Adult Medical/Surgical Nursing – Essay Example

Adult Medical/Surgical Nursing – Essay Example

Adult medical/surgical nursing has been regarded as the basic roots of nursing from which various sub-specialty and super-specialty arenas like oncology, cardiology and neurology have branched out. Due to this traditional approach, this field in itself could not achieve the status of being a separate specialty; although on recent years Academy of Medical-Surgical Nurses (AMSN) has provided the field it’s long overdue status (Gatson, 2004). “Medical-surgical or adult health nursing is a complex specialty that requires a wide-ranging literature to inform its research and practice” (Taylor, 2005). Medical-surgical nurses, also known as adult health nurses, specialize in the care of adults with a “known or predicted physiological alteration” (ANA, 1974).The vast scope of adult medical/surgical nursing extends to healthcare settings, including acute and sub acute medical-surgical units, collaborative practices with physicians, home health care agencies, clinical education, and care management that aim to deliver quality, evidence-based care in order to maximize patient care outcomes.  Adult Medical/Surgical Nursing – Essay Example.Most adult patients present with the most complex health needs there it is required for a learner to develop critical thinking skills while assessing, planning, implementing and evaluating care of the adult client at an accomplished level (PCT, Catalog). Furthermore, the majority of health care consumers in the country comprise of adult clients. The specialized and advanced knowledge and skills of adult medical /surgical nurses are needed to deal with acute illness complicated by co morbidities like diabetes, hypertension, and cardiovascular disease all of which are specific to the adult population. Comprehensive, total patient care, rather than a focus on a particular organ system or problem, is an important aspect of this specialty (Harkness, 1999). The scope of adult nursing is not restricted to a particular disease or a body system and holistic wellbeing which demand an extensive knowledge base about all aspects of adult health. “The care provided is holistic and is rooted in health promotion, disease prevention, and health maintenance and may be carried out in community and institutional settings” (Grindel, 2005).

The field of nursing involves simultaneous application of art and a scientific knowledge to understand oneself and one’s relationship with individuals, groups, and communities. “Nursing is a therapeutic helping relationship devoted to promoting, restoring, and maintaining the health of individuals, families, groups and communities” (Aurora, Catalog). Learners ought to undergo a rigorously planned professional curriculum for human services that is applicable to the society and reflects the diverse needs of the community with the primary areas of focus being caring, health, learning and commitment to human dignity. Adult Medical/Surgical Nursing – Essay Example.

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Certification for Adult Medical-Surgical Nursing should be delivered solely on basis of individual performance regarding professional practice of medical-surgical nursing (Aurora, Catalog). The certificate program may contain printed hand-outs, videotapes, computerized simulations and lessons, case studies and practical assignments based on advanced reading and research. Knowledge and skill development can be further enhanced by active interactions like educational forums, conferencing, learning labs and faculty consultation. Hands-on clinical training can be conducted under the guidance of preceptors and faculty in medical-surgical areas at authorized medical institutes. Clarity of theoretical concepts is assessed by examinations and written or oral assignments. Practical and clinical skills are assessed in simulated lab situations prior to the actual internship. Learners with prior knowledge, skills, and/or experience fundamental to medical-surgical nursing practice may qualify prior to internship. Learners have to develop a constant need to broaden their knowledge base by through research and evidence-based practice projects. Medical-surgical or adult health nurses may pursue advanced .

According to the Academy of Medical-Surgical Nurses (AMSN), medical-surgical nursing is the foundation of all nursing practice. At one point, all nurses were put in the medical/surgical environment (“What is Medical-Surgical Nursing?,” para. 1. 2014). Today, there are many different types of nursing; although medical-surgical nurses are the largest group of practicing professionals and one of the most demanding nursing specialties (“What is Medical-Surgical Nursing?,” para. 2 2014). They can be put in many different facilities and work with a variety of patients. Medical surgical nurses have many duties and responsibilities throughout the day; but is overall a rewarding job to have. The Occupational Outlook Handbook (January 8, 2014) describes how medical-surgical nurses provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members (“Registered Nurses,” para. 2). The interviewed medical-surgical nurse, Carolina Rojas, stated how takes care of patients who come into the hospital with serious surgical procedures. She normally, “…assesses a patient from head to toe, finds the issue, takes inventory of the patient, coordinates the care between the different doctors and other healthcare workers needed, and makes sure that I follow the orders of the doctors and healthcare providers” (Rojas 2015). This being said, medical-surgical nurses must often use

