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 – Healthy Ageing and Chronic Conditions

Assessment 2 – Case study essay

Semester 2/2021

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Assessment details

Assessment 2: Case study essay

Weighting: 40%

Word count: There is a word limit of 2000 words (+/- 10%)

Submission details: via Blackboard> Assessments> Assessment 2>Turnitin link

Aim of assessment

The purpose for this case study essay is to enable students to produce a nurse-led case discussion of an older adult, using evidence-based information relevant to nurses and up-to-date Australian statistics, for improving the health and quality of life for elderly persons who have multiple comorbidities and care needs. Content should include discussion on the questions provided in the case study using a holistic approach.

Case study

Maria Russo is an 83-year-old lady with a rich Italian background. She migrated to Australia when she was 51 years and ever since has lived and worked in Australia, she is a widow who lives alone in her unit and has been independent with her activities of daily living. She has two daughters Gianna and Bianca who live nearby and are fully involved with the care of Maria.  Mrs Russo presented to emergency department (ED) via ambulance following a fall in her garden. She had fractured her left NOF and has been to operation theatre (OT) for total hip replacement (THR). Mrs Russo is now day 7 post op.

Mrs Russo has a medical history of osteoarthritis and had a major stroke 5 years ago but managed to recover well after months of rehabilitation. She has moderate congestive cardiac failure, a mild cognitive impairment, NIDDM for ~ 20 yrs, with pain associated to neuropathy. She has had two recent transient Ischaemic attacks (TIAs) at home and managed to recover well after few days of staying in bed. Since she lost her husband, Mr Russo 7 years ago, she cycles through depression if she forgets to take her antidepressants. She wears glasses for her vision impairment related to glaucoma, cataracts, and diabetic retinopathies. She also wears bilateral hearing aids.

During her stay in acute care ward, the nurses documented in her progress notes that Mrs Russo is:

  • Underweight with a BMI of 14
  • On admission looks quite dishevelled and dehydrated indicating possible neglect and poor care
  • Very frail with multiple skin tears on her lower limbs and stage 1 pressure injury to her sacrum
  • Old scars to lower legs with possible history of healed venous/arterial ulcers
  • Might have been on the ground for over 8 hours before a neighbour found her
  • Denies pain, but noticed to be grimacing and wincing during transfers and repositioning  
  • No recollection of memory of her having used her bowels 4 days before she presented in ED
  • Developed delirium post-surgery that resolved after treatment and hydration

              After nine days in acute care ward and three weeks in rehabilitation ward, Mrs Russo was not able to return home and care for herself. After a long discussion with the inter-disciplinary care team (MDT), her daughters Bianca and Giana reluctantly agreed to transfer Mrs Russo to an aged care facility where she will receive 24hr care. Health education during discharged included:  medication compliance, hydration and nutrition, bowel management, skin care, prevention of skin tears as well as future advise on palliative care and end of life care.

Questions 

  1. Outline the statistics (incidence and prevalence) of contemporary ageing in Australia and the impact of the ageing population to the health care system. In your discussion explain why nurses need to be culturally competent to care for older adults in Australia (approx. 200 words)
  2. Upon discharge, Mrs Russo and her daughters were given vital information and health education regarding her health issues and wellness. Explain why health promotion is important in the care of older adults (approx. 200 words)
  3. Identify the conditions that lead to hearing impairment of Mrs Russo and discuss the associated challenges for her as an older adult (approx. 200 words).
  • Consider Mrs Russo’s chronic pain. What assessments will you undertake and what actions will be implemented to reduce/eliminate the pain (approx. 200 words)
  • The occurrence of dementia, delirium and depression are common in older adults as seen in the case study of Mrs Russo. Explain in detail why the nurse needs to be able to distinguish between the three conditions (approx. 200 words)
  • Mrs Russo’s progress notes highlighted some possibility of neglect and poor care at home. From your weekly readings and possible experiences, discuss the risk factors of the older adults that makes them more susceptible to elder abuse (approx. 200 words)
  • Considering the transfer of Mrs Russo to an aged care facility, describe what attributes the registered nurse will need to have in order for Mrs Russo to adapt to her new and final home (approx. 200 words)
  • Considering frailty of Mrs Russo, it is possible that she might enter her palliative/end of life care phase in the near future.  Discuss the nurse’s role in end-of-life care (approx. 200 words)

Important details about your assessment

  • This essay requires a standard essay introduction and conclusion.
  • There is a word limit of 2000 words (+/- 10%) as per SNM Presentation and Assignment Guidelines.
  • Marks will be allocated as per SNM Assessment Rubric & the essay specific criteria below.
  • Submission instructions and the link is accessible under the ‘assessments’ tab.
  • Students should refer to the SNM Presentation and Assignment Guide, ECU APA  7th Ed. Referencing Guide, and the SNM Marking Assessment Rubric.
  • Graphs, tables and flow charts to support discussion will not be accepted.

