Details : The following written assignment is based on a scenario of Mr Reginald Sharman. The video of the scenario is available on the Moodle site and is called ‘Reginald Sharman and you as a first year nursing student’. (There video is broken up into 3 parts specific to your assignment). You cannot complete this assignment without referring to the video.

In preparation for the assignment, you will need to download the following documents: ·
Fluid balance chart, · QADD’s vital signs chart, · Nursing progress notes.

These will be available in the assignment section on the Moodle site. You are then to read the assignment task set out below and watch the video in all 3 parts. This assignment has a focus on patient assessment, fluid balance charts, vital signs, stoma management and professional communication.

Each of these are linked to the National Safety and Quality Health Service Standards.

Setting the scene for your assignment You are a first year nursing student on your first clinical placement. You are on the Rehabilitation ward at CQUniversity Hospital. It is the morning shift and you have been assigned the responsibility of looking after Mr Reginald Sharman.

Who is Reginald?

The following are Reginald’s demographic details taken from his patient chart. This is important information that you will require when completing patient charts for your assignment.

Patient’s full name: Reginald Sharman · Date of birth: 21/01/1932 · UR number: 3066625 · Address: 23 Ames Street, Doblo, Queensland. · Hospital name/ ward: Ward D CQU · Doctor: Dr William Crane · Weight: 80kgs · Height: 160cm

It is 0700hrs and you have just started your shift. Clinical handover has begun. You receive the following information at Reginald’s bedside from the nurse who is about to go off duty. The nurse refers to Reginalds care plan in the process of delivering the information to you.

Situation: Mr Reginald Sharman was transferred from the medical ward to the rehabilitation ward yesterday after experiencing a cerebral vascular accident (CVA) two weeks prior.

Background: Mr Sharman has a history of conjestive cardiac failure, diabetes and repeated urinary tract infections. He lives alone after his wife passed away three years ago. Mr Sharman is currently on diuretics and oral hypoglyceamics.

Assessment: Mr Sharman has left sided weakness. He has some difficulty expressing himself verbally as a result of the CVA. He is high risk for pressure injuries and falls. He has full swallowing reflex but does require assistance with meals. He is currently scoring zero on the ADDS chart. His blood sugar level is currently 5.5 mmols.

Recommendations: Standard precautions are in place. Reginald is on a fluid balance chart and we are measuring all input and output. Reginald requires vital signs observations 4/24. Blood glucose level BD. He requires full assistance with activities of daily living and is A 1 for mobilization. He requires falls prevention and pressure injury prevention care. The medical team will review Reginald this morning at 1000hrs but Notify Dr Crane if you have any concerns.

Your responsibilities in looking after Reginald whilst under the supervision of the registered nurse includes:

· attending to his hygiene and toileting needs; · assisting with meals; · mobilising Reginald safely; · pressure injury and falls prevention; · monitoring his vital signs and · maintaining his fluid balance chart.

What do you need to do next?

Title page and general instructions

Create a title page for the assignment and include all relevant information including student name, number, unit name and number, assignment number & word count. Ensure you use 12 point font and double line spacing. Please also ensure you include a contents page.

The first part of your assignment
Open your assignment with an introduction then move into the required tasks as per instructions (allow 200 words). Explain in the written part of your assignment: · What clinical handover is and how it relates to Standard 6 ‘Communicating for Safety’, · describe what the nurse should do when providing the handover to the oncoming staff, · describe what the nurse should do who is receiving the handover. You should allow 500 words for this part. Please back up your information with quality references.

The second part of this assignment Prior to caring for Reginald, you are conscious that you need to maintain hand hygiene. Complete the hand hygiene package. Please refer to on-line hand hygiene package available at www.hha.org.au/home/student-health-practitioners.aspx. Once completed you will need to print off the certificate. You will need to submit this in Appendix 1 of your assignment.

The third part of this assignment You are also aware, based on the clinical handover, that Reginald has had a cerebral vascular accident (CVA) and is at risk of falls and pressure injuries. You are to briefly explain: · What puts Reginald at risk of falls and pressure injuries and · What is the nurse’s responsibility in assessing, managing and documenting that risk. You should allow 500 words for this. Please back up your information with quality references.

The fourth part of the assignment Your shift progresses. You attend to Reginald’s care. It is now 1130 in the morning. You realize that you have not completed the fluid balance chart so you go to Reginald to ask about his intake and output. Download the fluid balance chart from the Moodle site and document all input and output from 0800hrs until 1130hrs according to what Reginald tells you in the video. This completed fluid balance chart will be Appendix 2 of your assignment.

The fifth part of the assignment Continue watching the video. At 1155hrs you go into Reginald’s room and he is sitting on the side of the bed. He states to you “when I pass urine it stings and it smells”. Reginald appears hot and flushed.

You then take Reginald’s vital signs. It is 1200hrs and your findings are as follows. · Respiration 18 · Pulse 110 · Blood pressure 120/80 (usual BP 110/70) · Temperature 39.0 · Oxygen saturation 97% · Oxygen flow rate 0- Mode Room air · Conscious state – Alert

Record the vital signs on the Adult QADD’s form as downloaded from the Moodle site. Include all points of identification on the chart. You are to add the score. You will need to submit this as Appendix 3. In the written section of your assignment you then need to explain, · what action should be taken based on the criteria of the score you calculated. · what nursing action you would take in regards to his reported urine complaint. · You should allow 200 words for this.

The sixth part of your assignment

The situation continues. Based on the above scenario you have sought the assistance of the registered nurse. The registered nurse asks you to contact the doctor about Reginald’s current situation. You are to apply ISBAR in communicating to the doctor.

It is 1230hrs and you contact the Doctor who advises that they will review Reginald within 30 minutes. Doctor reviewed Reginald at 1300hrs and asked for: hourly observations, to obtain a mid-stream urine specimen and send to pathology, encourage fluids, and for the registered nurse to administer analgesia as per orders on the medication chart.

In the written part of your paper you are to include the communication you gave under the ISBAR framework. You should allow 300 words for this.

The final part of your assignment

You are now required to enter what has occurred in the nursing progress notes. Enter the situation assuming the time is now 1400hrs and the date is Tuesday 03/05/2018. Your documentation can commence from the point of Reginald advising you that he was feeling unwell. All events unfolding from that point should be documented on the downloaded nursing progress notes adhering to the principles of professional documentation.

You will submit this as Appendix 4 with your assignment.

You should close your assignment with a conclusion (allow 150-200 words).

Summarising what you need to do:

View the scenario of Reginald Sharman and your written assignment on the Moodle site.

Explain in the written part of your assignment the following, what clinical handover is and; what steps should the nurse take at the bed side when providing the handover to the oncoming staff and what steps should the nurse take who is receiving the handover.

Complete the hand hygiene package. Please refer to on-line hand hygiene package available at www.hha.org.au/home/student-health-practitioners.aspx. 

Briefly explain in the written part of your assignment the following: why Reginald is at risk of falls and pressure injuries and what is the nurses responsibility in assessing and documenting that risk.

Download the fluid balance chart from the Moodle site and document all input and output from 0800hrs until 1130hrs.

Record the vital signs on the Adult QADD’s form as downloaded from the Moodle site. Include all points of identification on the chart. You are to add the score and include appropriate interventions.

In the written section of your assignment you then need to explain what action should be taken based on the criteria of the score you calculated.

In the written part of your paper you are to include the communication you gave under the ISBAR framework.
You are now required to enter what has occurred in the nursing progress notes.

Make sure you have a conclusion at the end of your paper.