NUR250 Medical Surgical Nursing 1
S2 2016
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
NUR250 Assessment 1
Topic: Nursing care of a patient requiring surgery
Due date: 1400 Friday Week 7
Length: 2000 words
Contribution to overall grade: 40%
Information on this document is to be read in conjunction with information on the NUR250 Learnline Assessments pages.
Before you start, a reminder to
? Check the submission time and day when you start your assignment and put a note for yourself somewhere where you will see it (on your semester calendar, your computer or on the fridge?)
? Locate and follow the presentation and resource guidelines for Assessment 1 on this document
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
2
NUR250 Assessment 1
Assessment 1 is to be prepared and submitted following the guidelines
below.
Marks are allocated for following presentation guidelines and attention to academic integrity and literacy
requirements.Adult Medical/Surgical Nursing – Essay Example.  See the Assessment 1 marking criteria for full details.
Academic Literacy
Assessment 1 is to be submitted and presented:
? On the Assessment 1 template located in the Assessment 1 folder on NUR250
Learnline
? As a computer generated document in Word compatible format.
? Contents page, title page, introduction and conclusion are NOT required
? 1.5 line spaced in either Arial font size 11 or Times New Roman or Calibri font size 11
or 12
? In clear, coherent Australian English that demonstrates progression towards the
standard for written communication for professional nursing practice in Australia
? Using appropriate professional terminology
? With no acronyms, abbreviations and/or nursing jargon
? Unless otherwise indicated, in grammatically correct sentences and topic paragraphs
? Referencing is required when and where appropriate. (See academic integrity
information below)
? No more than 10% over or under the stated word count
o Note: Word count is assessed from the first word under Task 1 heading.
Headings, any task information copied in and in-text citations are included in
the word count
? Use of trade names is not acceptable. Only generic terms or names are to be used
when referring to specific medications or other prescribed treatments or resources
that may be used in nursing practice
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
3
Academic Integrity: Use of current, reliable evidence for practice
Marks are allocated for quality of sources, use of CDU APA format and your ability to paraphrase information
Although not always a requirement of CDU APA, where there is no DOI for the article, students are
requested to include an active URL in your reference list for this assignment and to ensure all URLs
are active. Do not remove the hyperlinks on URLs. Markers must be able to access ALL of you
sources
? Resources for NUR250 assignments should be from quality, reliable
and reputable nursing journals. This is where you will find information about the
nursing management of patient/health problems. Remember that you will have to apply
information from other countries to the Australian health and nursing context.
? In some items, it may be appropriate to use articles from other journals. If you locate what
you think is a relevant article from a non-nursing journal, carefully evaluate the article to
ensure it is relevant to nursing, and/or that the information is relevant to the role and scope
of practice of the RN in Australia and/or to humans.
? All resources must be dated between 2009 and 2016
? There must be at least 12 peer-reviewed journal articles cited in your
assignment. Articles reporting original research, formal literature and/or systematic
reviews are the preferred resources.
? Only one textbook can be cited as a reference in the assignment and it
must be a current edition. This includes any books from the CDU Library eBook collection.Adult Medical/Surgical Nursing – Essay Example.  If
you must use a textbook, one of the set texts is the preferred reference.
? Relevant documents from reputable, reliable, professional websites may be used where it is
appropriate to do so.
? All resources cited in your assignment must have complete and correct details in the
reference list, including either a DOI or an active URL
Resources that are NOT appropriate
The following are NOT appropriate resources as they cannot be considered reliable
sources of information:
? Textbooks for lower level nursing courses. For example, any edition of Tabbner’s Nursing
Care (Funnell and/or Koutoukidis, et al) does not have the depth or breadth of information
required by a RN.
? Dictionaries
? Journal abstracts and journal articles that are not in English
? Journal articles that cannot be accessed via CDU databases or freely online
? Websites such as Wikipedia, myDr, RNCentral, Scribd, and other blog sites
? Information such as clinical guidelines from organisational intranet sites or other sites that
require registration or log in to access material. This is not publicly available information.
? Consumer websites such as the Better Health Channel or consumer information from
government departments or agencies
? Preview copies of books from online retailers
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
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Assessment 1: Nursing care of a person requiring surgery
Source: Flickr
Meet Gill
You will be caring for her today
Shift handover:
Gill is a 63 year old female with osteoarthritis in both hips. She was admitted this morning
for an elective total hip replacement (total hip arthroplasty) of her left hip.
Gill has a past history of bilateral hip pain and severe pain in the groin, lateral hips and
buttocks. X-rays show bone spurring and severe joint space narrowing in both hips
consistent with advanced osteoarthritis.  Adult Medical/Surgical Nursing – Essay Example.Conservative management has not helped her
symptoms and she currently ambulates with a single prong walking stick.
Gill is currently nil by mouth and has intravenous fluids running at maintenance. Her
current medications include regular paracetamol, diclofenalac, and prn oxycodone. Medical
staff have also prescribed glucosamine and chondroitin as Gill takes these regularly at home.
Prophylactic intravenous antibiotics commenced this morning and are to be continued for
24 hours post operatively. Subcutaneous enoxaparin is to be commenced 4 hours after
return to ward if observations and recovery from anaesthesia and surgery are satisfactory.
Gill has a long history of smoking but stopped recently on medical advice in preparation for
surgery. She has no other significant medical history and, until recently, has been actively
involved in part time work, walking, gardening, and community organizations.
Gill lives alone in a small unit that she owns. Her husband passed away several years ago
and she has an adult daughter living overseas and a son and his family living interstate.
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
5
Assessment 1 Tasks:
Based on the handover you received at the beginning of your shift today, other information included
below and current reliable evidence for practice, address the following 5 tasks.
Do not make up or assume information in relation to or about Gill, the photo is not an
indication of her age or appearance. Only use what you know from the information you received
today.
Note:
Students are expected to demonstrate person-centred care and that they have read beyond the set
texts to prepare their responses and can apply and integrate knowledge to practice.
Reliance on text books alone is no guarantee that your information is current and reliable evidence
for practice. However, set texts are a good place to start to identify key points and to develop
search strategies to locate appropriate journal articles.
Task 1:
Patient teaching is a key nursing responsibility when preparing a person for surgery. You recognise
that two (2) important areas that you need to teach Gill about are post-operative breathing
exercises and movement restrictions.
In grammatically correct sentences and topic paragraphs,
? Identify the specific information you will need to tell Gill today about the two (2) areas
above before she goes to theatre
AND
? Explain
o Why these two (2) areas are an important aspects of Gill’s care
o How you will ensure that Gill knows and understand what she needs to do after her
surgery
(300 words, 5 marks)
Task 2:
While Gill is in theatre, you start to plan the care she will require on her return. You recognise that
two (2) priority nursing problems will be pain and restricted mobility.
In grammatically correct sentences and topic paragraphs,
? Explain
o Why these two (2) nursing problems are a priority in Gill’s care
AND
? Identify how you will position Gill in bed
? Explain why it is important that Gill is nursed in this position
(250 words, 5 marks)
Task 3
Two important aspects of medication management by registered nurses is for the nurse to
understand why a patient has been prescribed specific medications and how to monitor the patient
to ensure they are responding to prescribed medications as they should.Adult Medical/Surgical Nursing – Essay Example.
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
6
In grammatically correct sentences and topic paragraphs and using current, reliable evidence for
practice,
? Briefly explain why Gill has been prescribed:
o Diclofenalac orally
o Combination chondroitin /glucosamine orally
o Subcutaneous enoxaparin
AND
? Identify and explain
o The nursing responsibilities associated with administering the 3 medications above
o How you will monitor Gill to ensure she is responding appropriately to these 3
medications you will be administering
(400 words, 10 marks)
Task 4:
While you are waiting for Gill to return, you recognise that there are a number of nursing problems
that will be part of Gill’s post-operative care plan. You have already discussed several in Tasks 1 and
2.
Based solely on the handover you have received complete the nursing care plan template provided
for Task 4.
? Identify the nursing problems you will include in Gill’s post-operative care.
o Do not include any nursing problems mentioned or discussed in Tasks 1 and 2
o Nursing problems must reflect physical, psychosocial and functional aspects of care
For each nursing problem you add to Gill’s care plan, identify:
? What it is related to
? Goal of care
? Nursing interventions or actions
? Rationales for interventions
? Indicators your plan is working
(800 words, 30 marks)

