• Rationales must be appropriately referenced
(Approximately 1000 words)
Task 3: Patient education
Discharge planning
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or
prevention of reinfection or deterioration on discharge.

Patient education and discharge planning starts on admission and you need to provide David with education during your shift in
preparation for discharge home.
• Explain two (2) important points/topics you will need to include in David’s preparation for discharge to aid healing and prevent further illness.
For each education point identified provide:
• One (1) strategy to assist David to implement the education into his daily routine.
(Approximately 350 words)
Task 4: Documentation
An important legal requirement of nursing practice is to effectively and succinctly document relevant information, actions and outcomes related to
patient care and provide an accurate reflection of the health status of the patient, their responses to care and the patient’s perspective.
• Make an entry into David’s patient progress notes documenting the successful implementation of your nursing care plan.
You can choose any progress note format but your documentation must:
Demonstrate person-centred care
Adhere to the legal and professional standards for documentation
Appropriate professional language must be used – legally recognised abbreviations may be used in this task but a KEY with full terminology must
be provided after the assignment references - key will be excluded from word count tally
(Approximately 300 words)
Your assignment must include a reference list after the completion of the tasks and a key if you have used abbreviations in task 2 or 4.
Task 1

Introduction:
The case scenario deals with a patient, M. David Smith who is a 72 year old Caucasian male who hails from Darwin. The patient at
present has been admitted to the CDU medical ward with a presenting complaint of Acute Kidney Injury which is secondary to Pyelonephritis.
The patient has a medical history of 1/52 fever, fatigue, decreased urine output, increased urgency and flank pain. In addition to this, the patient
is a widower who lives independently and is able to effectively manage his activities of daily living. Mr. Smith has a daughter who stays nearby
and occasionally helps him with his every day activities if required. The provided medical history of the patient further suggests that he is
diagnosed with Type II Diaabetes, HTN, Hyperlipidaemia, Chronic Kidney disease stage 3 (Baseline Egfr 40ml/min/1.73m2), chronic venous leg
ulcer in the left leg, obesity and anxiety. The provided information also reveals that Mr. Smith is an ex-smoker who quit smoking 5 years ago
and consumes a bottle of wine every night. This case study intends to delve deeper into the patient’s case scenario and make use of the evidence
based treatment strategies to prioritise care and create an effective care plan.
Task 1 Assessment:
On critically analysing the case scenario, it can be mentioned that the three nursing assessments that would be conducted by me at the
commencement of my shift would include, conducting a vital sign assessment, pain assessment and nutritional assessment. The rationale for
conducting a vital assessment would include assessing the vital signs of the patient so as to develop an overview about the state of physiological
condition of the patient. Research studies report that hypertension is one of the foremost co-morbid factors of Type II Diabetes mellitus (De Boer
et al. 2017). Hence, it is vital that while caring for a patient with Diabetes, a nursing professional must assess the level of blood pressure
periodically and document the observations. In addition to this, other vital signs that would be assessed include assessing the body temperature,
airway, heart rate, respiratory rate and the oxygen saturation rate. The documented observation data would suggest the current physiological
condition of the patient and based on the documented observation, appropriate intervention would be applied. The second set of assessment that
would be conducted would include the pain assessment. Upon presentment the patient had mentioned about experiencing pain in the right flank
region. Therefore, conducting a pain assessment would help to assess the level and type of pain sustained by the patient after the commencement
of the medication. The rationale for conducting the assessment can therefore be explained as the analysing the quality of pain currently
experienced by the patient and applying appropriate interventions to optimise the impact of pain (Cameron et al., 2015). The third assessment
that would be conducted includes the nutritional assessment and the rationale for the same can be explained as assessing the nutritional intake
and the nutritional needs of the patient. Research studies suggest that nutritional assessment is the systematic procedure of interpreting and
collecting health related information to understand the cause and nature of nutritional related health disorders (Landoni et al., 2016; James et al.,
2015). In this context it should be noted that the patient is tolerating a Diabetic diet, therefore conducting the nutritional assessment would help
to understand that whether or not the patient is consuming an optimal diet which has been devised as per his physical health condition. In
addition to this, the assessment would also help to estimate the impact of the Diabetic medications that the patient is currently consuming which
would help to analyse the blood glucose level. As suggested by the evidence base, Diabetic medication works by lowering the blood glucose
level but in order to maintain normal physiological functions, a minimal amount of blood glucose level is required (James et al., 2015). If a
patient does not consume an adequate amount of nutrition, then the blood glucose level might fall below the normal range and lead to adverse
complications.
The above mentioned three assessments are vital for David as it would help to analyse the current physiological state of David and direct
the nursing care professional to implement appropriate measures so as to monitor the physical health condition of the patient and implement
appropriate care interventions to accelerate the process of recovery.

