Nursing: Patient Assessment, Diagnosis and Care Plan Scenarios

This nursing assignment presents three distinct patient scenarios requiring comprehensive assessment, diagnosis, and care planning. The first scenario involves a patient with a Colle’s fracture, focusing on neurovascular observations, pain management, and potential complications like complex regional pain syndrome. The second scenario examines a patient presenting with symptoms indicative of a urinary tract infection (UTI), emphasizing diagnostic tests, neurological assessment, and age-related considerations. The third scenario explores a patient with symptoms suggestive of viral gastroenteritis, highlighting the importance of identifying the cause, necessary health information, and appropriate assessment measures. Each scenario requires a thorough understanding of nursing principles and the application of evidence-based practices to ensure optimal patient outcomes. Desklib offers a wealth of resources, including solved assignments and past papers, to support students in mastering these crucial nursing concepts.

Nursing assignment
NURSING ASSIGNMENT
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Nursing assignment
Scenario -1
Answer -1
Emma requires neurovascular observations on admission to determine her intensity of
Colle’s fracture after fall. Firstly, it is essential to perform admission assessment that
involves observing general appearance, patient history, the physical and mental
condition of the patient. As the attending nurse, it is essential to observe the level of
pain in the injury region by using a pain assessment tool. Further, the sensation and
motor function should be observed in Emma’s fractured left distal radius region.
Lastly, vital signs parameters should be observed that involves colour, temperature,
swelling, pulse and capillary refill (LeMone et al. 2015).
Answer -2
The unremarkable vital signs shall be documented in “Adult vital sign chart” for
proper care treatment of Emma (Dains, Baumann & Scheibel, 2015).
Answer -3
To reduce or manage the swelling observed in fingers and hands of Emma two actions
shall be performed that are cold therapy and rest at this stage. The action of providing
cold therapy will work to reduce swelling by restricting the blood flow and slowing
metabolism in cells. Further, rest is followed to irritate the damaged cells helping in
recovery (LeMone et al. 2015).
Answer- 4
As Emma is complaining about increasing pain, a possible solution is pain relief. In
the case of Emma, any pain relief except morphine is suitable for her pain treatment
because she is allergic to morphine. Further, it is required to ensure her time of
contraceptive pill before implementing pain relief because the action of pain relief can
counter with contraceptive creating complications (Dains, Baumann & Scheibel,
2015).
Answer – 5
In the provided situation where Emma is facing worsening pain even after
implementation of pain relief it is critically essential to perform a detailed
Neurovascular assessment of her affected body region. This detailed neurovascular
assessment shall help to detect the damage in a specific region or nerve that is
creating an increase in swelling symptom.
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Nursing assignment
Through neurological assessment, the pain, sensation and function of radial, median
and ulnar nerve shall be assessed to determine their functionality. This shall help to
detect the proper region of defect leading to increased swelling in the wrist (LeMone
et al. 2015).
Answer – 6
Complex regional pain syndrome is one of the most common complications of Colle’s
fracture. The provided signs in Emma’s case matches the symptoms of regional pain
syndrome where swelling followed by loss of sensation, change in skin colour and
texture are the most common symptoms. Basically, this can be the shoulder-hand
syndrome in case of Emma, which is a category of complex regional pain syndrome
(Moyce, Lash & de Leon Siantz, 2016).
Answer – 7
The Complex pain syndrome is a critical situation that requires professional treatment,
therefore, as an attendant nurse, a proper communication shall be transferred to doctor
for providing further assistance to handle Emma’s case (Dains, Baumann & Scheibel,
2015).
Answer – 8
In the case of Emma as she was a victim of fall that caused Colle’s fracture, the two
potential complications in her case are malposition-malunion and wrist osteoarthritis.
The malposition-malunion generally occurs after bone trauma. The deformed position
(malposition) of healing fracture leads to limb shortening termed as malunion. This
can be identified as a shortened limb. Another complication is wrist osteoarthritis,
which is the most common complication after Colle’s fracture. This is considered as
post-traumatic condition after surgery identified by joint instability, licking, stiffness
and swelling on the wrist (Bruyneel et al. 2015).
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Nursing assignment
Scenario -2
Answer – 1
Tests required for the complete diagnosis of Urinary Tract Infection (UTI) are: -
 Analysis if urine
 Culturing urinary tract bacteria in laboratory
 Magnetic resonance imaging (MRI) of the urinary tract
 Cystoscopy (Zolnierek, 2014).
Answer -2
As per the case study details, the most unlike or unexpected assessment performed in
Judith Mason case was GCS because she was in a completely normal condition last
night with no improper or doubtable medical situation to perform coma test. However,
the symptoms of hallucination, disorientation and confusion must have resulted in an
instinct to perform GCS but before this GCS other primary assessment should have
been given priority (Ackley, Ladwig & Makic, 2016).
