Assignment Task
Case Study 1 (Remote Clinic)
As the RN you arrive at the remote clinic at Wilcannia for your fortnightly visit, the population here is mainly Indigenous Australians and there is a high percentage of children in this community. It is normally quite a busy day.
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Get Help Now!The next patient you see is Ashanti, a 3 year old indigenous girl. Ashanti presents in the arms of her Mother with her Grandmother present. When asked about Ashanti’s chief complaint, her mother explains she has ‘had the runs for a few days and whatever I give her just goes straight through’. Ashanti is lethargic and unable to walk. On examination you observe Ashanti to be speaking quietly to her Grandmother, you notice there is no accessory muscle usage but there is an increase in her work of breathing (WOB). She has normal breath sounds on auscultation, is pale and cool to touch, she has cracked lips, a dry tongue, sunken eyes and looks very unwell. There is no sign of any wounds or lesions which could indicate an infection as the cause of her deterioration. On further questioning Ashanti’s Mother tells you she has had about 2 cups of juice today you work this out to equate to approximately 400mls. You also ask about her urine output, Ashanti’s Mother is unsure about this as she just states that it is just her bowels that are working, as far as she knows she has not passed urine and has not noticed any urine in her nappies. You ask when she last passed urine and you are told ‘it has not been for a day or so’.
Questions:
1. Discuss your assessments on this patient, identify signs of deterioration and clearly state if the patient requires a clinical review or rapid response as per Between the Flags (BTF). Justify your decision with data from the case and relevant support. .2Document a succinct and accurate ISBAR handover in verbal script format (eg. Hello, my name is…)
2. Considering the assessment findings, prioritise and discuss the immediate nursing management of the patient
3. Succinctly discuss the ongoing management of this case and integrate the relevant members of the interdisciplinary tea
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