If the above listed assessments are not carried out then the process of monitoring the physiological body process of the patient would
become exceedingly difficult. In addition to this, evaluation of the impact of the administered medication would also be extremely complex
which serves as a key indication of the effectiveness of the devised treatment measures.
For the purpose of documentation the progress notes and the medication chart would be filled up by me and in order to assist the next RN
after the completion of my shift, I would effectively communicate and present a brief about the current physiological state of the patient. In
addition to this, I would also hand over the progress notes, medication chart and the ISBAR handover which would detail the observed data and
assist the RN with the continued treatment process.
Task 2

Nursing Care Plan: David Smith
Nursing problem: Acute Pain
Related to: The pain experienced by Mr. Smith in the right flank region.
Goal of care Nursing interventions Rationale Evaluation
 To minimise
pain
 To minimise
restlessness
 Conduct pain assessment
 Conduct abdominal assessment
 Implement repositioning and
commence heat/cold medications
 Detailed pain assessment would
help to retrieve a detailed
baseline data that would help in
deciding the course of
intervention. For instance,
research studies mention that a
sudden pain relief sensation in a
patient suffering from
appendicitis indicates a rupture
or an emergency.
 The evidence base suggests that
flank pain is associated with
discomfort within the abdominal
back and sides and normally
develops within the area below
the ribs just above the pelvis.
The pain is mostly experienced
within one side of the body and
severe pain indicates a symptom
of urinary tract infection,
dehydration or presence of
kidney stones or a renal
infection (Cameron et al., 2015).
This accounts for the reason
why conducting an abdominal
assessment would help to
analyse the aetiology of the pain
and implement appropriate
Evaluation would be done with the help of
comparison of obtained patient data with the
normal range of data. Further lower pain
score would also help to evaluate the status
and quality of pain.

measures to foster improved
outcome.
 The evidence base also suggests
that flank pain is associated with
discomfort experienced while
relaxing or sleeping.
Repositioning the patient and
inducing hot/cold treatment can
help in envisioning relief (James
et al., 2015).
Nursing problem: Risk of fluid imbalance
Related to: Inadequate fluid intake that can trigger the symptoms of renal disorder and place the patient at a high risk of fluid volume deficit
Goal of care Nursing interventions Rationale Evaluation
 The patient
would be able to
develop an
understanding
about the
dietary and fluid
restrictions
 The patient
would be able to
exhibit
behaviour of
monitoring fluid
status and
prevent
recurrence
 Stability of fluid
 The patient’s body weight would be
assessed on a regular basis and the
nurse would critically take note of
any excess weight gain.
 The nurse would take note of the
presence of neck or peripheral vein
distention accompanied with
oedema or symptom of dyspnea
 Vital assessment must be conducted
and the central venous pressure
must also be assessed and
documented (Watkins, Whisman &
 Research studies suggests that 1
l of fluid retention is equivalent
to a weight gain of 1 Kg which
equals 2.2 pounds (Landoni et
al., 2016)
 Neck or peripheral vein
distention is strongly indicative
of the signs and symptoms of
decompensation or cardiac
failure (Doenges et al., 2016)
 Fluid imbalance results in
tachycardia and hypertension. In
Vital signs within the normal range would
help to monitor the quality of the
physiological state of the client.

