I2 Case Analysis: Applying A2K Framework to Mr. Porter's Nursing Care

This report provides a comprehensive analysis of Mr. David Porter's nursing care, focusing on a case study involving a closed transverse fracture to the right femur. The report begins with an introduction to the importance of the connection between nursing theory and practice, followed by an overview of Mr. Porter's medical history, including hypertension, osteoarthritis, and other conditions. The main body of the report applies the A2K assessment framework to differentiate between normal and abnormal clinical findings, proposes nursing interventions, and explains their rationale. The report also identifies and relates relevant Standards of Practice from the NMBA and fundamental responsibilities from the ICN Code of Ethics to the nursing care of the patient. The report includes a detailed discussion of medication administration, safety considerations (including the '5 Rights'), and the nurse's role in administering or withholding interventions. The conclusion summarizes the key findings and the importance of evidence-based practice in nursing care. The report references peer-reviewed scholarly sources to support all areas of the response.

Essential Nursing Care Theory to
Practice

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Question 1: Apply the A2K Assessment Framework (Primary and Secondary Survey) to Mr
Porter's case and differentiate between the normal and abnormal clinical findings. Propose at
least two (2) nursing assessments that are indicated based on the abnormal findings
and explain why these assessments are necessary.................................................................1
Question 2: Identify one (1) nursing intervention (medication OR Intravenous
fluid OR blood product) that has been prescribed for the patient and explain:.....................3
Question 3: Identify and relate one (1) Standard of Practice (NMBA, 2016) AND one (1)
fundamental responsibility from the ICN Code of Ethics for nurses (ICN, 2012) to the nursing
care of the patient in the scenario...........................................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Nursing care refers to process of providing medical care and support by a registered & skilled
nurse for wellbeing of an individual. It includes the several important steps to deliver appropriate
care including assessment, diagnosis, planning, implementation and evaluation. However, it is
observed that care services are required to be delivered on the basis of actual care needs of
patient in order to make them healthy. It involves the criterion of formulating appropriate care
plan for providing effective treatment to make individual disease free (Koutoukidis, Stainton and
Hughson, 2016). Moreover, it is observed that important principles of care should be followed
like dignity, independence, partnership, privacy, respect, rights, safety, equality, inclusion,
confidentially and choice. In context of this, it is based on the case scenario of patient named Mr
David Porter with a situation of closed transverse fracture to the shaft of the right femur. It
includes history of several health problems including hypertension, osteoarthritis, gastro-
oesophageal reflux disease, atrial filtration and congestive cardiac failure. This assignment will
focus on difference between normal and abnormal clinical findings of patient. It will also include
suitable and appropriate nursing intervention of given patient for their wellness. The standards of
practice and fundamental responsibility regarding nursing care scenario of patient is given
below.
MAIN BODY
Question 1: Apply the A2K Assessment Framework (Primary and Secondary Survey) to Mr
Porter's case and differentiate between the normal and abnormal clinical
findings. Propose at least two (2) nursing assessments that are indicated based on the
abnormal findings and explain why these assessments are necessary.
A2K assessment framework can be defined as an effective framework to carry out assessment of
clinical condition of an individual to provide appropriate care services for them. It includes the
criterion of evaluating the actual condition of selected patient in order to formulate accurate
decision making of treatment for wellbeing of them. Basically, it is necessary to assess the
situation of client by identifying relevant symptoms and its cause with the help of conducting
clinical procedures for assessment (Smith and Field, 2019). It will provide support to make
decision of treatment along with preparing more effective as well as efficient care plan for
wellness of an individual. Meanwhile, it has been analysed that primary assessment includes the
1

way of conducting physical examination and some of necessary pathological procedures to
determine actual medical problem of patient. However, the secondary assessment includes the
study of previous clinical reports and prescription of earlier physicians related to medial history
of client (Machiels and et. al., 2017). It is favourable to gain previous clinical information about
client which helps to analyse the medicinal allergy as Mr David Porter was allergic from
Morphine then relevant medicines should not be given to him. Moreover, it will facilitate to
eliminate risk of drug errors and helps to deliver appropriate treatment to make them disease
free.
Difference between normal and abnormal clinical findings
Factors Normal Abnormal
Blood Pressure 120/80 mmHg 170/65 mmHg
Heart Rate 60 to 100 bpm 98 bpm (irregular)
Respiratory Rate 12 to 16 20/minute
SpO2 At least 95 % in room air 96% on room air
Peripheral pulses present R=L R=L
Cap refill < secs R=L R=L
GCS 13/15 15/15
Temperature 37 °C 36.0°C
In context of Mr David Porter, it has been analysed that effective interventions are required to be
formulated for treating the problem of fracture of femur and relevant pain because that pain is
sometime very terrible. It is necessary for physicians to treat these two health issuer on priority
for which appropriate nursing intervention are mentioned below.
Intervention 1: It includes the criterion of carrying out surgery in order to treat the problem of
closed transverse fracture to the shaft of the right femur in respect of improving their health
condition (Locsin, 2017). This clinical situation requires a surgical treatment for treating the
problem of fracture for David that facilitates to make them feeling relived from the relevant pain
accordingly.
Intervention 2: The second intervention includes the way of providing pain medication by
avoiding the morphine related medicine as client is allergic from the same (Kardong-Edgren,
Oermann and Rizzolo, 2019). It includes providing pain relieving medicines which are free of
2

