Assignment Directions
Read the following case study:
You are a staff nurse working in
an intensive care unit and assigned to care for a 75-year-old Asian man who had
coronary artery bypass graft surgery four days ago. The patient has a history
of chronic obstructive pulmonary disease exacerbated by heavy smoking. His
postoperative course has been difficult, and he has suffered a number of
setbacks. Staff members, despite their diligent efforts, have not been able to
wean him off the ventilator since the surgery. He has required frequent
suctioning throughout the shift, and he is being evaluated for the development
of ventilator-associated pneumonia.
Today, when returning from lunch,
you observed that an experienced nurse was suctioning your patient. His
secretions were thick, and you observed that the nurse was instilling saline
into the patient’s endotracheal tube as she was suctioning him. The patient
turned red and began coughing, and it was obvious he was in distress.
You asked the nurse why she was
instilling saline into his endotracheal tube. She replied that this was being
done to loosen the secretions. You told her this was no longer an acceptable
practice. She stated that she had many years of critical care experience and
she didn’t care what anyone said, that the only way you could loosen the
patient’s secretions would be to instill saline. She also said that would be
the last time she would do something for one of your patients while you were at
lunch.
Determine a plan of care for the ICU patient described in the case
using the nursing process.
Define each step of the nursing process and align each step to critical thinking and clinical decision-making
processes.
Format your plan of care as a Word document report, aligning the
nursing process steps to the critical thinking and clinical decision-making
processes in a table and include it in your final report. Your report will be
delivered to your nursing supervisor for her review.
Submit your assignment.
Assignment adapted from Leading
and Managing in Nursing (Ch. 21), by Patricia S. Yoder-Wise, 2015, St
Louis, MI: Elsevier. Copyright 2015 by
Elsevier. Adapted
with permission.
Competency Assessment Rubric
Assignment/Performance
Criteria
Mastery 100%
Meets Expectations 85%
Not Met 0%
Plan of Care (weight 30%)
The plan of care for the
patient was thoroughly described.
The plan of care for the
patient was partially described.
The plan of care for the
patient was not described.
Nursing Process (weight 30%)
Each step of the nursing
process was fully defined.
Each step of the nursing
process was partially defined.
None of the steps of the
nursing process was defined.
Align
Nursing, Critical
Thinking,
and Decision-
Making Processes
(weight
35%)
Each step of the plan of
care to critical thinking and clinical decision-making processes was
comprehensively aligned.
Each step of the plan of
care to critical thinking and clinical decisionmaking processes was partially
aligned.
None of the step to
critical thinking and clinical decision-making processes.
Grammar
and Writing
Mechanics
(weight
5%)
Accuracy in grammar,
sentence structures, sentence boundaries, and word choice enhanced content.
Occasional
inaccuracies/errors (less than 5) in
grammar, sentence structures, sentence boundaries, and word choice did not
detract from the content.
Frequent
inaccuracies/errors (greater than 5) in
grammar, sentence structures, sentence boundaries, and word choice detracted
from the content.