volume would
be detected by
means of stable
vital sign
assessment
Booker, 2016) certain cases, Tachypnea might
be present with or without
Dyspnea. Increase in central
venous pressure accompanied
with adventitious breath sounds
is generally indicative of
Dyspnea. In addition to this,
hypertension may also occur
which might trigger serious
conditions such as cardiac
failure (Doenges et al., 2016).
Nursing problem: Risk of infection
Related to: The risk of infection associated with the placement of 2 x IVC’s inserted to both ACF’s. Research studies suggest that intravenous catherization is
predominately an invasive procedure that poses a high end risk of developing infections (Saint et al., 2016).
Goal of care Nursing interventions Rationale Evaluation
 Early
identification of
infection to
apply proper
intervention
 Patient is free
from infection
validated by the
viral assessment
 Encourage a fluid intake of 2000 to
3000 ml water on a per day basis
unless it is contraindicated
 Limit visitors
 Educate the patient about effective
hand hygiene technique
 Fluids help to dilute the urine
and encourage frequent
emptying of the bladder.
Frequent urination helps to
reduce the stasis of the urine
which reduces the risk of
urinary tract infections
 Limiting visitors helps to reduce
the transmission of pathogens
 Effective hand hygiene and
friction with running water and
soap helps to remove
microorganism from hands
which reduces the possibility of
transmission of infection (Saint
et al., 2016).
Vital assessment would help to monitor the
physiological state of the client. Prevalence
of infection is associated with abnormality
within the vital signs. Thus. Vital signs
within the normal range would help to
ensure that the patient is free from any
infections.

Nursing problem: Anxiety
Related to: mental unrest and feelings of anxiety can delay the process of recovery and neutralise the effect of the applied set of interventions
Goal of care Nursing interventions Rationale Evaluation
 Patient is able to
describe the
anxiety and can
demonstrate
self-coping
mechanisms
 Patient is able to
reassure self
 Patient is able to
identify and use
strategies that
help to reduce
anxiety levels
 Identify patient’s level of awareness
about the anxiety
 The nurse must help the patient to
get accustomed to the new
environment by making the patient
familiar with new people
 Communication must be carried out
with the patient using simple
language and concise statements.
 A cause of anxiety cannot
always be identified which can
make the patient feel that the
experienced feelings are
counterfeit and in such cases
acknowledging the feelings
experienced by the patient helps
in validation and acceptance of
the feelings
 Awareness of the new
environment fosters comfort and
helps in the reduction of anxiety
level experienced by the patient.
Research studies state that
anxiety can increase to an
uncontrolled level due to the
exposure to unknown
environmental stimuli
(MacLeod & Clarke, 2015).
 While experiencing anxiety it is
difficult for the patient to
understand complex terms,
Patient’s level of stability would help to
monitor the effectiveness of the applied
interventions.

conversing in simple language
can facilitate better
understanding
Nursing problem: Impaired skin integrity
Related to: Impaired skin integrity increases the risk of infection which can lead to skin damage
Goal of care Nursing interventions Rationale Evaluation
 Patient’s skin
remains intact
with an absence
of redness and
capillary refill
time being less
than 6 seconds
 conduct skin assessment
 Use an objective tool for the
purpose of pressure ulcer risk
assessment
 Assessment of the skin would
help to retrieve relevant baseline
data which can help to apply
relevant interventions in order to
prevent impaired skin integrity
 The use of acute or long term
care assessment using different
assessment scale such as the
Braden Scale or the Norton
Scale can help to identify the
risks associated with the
development of an ulcer
(Campbell et al., 2016).
Conducting assessment using the objective
tool would help to identify the risk of
pressure ulcers and monitor the quality of
skin integrity (Campbell et al., 2016).

Task 3
Prior to discharging the patient from the care ward, health literacy would be imparted to the patient, such that the patient is able to cope
with the illness after his discharge. As has already been mentioned in the case scenario, David consumes 1 bottle of Wine every night and is
suffering from Type II Diabetes. He would be educated about the impact of alcohol consumption on the overall body weight and its interference
with the insulin hormone that alters the blood-glucose level within the body. He would also be educated about the adverse effect of obesity on
poor blood glucose level regulation within the blood and hypertension and would be referred to a nutritionist and a fitness expert for proper
weight management. He would also be made aware about the risks associated with alcohol consumption which might even lead to
cardiovascular disorders and complicate his physical health conditions (Powers et al., 2017). He would be asked to maintain a record of the times
he consumed alcohol and would be asked to present it during the time of is follow-up session. This would help to motivate him to avoid the
consumption of alcohol. Further, he would also be taught about self-management strategies such as mediation management and blood-glucose
monitoring with the use of glucometer strips such that he can monitor his blood glucose level and efficiently manage his Diabetic symptoms (De
Boer et al., 2017).