Marking criteria:

Below you will find two tables: The first is the SNM generic marking rubric, the second is an interpretation of that rubric to help you recognise which areas are important (it shows you what elements you need to address in order to get full marks). The points in brackets show you how those elements are weighted, e.g. the introduction can get up to 5 points etc.

 Well Below Average (<25%)Below Average (26-49%)Pass/Average (50-59%)Credit (60-69%)Distinction (70-79%)High Distinction (>80%)
ContentDoes not address assessment item. No evidence to support main ideas. Unable to demonstrate an understanding of the main ideas or concepts. No credible sources used to support main ideas.Does not or poorly addresses assessment item. Insufficient evidence to support main ideas. Unable to or poorly demonstrates an understanding of the main ideas or concepts. Ideas are not relevant to the topic. Limited referencing to support ideas.Assessment item addressed at a superficial level. Minimal evidence to support main ideas. Able to demonstrate an understanding of the main concepts at a basic level. Some ideas presented have relevance to the topic.Most parts of the assessment item addressed at a satisfactory level and supported by adequate evidence. Able to demonstrate an understanding of the main concepts. Most ideas presented have relevance to the topic.All parts of the assessment item addressed at a good level and supported by quality evidence. Able to demonstrate a solid understanding of the main concepts. Most ideas presented have relevance to the topic.Content fully addresses all parts of the assessment item. Thorough exploration of concepts and well-formed ideas, supported by high quality evidence. Able to demonstrate an in-depth understanding of the main concepts. All ideas presented have relevance to the topic.
0-1011-1920-2324-2728-3132-40
Application of Critical ThinkingDoes not demonstrate critical thinking appropriate to required level. No application of professional practice and/or evidence based thinking to assessment item.Poorly demonstrates critical thinking appropriate to required level. Poor application of professional practice and/or evidence based thinking to assessment item.Limited demonstration of critical thinking appropriate to level of education. Limited application of professional practice and/or evidence based thinking to assessment item.Demonstration of critical thinking appropriate to level of education. Application of professional practice and/or evidence based thinking to assessment item.Very good demonstration of critical thinking appropriate to level of education. Very good application of professional practice and/or evidence based thinking to assessment item.Excellent demonstration of critical thinking appropriate to level of education. Excellent application of professional practice and/or evidence base to practice in assessment.
0-56-910-1112-1314-1516-20
Structure and PresentationThe assignment does not conform to the structure of the assessment item. No introduction to the assessment. Poor or non- existent paragraphing. No logical/cohesive development of ideas. No summation of key points in conclusion. Does not comply with ECU SNM Assignment Writing Guidelines.Limited aspects conform to the structure of the assessment item. Poor introduction to the assessment. Limited paragraphing. Omits or poor summation of key points in conclusion. Poorly complies with ECU SNM Assignment Writing Guidelines. Does not follow specific assignment instructions as per Unit Semester PlanSome aspects conform to the structure of the assessment item ECU SNM Assignment Writing Guidelines. Limited introduction of topic and summation of key points in conclusion. Minimal paragraphing, and logical/cohesive development of ideas.Complies with ECU SNM Assignment Writing Guidelines. Follows specific assignment instructions as per Unit Semester Plan. Introduction adequately introduces topic and summarises key points in conclusion. Paragraphing is evident, and there is a logical/cohesive development of ideas in some of the assessment item.Complies with ECU SNM Assignment Writing Guidelines to a very high standard. Follows specific assignment instructions as per Unit Semester Plan completely. Very good introduction of topic and summation of key points in the conclusion that reflects the student’s position and provides clear insights into the issue. Very good paragraphing, and logical/cohesive development of ideas in most of assessment item.Complies with ECU SNM Assignment Writing Guidelines to an excellent standard. Follows all specific assignment instructions as per Unit Semester Plan. Excellent introduction of topic and strong summation of key points in the conclusion that reflects the student’s position and provides clear insights into the issue. Excellent paragraphing and logical/cohesive development of ideas throughout.
0-56-910-1112-1314-1516-20