morphine extract in terms of reliving the severe pain faced by client for improving their
condition to gain completely well situation of them.
Question 2: Identify one (1) nursing intervention (medication OR Intravenous fluid OR blood
product) that has been prescribed for the patient and explain:
In context of given case scenario related to Mr David Porter, it has been evaluated that
medication is required to be provided for relieving the symptom of pain. It is necessary to reduce
the pain which make patient capable to get involved in decision making f their treatment of
surgery. However, it is observed that medication plays an important role for treating the pain of
client because fracture is responsible for developing pain which increases its severity till the
problem was treated or pain is medicated (McCormack and McCance, 2016). It is very important
to provide appropriate medicine for reducing the severity of pain for David that helps in recovery
of respective problem effectively.
 why the intervention is specifically indicated
Considering the intervention of providing pain reliever without extract of morphine, it has been
analysed that reduced pain is supportive for David for improving their condition. It includes the
way of relieving patient’s symptoms of pain which is helpful to enhance the recovery rate that
impact positively on clinical condition of an individual in order to make them wellbeing as soon
as possible (Younas and Quennell, 2019). However, the pain developed due to fracture and
surgical procedure also create pain for patient which are required to be treated for gaining better
health condition. Meanwhile, it has been identified that actual problem of fracture and relevant
symptoms which facilitates to enhance the health condition for making client completely
wellbeing respectively.
 the safety considerations (including the '5 Rights') needed when a nurse is
administering this intervention;
As per the given case of David, it has been evaluated that care professionals associated with
given client is required to follow safety standards in terms of maintaining safety factor of them.
It includes focusing on several factors like safe, effective, caring, responsive to needs of client
and well-led to deliver appropriate medical facilities. Meanwhile, it is necessary to protect
patient from any kind of abuse, neglect or harm at care centre while providing treatment for their
wellbeing (Digby, Williams and Lee, 2016). It involves the criterion of considering care
standards including dignity & respect, compassion, is included, responsive care & support and
3

wellbeing of client. However, it is necessary to use principles of care such as dignity,
independence, partnership, privacy, respect & rights, safety, equality, inclusion and
confidentiality. Moreover, it is necessary for practitioners to maintain rights of patient while
dealing with David to treat his problem including right to appropriate medical care, right to
informed consent, right to privacy, right to information, right to self-determination, right to
religious beliefs and right to medical records. It is required to consider 5 rights of patient while
providing medication such right patient, right drug, right dose, right route and right time
respectively (Koutoukidis and Stainton, 2016).
 Why a nurse should administer the intervention OR why a nurse might choose to
withhold the intervention and seek clarification.
According to the selected intervention of providing medication to David, it has been analysed
that appropriate dosage of medicine should be provided by nursing staff only because they are
taking care of client for all the time along with monitoring the actual condition of them. It
includes the use of appropriate dose of specific medication to provide to patient which helps to
relive the severe symptom in order to make them disease free accordingly (Simpson and Lyndon,
2017). However, it has been identified that nurses are with client all the time and monitor the
effects of medication for improving their health condition.
Question 3: Identify and relate one (1) Standard of Practice (NMBA, 2016) AND one (1)
fundamental responsibility from the ICN Code of Ethics for nurses (ICN, 2012) to the
nursing care of the patient in the scenario.
Considering the given case of David, it has been evaluated that care standards of NMBA are
required to be followed which helps to deliver appropriate care services to client. It includes the
criterion of considering all the care standards which are favourable in terms of increasing the
effectiveness of medical facilities for treating the specific health problem of an individual in
proper manner. However, these standards are helpful to direct efforts of care practitioners in
correct direction which impact positively in patient condition to make them healthy as soon as
possible (Hawthorne and Gordon, 2020). The medical professionals associated with case of
David are required to follow care standards provide by NMBA in which some of them are
mentioned here. Initially, it is necessary for nursing staff thinks critically and analyses the
nursing practices in effective manner. Secondly, it is required for nurse to get involved into
appropriate therapeutic as well as professional relationships for providing appropriate treatment
4