Task 4
Progress Notes
Patient’s Name: David Smith
Date of birth: 26/03/1948
Medical Record Number: XXXX Date: xx/xx/xxxx
New Patient
Patient David Smith has been to the CDU medical ward with the presenting complaint of
Acute Kidney injury to Pyelonephritis. He had a 1/52 history of fever, fatigue and
reduced urine output and experienced pain in the right plank region. He was
transferred to the CDU medical ward for continuum of care.
At the commencement of shift, patient looked unwell and was restless and had a flushed
experience. His urine was dark in colour and emitted a pungent odour. He had urinated
100 ml into the urine bottle since his admission to the hospital 4 hours ago and had 2 x
IVC’s inserted to both ACF’s and was tolerating a diabetic diet. He had opened his
bowels in the morning.
After the commencement of my shift, I conducted the vital sign assessment, pain
assessment and the nutritional assessment to note any abnormality. Further, to
minimise the pain repositioning and hot and cold medications were administered. Also,
abdominal assessment was conducted to take note of any ambiguity. Also, patient was
encouraged to consume water to reduce the risk of hypertension and incidence of
infection. Patient was also educated about effective hand hygiene to reduce the risk of
infection. A positive therapeutic relationship was maintained with the patient so as to
ensure the patient does not experience anxiety. Skin assessment was conducted and
pressure risk assessment was conducted to ensure that the skin integrity was not
impaired. The patient felt better and responded positively to the applied interventions.
During the discharge the patient was educated about the Diabetic symptom
management and was encouraged to quit alcohol consumption by maintaining a
reflective journal and presenting it during the next follow up visit. The patient was also
trained with self-management strategies such as medication management and blood
glucose monitoring to acquire improved health outcome.
Next Follow up visit: xx/xx/xxxx (4 months after the present visit)

Fit for discharge.
Conclusion:
Therefore, to conclude it can be mentioned that the case scenario critically presents the case of David Smith who suffers from a
chronic health condition Diabetes and also experiences a number of health complications. In order to create an effective care plan, the
patient had been placed at the core of the care process and accordingly a care plan had been drafted that addresses the holistic needs of
the patient.
Key (if required)

References
Cameron, P., Jelinek, G., Kelly, A. M., Murray, L., & Brown, A. F. T. (2015). Textbook of adult emergency medicine. Churchill Livingstone.
DOI: https://doi.org/10.1016/j.annemergmed.2004.09.033
Campbell, J. L., Coyer, F. M., & Osborne, S. R. (2016). The skin safety model: reconceptualizing skin vulnerability in older patients. Journal of
Nursing Scholarship, 48(1), 14-22.DOI: https://doi.org/10.1111/jnu.12176
De Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., ... & Bakris, G. (2017). Diabetes and hypertension: a
position statement by the American Diabetes Association. Diabetes care, 40(9), 1273-1284. DOI: https://doi.org/10.2337/dci17-0026
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse's pocket guide: Diagnoses, prioritized interventions, and rationales. FA
Davis.Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=1sxmCwAAQBAJ&oi=fnd&pg=PR1&dq=FLUID+IMBALANCE+INTERVENTION&ots=mvuWhljjQh&sig=aGHdTMFCv4
Qu0jwDTVZ80sgr2Tg&redir_esc=y#v=onepage&q=FLUID%20IMBALANCE%20INTERVENTION&f=false
James, M. T., Grams, M. E., Woodward, M., Elley, C. R., Green, J. A., Wheeler, D. C., ... & Sarnak, M. J. (2015). A meta-analysis of the
association of estimated GFR, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. American Journal of Kidney
Diseases, 66(4), 602-612. DOI: https://doi.org/10.1053/j.ajkd.2015.02.338
Landoni, G., Pisano, A., Zangrillo, A., & Bellomo, R. (Eds.). (2016). Reducing mortality in acute kidney injury. Springer. Retrieved from:
https://link.springer.com/book/10.1007%2F978-3-319-33429-5
MacLeod, C., & Clarke, P. J. (2015). The attentional bias modification approach to anxiety intervention. Clinical Psychological Science, 3(1),
58-78. DOI: https://doi.org/10.1177/2167702614560749
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., ... & Vivian, E. (2017). Diabetes self-management education
and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes
Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 43(1), 40-53. DOI: https://doi.org/10.1177/0145721716689694

