NU117 Nursing Management of the Physically III Adult 1 NUIG Assignment Sample Ireland

Nursing management of the physically III adult requires a holistic and individualized approach in order to meet the patient’s needs. Some common considerations when caring for a physically III adult include providing adequate nutrition, hydration, and toileting; managing pain and other symptoms; promoting safety and mobility, and protecting the patient’s dignity.

It is important to assess the patient’s condition regularly in order to identify any changes that may require alterations to the nursing plan of care. Patients who are physically III often require assistance with basic activities of daily living, so it is essential that nurses provide compassionate care while also ensuring that safety is maintained at all times.

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In this unit, there are many types of assignments given to students like individual assignments, group-based assignments, reports, case studies, final year projects, skills demonstrations, learner records, and other solutions given by us. We also provide Group Project Presentations for Irish students.

In this section, we are describing some briefs. These are:

Assignment Brief 1: Review An Bord Altranais guidelines – “Guidance to Nurses and Midwives on Medication Management” July 2007.

The An Bord Altranais guidelines “Guidance to Nurses and Midwives on Medication Management” is an excellent resource for nurses and midwives when it comes to medication management. The guidelines provide information on topics such as safe medication practices, handling of medications, and storage of medications.

In addition, the guidelines also provide helpful tips on how to properly label medications and how to report any suspected medication errors. Overall, the An Bord Altranais guidelines provide a comprehensive overview of best practices when it comes to medication management, and are a valuable resource for nurses and midwives.

Assignment Brief 2: Define selected terms related to the safe administration of medications.

The safe administration of medications includes a few key terms:

Dosage: The amount of medication that is recommended for a patient to take.

Frequency: The number of times per day, week, or month that a patient should take their medication.

Route: The method by which medication should be taken, such as orally, topically, or intravenously.

Side effects: Possible negative reactions that could occur from taking a medication.

Contraindications: Conditions or situations in which a particular medication should not be taken.

Interactions: The potential for two or more medications to interact with each other, sometimes resulting in harmful side effects.

Assignment Brief 3: Describe the various routes of medication administration.

There are a variety of routes of medication administration, each with its own benefits and drawbacks. These are:

Oral medications are swallowed and absorbed through the digestive system. This is the most common route of administration because it’s convenient and easy to use. However, not all medications are absorbed through the gut, and some may be metabolized by the liver before they can be effective.

Topical medications are applied to the skin and absorbed through the epidermis into the bloodstream. This is a common route for administering drugs such as creams or ointments for treating skin conditions. The downside is that topically-applied drugs may not be absorbed evenly, and they can be irritating to the skin.

Parenteral medications are injected into the body via a needle or catheter. This route is often used when intravenous administration is required, as it allows drugs to be delivered directly to the bloodstream. However, parenteral medications can also be injected into muscle tissue (intramuscular) or under the skin (subcutaneous).

Nasal administration involves inhaling a drug through the nose. This is a common route for administering drugs such as nasal sprays or inhalers. Nasal administration can be convenient and fast-acting, but it may not be suitable for all drugs.

Rectal administration involves inserting a drug into the rectum, where it is absorbed through the mucous membrane. This route is often used for administering drugs to children or those who are unable to take medications orally. However, it can be uncomfortable and inconvenient for patients.

Eye drops are applied to the eyes and absorbed through the conjunctiva. This is a common route for administering drugs such as eye drops or ointments. Eye drops can be a convenient way to deliver medication directly to the site of action, and they are often well-tolerated.

Assignment Brief 4: State the five rights related to safe drug administration.

The five rights of safe drug administration are the right patient, the right drug, the right dose, the right route, and the right time. It is important to ensure that each of these rights is upheld during the medication process in order to reduce the risk of errors and adverse effects.

The right patient means that the medication is intended for the specific individual who will be taking it. This can be verified by checking the patient’s name and date of birth against the medical record.

The right drug refers to the medication that has been prescribed for the patient. This can be checked by comparing the prescription with the medication label or package insert.

The right dose is the amount of medication that has been prescribed for the patient. This can be checked by comparing the prescription with the medication label or package insert.

The right route is the method of administration that has been prescribed for the patient. This can be verified by checking the prescription or by asking the patient how they are supposed to take the medication.

The right time is the scheduled time for taking the medication. This can be verified by checking the prescription or by asking the patient when they are supposed to take the medication.

Assignment Brief 5: Demonstrate how to correctly identify a patient.

The first step in correctly identifying a patient is to take a complete medical history. This should include information about the patient’s health history, current medications, and any allergies they may have.