facilities for patient wellbeing. Thirdly, it involves the criterion of maintaining the capability for
practice in respect of treating specific heath problem of client in more effective as well as
efficient manner. Meanwhile it is necessary for nursing staff to comprehensively conduct
assessments which help to make accurate decision of care services suitable for patient. However,
it includes the standard of developing a plan for nursing practice to consider accurate clinical
procedures for wellness of an individual. In addition to this, it has been identified that nursing
staff should deliver safe, appropriate and responsive quality nursing practice respectively
(Newton and Krebs, 2020). Moreover, it is very important to follow the standard of evaluating
the outcomes to inform nursing practice in terms of improving health condition of given client.
On the other hand, it has been analysed that ICN codes of ethics are very important to be
followed by care professionals dealing with case of David for his wellness. It includes the
criterion of nurse to have fundamental responsibility to consider the ICN codes of ethics in order
to deliver appropriate care facilities. However, it is necessary to utilisation of relevant factors
such as nurses & people, nurses & practice, nurses & profession and nurses & co-workers. In
case of David, the ICN code of ethics related to given case is nurse & people in which nursing
staff is responsible for providing care services to needy individuals. It is necessary for them to
consider number of components whole providing care to patients such as human rights, values,
customs and spiritual beliefs for welfare of individual, family members as well as community to
respect them (Holmberg and et. al., 2020).
Meanwhile, it is observed that more effective as well as efficient care standards, guidelines,
ethical principles and legislations are required to be considering while providing care to David in
order to deliver better quality of treatment. It will provide support to treat the respective problem
of fracture effectively which facilitates to make them disease free (Bail and Grealish, 2016).
CONCLUSION
From the above project, it has been concluded that nursing care can be defined as the process of
delivering support and care services by a registered as well as skilled nurse for making an
individual healthy. It includes the criterion of following all the desired ethical principles,
legislations, codes of conduct, guidelines, and care standards etc. which facilitate to formulate
accurate decision of providing treatment. However, it is observed that proper assessment is
required to be done with the help of using A2K assessment framework which is favourable to
gain information about actual condition of patient. It will facilitate to formulate more effective as
5

well as efficient care plan by making suitable nursing interventions according to particular health
problem of client. It will facilitate to care professionals to put efforts in correct direction in order
to make an individual wellbeing. Moreover, it is beneficial in respect of providing appropriate
medication and care facilities to client by considering ethics and standards of care.
6

REFERENCES
Books and journals
Koutoukidis, G., Stainton, K., & Hughson, J. (2016). Tabbner's Nursing Care: theory and
practice. Elsevier Health Sciences.
Smith, B., & Field, L. (2019). Nursing care: An essential guide for nurses and healthcare
workers in primary and secondary care. Routledge.
Locsin, R. C. (2017). The co-existence of technology and caring in the theory of technological
competency as caring in nursing. The Journal of Medical Investigation, 64(1.2), 160-164.
McCormack, B., & McCance, T. (Eds.). (2016). Person-centred practice in nursing and health
care: theory and practice. John Wiley & Sons.
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: an integrative
review. Scandinavian journal of caring sciences, 33(3), 540-555.
Digby, R., Williams, A., & Lee, S. (2016). Nurse empathy and the care of people with
dementia. Australian Journal of Advanced Nursing, The, 34(1), 52.
Simpson, K. R., & Lyndon, A. (2017). Consequences of delayed, unfinished, or missed nursing
care during labor and birth. The Journal of perinatal & neonatal nursing, 31(1), 32-40.
Hawthorne, D. M., & Gordon, S. C. (2020). The Invisibility of Spiritual Nursing Care in Clinical
Practice. Journal of Holistic Nursing, 38(1), 147-155.
Newton, R. H., & Krebs, A. (2020). Bridging the Theory-Practice Gap Using Simulation to
Teach Care of Patients With Disabilities. Teaching and Learning in Nursing.
Holmberg, M. & et. al. (2020). Dyadic teams and nursing care: a critical incident study of nurses
in the emergency medical service. Journal of Clinical Nursing.
Bail, K., & Grealish, L. (2016). ‘Failure to Maintain’: A theoretical proposition for a new quality
indicator of nurse care rationing for complex older people in hospital. International journal of
nursing studies, 63, 146-161.
Koutoukidis, G., & Stainton, K. (2016). Essential Enrolled Nursing Skills for Person-Centred
Care. Elsevier Health Sciences.
Kardong-Edgren, S., Oermann, M. H., & Rizzolo, M. A. (2019). Emerging theories influencing
the teaching of clinical nursing skills. The Journal of Continuing Education in Nursing, 50(6),
257-262.
Machiels, M. & et. al. (2017). Interventions to improve communication between people with
dementia and nursing staff during daily nursing care: a systematic review. International journal
of nursing studies, 66, 37-46.
7