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Short Answer Test (SAT) Assessment 2 Week 7 Commencing Monday, April 4th In registered tutorials Weighting – 40% 1000 words Short Answer Test (SAT) Week 7, in registered tutorial groups Weighting: 40% Word limit: 1000 words Submission Details: This is a closed book assessment that will be completed in your tutorial class in week 7. All students must attend their allocated tutorial to complete this assessment. You have an allocated time of 90 minutes. Marking Criteria and Standards: See page 12-17 of the Learning Guide Aim of assessment The purpose of this short answer test in-class assessment is to enable the student to demonstrate: • An understanding of the principles of perioperative nursing care in relation to a person who has Crohn’s disease (Learning outcome 1). • An understanding of alterations in body fluid homeostasis and the management of fluid balance in the perioperative period (Learning outcome 1). • An understanding of the role of the nurse in the perioperative period in relation to a person who has Crohn’s disease (Learning outcome 2). • An understanding of the pathophysiology of Crohn’s disease (Learning outcome 5). • An understanding of pharmacological agents that may be used in the perioperative care of a person who has Crohn’s disease (Learning outcome 6). • An understanding of how safe and effective administration of pharmacological agents support people in perioperative care (Learning outcome 1, 6 & 7). • An evaluation of relevant literature to support an understanding of the pathophysiology, pharmacological and nursing management of a person experiencing Crohn’s disease and is able to express this in a clear and succinct writing style (Learning outcome 9). Details Lucy is a 19 year old university student. She has been admitted to hospital with a six (6) day history of lower right quadrant abdominal cramping pain increasing with intensity, diarrhoea with blood, anorexia, fatigue, nausea and episodes of vomiting. Lucy states that she was diagnosed with Crohn’s disease at age 15. She has had two previous hospital admissions for acute exacerbations of Crohn’s disease with clinical manifestations of diarrhoea, abdominal pain and vomiting. Her Crohn’s disease has been managed with a combination of diet, medication and medical monitoring. Remission of her Crohn’s disease was maintained by oral mesalazine (Mesasal). Lucy currently rates her pain as 9/10. On examination, Lucy was pale, her extremities were cool, and her skin was dry with poor turgor. Her abdomen was distended and tender. A mass was palpable in the lower right abdominal quadrant. Observations on admission • Blood pressure: 95/60 • Pulse rate: 110 beats/minute • Respiratory rate: 22 breaths/minute • Temperature: 37.7C • Sa02: 98% in room air • Weight: 62 kilograms • Height: 165 cm • Urinalysis: • specific gravity: 1040 • dark coloured urine • no other abnormalities noted Initial pathology results • Haemoglobin: 105 g/L (117 – 157 g/L) • Haematocrit: 49% (35 – 47%) • WBC 15000/mm3 ( 3500 – 11000 mm3) • Erythrocyte sedimentation rate (ESR): 28mm/hour (0 – 20 mm/hour) • C-reactive protein (CRP): 30mg/dl (20 mg/dl) • Albumin: 28g/L (35 – 50 g/L) The MO orders the following • fentanyl 75mcg IMI QID PRN • metoclopramide (Maxolon) 10mg IMI TDS • 1000mL 0.9% normal saline over 8 hours • nil by mouth Unit: 401010 Health Variations 1 Lucy was prepared and sent for an urgent colonoscopy, upper barium x-ray and abdominal CT scan. A bowel obstruction at the proximal end of the ascending colon at the ileocecal junction was diagnosed. A balloon dilation of the obstructed colon was attempted, but was unsuccessful. Lucy was scheduled for a surgical resection of the affected proximal ascending colon and end-to-end anastomosis of her colon. Questions Question 1. 10 marks (250 words) Explain the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. (Learning outcome 5; NMBA competency standards 2.6, 3.1, 4.2) Question 2. 10 marks (250 words) Explain the pathophysiological processes that lead to Lucy’s conscious perception of pain in her lower right abdominal quadrant. (Learning outcomes 1, 5; NMBA competency standards 2.6, 4.2, 3.1) Question 3. 5 marks (165 words) Describe the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. (Learning outcome 1, 2; NMBA competency standards 2.6, 3.1, 4.2, 5.2, 5.3) Question 4. 5 marks (165 words) Describe the mechanism of action of fentanyl in relation to its administration to Lucy. (Learning outcome 6; NMBA competency standards 1.1, 2.6, 3.1, 4.2) Question 5. 5 marks (165 words) Prioritise the nursing responsibilities and associated rationales related to the administration of fentanyl to Lucy. (Learning outcome 7; NMBA competency standards 1.1, 1.2, 1.3, 2.2, 2.5, 2.6, 5.2, 5.3, 6.1, 7.4) END OF QUESTIONS NOTE - WORD LIMIT There is a total word limit of 1000 words for the SAT. If you exceed the word limit by more than 10% the marker will stop marking at 1100 words (word limit of 1000 words + 10%). This assessment does not require in text citations or a reference list. Marking criteria and standards: Assessment 2 – Short Answer Test (SAT) In Class closed book assessment based on Case History Criteria Mark High Distinction Distinction Credit Pass Fail Q 1. Accurately, clearly and comprehensively explains the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. /10 Provides an accurate, clear and comprehensive explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides an accurate and clear explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides an accurate explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. The information may be incomplete or lack clarity in explaining the pathogenesis of Crohn’s disease and the development of Lucy’s obstruction of the proximal ascending colon. Provides a basic explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow in explaining the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides a superficial explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Explanation does not accurately identify the events that occur in the pathogenesis of Crohn’s disease and the development of Lucy’s obstruction in her proximal ascending colon. Response does not demonstrate an understanding of the pathogenesis of Crohn’s disease and the development of a bowel obstruction. 