The next step is to perform a physical examination. During the physical exam, the doctor will examine the patient’s skin, hair, eyes, ears, nose, and throat. They will also listen to the patient’s heart and lungs and check their blood pressure.

If necessary, additional tests may be performed to help identify the patient. These tests can include blood tests, x-rays, or scans.

Once the patient has been correctly identified, a treatment plan can be created. This plan will take into account the patient’s medical history and current health condition.

Assignment Brief 6: Correctly calculate a prescribed medication dose (to compute medication doses accurately using the metric system & using a standard formula to calculate drug dose).

To calculate a prescribed medication dose, you will need to know the patient’s weight, the dosage prescribed by the doctor, and the strength of the medication.

The formula to calculate a prescribed medication dose is as follows:

Dose (in mg) = Weight (in kg) x Desired Dose (in mg)/Strength of Medication (in mg/kg)

For example, if a doctor prescribes 60 mg of medication to be taken orally every 12 hours for a patient who weighs 70 kg, then you would use the following calculation:

Dose (in mg) = 70 kg x 60 mg/1000

Dose (in mg) = 4200 mg/day

If the medication is to be given intravenously, then you will also need to factor in the patient’s infusion rate. The infusion rate is usually expressed in mL/hr or drops/minute.

For example, if a patient is to receive an infusion of 20 mg of medication over a period of 60 minutes, then you would use the following calculation:

Dose (in mg) = 20 mg/60 minutes

Dose (in mg) = 0.33 mg/minute

To convert from mL/hr to drops/minute, divide the mL/hr by 60. To convert from drops/minute to mL/hr, divide the drops/minute by 60.

Assignment Brief 7: Administer oral medications safely and accurately.

Administering oral medications safely and accurately is critical in ensuring that the patient receives the correct medication in the correct dosage.

When administering oral medications, it is important to ensure that the patient has a clear understanding of what they are taking and how to take it. The patient should also be advised to take any notes they may have about their medication with them to their next appointment.

In addition, it is important to make sure that you are familiar with the specific medication being administered, as well as any potential interactions between that medication and other drugs the patient may be taking. If you have any questions about how to administer a particular oral medication, be sure to consult your pharmacist or doctor for further guidance.

Oral medications can be administered either by mouth or through a feeding tube. When administering oral medications by mouth, it is important to ensure that the patient is able to swallow the medication without difficulty. If the patient is having difficulty swallowing, you may need to give the medication through a feeding tube.

When administering oral medications through a feeding tube, it is important to follow the specific instructions provided by your pharmacist or doctor. Be sure to rinse the feeding tube with water after each medication administration.

It is also important to monitor the patient for any adverse reactions to their oral medications. If you notice any signs of an allergic reaction, such as hives or a rash, be sure to notify the patient’s doctor or pharmacist immediately.

Assignment Brief 8: Select subcutaneous injection sites.

There are four main subcutaneous injection sites: the outer aspect of the upper arm, the front of the thigh, the lower back/buttocks, and the hip. Each site has its own advantages and disadvantages. 

The outer aspect of the upper arm is a good choice for people who are injecting themselves for the first time. This area has a lot of fatty tissue, so the needle doesn’t have to go very deep to reach the subcutaneous layer. Plus, it’s easy to see this area of your body so you can be sure you’re injecting into a safe spot. 

The front of the thigh is another popular injection site. This area also has a lot of fatty tissue, so the needle doesn’t have to go very deep. The main advantage of this site is that it’s easy to reach, even if you’re injecting yourself. 

The lower back/buttocks are a good choice for people who have a lot of fatty tissue. This area has more fatty tissue than the upper arm or thigh, so the needle doesn’t have to go as deep to reach the subcutaneous layer. However, it can be difficult to see what you’re doing, so it’s important to be careful when injecting in this area. 

The hip is another option for people who have a lot of fatty tissue. This area is also easy to reach, and it’s easy to see what you’re doing. However, the needle has to go quite deep to reach the subcutaneous layer, so it’s important to be careful when injecting in this area.

In general, the best injection site is the one that is easiest for you to reach and see. If you have a lot of fatty tissue, you may want to choose an injection site that is less likely to cause bruising. 

Assignment Brief 9: Prepare & administer a subcutaneous and intramuscular injection.