Saint, S., Greene, M. T., Krein, S. L., Rogers, M. A., Ratz, D., Fowler, K. E., ... & Faulkner, K. (2016). A program to prevent catheter-associated
urinary tract infection in acute care. New England Journal of Medicine, 374(22), 2111-2119. DOI: 10.1056/NEJMoa1504906
Watkins, T., Whisman, L., & Booker, P. (2016). Nursing assessment of continuous vital sign surveillance to improve patient safety on the
medical/surgical unit. Journal of clinical nursing, 25(1-2), 278-281.DOI: https://doi.org/10.1111/jocn.13102
Marking Rubric
Needs development Satisfactory Excellent
Tasks 1, 3 and 4
- Assessing
- Patient education
- Documentation
(15)
0 – 5 marks
Demonstrates a limited knowledge of
assessment, documentation and patient
education.
Does not demonstrate safe practice,
knowledge of the relevant assessments
5 – 10 marks
Demonstrates satisfactory knowledge of
assessment, documentation and patient
education.
Rationales demonstrate satisfactory ability
to conduct the relevant assessments and
10 – 15 marks
Demonstrates excellent safe practice knowledge
for assessment, documentation and patient
education.
Explains clearly, succinctly and specifically how to
conduct the relevant assessments and explains

and/or explain their relevance to renal
function.
Unsatisfactory rationales or explanations for
care planning and assessments and/ or
limited ability to explain and justify nursing
actions and education including use of
medications.
Documentation is not comprehensive and/or
does not meet legal requirements.
explain their relevance to renal function.
Demonstrates a satisfactory ability to
provide relevant and comprehensive patient
education including use of medications.
Documentation is clear, succinct and meets
most legal requirements, with errors.
their relevance to renal function.
Demonstrates a high level ability to provide
relevant and comprehensive patient education
including use of medications.
Documentation is clear, succinct and meets legal
requirements.
Task 2 – Planning
care (15)
0 – 5 marks
Poor interpretation of task or
Limited or little ability to develop
individualised, comprehensive nursing care
relevant to the case study and nursing
problem and/or limited to no critical thinking
demonstrated in planning and evaluating
nursing care.
Less than 7 nursing actions/ interventions
identified and/or
Nursing actions are not within the scope of a
registered nurse.
No evidence to support rationales for care.
5 – 10 marks
Demonstrates satisfactory ability and/or
developing critical thinking ability to develop
individualised, comprehensive nursing care
relevant to the case study and nursing
problem, including evaluating nursing care.
8 – 15 nursing actions/interventions
identified.
Most interventions are within the scope of
the registered nurse.
Rationales are referenced and demonstrate
satisfactory ability to explain or justify each
nursing action.
10 – 15 marks
Demonstrates high level ability and critical
thinking to develop individualised,
comprehensive nursing care relevant to the case
study, nursing problem, and evaluating nursing
care.
More than 15 actions/interventions identified.
All interventions are within the scope of the
registered nurse and relevant to the patient
scenario.
All rationales are referenced and demonstrate
high level ability to explain or justify each nursing
action.

Academic Integrity -
referencing &
Evidence for
practice - research
(5)
0 – 2 marks
Demonstrates little or limited ability to
acknowledge the work of others.
No or limited in-text citations and/or
incomplete reference list and/or inaccurate
and/or inconsistent referencing format.
Significant use of direct quotes (<5)
Academic integrity standards not met.
Less than 7 peer reviewed journals and/or
More than 2 current text books cited.
Some journals or texts are more than 10
years old.
Numerous inappropriate resources in
reference list.
3 – 4 marks
Demonstrates a satisfactory ability to
acknowledge the work of others. Most ideas
supported with appropriate in-text citations
and there is a complete reference list. Some
minor inconsistencies, in CDU APA 6th
format.
Academic integrity policies and standards at
a satisfactory level.
7 - 10 relevant peer reviewed journals.
No more than 2 current text books cited.
Journal articles and textbooks are no more
than 10 years old.
May have occasional inappropriate resources
in reference list.
5 marks
Demonstrates high level ability to acknowledge
the work of others. All ideas supported with
appropriate and accurate in-text citations and
there is a complete and accurate reference list.
No errors detected in CDU APA 6th format.
Academic integrity standards met at a high level.
Minimum of 10 peer reviewed journals.
No more than 2 current text books cited.
Journal articles and textbooks are no more than 5
years old.
No inappropriate resources in reference list.
Presentation &
Academic Writing
(5)
0 – 2 marks
Presentation guidelines met.
3 – 4 marks
Presentation guidelines met with errors.
5 marks
Presentation guidelines met with no errors.