NRSG378: Extended Clinical Reasoning

2025 Semester 1

Assessment Information:

Assessment Title: Assessment Task 3 – Case Study

Weighting: 50%

Length: 2000 words (+/- 10%; includes intext citations, excludes reference list)

Purpose

This assessment enables requiring extended students to apply knowledge from unit learnings to an issue clinical reasoning. The assessment will engage students with the application of theory to practice, and is designed to facilitate an understanding of the impact of illness on the patient. It is also intended to give students the opportunity to demonstrate the ability to use a clinical reasoning framework to plan the care of an acutely unwell patient

Appendix Rubric

Appendix of the NRSG378 Assessment information. Also located on Canvas with the assessment information

Canvas Resource

A National Q&A Session will be held during week nine (9) of the semester. The Q&A session will unpack the assessment task requirements. Students will have the opportunity to ask the National LICs any questions or clarifications they require. All students are recommended to attend this session. A recording of the National Q&A session will be made available for students. The link will be made available on the Assessments page of the Canvas unit.

Learning Outcomes Assessed: LO1, LO2, LO3, LO4, LO5

Task: Enables students to apply knowledge from unit learnings to an issue requiring extended clinical reasoning.

Assignment Overview

Task: 1

Case Study

Using the case study provided use a clinical reasoning approach to demonstrate high-quality, evidence-informed nursing care for an acutely unwell patient

Using Evidence-Based Research

Provide evidence-based responses to all questions. Use at least 15 evidence-based references, such as peer-reviewed journal articles, systematic reviews, or research studies published within the last seven years.

You may also include guidelines or policies (e.g., national standards) to support your answers, but do not over-rely on these as primary sources (i.e. use them and other sources concurrently: See APA Guide: Multiple Sources)

Reference Formatting

Use APA 7th edition formatting for in-text citations and the reference list. For guidance, refer to the ACU Library APA Citation Guide and the APA Citation Guidelines

Assignment Questions

Presenting medical concern, pathophysiology and further nursing assessments (600 words):

Part 1A

Based on the limited clinical information currently available, identify one significant presenting concern or potential issue Lily may be experiencing. Discuss the observed evidence (e.g., presenting signs and symptoms) that supports your impression, and identify (no need to explain) any gaps or uncertainties where further assessments are required to clarify Lily’s condition and guide care planning.

Part 1B

Using your initial impression of Lily’s presenting concern (Part 1A), discuss the potential underlying pathophysiological processes that could explain the observed signs and symptoms you identified and explain how these processes may contribute to Lily’s clinical presentation.

Part 1C

Identify and explain which additional assessments are required to provide further clarity regarding Lilly’s clinical presentation and condition. Present these in a list format, and for each item, include a brief rationale explaining its importance or purpose. If recommending repeated assessments, justify why ongoing monitoring is required.

Disease Pathophysiology and Complications (600 words):

Based on Lily’s medical and surgical history and presenting condition, she is at risk of acute deterioration. Lily may be at risk of the following complications

Septic shock

Respiratory failure or Acute Respiratory Distress Syndrome (ARDS)

Right-sided heart failure

Fluid overload

For this question, select two (2) complications from above and address the following questions: For each selected complication:

Explain why Lily is at risk for developing this complication, using specific details from her clinical presentation and patient assessment findings and relevant medical history.

Discuss the underlying pathophysiological mechanisms contributing to the complication, focusing on key processes that increase her risk. Use evidence-based references and data (signs and symptoms) from the case study to support your response.

Identify Nursing Issues (400 words)

Using the nursing problem/issue format, identify and prioritise three (3) high-priority nursing problems/issues to address during the patient’s current admission.

Part 3A

Identify three nursing problems that are critical to the patient’s immediate care and safety.

Given the acute nature of this presentation, focus on urgent clinical needs rather than lower-priority issues such as ADLs. Your response must include:

A minimum of two actual problems are required; one potential at-risk problem may be identified, but you must justify why it is a priority concern.

For each nursing problem, use the nursing problem/issue format:

Problem (P): State the issue using appropriate terminology (e.g., "Ineffective airway clearance" or "Risk for aspiration").

Aetiology (A): Identify the related cause or contributing factors (e.g., "related to excessive secretions" or "related to impaired swallowing").

Symptoms (S): Provide evidence or defining characteristics (e.g., "as evidenced by laboured breathing and oxygen saturation of 88%").

Part 3B

Justify why this nursing problem is a high priority:

Explain how this issue impacts the patient’s immediate safety, health, or recovery. Use patient assessment findings, clinical reasoning, and evidence-based sources to support your response.

Nursing Care Strategies (400 words):

Identify, rationalise, and explain, in order of priority, the nursing care strategies you would. Implement or advocate for this patient within the first 24 hours of her admission. These strategies should address the patient’s most urgent needs, as identified in your prioritised nursing diagnoses (Question 3).

For each strategy:

Describe the nursing care strategy: Clearly state the intervention or action you would take.

Rationalise the strategy: Explain why this action is a priority, referring to the patient’s clinical presentation, assessment findings, and identified nursing problems.

Explain how the strategy will address the patient’s needs: Provide evidence-based reasoning that connects the intervention to expected outcomes and supports the patient’s immediate safety, health, or recovery.

Ensure your response focuses on high-priority strategies related to the acute emergency presentation and excludes lower-priority actions such as ADLs unless directly relevant to the patient’s safety