The subcutaneous injection is a type of injection that goes under the skin, while the intramuscular injection is a type of injection that goes into the muscle. Here are some basic steps on how to prepare and administer both types of injections:

• Sanitize your hands and the area where you will be giving the injection with alcohol or antibacterial soap.
• If using a vial, remove the cap and draw up the desired amount of drug into a syringe. If using an ampule, break off the top and squeeze all of the liquid into the syringe.
• Inject air into the vial or ampule to create pressure (if using a syringe). This will make it easier to draw the drug into the syringe.
• Place the needle into the vial or ampule at a 90-degree angle and inject the air into the container.
• Turn the vial or ampule upside down and keep the needle in place. Draw up the desired amount of drug into the syringe.
• Remove the needle from the vial or ampule and recap it.
• To give a subcutaneous injection, insert the needle at a 45-degree angle and inject the drug into the fatty tissue just under the skin.
• To give an intramuscular injection, insert the needle at a 90-degree angle and inject the drug into the muscle.
• Remove the needle from the skin and apply pressure to the injection site with a cotton ball or Band-Aid.
• Dispose of the needle and syringe in a sharps container.

Assignment Brief 10: Accurately document drug administration.

It is important to accurately document drug administration in order to ensure patient safety and efficacy of treatment. There are a few key points to keep in mind when documenting drug administration: 

• The route of administration (oral, IV, etc.) 
• The dosage 
• The time the drug was administered 
• Any special instructions or precautions that need to be followed. 

By accurately documenting drug administration, you can help ensure that patients receive the best possible care.

Assignment Brief 11: Discuss the factors that commonly cause medication errors.

There are many factors that commonly cause medication errors. One of the most common is when a patient is given the incorrect medication or dosage. Another common mistake is when a patient is given medications that interact with each other, which can result in serious side effects.

Other factors that can lead to medication errors include poor communication among healthcare providers, illegible handwriting, and outdated information in medical records. It’s also important for patients to be aware of the potential for medication errors and to take an active role in their own healthcare by asking questions and verifying all of their medications before leaving the pharmacy.

Assignment Brief 12: Prepare and commence an intravenous infusion.

Before starting the infusion, it is important to check that the equipment is working properly and that all accessories are available. Next, gather all necessary supplies including gloves, a sterile field, 2% lidocaine (optional), large bore IV tubing, and a venous lock.

The site for infusion should be cleaned with an antiseptic solution and then patted dry. If using lidocaine, it should be applied topically to the site and allowed to dry. Once everything is ready, put on gloves and begin by setting up the sterile field. Open the package of IV tubing and remove the tube from its wrapper. Next, hold one end of the tubing against the venous lock while making sure that the other end stays elevated. Slowly insert the tubing into the vein until you reach the hub of the venous lock. Be sure to avoid touching the surrounding tissue with the tubing.

Once the tubing is in place, secure it with tape and remove any air bubbles from the line by holding the end of the tubing above the level of the venous lock and gently tapping on it with your finger. Once the infusion is started, it should flow smoothly and without interruption. If any problems occur, notify your supervisor immediately.

Assignment Brief 13: Calculate an intravenous infusion rate.

To calculate an intravenous infusion rate, you need to know the volume of liquid that you want to infuse, the time over which you want to infuse it, and the desired flow rate. You can then use the following formulas:

Volume = Infusion Rate x Time

or

Infusion Rate = Volume / Time

For example, if you want to infuse 500 mL of fluid over a period of 2 hours, your infusion rate would be 500 mL / 2 hours = 250 mL/hour.

Assignment Brief 14: Monitor a client receiving an intravenous infusion.

A client receiving an intravenous infusion should be monitored for the following: 

• Vital signs, including heart rate and blood pressure
• Level of consciousness and awareness
• Color, warmth, and moisture of the skin
• The presence of swelling or redness at the injection site
• Amount and rate of fluid infused
• Electrolyte levels, especially potassium levels
• Urine output

If any of these parameters are outside of the normal range, or if the client experiences any adverse reactions, the infusion should be stopped and the physician notified immediately.

Assignment Brief 15: Measure and record intravenous fluid intake and urinary output.

Intravenous fluids are critical for maintaining hydration and blood pressure in hospitalized patients. It is important to monitor and record the intake and output of these fluids to ensure that the patient is receiving the correct amount.

Urine output can be easily monitored by observing the color, smell, and volume of the urine. Intravenous fluid intake can be tracked by measuring the volume of fluid given to the patient and noting any changes in clinical condition. By carefully monitoring both intravenous fluid intake and output, nurses can ensure that patients remain hydrated and healthy.

Assignment Brief 16: Change an intravenous solution, administration set, and dressing, and discontinue intravenous therapy.