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Task 5:
An important legal requirement of nursing practice is to effectively and succinctly communicate
relevant information, actions and outcomes related to patient care and provide an accurate
reflection of the health status of the patient, their responses to care and the patient’s perspective.
It is now Day 5 post-operation and the Orthopaedic Team have decided that Gill is ready to be
transferred to a rehabilitation facility for ongoing treatment and therapy to assist her to reach
optimum function and mobility.
Using the ISBAR format, the handover you initially received and the additional information below:
? Write a handover for the rehabilitation service that clearly and succinctly outlines the
important information other health professionals, including other nurses, need to know
about Gill
Additional information you need to know for Task 5 is on next page
NUR250 Medical Surgical Nursing 1: Assessment 1 Topic and Tasks S2 2016
7
During the past 5 days
? Gill recovered well from surgery with no complications
? With physiotherapy assistance Gill has been mobilising since post-operative Day 2
? Gill is not yet weight bearing on left leg
? Observations stable and within normal parameters
? Wound healing well, dressed daily with a non-adherent dressing and sutures to remain until
day 14 post-operation
? Medications continue as prescribed
? Indwelling catheter removed Day 3 post operation
During your shift today the following has occurred:
? Gill has declined the prescribed subcutaneous enoxaprin due to extensive bruising on
her abdomen
? You have assisted her to transfer onto a commode chair to shower and to sit out of bed
? Gill has been reviewed by the physiotherapist and assisted to mobilise with a forearm
support frame. Adult Medical/Surgical Nursing – Essay Example.
? Gill regularly complains of pain but is declining oxycodone. She states it is making her
drowsy and nauseated
? Towards the end of your shift Gill reports moderate pain and some swelling in her left
lower leg
? Gill’s heart rate and blood pressure are elevated above her normal values
Your handover must:
? Demonstrate person-centred care
? Address the physical, functional and psychosocial aspects of care and reflect any changes
you have made to Gill’s care plan
? Adhere to the legal and professional standards for documentation
? Be in appropriate professional language
? NO abbreviations or nursing jargon
(250 words, 5 marks)
Before you submit
? Check you have followed the presentation guidelines for Assessment 1
? Ensure the academic integrity of your work. Adult Medical/Surgical Nursing – Essay Example.

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