Answer -3
As per Mrs. Mason’s neurological assessment, the two conditions that may have
resulted in her present situation can be fall incidence at night or occurrence of heart
disease. However, fall incidence is unlike because she didn’t mention about it in her
medical details with no proper sign of injury. Further, decreases in her PR rate
indicated abnormal heart condition but overall normal vital sign ignore the occurrence
of any heart condition in her situation (LeMone et al. 2015).
Answer- 4
If Mrs. Mason should have been 30 years of age following this medical condition then
surely her clinical picture would differ involving more primary and secondary
assessment because symptoms like confusion, hallucination and disorientation are rare
at age of 30. Further, low PR of 88 and BP of 105/70 would have been a serious
concern for such a young lady (Bruyneel et al. 2015).
Answer -5
Yes, surely Mrs. Mason is less vulnerable to age-related complication because as per
her age, having no regular medication or co-morbidities indicates promising health.
Some of the most common complications of patients above 60 years involve heart
disease, mental health issues, weakness, respiratory issues etc. (Ackley, Ladwig &
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Nursing assignment
Makic, 2016).
Answer- 6
a) The required assessment in this condition is fall risk assessment
b) Required precautions: -
 Providing walking aids
 Providing physical support
 Properly observing patient’s movement
 Suggesting complete bed rest
c) Mrs. Mason should be referred to a Physical therapist to manage her present
condition (Urden, Stacy & Lough, 2017).
Answer – 7
The two types of documentation are: -
 Admission summary
 Adult vital signs chart (Dains, Baumann & Scheibel, 2015).
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Nursing assignment
Scenario – 3
Answer -1
The most likely diagnosis in Mr. Kaur’s case can be a viral infection such as “stomach
flu”. The mentioned symptoms and case information point towards occurrence viral
gastroenteritis (stomach flu) in Mr. Kaur’s case. The symptoms of nausea, vomiting,
diarrhoea and abdominal cramps indicate causes like stomach flu, indigestion, food
allergies, drug allergies and many other stomach related diseases with no other
potential sign of any other disease. His vital signs are completely normal. Further, the
viral gastroenteritis possesses potential to get transmitted through the fecal-oral
(saliva) route. In the case information it is mentioned that Vickram’s girlfriend,
Jasmine was confronting the same symptoms a day before. This information about
case lead to the conclusion that stomach flu can be a predictable diagnosis (Ackley,
Ladwig & Makic, 2016).
Answer -2
The main cause of concern in Vickram’s case is to detect the cause of his mentioned
symptoms. For the assessment of proper cause, there should be a physical
examination (identifying dehydration, pain, tenderness and abdominal sounds)
followed by stool and urine tests (Kelly & Field, 2016)
Answer -3
Health information required by treating team involves: -
Clinical investigations
 Blood test
 Stool and urine test
Nursing assessments
 Examination of mouth, pharynx, abdomen
 Rectal and neurological examination
 Review of clinical investigations (Bruyneel et al. 2015).
Answer -4
The two types of nursing documents required are: -
 Admission summary
 Review reports of clinical investigation (Dains, Baumann & Scheibel, 2015).
Answer -5
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Nursing assignment
The four assessment measures taken in the hospital are: -
 Physical examination
 Bacterial culture test (stool culture)
 Abdominal X-ray
 CT abdomen (Bruyneel et al. 2015).
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Nursing assignment
References
Books
Ackley, B. J., Ladwig, G. B., & Makic, M. B. F. (2016). Nursing Diagnosis
Handbook-E-Book: An Evidence-Based Guide to Planning Care. Elsevier Health
Sciences.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2015). Advanced Health Assessment &
Clinical Diagnosis in Primary Care-E-Book. Elsevier Health Sciences.
LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L., & Reid-Searl, K.
(2015). Medical-surgical nursing. Pearson Higher Education AU.
Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing-E-Book:
Diagnosis and Management. Elsevier Health Sciences.
Journals
Bruyneel, L., Li, B., Ausserhofer, D., Lesaffre, E., Dumitrescu, I., Smith, H. L., ... &
Sermeus, W. (2015). Organization of hospital nursing, provision of nursing care,
and patient experiences with care in Europe. Medical Care Research and
Review, 72(6), 643-664.
Kelly, M. P., & Field, D. (2016). Medical sociology, chronic illness and the
body. Sociology of Health & Illness, 18(2), 241-257.
Moyce, S., Lash, R., & de Leon Siantz, M. L. (2016). Migration experiences of
foreign educated nurses: a systematic review of the literature. Journal of
Transcultural Nursing, 27(2), 181-188.
Zolnierek, C. D. (2014). An integrative review of knowing the patient. Journal of
nursing scholarship, 46(1), 3-10.
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