To change an intravenous solution, administration set, and dressing, and discontinue intravenous therapy:

• Wash your hands thoroughly with soap and water.
• Remove the old IV solution bag from the IV stand.
• Discard the old IV solution bag in a designated trash receptacle.
• Remove the old administration set from the IV stand.
• Discard the old administration set in a designated trash receptacle.
• Remove the old dressing from the IV site. 
• Discard the old dressing in a designated trash receptacle or wound care waste container (if applicable).
• Attach a new administration set to the new IV solution bag according to the manufacturer’s instructions.
• Hang the new IV solution bag on the IV stand.
• Prime the new administration set according to the manufacturer’s instructions.
• Apply a new dressing to the IV site according to institutional policy.
• Remove the old IV catheter from the patient’s vein, using the sterile technique if possible.
• Discard the old IV catheter in a designated trash receptacle or medical waste container.
• Insert a new IV catheter into the patient’s vein, using a sterile technique if possible.
• Tape the new IV catheter in place according to institutional policy.
• Start the infusion of the new IV solution.
• Document the change in IV solution, administration set, and dressing, and the discontinuation of IV therapy, in the patient’s medical record.

It is important to always follow institutional policy when changing an intravenous solution, administration set, and dressing. Failure to do so could result in harm to the patient.

Assignment Brief 17: Discuss the complications of intravenous therapy.

Intravenous therapy can be complicated, and there are a number of potential complications that can occur. These include:

Phlebitis: This is inflammation of the vein, and can be caused by the needle or catheter irritating the vein. It can also be caused by the solution being injected into the vein. Symptoms include pain, redness, and swelling. Phlebitis can usually be treated with warm compresses and elevation of the affected limb.

Thrombophlebitis: This is a clot that forms in the vein, and is more serious than phlebitis. It can cause blockage of blood flow and symptoms including pain, redness, swelling, and warmth at the IV site. If thrombophlebitis is suspected, the patient should be immediately transferred to the ICU for treatment.

Infection: The insertion of a needle or catheter into the vein can introduce bacteria into the bloodstream, which can lead to infection. Symptoms of infection include fever, chills, redness, and swelling at the IV site. If the infection is suspected, the patient should be transferred to the ICU for treatment.

Hematoma: This is a collection of blood outside of the vein, and can occur when the needle or catheter punctures the vein. Symptoms include pain, swelling, and bruising at the IV site. Hematomas can usually be treated by applying pressure to the site.

Air embolism: This is when air enters the bloodstream and travels to other parts of the body, where it can cause serious problems. Symptoms include shortness of breath, chest pain, and a racing heart rate. If an air embolism is suspected, the patient should be transferred to the ICU for treatment.

Fluid overload: This is when the patient receives too much fluid through the IV and can cause a number of problems including swelling of the arms and legs, shortness of breath, and chest pain. If the fluid overload is suspected, the patient should be transferred to the ICU for treatment.

Allergic reaction: Some people can have an allergic reaction to the IV solution, which can cause symptoms including hives, itching, and swelling. If an allergic reaction is suspected, the patient should be transferred to the ICU for treatment.

These are just a few of the potential complications that can occur with intravenous therapy. It is important to be aware of these complications and to take steps to prevent them.

Assignment Brief 18: Describe & demonstrate nursing measures to promote respiratory function and oxygenation (respiratory status assessment, positioning, deep breathing & coughing exercises, postural drainage, chest percussion, vibration, and incentive spirometry).

There are a number of nursing measures that can be taken to promote respiratory function and oxygenation. Some of these measures include:

• Ensuring that the patient is in a comfortable position with good support for the head, neck, and back. This will help to ensure that the patient is able to breathe deeply and evenly.
• Encouraging the patient to take deep breaths and cough regularly. This helps to loosen any secretions in the lungs and prevent them from becoming stagnant.
• Providing humidified oxygen if needed. This can help to soothe the airways and make breathing easier.
• Monitor the patient’s vital signs closely. This will help to identify any changes in respiratory status early on.
• Position the patient for postural drainage if indicated. This helps to drain secretions from the lungs and prevents them from becoming stagnant.
• Performing chest percussion and vibration if indicated. These techniques help to loosen secretions in the lungs and make them easier to remove.
• Utilizing incentive spirometry if indicated.

Assignment Brief 19: Prepare oxygen therapy to be administrated safely to a client and document treatment (nasal cannulae, simple face mask, venturi-mask, and humidification)

To prepare oxygen therapy for safe administration to a client, you will need to gather the following supplies: 

• A clean, dry oxygen tank and regulator 
• An oxygen mask or cannula 
• Tube of lubricant 
• Cotton balls 
• Alcohol wipes 

Once you have all of your supplies, follow these steps: 

• Clean the tank valve with an alcohol wipe and attach the regulator.  
• Open the valve slowly until the needle on the gauge points to the number in the green area. This is typically between 2-3. 
• Attach the oxygen mask or cannula to the tubing. If using a mask, put lubricant inside each nostril. If using a cannula, lubricate the tubing where it will go into the client’s nose.
• Place the mask or cannula over the client’s nose and mouth (or insert the cannula into the nostrils), making sure that it is secure and fits comfortably.
• Turn on the oxygen by turning the knob on the regulator. The flow should be set at 6-8 liters per minute.
• Check the client’s oxygen saturation level every 15 minutes and adjust the flow as needed.
• Keep a close eye on the client’s condition and notify the doctor if any changes occur.

