University Nursing Assignment 3: Health Variations 1 - SAT Assessment

This nursing assignment solution addresses a case scenario involving a patient with Crohn's disease requiring perioperative care. The assignment emphasizes adherence to the NMBA standards of practice, particularly the use of evidence-based practice in patient treatment. It highlights the nurse's responsibilities, including assessing patient allergies, involving family members in clinical decisions, and following appropriate legislations and policies. The solution explores the pathogenesis of Crohn's disease, including transmural inflammation, skip lesions, and weight loss complications. It also explains the impact of stricture formation on the digestive system. Additionally, the assignment discusses the administration of Hartmann's solution and its role in fluid and electrolyte balance, especially for patients experiencing dehydration due to diarrhea and vomiting. The solution underscores the importance of comprehensive nursing care plans, effective collaboration with healthcare professionals, and continuous patient monitoring.

Running head: NURSING ASSIGNMENT
Unit: 401207 Health Variations 1 - Perioperative
Short Answer Test (SAT) Assessment 2
Name of the Student
Name of the University
Author Note

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Answer 1
In this case scenario, the nurse is required to show compliance to and adhere to the
NMBA standards of practice, the prime responsibility of which is to focus on proper analysis,
access and utilization of best and most relevant evidences that focus on treatment of Chron’s
diseases, in this context. Considerations regarding previous history of allergy or hypersensitivity
of the patient to opioid medications and their side effects are another major nursing responsibility
before pethidine administration. It is imperative in the nursing profession to involve family
members before any clinical decisions related to a patient are taken. Incorporation of family
preferences in EBN facilitates positive clinical encounters and the opinions offered by them help
in appropriate formulation of treatment plans. This can be brought about by initiating an
effective conversation with Jordan’s family members.
Prior to administration of pethidine, the nurse is expected to follow appropriate
legislations, guidelines and policies. Appropriate legislations and policies should have been
followed regarding taking informed consent of the patient and maintaining confidentiality of
essential clinical and personal patient information. Moreover, strict adherence to the healthcare
organisation’s policies should have been followed before disclosure of patient informed consent
and confidential information. Appropriate ethical framework related to allocation of resources,
discharge planning and decision-making are also crucial for the role of a nurse. In addition to
monitoring and recording the vital signs of the patient, nursing responsibility is also associated
with assessment of the colour and texture of the skin, presence of skin lesions, grip strength
analysis, and pupil size determination. Other responsibilities are related to use of a wide range of
assessment tools for determining the physiological condition of a particular patient. Scope of

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nursing practice also requires an effective collaboration with concerned healthcare professionals
that will provide a clear understanding of the factors that predisposed a patient to the
physiological abnormality. It will also help in drawing relevant information on the possible side
effects and contradictions of the proposed intervention or nursing care plan. The nurse should
formulate a comprehensive nursing care plan by utilizing clinical expertise, patient preferences
and best available therapeutic evidences.
Evidence-based practice should be followed by delivery of appropriate, safe and a
responsive quality of nursing practice. There was a need to record previous history of respiratory
depression, alcoholism or COPD in the patient, thereby leading to a modification of the proposed
nursing plan. Proper delegation of enrolled nurses for the treatment of Jordan was also
necessary. This delegation would enable division of nursing tasks according to scope of practice.
Proper evaluation of Jordan’s health outcomes upon pethidine administration is also critical. This
will help in revising the treatment plan upon encountering adverse health outcomes and
monitoring progress of the patient.
Answer 2
Chron’s disease pathogenesis encompasses proinflammatory response dysregulation
concerning gut commensal bacteria. The major features that underlie this pathogenesis are
related to transmural inflammation patterns. These are commonly referred to as origin of
inflammation in the tissues that are found lining or spanning the depth of intestinal walls. These
inflammations are characterized by focal infiltration, triggered by neutrophils. Characteristic
signs, commonly referred to as skip lesions, are found in the form of an abrupt transition between
the ulcer and unaffected tissues. Chron’s disease is most commonly associated with drastic

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weight loss. The primary reason for such reduction in weight can be attributed to loss of appetite
in the patient. Inflammation that occurs in Chron’s disease results in diarrhea, and nausea,
thereby curbing the appetite and making it difficult to eat adequate amount of food.
Food aversions, loss of nutrient due to bleeding from the intestine and an increase in the
amount of burnt calories also lead to weight loss related health complications. Avoidance of
eating food to prevent relapse of unpleasant symptoms also lead to weight loss. Stricture
formation refers to narrowing of the walls of intestine that hampers the digestive system. These
strictures occur due to scar buildup in the intestinal walls. Scar tissue often develop when the
inflammation of intestinal cells continues for a prolonged time. Presence of this inflammation
creates significant damages in the cells that have been repaired. This leads to scar formation.
Scar buildup in the intestinal regions thereby result in stricture development.
Answer 3
Intravenous administration of Hartmann’s solution or ringer’s lactate solution was done
in this case. It is a solution of calcium chloride, sodium chloride, sodium lactate, and potassium
chloride. It helps in replacing lost fluids and electrolytes from the body of patients, suffering
from extreme dehydration. Patients reporting a low amount of blood are also administered upon
by this solution. Another characteristic feature of the solution includes its effectiveness as a fluid
resuscitation agent in treatment of trauma, surgical blood loss and severe burns.
Fluid balance is an essential physiological feature that is needed for maintaining a steady
state in the human body. Acute fluid loss from the body occurs due to renal failure that directly
results in chemical and electrolyte imbalance. Jordan reported a history of acute diarrhoea and

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vomiting that contributed to dehydration and loss of necessary fluids, thereby contributing to
electrolyte imbalance, which was corrected by IV Hartmann’s solution administration.