ReferencingReferencing does not follow instructions in the ECU Referencing Guide. In text and/or end-text referencing has multiple errors. Includes references in conclusion.Referencing poorly follows instruction in the ECU Referencing Guide. In text and/or end-text referencing has many errors. Includes references in conclusion.Mainly adheres to instruction in the ECU Referencing Guide. In text and/or end- text referencing has some errors.Adheres to instruction in the ECU Referencing Guide. In text and/or end-text referencing has few errors.Adheres to instruction in the ECU Referencing Guide. In text and/or end-text referencing has very few errors.Completely adheres to all instruction in the ECU Referencing Guide. In text and/or end-text referencing has no errors.
0-23-456-78-910
 Low ProficiencyDeveloping ProficiencyModerate ProficiencyHigh Proficiency
English Language ProficiencyMultiple grammatical, spelling and punctuation errors were present throughout. Sentence structure poor making it difficult to determine meaning.Many grammatical spelling and punctuation errors were present and needs improvement. Sentence structure needs improvement.Mostly correct grammar, spelling and punctuation evident throughout. Sentence structure acceptable but needs improvement.Mainly correct grammar, spelling and punctuation. Very few errors. Sentence structure was of a good standard.Grammar, spelling and punctuation were error free. Sentence structure of a high standard. Effective use of all sentence and paragraph writing conventions were clearly demonstrated. Logical application of arguments throughout paper.Grammar, spelling and punctuation were error free. Sophisticated use of all sentence and paragraph writing conventions were clearly demonstrated. Logical application of arguments throughout paper.
0-2-23-4567-89-10
Case study specific criteria to be considered in conjunction with the SNM Assessment rubric:   Points AvailableRubric Points Available
Introduction – 150 Words Introduction of older adult, comorbidities  objectives and care needs.scope & structureGetting the reader’s interest(5)Structure/Presentation 20
Paper Formatting and Presentation   Submitted via TurnitinCoversheet completed Title page  Page numbersUse double-spacing throughout the entire paperSpacing MUST be consistent between the headings/subheadings and the textCorrect font, in black colour and same size font throughout(5) 
Paragraphing & Logic Logical arguments and logical connection between ideas. Well-developed paragraphs. Use of third personAppropriate professional language(5) 
Conclusion – 150 words Summary of key pointsDo not introduce new topicsNo references in the conclusion   (5) 
Question 1 Outline the statistics (incidence and prevalence) of contemporary ageing in Australia and the impact of the ageing population to the health care system. In your discussion explain why nurses need to be culturally competent to care for older adults in Australia (approx. 200 words)(5)Content 40
Question 2 Upon discharge, Mrs Russo and her daughters were given vital information and health education regarding her health issues and wellness. Explain why health promotion is important in the care of older adults (approx. 200words)(5) 
Question 3 Identify the conditions that lead to hearing impairment of Mrs. Russo and discuss the associated challenges for her as an older adult (approx. 200 words)(5) 
Question 4 Consider Mrs Russo’s chronic pain. What assessments will you undertake and what actions will be implemented to reduce/eliminate the pain (approx. 200words)(5) 
Question 5 The occurrence of dementia, delirium and depression are common in older adults as seen in the case study of Mrs. Russo. Explain in detail why the nurse needs to be able to distinguish between the three conditions. (approx. 200 words)(5) 
Question 6 Mrs. Russo’s progress notes highlighted some possibility of neglect and poor care at home. From your weekly readings and possible experiences, discuss the risk factors of the older adults that makes them more susceptible to elder abuse. (approx. 200 words)(5) 
Question 7 Considering the transfer of Mrs. Russo to aged care facility, describe what attributes the Registered Nurse will need to have in order for Mrs. Russo to adapt to her new and final home. (approx. 200 words)(5) 
Question 8 Considering frailty of Mrs. Russo, it is possible that she might enter her palliative/end of life care phase in the near future.  Discuss the nurse’s role in end-of-life care (approx. 200 words)(5) 
This section will be assessed all throughout the paper – Critical thinking skills(20)Application of Critical Thinking 20
Referencing & APA Strict APA 7th ed. is required in-text and in the reference section (double-space or single-space the reference list)If multiple sentences (a short paragraph for example), are supported by the same reference, cite immediately after the first sentence, and at the end of the section that uses that particular referenceMarks will not be awarded if in-text citations are not clearYou should use a minimum of 10 references of which at least 8 are journal articles. You can also use Government and organisational reports but make sure the sources are credible and that you understand the statistical data that is presented. All resources are up to 5 years old. Wikipedia and Dictionary.com will not be accepted as a reference source!  (10)Referencing 10
English Language Grammar, spelling and punctuation were error free. Sophisticated use of all sentence and paragraph writing conventions were clearly demonstrated. Logical application of arguments throughout paper.(10)ELP 10
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