Assignment Brief 20: Monitor the client receiving oxygen therapy and be aware of the hazards associated with the administration of oxygen therapy.

When providing oxygen therapy to a client, it is important to monitor their condition closely in order to be aware of any potential hazards. Some of the associated hazards with oxygen therapy include:

• Fire: Oxygen is highly flammable, and can easily ignite if exposed to an open flame. Always use caution when transporting oxygen tanks and cylinders, and never smoke near a client who is receiving oxygen therapy.
• Explosion: An oxygen tank that is not properly secured can explode if it is dropped or hit by another object. Make sure all tanks are securely fastened before moving them.
• Asphyxiation: Carbon dioxide build-up can occur when too much oxygen is given to a client, leading to asphyxiation. Monitor the client’s oxygen saturation level closely, and adjust the flow as needed.
• Pneumonia: When a client is receiving high levels of oxygen, there is a risk of developing pneumonia. Watch for signs of respiratory distress and report any changes to the doctor.

By being aware of these hazards, you can take steps to prevent them from occurring and keep the client safe.

Assignment Brief 21: Record client’s response to oxygen therapy including SpO2 level.

The client’s oxygen level was 92% and their response to the therapy was positive.

Oxygen therapy is a common treatment for conditions such as pneumonia, COPD, and other respiratory illnesses. It works by delivering high concentrations of oxygen through a face mask or nasal cannula to help improve the patient’s breathing and overall health.

In this case, the client’s oxygen level was within the normal range and their response to the therapy was positive. This indicates that they likely found relief from their respiratory illness and were able to breathe more easily. Thanks for providing this valuable feedback!

Assignment Brief 22: Perform, interpret and document peak flow reading.

To perform a peak flow reading, you will need a peak flow meter. Begin by exhaling fully, then place the mouthpiece of the peak flow meter in your mouth and seal your lips around it. Inhale deeply through your nose and then exhale as forcefully as possible into the meter. The reading on the gauge will indicate your peak expiratory flow rate (PEFR).

Documenting your PEFR readings over time can help you track your lung function and identify any trends or patterns. If you have asthma, for example, you might use peak flow readings to help monitor and manage your condition.

A peak flow reading can be performed using a peak flow meter. The reading on the gauge will indicate the patient’s peak expiratory flow rate (PEFR). By documenting these readings over time, it is possible to track the patient’s lung function and identify any trends or patterns. This information can be especially helpful for those with asthma, as it can be used to help monitor and manage the condition.

Assignment Brief 23: Administer inhalation therapy (nebulizers & inhalers).

Peak flow is a measure of how well your lungs are able to move air out. The peak flow reading measures the highest point at that you can expel air from your lungs in one second. To perform a peak flow reading, you will need a peak flow meter. 

To interpret your peak flow reading, compare it to the “normal” ranges for your age, height, and sex. These ranges are listed on the side of most peak flow meters. If your reading is within the normal range, it means that your lungs are functioning properly. If your reading is below the normal range, it may be an indication of lung disease or asthma. 

It is important to document your peak flow readings so that you can track your lung function over time. You should also keep track of any medications that you are taking, as well as any changes in your symptoms. This information can be helpful in managing your condition.

Assignment Brief 24: Perform nasopharyngeal suctioning.

Nasopharyngeal suctioning is the process of clearing the nasopharynx (back of the nose and throat) of secretions and obstruction. This is most commonly done in patients who are intubated and unable to clear their own airways.

Nasopharyngeal suctioning is performed by using a suction catheter to remove the secretions and obstructions from the back of the nasal cavity. The catheter is inserted into one nostril and suited through the nasal passages until it reaches the throat. Suction is then applied to dislodge and remove any secretions or obstructions.

The procedure can be uncomfortable for patients, so sedation or general anesthesia may be necessary. Recovery from the procedure is usually quick, and patients are typically able to go home the same day.

Nasopharyngeal suctioning is a safe and effective way to clear the airway and improve breathing. It is important to follow up with your doctor after the procedure to ensure that your condition is being managed properly.

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