8.5-10 7.5-8 6.5-7 5-6 =4.5 Criteria Mark High Distinction Distinction Credit Pass Fail Q 2. Accurately, clearly and comprehensively explains the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. /10 Provides an accurate, clear and comprehensive explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides an accurate and clear explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides an accurate explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. The information may be incomplete or lack clarity in explaining the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides a basic explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow in explaining the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides a superficial explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Explanation does not accurately identify the events that occur in the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Response does not demonstrate an understanding of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. 8.5-10 7.5-8 6.5-7.0 5-6 =4.5 Criteria Mark High Distinction Distinction Credit Pass Fail Q 3. Accurately, clearly and comprehensively describes the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. /5 Provides an accurate, clear and comprehensive description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Provides an accurate and clear description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Provides an accurate description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Some information may be incomplete or lack clarity. Provides a basic description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow. Provides a superficial description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Response does not demonstrate an understanding of the characteristics of the intravenous fluid and/or the specific rationale, related to the details of the case study, for its administration to Lucy. 4.5-5 4 3.5 2.5-3 =2 Criteria Mark High Distinction Distinction Credit Pass Fail Q 4. Accurately, clearly and comprehensively describes the mechanism of action of fentanyl in relation to its administration to Lucy. /5 Provides an exceptionally accurate, clear and comprehensive description of the mechanism of action of fentanyl in relation to its administration to Lucy. Provides an accurate and clear description of the mechanism of action of fentanyl in relation to its administration to Lucy. Provides an accurate description of the mechanism of action of fentanyl in relation to its administration to Lucy. However, the response may lack some relevant information or clarity. Provides a basic description of the mechanism of action of fentanyl in relation to its administration o Lucy. Description may contain minor inaccuracies, omission of relevant information, repetition or lack clarity. Provides a superficial description of mechanism of action of fentanyl in relation to its administration to Lucy. Response does not show an understanding of the mechanism of action of fentanyl in relation to its administration to Lucy. 4.5-5 4 3.5 2.5-3 =2 Criteria Mark High Distinction Distinction Credit Pass Fail Q 5. Accurately, clearly and comprehensively prioritises the nursing responsibilities and associated rationales in relation to the administration of fentanyl to Lucy. /5 Comprehensively, clearly and accurately prioritises all relevant nursing responsibilities related to the administration of fentanyl to Lucy. Provides detailed and accurate rationales for each of these actions. Accurately prioritises all relevant nursing responsibilities related to the administration of fentanyl to Lucy. Provides accurate rationales for each of these actions. Accurately prioritises most relevant nursing responsibilities related to the administration of fentanyl to Lucy. Provides accurate rationales for each of these actions. Identifies most relevant nursing responsibilities related to the administration of fentanyl to Lucy. Nursing interventions may not be presented in a prioritised order. Provides superficial rationales for these actions. Some nursing actions may lack specific rationales. Identifies minimal relevant nursing responsibilities related to the administration of fentanyl to Lucy. Does not provide associated rationales for these actions. Rationales may be inaccurate, incomplete and not related to specific nursing actions. 4.5-5 4 3.5 2.5-3 =2 Criteria Mark High Distinction Distinction Credit Pass Fail Academic Writing Style. /5 Writes in an advanced style exhibiting highly coherent and logical flow of ideas. No errors in spelling, grammar, punctuation or sentence structure. Writes clearly and succinctly with a coherent, logical flow of ideas exhibiting advanced clarity. No errors in spelling, grammar, punctuation or sentence structure. Ideas are clearly expressed. Use of language enables effective flow of ideas. Minor errors in spelling, grammar, punctuation or sentence structure that do not impede the logical flow of ideas and meaning. Writes in a reasonably clear style, but limited use of language sometimes hinders the effective flow of ideas and meaning. Minor, frequent errors in spelling, grammar, punctuation or sentence structure sometimes impede meaning and the flow of ideas. Writes in an elementary style with basic use of language and poor articulation of ideas. Organisation of material and main points are unclear, confused or disorganised Multiple errors in spelling, grammar, punctuation and sentence structure. 4.5-5 4 3.5 2.5-3 =2 Comments:

Question Set #323

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